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Sales I, Vieira-da-Motta O, Tavares A, Ruiz-Miranda CR, de Lencastre H, Miragaia M. Impact of human created environments in the pathogenic potential and antimicrobial resistance of staphylococci from wild neotropical primates in Brazil. Comp Immunol Microbiol Infect Dis 2024; 104:102094. [PMID: 38035481 DOI: 10.1016/j.cimid.2023.102094] [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] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 11/05/2023] [Accepted: 11/13/2023] [Indexed: 12/02/2023]
Abstract
The non-human primate (NHP) Leontopithecus rosalia is an endangered species native of Brazil and lives in forest fragments with different levels of contact with humans (natural, private and urban). Other NHPs - Callithrix spp. - were introduced by humans and co-exist and interact with the native species in these forests. To evaluate if living in or close to human-modified environments could constitute a risk for L. rosalia, we compared the prevalence, genetic background, antibiotic susceptibility and virulence gene content of staphylococci collected from the native and the introduced species from different forest fragments. We found that presence in human-dominated environments increased the colonization rate of L. rosalia with Mammaliicoccus sciuri (former Staphylococcus sciuri) from 18 % to 85 % (p = 0.0001) and of Callithrix spp with Staphylococcus aureus from 6 % to 100 % (p = 0.0001). According to molecular typing data obtained differences probably resulted from dissemination of these bacterial species from the invader NHP species and from humans. Changes in microbiota were paralleled by an increase in the prevalence of Panton-Valentine Leukocidin gene and in resistance to beta-lactams, macrolides and/or lincosamides as exposure to human environment increased. In particular, erythromycin resistance in S. aureus from Callithrix spp. increased from 0 % to 50 % and resistance rate to at least one antibiotic in coagulase-negative staphylococci species from L. rosalia increased from 13 % to 56 % (p = 0.0003). Our results showed that contact of native animal species with human-created environments increased the content of antimicrobial resistant and pathogenic bacteria on their commensal microbiota, which ultimately can impact on their health. IMPORTANCE: Endangered animal species are vulnerable to environmental alterations and human activities have been repeatedly identified as factors driving drastic changes in the natural landscape. It is extremely important to monitor changes in the environment surrounding protected species, because this could lead to early detection of any potential threats. In this study, we found that the contact of L. rosalia - a protected non-human primate from Brazil - with human environments is related to changes in their commensal microbiota. These included an increase in the number of pathogenic and antibiotic resistant bacteria, which have a higher potential to cause infections that are more difficult to treat. We provided evidence for the harmful impact human contact has on L. rosalia. Also, our results suggest that monitoring of commensal microbiota of protected animal species might be a useful way of sensing the risks of protected species to human exposure.
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Affiliation(s)
- Indiara Sales
- Laboratory of Bacterial Evolution and Molecular Epidemiology, Instituto de Tecnologia Química e Biológica António Xavier, NOVA University (ITQB-NOVA), Oeiras, Portugal; Universidade Estadual do Norte Fluminense Darcy Ribeiro-UENF, Centro de Ciências e Tecnologias Agropecuárias, Laboratório de Sanidade Animal-Setor Doenças Infecto-contagiosas, Rio de Janeiro, Brazil
| | - Olney Vieira-da-Motta
- Universidade Estadual do Norte Fluminense Darcy Ribeiro-UENF, Centro de Ciências e Tecnologias Agropecuárias, Laboratório de Sanidade Animal-Setor Doenças Infecto-contagiosas, Rio de Janeiro, Brazil
| | - Ana Tavares
- Laboratory of Molecular Genetics, Instituto de Tecnologia Química e Biológica António Xavier, NOVA University (ITQB-NOVA), Oeiras, Portugal
| | - Carlos Ramón Ruiz-Miranda
- Universidade Estadual do Norte Fluminense Darcy Ribeiro-UENF, Centro de Biociências e Biotecnologia, Laboratório de Ciências Ambientais, Campos dos Goytacazes, Rio de Janeiro, Brazil
| | - Hermínia de Lencastre
- Laboratory of Molecular Genetics, Instituto de Tecnologia Química e Biológica António Xavier, NOVA University (ITQB-NOVA), Oeiras, Portugal; Laboratory of Microbiology & Infectious Diseases, The Rockefeller University, New York, USA
| | - Maria Miragaia
- Laboratory of Bacterial Evolution and Molecular Epidemiology, Instituto de Tecnologia Química e Biológica António Xavier, NOVA University (ITQB-NOVA), Oeiras, Portugal.
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Antunes A, Racha-Pacheco R, Esteves C, Tavares A, Mendez J, Pacheco P, Short D. PRO-Act: a healthcare provider workshop outlining the added value of implementing PROs in routine HIV practice. J Patient Rep Outcomes 2023; 7:50. [PMID: 37261556 DOI: 10.1186/s41687-023-00584-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 04/24/2023] [Indexed: 06/02/2023] Open
Abstract
Patient Reported Outcomes (PROs) are an evidenced way of adding value to routine clinical care. As a source of unique information on the effect of a medical condition and its treatment from the patients' perspective (Mercieca-Bebber et al. in Patient Relat Outcome Meas 9: 353-367, https://doi.org/10.2147/PROM.S156279 , 2018), PROs allow for an improved assessment in routine clinical care of symptoms, side effects, functional outcomes (physical, sexual, social, emotional, cognitive functioning), and health-related quality of life (HRQoL). By helping to align healthcare providers' interventions with what matters most to the patient, PROs contribute to the individualized choice of Anti-Retroviral Therapy (Carfora et al. in PLoS ONE 17(4): e0267030, https://doi.org/10.1371/journal.pone.0267030 , 2022) as a paramount component of tailored and person-centred care management, in routine clinical practice. This article outlines a practical framework and process tested in Portugal to raise awareness of PROs' added value, and to help guide first steps in the implementation and seamless integration of PROs, in routine HIV care.
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Affiliation(s)
- António Antunes
- ViiV Healthcare Medical Department, Rua Dr. António Loureiro Borges, nº 3 - Arquiparque - Miraflores, 1495-131, Algés, Portugal
| | | | - Catarina Esteves
- Infectious Diseases Ward, Hospital de Cascais, Av. Brigadeiro Victor Novais Gonçalves, 2755-009, Alcabideche, Portugal
| | - Ana Tavares
- ViiV Healthcare Medical Department, Rua Dr. António Loureiro Borges, nº 3 - Arquiparque - Miraflores, 1495-131, Algés, Portugal
| | - Josefina Mendez
- Hospital Santo António, Largo Do Prof. Abel Salazar, 4099-001, Porto, Portugal
| | | | - Duncan Short
- ViiV Healthcare Implementation Science Department, 980 Great West Road, Brentford Middlesex, TW8 9GS, UK
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3
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Santonen T, Louro H, Bocca B, Bousoumah R, Duca RC, Fucic A, Galea KS, Godderis L, Göen T, Iavicoli I, Janasik B, Jones K, Leese E, Leso V, Ndaw S, Poels K, Porras SP, Ruggieri F, Silva MJ, Van Nieuwenhuyse A, Verdonck J, Wasowicz W, Tavares A, Sepai O, Scheepers PTJ, Viegas S. The HBM4EU chromates study - Outcomes and impacts on EU policies and occupational health practices. Int J Hyg Environ Health 2023; 248:114099. [PMID: 36528954 DOI: 10.1016/j.ijheh.2022.114099] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 12/02/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022]
Abstract
Within the EU human biomonitoring initiative (HBM4EU), a targeted, multi-national study on occupational exposure to hexavalent chromium (Cr(VI)) was performed. Cr(VI) is currently regulated in EU under REACH (Registration, Evaluation, Authorisation and Restriction of Chemicals) and under occupational safety and health (OSH) legislation. It has recently been subject to regulatory actions to improve its risk management in European workplaces. Analysis of the data obtained within the HBM4EU chromates study provides support both for the implementation of these regulatory actions and for national enforcement programs and may also contribute to the updating of occupational limit values (OELs) and biological limit values for Cr(VI). It also provides useful insights on the contribution of different risk management measures (RMMs) to further reduce the exposure to Cr(VI) and may support the evaluation of applications for authorisation under REACH. Findings on chrome platers' additional per- and polyfluoroalkyl substances (PFAS) exposure highlight the need to also pay attention to this substance group in the metals sector. A survey performed to evaluate the policy relevance of the HBM4EU chromates study findings supports the usefulness of the study results. According to the responses received from the survey, the HBM4EU chromates study was able to demonstrate the added value of the human biomonitoring (HBM) approach in assessment and management of occupational exposure to Cr(VI). For future occupational studies, we emphasise the need for engagement of policy makers and regulators throughout the whole research process to ensure awareness, relevance and uptake of the results in future policies.
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Affiliation(s)
- Tiina Santonen
- Finnish Institute of Occupational Health, Helsinki, Finland.
| | - Henriqueta Louro
- Department of Human Genetics, National Institute of Health Doutor Ricardo Jorge, I.P, and Centre for Toxicogenomics and Human Health (ToxOmics), NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Beatrice Bocca
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy
| | - Radia Bousoumah
- French National Research and Safety Institute (INRS), Vandoeuvre-les-Nancy, France
| | - Radu Corneliu Duca
- Department Health Protection, Laboratoire National de Santé (LNS), Dudelange, Luxembourg; Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven (University of Leuven), Leuven, Belgium
| | - Aleksandra Fucic
- Institute for Medical Research and Occupational Health, Zagreb, Croatia
| | - Karen S Galea
- Institute of Occupational Medicine (IOM), Edinburgh, UK
| | - Lode Godderis
- Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven (University of Leuven), Leuven, Belgium; IDEWE, External Service for Prevention and Protection at Work, Heverlee, Belgium
| | - Thomas Göen
- Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg, Germany
| | - Ivo Iavicoli
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Beata Janasik
- Nofer Institute of Occupational Medicine, Lodz, Poland
| | - Kate Jones
- Health and Safety Executive, Harpur Hill, Buxton, UK
| | | | - Veruscka Leso
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Sophie Ndaw
- French National Research and Safety Institute (INRS), Vandoeuvre-les-Nancy, France
| | - Katrien Poels
- Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven (University of Leuven), Leuven, Belgium
| | - Simo P Porras
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Flavia Ruggieri
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy
| | - Maria J Silva
- Department of Human Genetics, National Institute of Health Doutor Ricardo Jorge, I.P, and Centre for Toxicogenomics and Human Health (ToxOmics), NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - An Van Nieuwenhuyse
- Department Health Protection, Laboratoire National de Santé (LNS), Dudelange, Luxembourg; Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven (University of Leuven), Leuven, Belgium
| | - Jelle Verdonck
- Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven (University of Leuven), Leuven, Belgium
| | | | - Ana Tavares
- Department of Human Genetics, National Institute of Health Doutor Ricardo Jorge, I.P, and Centre for Toxicogenomics and Human Health (ToxOmics), NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal
| | | | - Paul T J Scheepers
- Radboud Institute for Biological and Environmental Sciences, Radboud University, Nijmegen, the Netherlands
| | - Susana Viegas
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal; Comprehensive Health Research Center (CHRC), Lisbon, Portugal
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Monteiro J, Caetano A, Costa C, Pires M, Tavares A, Mariano M, Madeira P, Bonito N, Sousa G. Systemic inflammatory index as a predictor of BCG-refractory non-muscle invasive bladder cancer. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)02585-x] [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: 11/11/2022] Open
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5
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Barradas M, Duarte F, Coutinho Dos Santos I, Resendes De Oliveira L, Serena C, Xavier Fontes A, Viveiros Monteiro A, Machado C, Dourado R, Santos E, Pelicano N, Pacheco M, Tavares A, Martins D. Physical activity and heart failure: a forgotten indicator. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Low physical activity may be associated with comorbidities, sedentary lifestyle or clinical worsening in heart failure (HF) patients. Cardiovascular implantable electronic devices (CIEDs) detect and analyse physical activity data that is often integrated in multifactorial algorithms for predicting HF decompensations, but its potential is probably underestimated.
Purpose
We hypothesized that low physical-activity levels, obtained from remote monitoring of CIEDs, help predict clinical outcomes in HF patients, independently from multifactorial algorithms.
Methods
We retrospectively evaluated consecutive patients with HF and CIEDs through clinical assessments and remote monitoring (two monitoring systems were used). Low activity was defined as <1 hour/day of physical activity and two groups of patients were defined: patients with low activity alerts (group 1) and patients without low activity alerts (group 2). Primary outcome was defined as death by all causes and secondary outcome as HF hospitalizations and sustained ventricular tachycardia (VT) or ventricular fibrillation (VF) episodes.
Results
From 121 patients with RPM, physical activity data was obtained in 104 (85,9%). Mean age was 63,98±12,44 years, 70,2% were males and follow-up was 59,19±38,491 months. Fifty-four (51,9%) had implantable cardiac resynchronization therapy (CRT) defibrillator (CRT-D), 46 (44,2%) transvenous implantable cardioverter defibrillator (ICD), and 4 (3,8%) CRT pacemaker (CRT-P). The aetiology was idiopathic in 42,5% and ischemic in 40,2%. Mean left ventricular ejection fraction was 34,08±11,40% and mean physical activity duration was 2,25±1,84 hours/day. Forty-eight (53,7%) had low activity alerts (group 1) and 56 (46,3%) had no low activity alerts (group 2). In group 1 mean period of low activity was 52,978±15,75 days/year. Patients from group 1 were older (p=0,001), had more oncological disease (p=0,041) and peripheral artery disease (p=0,028). Three deaths occurred in total, all in group 1 (p=0,039) and HF hospitalizations were more frequent in group 1 (1,68±2,59 vs 0,69±1,32, p=0,005). Low activity burden was also associated with atrial fibrillation burden (r=0,473, p<0,05) and number of episodes of VT or VF (r=0,267, p=0,007). A decrease of 50% or more in mean duration of physical activity, but above 1 hour/day, was associated with increase HF hospitalizations (1,83±2,13 vs 1,05±1,95, p=0,006).
Conclusion
Low physical activity data obtained from CIEDs was associated with HF hospitalizations, arrhythmic events and death by all causes, independently of multifactorial algorithms. A decrease in basal activity even above alert threshold, was associated with HF hospitalizations and may be an even earlier sign of HF decompensations.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Barradas
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | - F Duarte
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | | | | | - C Serena
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | | | | | - C Machado
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | - R Dourado
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | - E Santos
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | - N Pelicano
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | - M Pacheco
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | - A Tavares
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | - D Martins
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
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Barradas M, Duarte F, Coutinho Dos Santos I, Resendes De Oliveira L, Serena C, Xavier Fontes A, Viveiros Monteiro A, Machado C, Dourado R, Santos E, Pelicano N, Pacheco M, Tavares A, Martins D. Lower rate limit in cardiac resynchronization therapy defibrillators. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
There is few data about programmed lower rate limit (LRL) in real world heart failure (HF) patients with cardiac resynchronization therapy–defibrillators (CRT-Ds) and its influence in clinical outcomes. Heart rate score (HRS) is the percentage of all atrial-paced and sensed events in the single tallest 10 beats/min device histogram bin and may indicate impaired heart rate variability.
Purpose
We hypothesized that higher LRL programming is associated with worse clinical outcomes as arrhythmic events and HF decompensations in chronic HF patients with CRT-Ds.
Methods
LRL was evaluated and HRS was calculated from remote monitoring in 126 HF patients with CRT-D. Primary outcome was defined as HF hospitalizations and related admissions to the emergency department and secondary outcome as number of device therapies, sustained ventricular tachycardia (VT) and ventricular fibrillation (VF).
Results
Mean age was 69,03±10,39 years, 81 (64,3%) were males and mean follow-up was 53,72±46,13 months. Mean left ventricular ejection fraction was 30,31±8,33% and 29 (23,0%) were in NYHA III–IV. HF aetiology was idiopathic in 39 (43,3%), ischemic in 32 (25,4%) and alcoholic cardiomyopathy in 8 (6,3%). Thirty-seven (29,4%) patients had atrial fibrillation and 33 (26,2%) coronary disease. LRL ranged from to 40 to 80 bpm and mean LRL was 52,64±9,64 and mean HRS 49,60±23,17%. Programmed LRL was higher in women (p=0,014), patients with atrial fibrillation (AF) (p=0,012) and coronary disease (p=0,015). Higher LRL correlated with HF hospitalizations and related admissions to the emergency department (ED) (r=0,541, p=0,001), VT or VF episodes (r=0,337, p=0,005) and CRT-D number of therapies (r=0,342, p=0,004) and higher HRS (r=0,547, p<0,05).
Conclusion
Higher LRL programming was associated with higher HRS, HF decompensations with hospitalization or admission to the emergency department, VT or VF episodes and CRT-D therapies in a real world population. More studies are required but lower LRL may be preferred in HF patients.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Barradas
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | - F Duarte
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | | | | | - C Serena
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | | | | | - C Machado
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | - R Dourado
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | - E Santos
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | - N Pelicano
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | - M Pacheco
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | - A Tavares
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | - D Martins
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
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Barradas M, Duarte F, Coutinho Dos Santos I, Resendes De Oliveira L, Serena C, Xavier Fontes A, Viveiros Monteiro A, Machado C, Dourado R, Santos E, Pelicano N, Pacheco M, Tavares A, Martins D. Biventricular or left univentricular pacing in heart failure patients: is there a better strategy. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Cardiac resynchronization therapy (CRT) is a cornerstone in treatment of heart failure (HF) with reduced left ventricular ejection fraction (LVEF) and ventricular dyssynchrony. Biventricular (BiV) pacing is often the preferred method and corrects electrical and mechanical dyssynchrony but Left ventricular (LV) preferential pacing is may preserve conduction via the right bundle branch, preventing deleterious effects from right ventricular. The evidence is sparse and there is doubts whether which programming strategy is better.
Purpose
We hypothesized that BiV is non-inferior to preferential LV pacing in HF patients with reduced LVEF and CRT devices in cardiovascular death and HF hospitalizations.
Methods
We retrospectively evaluated 147 patients with HF patients with reduced LVEF and CRT devices. Two groups were defined: LV pacing (group 1) and BiV pacing (group 2). Primary outcome was defined as cardiovascular death and secondary outcome as HF hospitalizations and NYHA class after CRT.
Results
Mean age was 70,26±10,6 years, 68,1% were males and follow-up was 52,22±44,51 months. One hundred and twenty six (85,7%) patients had implantable cardiac resynchronization therapy (CRT) defibrillator (CRT-D) and 21 (14,3%) CRT pacemaker (CRT-P). Mean LVEF was 31,1±8,5% and mean QRS duration before CRT implantation was 149,5±48,6 ms. Thirty-nine (36,4%) patients were in NYHA III–IV. HF aetiology was idiopathic in 51 (47,2%), ischemic in 36 (33,3%) and alcoholic cardiomyopathy in 9 (8,3%). Forty-five (40,5%) patients had atrial fibrillation and 37 (35,6%) coronary disease. Patients in group 2 were more frequently males than group 1 patients (46 (78,0%) vs 32 (56,1%) respectively, p=0,012). There were no differences in regard to age, LVEF, HF aetiology or other comorbidities between groups. In 57 (49,1%) CRT was programming in preferential LV pacing and 50 (50,9%) in BiV pacing. There were 2 deaths in group 1 and 3 in group 2 (OR 0.80, 95% CI 0.27–2.40). There were 0,98±3,17 hospitalizations per patient and there were no differences in HF hospitalizations between groups (OR 1.01, 95% CI 0.92–1.18) or NYHA after 6 months of CRT (p=0,364).
Conclusion
BiV pacing was not inferior to LV-only pacing in regard to cardiovascular death, HF hospitalizations and NYHA class improvement. There was no clear advantage for one pacing strategy over the other but more studies are still required.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Barradas
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | - F Duarte
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | | | | | - C Serena
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | | | | | - C Machado
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | - R Dourado
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | - E Santos
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | - N Pelicano
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | - M Pacheco
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | - A Tavares
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | - D Martins
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
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Barradas M, Duarte F, Coutinho Dos Santos I, Resendes De Oliveira L, Serena C, Xavier Fontes A, Viveiros Monteiro A, Machado C, Dourado R, Santos E, Pelicano N, Pacheco M, Tavares A, Martins D. Suboptimal coronary flow after PCI in STEMI patients: clinical implications and predictors. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Even in experienced angioplasty centers, percutaneous coronary intervention (PCI) in the acute setting of ST-elevation myocardial infarctions (STEMI) is associated with a low, but still significant rate of suboptimal coronary flow. Identification of its clinical impact and potential modifiable risk factors is important.
Purpose
To evaluate the clinical impact of suboptimal coronary flow after PCI in STEMI patients and to access potential predictors of suboptimal coronary flow.
Methods
We retrospectively evaluated 103 hospitalized patients with acute STEMI who were admitted to our center between 2018 and 2019 and underwent PCI. Coronary flow was accessed using the Thrombolysis in myocardial infarction (TIMI) Flow Grading System. Patients were divided into suboptimal patency of the culprit-vessel, defined as TIMI flow ≤2 (group 1, n=8 (7,8%)) and optimal patency of the culprit-vessel defined as TIMI flow 3 (group 2, n=95 (92,2%)). Glomerular filtration rate (GFR) was calculated using the Modification of Diet in Renal Disease (MDRD) formula.
Results
Mean age 58,15±12,6 years and 85,4% were males. Seventy-eight patients (75,7%) had history of smoking, 45 (43,7%) dyslipidemia, 20 (19,4%) previous acute coronary syndrome, 18 (17,5%) diabetes, 17 (15,5%) were obese and 4 (3,9%) had chronic kidney disease. The revascularization strategy was primary PCI in 55 (54,4%) patients and fibrinolytic therapy with facilitated PCI in 48 (46,6%) patients. Infarct-related artery was the left anterior descending artery in 45 (45,5%) and multivessel disease was present in 38 (38,0%). Angiographic no-reflow after PCI was 3,0%. Intrahospital cardiovascular death occurred in 4 (3,9%) patients and was significantly associated with suboptimal flow (p=0,036) and there was no association with stent thrombosis. Predictors of suboptimal flow were higher blood urea nitrogen, creatinine and GFR at hospital admission (p=0,017 and p=0,012), peak creatinine (p=0,012) and stent length (p=0,038). Suboptimal flow was associated with higher Zwolle score (p=0,010) and ischemic Paris score (p=0,036).
Conclusion
Failure to achieve optimal culprit-vessel patency after PCI in STEMI patients, although infrequent, is associated with increased hospital cardiovascular death. Longer stents could be and important modified risk factor. Renal dysfunction is an important comorbidity that should be promptly identified and could be partially improved with medical treatment.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Barradas
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | - F Duarte
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | | | | | - C Serena
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | | | | | - C Machado
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | - R Dourado
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | - E Santos
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | - N Pelicano
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | - M Pacheco
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | - A Tavares
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | - D Martins
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
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9
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Tavares A, Aimonen K, Ndaw S, Fučić A, Catalán J, Duca RC, Godderis L, Gomes BC, Janasik B, Ladeira C, Louro H, Namorado S, Nieuwenhuyse AV, Norppa H, Scheepers PTJ, Ventura C, Verdonck J, Viegas S, Wasowicz W, Santonen T, Silva MJ. HBM4EU Chromates Study-Genotoxicity and Oxidative Stress Biomarkers in Workers Exposed to Hexavalent Chromium. Toxics 2022; 10:483. [PMID: 36006162 PMCID: PMC9412464 DOI: 10.3390/toxics10080483] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/13/2022] [Accepted: 08/17/2022] [Indexed: 06/15/2023]
Abstract
A study was conducted within the European Human Biomonitoring Initiative (HBM4EU) to characterize occupational exposure to Cr(VI). Herein we present the results of biomarkers of genotoxicity and oxidative stress, including micronucleus analysis in lymphocytes and reticulocytes, the comet assay in whole blood, and malondialdehyde and 8-oxo-2′-deoxyguanosine in urine. Workers from several Cr(VI)-related industrial activities and controls from industrial (within company) and non-industrial (outwith company) environments were included. The significantly increased genotoxicity (p = 0.03 for MN in lymphocytes and reticulocytes; p < 0.001 for comet assay data) and oxidative stress levels (p = 0.007 and p < 0.001 for MDA and 8-OHdG levels in pre-shift urine samples, respectively) that were detected in the exposed workers over the outwith company controls suggest that Cr(VI) exposure might still represent a health risk, particularly, for chrome painters and electrolytic bath platers, despite the low Cr exposure. The within-company controls displayed DNA and chromosomal damage levels that were comparable to those of the exposed group, highlighting the relevance of considering all industry workers as potentially exposed. The use of effect biomarkers proved their capacity to detect the early biological effects from low Cr(VI) exposure, and to contribute to identifying subgroups that are at higher risk. Overall, this study reinforces the need for further re-evaluation of the occupational exposure limit and better application of protection measures. However, it also raised some additional questions and unexplained inconsistencies that need follow-up studies to be clarified.
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Affiliation(s)
- Ana Tavares
- Department of Human Genetics, National Institute of Health Dr. Ricardo Jorge (INSA), Av. Padre Cruz, 1649-016 Lisbon, Portugal
| | - Kukka Aimonen
- Finnish Institute of Occupational Health, 00250 Helsinki, Finland
| | - Sophie Ndaw
- French National Research and Safety Institute, 54500 Vandœuvre-lès-Nancy, France
| | - Aleksandra Fučić
- Institute for Medical Research and Occupational Health, Ksaverska Cesta 2, HR-10001 Zagreb, Croatia
| | - Julia Catalán
- Finnish Institute of Occupational Health, 00250 Helsinki, Finland
- Department of Anatomy Embryology and Genetics, University of Zaragoza, 50013 Zaragoza, Spain
| | - Radu Corneliu Duca
- Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven (University of Leuven), O&N 5b, Herestraat 49, P.O. Box 952, 3000 Leuven, Belgium
- Department of Health Protection, Laboratoire National de Santé (LNS), 3555 Dudelange, Luxembourg
| | - Lode Godderis
- Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven (University of Leuven), O&N 5b, Herestraat 49, P.O. Box 952, 3000 Leuven, Belgium
- IDEWE, External Service for Prevention and Protection at Work, 3001 Heverlee, Belgium
| | - Bruno C. Gomes
- Centre for Toxicogenomics and Human Health (Toxomics), NOVA Medical School, Universidade NOVA de Lisboa, Campo dos Mártires da Pátria, 130, 1169-056 Lisbon, Portugal
| | - Beata Janasik
- Department of Environmental and Biological Monitoring, Nofer Institute of Occupational Medicine, 91348 Lodz, Poland
| | - Carina Ladeira
- HTRC—Health & Technology Research Center, ESTeSL—Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, 1549-020 Lisbon, Portugal
| | - Henriqueta Louro
- Department of Human Genetics, National Institute of Health Dr. Ricardo Jorge (INSA), Av. Padre Cruz, 1649-016 Lisbon, Portugal
- Centre for Toxicogenomics and Human Health (Toxomics), NOVA Medical School, Universidade NOVA de Lisboa, Campo dos Mártires da Pátria, 130, 1169-056 Lisbon, Portugal
| | - Sónia Namorado
- Department of Human Genetics, National Institute of Health Dr. Ricardo Jorge (INSA), Av. Padre Cruz, 1649-016 Lisbon, Portugal
| | - An Van Nieuwenhuyse
- Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven (University of Leuven), O&N 5b, Herestraat 49, P.O. Box 952, 3000 Leuven, Belgium
- Department of Health Protection, Laboratoire National de Santé (LNS), 3555 Dudelange, Luxembourg
| | - Hannu Norppa
- Finnish Institute of Occupational Health, 00250 Helsinki, Finland
| | - Paul T. J. Scheepers
- Radboud Institute for Health Sciences, Radboudumc, 6500 HB Nijmegen, The Netherlands
| | - Célia Ventura
- Department of Human Genetics, National Institute of Health Dr. Ricardo Jorge (INSA), Av. Padre Cruz, 1649-016 Lisbon, Portugal
- Centre for Toxicogenomics and Human Health (Toxomics), NOVA Medical School, Universidade NOVA de Lisboa, Campo dos Mártires da Pátria, 130, 1169-056 Lisbon, Portugal
| | - Jelle Verdonck
- Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven (University of Leuven), O&N 5b, Herestraat 49, P.O. Box 952, 3000 Leuven, Belgium
| | - Susana Viegas
- NOVA National School of Public Health, Universidade NOVA de Lisboa, 1600-560 Lisbon, Portugal
- Comprehensive Health Research Center (CHRC), 1169-056 Lisbon, Portugal
| | - Wojciech Wasowicz
- Department of Environmental and Biological Monitoring, Nofer Institute of Occupational Medicine, 91348 Lodz, Poland
| | - Tiina Santonen
- Finnish Institute of Occupational Health, 00250 Helsinki, Finland
| | - Maria João Silva
- Department of Human Genetics, National Institute of Health Dr. Ricardo Jorge (INSA), Av. Padre Cruz, 1649-016 Lisbon, Portugal
- Centre for Toxicogenomics and Human Health (Toxomics), NOVA Medical School, Universidade NOVA de Lisboa, Campo dos Mártires da Pátria, 130, 1169-056 Lisbon, Portugal
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10
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Duarte F, Coutinho I, Barradas MI, Oliveira L, Serena C, Fontes A, Monteiro A, Machado C, Santos E, Pelicano N, Pacheco M, Tavares A, Martins D. Acute ST-elevation myocardial infarction: are men and women particular cases of STEMI ? Eur J Cardiovasc Nurs 2022. [DOI: 10.1093/eurjcn/zvac060.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
ST-segment elevation myocardial infarction (STEMI) has high levels of morbidity and mortality. Multiple risk factors may contribute to clinical outcomes and some studies demonstrate gender-related differences in baseline characteristics and in-hospital management.
Purpose
To access the difference in clinical characteristics and prognostic outcomes between men and women who were admitted in our Cardiac Intensive Care Unit with STEMI diagnosis.
Methods
We retrospectively analyzed 121 non-consecutive patients with STEMI during a mean follow-up period 135 ± 31 weeks.
We accessed baseline characteristics and time course of events (symptom onset-to-door admission; time to first EKG; time to fibrinolytic therapy; door-to-cath lab time and time from fibrinolytic therapy to PCI (for patients transferred from another centers).
Primary endpoint (PE) was a composite of in-hospital cardiovascular death, arrhythmic events or STEMI evolution in Killip-Kimbal III or IV.
Secondary endpoint (SE) was in-hospital major bleeding events, considered intracerebral hemorrhage, cases of hemodynamic compromise or requiring a blood transfusion.
Tertiary endpoint (TE) included admissions to the emergency department or hospitalization by heart failure decompensation, acute or chronic coronary syndromes and all-cause mortality.
Results
Of the 121 patients, 102 were male (84.3%) and 19 (15.7%) female. The mean age was 58.3 ± 12.7 years and women had a superior mean age (69.8 ± 12.2 years) vs. Men mean age 56 ± 11.6 years.
Hypertension was more prevalent in women (84.2% vs. 47.1%, respectively; p 0.003) and also diabetes – 36.8% of women had type 2 diabetes (vs 10.8% of men) and 5.3% of these female patients requires insulin therapy (vs 2% of men; p 0.021).
According to Charlson Comorbidity Index (CCI), women had a higher disease burden with 73.7% of them included into the moderate or severe group of mortality risk, compared to 42.2% of men (p 0.014).
Conversely, less women smoke (31.6% vs. 82.2%; p <0.001) and less frequently chest pain was the onset symptom (78.9% vs. 95.1%; p 0.04).
Time since symptom onset to door admission was estimated on 510 ± 1149 minutes and the mean women delay was superior (557 ± 858 minutes).
Regarding to in-hospital hemorrhagic events (secondary endpoint), female patients had a statistically significant higher risk (22.2% vs. 7.1%, p 0.045), independently of hypertension, diabetes or anticoagulant therapy (r=0.249; ANOVA p-value < 0.005), but it was associated with higher CCI (p 0.033). No other gender differences in outcomes or survival function were observed.
Conclusion
Our study demonstrates gender-related differences among patients with STEMI. Indeed, women were older, had more clinical cardiovascular risk factors and tend to delay hospital admission after symptoms onset. Secondary endpoint was statistically more frequent in women, but no other differences in outcomes were observed.
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Affiliation(s)
- F Duarte
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | - I Coutinho
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | - M I Barradas
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | - L Oliveira
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | - C Serena
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | - A Fontes
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | - A Monteiro
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | - C Machado
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | - E Santos
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | - N Pelicano
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | - M Pacheco
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | - A Tavares
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | - D Martins
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
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11
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Flora S, Cruz J, Tavares A, Ferreira J, Morais N. Association between endurance of the trunk extensor muscles and balance performance in community-dwelling older adults: a cross-sectional analysis. International Journal of Therapy and Rehabilitation 2022. [DOI: 10.12968/ijtr.2020.0036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background/Aims Previous research has disregarded the performance of the extensor muscle group of the trunk in balance control. The main purpose of this exploratory study was to assess the association between balance performance and endurance of the trunk extensor muscles in older adults, considering possible co-factors such as age and body mass index. Methods A correlational and predictive cross-sectional study was conducted with 61 community dwelling older adults (women n=45) with a mean age of 71 years (± standard deviation 6 years), and a mean body mass index of 28.1 kg/m2 (± standard deviation ± 4.7 kg/m2). The Berg Balance Scale was used to assess balance performance and Trunk Extensor Endurance Test to assess muscle endurance. Spearman's correlation coefficients (ρ) and single and multiple regression analyses were performed. Statistical significance was set at 0.05. Results The largest correlations were found between the Berg Balance Scale score and Trunk Extensor Endurance Test (ρ=0.41, P=0.001) and body mass index (ρ=−0.36, P=0.005). Muscle endurance alone predicted ~10% of the Berg Balance Scale score (R2=0.10, P=0.015). When combined with body mass index, it accounted for ~19% (R2=0.19, P=0.002). Adding the remaining variable (age) to the previous model increased the prediction by ~3% (R2=0.22, P=0.002). Conclusions Muscle endurance and body mass index significantly predicted (~19%) balance performance in older adults. Because these are modifiable factors, they should be routinely included in the screening of balance performance in older adults and addressed accordingly in preventive or rehabilitation programmes.
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Affiliation(s)
- Sofia Flora
- Center for Innovative Care and Health Technology, Polytechnic of Leiria, Leiria, Portugal
| | - Joana Cruz
- Center for Innovative Care and Health Technology, School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal
| | - Ana Tavares
- School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal
| | - Joana Ferreira
- School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal
| | - Nuno Morais
- Centre for Rapid and Sustainable Product Development, School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal
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12
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Duarte F, Barradas MI, Barradas MI, Oliveira L, Oliveira L, Serena C, Serena C, Fontes A, Fontes A, Monteiro A, Monteiro A, Machado C, Machado C, Dourado R, Dourado R, Santos E, Santos E, Pelicano N, Pelicano N, Pacheco M, Pacheco M, Tavares A, Tavares A, Martins D, Martins D. Risk scores in predicting adverse events after an acute coronary syndrome. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehab849.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
ST-segment elevation myocardial infarction (STEMI) is a serious event that usually occur in patients with cardiovascular risk factors and is associated with great morbidity and mortality.
PARIS ischemic risk score and TIMI score were validated to evaluate ischemic risk in STEMI patients who underwent percutaneous coronary intervention (PCI) and to estimate mortality, respectively.
Despite these specific purposes, the usefulness of these scores in predicting adverse cardiovascular events (ACE) is unknown.
Objectives
To assess the prognostic value of PARIS and TIMI scores for cardiovascular events, coronary ischemic events and mortality in patients after STEMI.
Methods
Retrospective single center cohort study enrolled 103 patients with STEMI diagnosis between 2018 and 2019, during a mean follow-up period 30.30 ± 6.46 months and patients were included regardless of the reperfusion strategy.
Primary endpoint (PE) was a composite of acute coronary events (ACE), admissions to the emergency department by heart failure (HF) decompensation or chronic coronary syndrome and HF hospitalization. Secondary endpoint (SE) was ACE. Cardiovascular and non-cardiovascular death was determined.
PARIS ischemic risk score was calculated and patients were stratified into low (0-2), intermediate (3-4) or high (≥ 5) ischemic risk categories. TIMI score was also assessed.
Results
Out of 103 patients with STEMI diagnosis, the median age was 58.15 ± 12.6 years and 85,4% were male. Fifty-seven patients (55.3%) had hypertension, 45 (43.7%) dyslipidemia, 18 (17.5%) diabetes, 17 (15.5%) were obese and seventy-eight patients (75.7%) had history of smoking. Twenty (19.4%) patients had a previous acute coronary syndrome and 15 underwent PCI.
Twenty-five (24.3%) patients were included in low PARIS ischemic risk category, 53 (51.5%) in intermediate risk and 20 (19.4%) in high risk category.
PE occurred in 16 patient (15.5%) and SE in 7 patients (6.8%).
Eight patients died during the follow-up period (7.8%), 4 of cardiovascular causes (50%), 3 of non-cardiovascular causes (37.5%) and 1 of unknown cause.
PARIS ischemic risk score showed prognostic value for PE, with an area under the curve (AUC) of 0.65, 95% confidence interval (CI) 0.506-0.806 and p-value 0.039.
PARIS score also had predictive value for SE (AUC 0.816, 95% CI 0.604-1.000; p 0.004) as well as TIMI score (AUC 0.738, 95% CI 0.560 – 0.917; p 0.032).
Both scores showed a good prognostic value in evaluating all-cause mortality, with a slightly better predictive value for TIMI score (AUC 0.91, 95% CI 0.802 – 1.00) when compared to PARIS score (AUC 0.84, 95% CI 0.685 – 0.987).
Conclusion
This study revealed that PARIS and TIMI scores have a good discriminatory power to predict prognosis in STEMI patients. According to our study results, these scores could be an interesting tool to determine the likelihood of fatal and non-fatal outcomes, including ACS.
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Affiliation(s)
- F Duarte
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - M I Barradas
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - M I Barradas
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - L Oliveira
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - L Oliveira
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - C Serena
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - C Serena
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - A Fontes
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - A Fontes
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - A Monteiro
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - A Monteiro
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - C Machado
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - C Machado
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - R Dourado
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - R Dourado
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - E Santos
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - E Santos
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - N Pelicano
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - N Pelicano
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - M Pacheco
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - M Pacheco
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - A Tavares
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - A Tavares
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - D Martins
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - D Martins
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
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13
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Duarte F, Barradas MI, Oliveira L, Serena C, Fontes A, Monteiro A, Machado C, Dourado R, Santos E, Pelicano N, Pacheco M, Tavares A, Martins D. Hemorrhagic risk scores in hospitalized patients with acute coronary syndrome: can they (only) predict bleeding events? Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehab849.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
Acute coronary syndrome (ACS) is a life-threatening condition and its therapeutic approach increases the risk of important bleeding events which are associated with a worse prognosis. Along with hemorrhagic events, a drop on hemoglobin level not related to bleeding or the development of anemia could have a negative impact on prognosis.
Both CRUSADE and PARIS bleeding risk scores are used to evaluate and to stratify the risk of major bleeding in ACS. However their actual predictive value has been questioned and validity of these scores in predicting in-hospital mortality (IHM) is not established.
Objectives
To evaluate the actual prognostic value of CRUSADE and PARIS bleeding scores in ACS patients during their hospitalization stay.
Methods
Retrospective single center cohort study including 103 hospitalized patients after an acute ST-segment elevation myocardial infarction (STEMI) regardless of its reperfusion strategy.
In-hospital major hemorrhagic events (IHMHE), considered intracerebral hemorrhage, those resulting in hemodynamic compromise or requiring a blood transfusion, were assessed. Data on hemoglobin levels (HL) at hospital admission and at the time of hospital discharge were also collected and a composite endpoint (CE) of IHMHE and a drop in HL ≥ 3g/dL were elaborated.
Both scores were calculated for each patient, its predictive value and their impact on IHM were determined.
Results
Out of 103 patients enrolled, the median age was 58.15 ± 12.6 years and 85.4% were male.
Two IHMHE occurred, twenty patients (19.4%) had anemia at the time of hospital discharge and 16 of these patients (15.5%) were not anemic at the time of hospital admission. Nine (8.7%) patients had a drop in their HL of at least 3g/dL.
The five bleeding risk categories defined by CRUSADE investigators were used, with 48 (46.6%) patients in the very low risk category, 9 (8.7%) and 6 (5.8%) in the high and very high risk category, respectively.
Hospitalization length stay was 5.6 ± 4.1 days with an overall in-hospital mortality (IHM) of 5.8%.
Receiver operating characteristic curve (ROC) analysis showed that CRUSADE score had an excellent discriminatory power for the CE (AUC 0.927, 95% CI 0.854-1.000) and the PARIS score had an acceptable discriminatory value (AUC 0.775, 95% CI 0.616-0.935).
Both CRUSADE and PARIS bleeding scores also had prognostic value in evaluating IHM (AUC 0.929, 95% CI 0.856-1.000 and AUC 0.788, 95% CI 0.634-0.942, respectively).
No specific and independent predictors of IHMHE were found, neither related to individual characteristics nor to therapeutic approach.
Conclusion
The presenting study showed that CRUSADE and PARIS scores still have discriminatory power to assess CE and to assess IHM in ACS patients. Their addition to stratification tools could be of interest.
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Affiliation(s)
- F Duarte
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - M I Barradas
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - L Oliveira
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - C Serena
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - A Fontes
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - A Monteiro
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - C Machado
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - R Dourado
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - E Santos
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - N Pelicano
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - M Pacheco
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - A Tavares
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - D Martins
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
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14
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Amado A, Castro B, Torre AP, Graça S, Tavares A, Póvoa A, Soares C, Gonçalves G. Serum TSH as a predictor of malignancy in indeterminate thyroid nodules. Ann R Coll Surg Engl 2021; 104:380-384. [PMID: 34939834 DOI: 10.1308/rcsann.2021.0196] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Thyroid nodules are lesions that are radiologically distinct from the thyroid parenchyma. Cervical ultrasound diagnoses 19-67% of nodules and is crucial in identifying those that lack cytological characterisation. Approximately 25% of biopsies reveal an indeterminate cytological result (Bethesda III), in which the risk of malignancy is variable (5-15%). The clinical importance of the diagnostic strategy used for thyroid nodules results from the need to exclude malignancy. The aim of this study was to evaluate the usefulness of serum thyroid-stimulating hormone (TSH) levels as a predictor of malignancy in cytologically indeterminate thyroid nodules. METHODS Our retrospective study included 40 patients with cytologically indeterminate thyroid nodules seen in our hospital between January 2013 and December 2017. Clinical parameters were reviewed, including age, gender, serum TSH levels, family history of thyroid carcinoma, radiation exposure and some sonographic features of the nodules. Statistical analysis was performed using SPSS. Statistical significance was defined as p<0.05. RESULTS Female gender was predominant (85%) and the mean (SD) age was 53.3 (15) years. Thyroid carcinoma was confirmed in 28% of patients. Median TSH levels were higher in patients with malignant (2.73µIU/ml) compared with benign (1.56µIU/ml) nodules (p<0.05). We demonstrated an increased risk of malignancy in patients with TSH levels of 2.68µIU/ml or above (p<0.05). CONCLUSION Higher serum TSH levels are associated with an increased risk of thyroid carcinoma in cytologically indeterminate nodules. TSH can become a fundamental diagnostic tool in stratifying the risk of malignancy and assist in diagnostic and therapeutic approaches to these nodules.
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Affiliation(s)
- A Amado
- Vila Nova de Gaia/Espinho Hospital Center (CHVNG/E), Vila Nova de Gaia, Portugal
| | - B Castro
- Vila Nova de Gaia/Espinho Hospital Center (CHVNG/E), Vila Nova de Gaia, Portugal
| | - A P Torre
- Vila Nova de Gaia/Espinho Hospital Center (CHVNG/E), Vila Nova de Gaia, Portugal
| | - S Graça
- Vila Nova de Gaia/Espinho Hospital Center (CHVNG/E), Vila Nova de Gaia, Portugal
| | - A Tavares
- Vila Nova de Gaia/Espinho Hospital Center (CHVNG/E), Vila Nova de Gaia, Portugal
| | - A Póvoa
- Vila Nova de Gaia/Espinho Hospital Center (CHVNG/E), Vila Nova de Gaia, Portugal
| | - C Soares
- Vila Nova de Gaia/Espinho Hospital Center (CHVNG/E), Vila Nova de Gaia, Portugal
| | - G Gonçalves
- Vila Nova de Gaia/Espinho Hospital Center (CHVNG/E), Vila Nova de Gaia, Portugal
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15
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Tzolos E, Bing R, Andrews J, Macaskill M, Tavares A, MacNaught G, Clarke T, Williams MC, Van Beek EJR, Koglin N, Stephens A, Dweck MR, Newby DE. In vivo coronary artery thrombus imaging with 18F-GP1 PET-CT. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0261] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Coronary artery thrombus is typically present in type 1 myocardial infarction, but small volumes in the setting of an uncertain culprit lesion may be beyond the detection limit of current imaging modalities.
Purpose
Using a novel glycoprotein IIb/IIIa-receptor radiotracer, 18F-GP1, we investigated whether positron emission tomography-computed tomography (PET-CT) could detect thrombus formation in coronary arteries.
Methods
In a single centre cross-sectional study, patients over 40 years of age with myocardial infarction were recruited after myocardial infarction and underwent underwent CT angiography and 18F-GP1 PET-CT. Stable patients with and without coronary artery disease formed a control cohort. Coronary artery 18F-GP1 uptake was visually assessed and quantified using maximum target-to-background ratios (TBRmax).
Results
Ninety-four (44 post-myocardial infarction and 50 control patients) were included in the cross-sectional analysis. The mean age of the post-myocardial infarction group was 61±9 years, three-quarters were male and two thirds had presented with ST elevation on electrocardiography. 34 (80%) patients post-myocardial infarction, but none of the control patients, demonstrated focal 18F-GP1 uptake in the coronary arteries.
Of 42 vessels with an angiographic culprit lesion, 35 (83%) had 18F-GP1 uptake which was significantly higher than non-culprit vessels (p<0.0001) as well as control vessels (p<0.0001), while non-culprit vessel uptake was similar to control vessel uptake (p=0.567): culprit vessel median TBRmax 1.2 [interquartile range 0.96–1.44], non-culprit vessel TBRmax 0.96 [0.84–1.03] and control vessel TBRmax 0.9 [0.76 to 0.94]. Linear regression models demonstrated univariable associations between coronary 18F-GP1 TBRmax and time from myocardial infarction, male sex and presence of culprit vessel. On multivariable analysis, only culprit vessel status was associated with TBRmax (adjusted R2= 0.22, P<0.001). Based on the Youden's index of the ROC curves, the optimal cut-off of predicting the presence of a culprit vessel was 1.20 with a specificity of 97%, accuracy of 83%, sensitivity (60%) and c-statictic of 0.74.
A patient with ectatic vessel and visual thrombus demonstrated the most intense 18F-GP1 uptake (TBRmax 2.0, highest in the cohort) in the region of heaviest thrombus burden (Figure 2). Extra-coronary uptake was seen in regions of left ventricular thrombus, left atrial appendage thrombus, pulmonary thromboembolism and intramyocardial microvascular obstruction.
Conclusions
18F-GP1 PET-CT is able to detect coronary artery thrombus in culprit lesions following myocardial infarction, as well as extra-coronary thrombotic pathologies that may be important in guiding patient management. 18F-GP1 is highly specific in recognising a culprit lesion from a non-culprit lesion both visually as well as quantitatively.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): British Heart Foundation Figure 1Figure 2
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Affiliation(s)
- E Tzolos
- University of Edinburgh, Edinburgh, United Kingdom
| | - R Bing
- University of Edinburgh, Edinburgh, United Kingdom
| | - J Andrews
- University of Edinburgh, Edinburgh, United Kingdom
| | - M Macaskill
- University of Edinburgh, Edinburgh, United Kingdom
| | - A Tavares
- University of Edinburgh, Edinburgh, United Kingdom
| | - G MacNaught
- University of Edinburgh, Edinburgh, United Kingdom
| | - T Clarke
- University of Edinburgh, Edinburgh, United Kingdom
| | - M C Williams
- University of Edinburgh, Edinburgh, United Kingdom
| | | | - N Koglin
- Life Molecular Imaging, Berlin, Germany
| | | | - M R Dweck
- University of Edinburgh, Edinburgh, United Kingdom
| | - D E Newby
- University of Edinburgh, Edinburgh, United Kingdom
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16
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Barradas Da Silva M, Duarte F, Oliveira L, Serena C, Fontes A, Monteiro A, Machado C, Dourado R, Santos E, Pelicano N, Pacheco M, Tavares A, Martins D. STEMI treatment in remote areas – challenges of the only interventional angioplasty center located in an archipelago. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
In remote islands lack of specialized medical facilities, long distance transfer and emergency medical system organization remains a challenge and fibrinolysis is necessary to achieve revascularization in optimal timing in ST-elevation myocardial infarction (STEMI) patients. Our angioplasty center is the only one located in an archipelago composed of nine islands, six of which do not have hospital facilities and only have small family health care units.
Purpose
To evaluate the reality and outcomes of our interventional angioplasty center and compare cardiovascular outcomes between STEMI patients from the main island and remote islands.
Methods
We retrospectively evaluated 103 patients with STEMI admitted to our center between 2018 and 2019. Patients from the main island where the center is located underwent primary percutaneous coronary intervention (PCI) (group 1, n=55) and patients from remote islands underwent fibrinolytic therapy followed by transference to our center with facilitated or rescue PCI (group 2, n=48). A subanalysis of the far remote islands without hospital facilities was also performed. Primary outcome was defined as cardiovascular death or re-infarction at two years and secondary outcome as intrahospital haemorrhagic complications.
Results
Mean age was 58,15±12,6 years, 85,4% were males and follow up period was 30,30±6,46 months. Seventy-eight patients (75,7%) had history of smoking, 45 (43,7%) dyslipidemia, 20 (19,4%) previous acute coronary syndrome, 18 (17,5%) diabetes and 17 (15,5%) were obese. Troponin I peak was 117,42±129,06 ug/L and 14 (13,6%) were in Killip Class III/IV. Infarct-related artery was the left anterior descending artery in 45 (45,5%) and multivessel disease was present in 38 (38,0%). In group 1 reperfusion after PCI was obtained in 91,5%. In group 2, 73,5% met criteria for reperfusion after fibrinolysis and 23,6% after rescue PCI. Mean time from fibrinolysis to PCI was 558±349 minutes. Rates of successful revascularization did not differ between groups, as well as complete patency of the culprit-vessel defined as thrombolysis in myocardial infarction (TIMI) flow 3 (91,5% vs. 97,2% and 90,0% vs. 93,0% respectively for group 1 and 2). Cardiovascular death at two years occurred in 4 (3,9%) patients and re-infarction in 11 (10,7%) and were similar between groups (3 (5,5%) vs. 1 (2,1%) and 8 (14,5%) vs. 3 (6,3%) respectively) as well as haemorrhagic complications (1 (1,8%) vs. 5 (10,4%) respectively). Nineteen (18,4%) patients were from far remote islands without hospital facilities and when comparing these patients with the others there was also no difference in primary outcome.
Conclusion
Even in remote islands, an organized STEMI network with attempted fibrinolytic treatment and coordinated transference of patients for facilitated or rescue PCI can provide successful revascularization with cardiovascular outcomes similar to those submitted to primary PCI.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
| | - F Duarte
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - L Oliveira
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - C Serena
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - A Fontes
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - A Monteiro
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - C Machado
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - R Dourado
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - E Santos
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - N Pelicano
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - M Pacheco
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - A Tavares
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - D Martins
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
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17
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Ribeiro Da Silva M, Vilela E, Mosalina Manuel A, Barbosa A, Almeida J, Guerreiro C, Ribeiro Queiros P, Tavares A, Dias A, Caeiro D, Sousa O, Braga P, Rodrigues A, Teixeira M, Fontes-Carvalho R. The impact of mitral regurgitation grade on exercise capacity following cardiac rehabilitation program after transcatheter aortic valve implantation. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Severe aortic stenosis (AS) and mitral regurgitation (MR) often coexist. Transcatheter aortic valve implantation (TAVI) is becoming widely used for the treatment of patients (pts) with symptomatic severe AS. However, conflicting data reside concerning the impact of MR on outcomes after TAVI. Also, very few data exist regarding the benefits of a cardiac rehabilitation program (CRP) following TAVI in pts with MR.
Purpose
To evaluate the effect of a CRP in functional parameters after TAVI, particularly in pts with MR grade ≥ II.
Methods
Retrospective study which included all pts submitted to TAVI between 2014 and 2020 that completed a CRP following the procedure. Cardiopulmonary exercise tests (CPET) were performed after TAVI at baseline (pre-CRP) and post-CRP. We evaluated pre- and post-CRP peak oxygen consumption (pVO2), pVO2 at the anaerobic threshold (AT), respiratory exchange ratio (RER), VE/VCO2 and CPET duration. The exercise protocol included low/medium intensity exercises and consisted of sessions 3 times per week carried over 3 months. MR grading severity was assessed with transthoracic echocardiography performed after TAVI and was divided into 2 groups (grade < II vs grade ≥ II).
Results
Fifty-two pts were included, 59,6% were male, mean age of 78,6±8,6 years-old. Mean Society of Thoracic Surgery (STS) risk score was 4,9. Mean pre-TAVI aortic valve area was 0,68 cm2, with a mean gradient of 45,5 mmHg and a mean ejection fraction (EF) of 51%. The majority of pts implanted a self-expandable prosthesis (55,8%).
Twenty-seven (51,9%) pts had MR grade ≥ II. Baseline characteristics were similar between pts with MR grade < II vs MR grade ≥ II, with the exception of the prevalence of coronary artery disease which was higher in MR grade ≥ II (p=0,036). Patients with MR grade < II had higher maximum and median aortic gradients before TAVI (p<0,05 for all). The mean number of cardiac rehabilitation sessions was 21±7, without differences between both groups. In pts with MR grade ≥ II, there was an improvement in CPET duration after CRP (HF protocol from 03:57 min to 05:02 min; p=0,017 and modified Bruce protocol from 06:03 min to 06:41 min; p=0,049) but without significant changes in pVO2 (14,7 mL/kg/min to 14,9 mL/kg/min; p=0,990), RER or VEVCO2/VO2 ratio. Patients with MR grade < II significantly improved pVO2 (13,8 mL/kg/min to 14,7 mL/kg/min; p=0,015), and CPET duration with HF protocol from 05:04 min to 06:23 min; p=0,006 after CRP. There was also an improvement in VEVCO2/VO2 ratio, although not statically significant.
Conclusions
Patients with MR grade < II after TAVI who underwent a CRP significantly improved pVO2 and CPET duration. Although pts with MR grade ≥ II did not improved pVO2 after a CRP, an improvement in CPET duration may translate into a clinical benefit in these pts. These results highlight the importance of further research and personalization among this potentially higher risk subset of pts.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Ribeiro Da Silva
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - E Vilela
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - A Mosalina Manuel
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - A Barbosa
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - J Almeida
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - C Guerreiro
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - P Ribeiro Queiros
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - A Tavares
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - A Dias
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - D Caeiro
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - O Sousa
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - P Braga
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - A Rodrigues
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - M Teixeira
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - R Fontes-Carvalho
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
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Oliveira L, Duarte F, Barradas MI, Serena C, Fontes A, Almeida C, Machado C, Dourado R, Monteiro A, Santos E, Pelicano N, Pacheco A, Tavares A, Martins D. Early and long term prognostic accuracy of 4 acute pulmonary embolism mortality risk scores. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Acute pulmonary embolism (PE) is a frequent condition associated with significant morbidity and mortality. Multiple scores have been developed and validated to predict 30-day mortality risk, however accurate prognostic assessment remains a challenge in clinical practice.
Purpose
To compare the performance of PESI, simplified PESI, Hestia and Bova scores in predicting in-hospital, 30-day and 1-year mortality risk for acute PE.
Methods
We retrospectively assessed consecutive patients from a single center registry who were hospitalized with acute PE between January 2017 and October 2020. Discriminative power of each score was assessed by receiver operating characteristic curve analysis. Charlson comorbidity index (CCI) was also assessed for comparison.
Results
A total of 131 patients with a mean age of 67.6±15.3 years were included with a mean follow-up of 46.3±17.7 months. Thirty-six patients (27.5%) had a recent hospitalization or major surgery and 26 (19.8%) a medical history of cancer. Besides anticoagulation, 7 patients (5.3%) underwent fibrinolysis. Overall in-hospital mortality was 8.4%, 30-day mortality 12.2% and 1-year mortality 19.8%. All acute PE scores, except Bova score, were significantly higher in those patients who died during hospitalization and on 30-day and 1-year follow-up. CCI was also higher in those patients. Discriminative power for in-hospital mortality was higher for PESI (c-statistic 0.84, 95% CI 0.74–0.93, p=0.002), followed by sPESI (c-statistic 0.77, 95% CI 0.65–0.90, p=0.010) and Hestia (c-statistic 0.77, 95% CI 0.61–0.92, p=0.011). The Bova score showed a poor discriminative power for prediction of in-hospital mortality (c-statistic 0.61, 95% CI 0.43–0.78, p=0.325). For 30-day and 1-year mortality PESI score still maintained the best performance with acceptable discriminative power (c-statistic 0.73, 95% CI 0.61–0.85, p=0.007 for 30-day mortality; c-statistic 0.80, 95% CI 0.71–0.89, p<0.0001 for 1-year mortality). However at longer follow-up CCI had a better performance to predict worse outcomes (c-statistic 0.79, 95% CI 0.65–0.92, p=0.001 for 30-day mortality; c-statistic 0.83, 95% CI 0.74–0.92, p<0.0001 for 1-year mortality).
Conclusions
All scores, except Bova score, showed overall good performance in stratifying mortality for acute PE, however PESI score performed better in this population particularly at shorter follow-up. At longer follow-up, although PESI score maintained an acceptable performance, comorbidities seem to play a bigger role. The different performance of multiple scores highlights the complexity of this condition.
Funding Acknowledgement
Type of funding sources: None. ROC curves for mortality risk scores
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Affiliation(s)
- L Oliveira
- Hospital Divino Espirito Santo, Cardiology, Ponta Delgada, Portugal
| | - F Duarte
- Hospital Divino Espirito Santo, Cardiology, Ponta Delgada, Portugal
| | - M I Barradas
- Hospital Divino Espirito Santo, Cardiology, Ponta Delgada, Portugal
| | - C Serena
- Hospital Divino Espirito Santo, Cardiology, Ponta Delgada, Portugal
| | - A Fontes
- Hospital Divino Espirito Santo, Cardiology, Ponta Delgada, Portugal
| | - C Almeida
- Hospital Divino Espirito Santo, Cardiology, Ponta Delgada, Portugal
| | - C Machado
- Hospital Divino Espirito Santo, Cardiology, Ponta Delgada, Portugal
| | - R Dourado
- Hospital Divino Espirito Santo, Cardiology, Ponta Delgada, Portugal
| | - A Monteiro
- Hospital Divino Espirito Santo, Cardiology, Ponta Delgada, Portugal
| | - E Santos
- Hospital Divino Espirito Santo, Cardiology, Ponta Delgada, Portugal
| | - N Pelicano
- Hospital Divino Espirito Santo, Cardiology, Ponta Delgada, Portugal
| | - A Pacheco
- Hospital Divino Espirito Santo, Cardiology, Ponta Delgada, Portugal
| | - A Tavares
- Hospital Divino Espirito Santo, Cardiology, Ponta Delgada, Portugal
| | - D Martins
- Hospital Divino Espirito Santo, Cardiology, Ponta Delgada, Portugal
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19
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Duarte F, Barradas M, Oliveira L, Serena C, Dourado R, Fontes A, Monteiro A, Machado C, Santos E, Pelicano N, Tavares A, Pacheco M, Martins D. New York Heart Association class change on heart failure patients with implantable devices: does it matters? Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Chronic heart failure (CHF) is a pathology with high prevalence and an important cause of morbidity and mortality. Benefits of implantable devices have been demonstrated in selected groups of patients with benefits on symptoms and heart failure hospitalization.
Purpose
To determine the clinical impact of New York Heart Association class change (NYHA) in patients with CHF and Cardiac Implantable Electric Devices (CIEDs).
Methods
We retrospectively enrolled 178 consecutive patients with CHF and CIEDs between November 2003 and January 2021, during a follow-up period of 51±43,9 months. Patients demographic characteristic and NYHA class change impact on occurrence of arrhythmic events, heart failure hospitalization (HFH) or long-term admission in an emergency department were assessed. Patients with NYHA class change were considered responders to therapy.
Results
Out of 178 patients enrolled in this study, sixty-seven (37,6%) had a reduction ≥1 in NYHA functional class and in this group, 61 patients (91,0%) had a cardiac resynchronization therapy (CRT) and 9% had an implantable cardioverter defibrillator. Mean age 68±11,3 years, 44 (65,7%) patients were male, 33 (49,2%) were in NYHA class II, 30 (44,8%) NYHA class III and 4 (6%) NYHA class IV. Mean QRS width 129,9±63,1 ms before CIEDs. Fifty-eight patients (86,6%) had an improvement in one NYHA functional class and 9 patients (13,4%) in two NYHA functional class.
Fourty NYHA responders patients (59,7%) had paroxistic or permanent atrial fibrillation and 31,9% had an epicardial coronary artery disease, that was a negative predictor of NYHA response (p=0,012).
A total of 35 (19,7%) enrolled patients experience non-sustained ventricular tachycardia (NSVT) and 74,3% were non-responders (p=0,019).
There was fifteen and twenty HFH at 2 and 5 years of follow-up, respectively, and we observed that an improvement in NYHA class was associated with a reduction in HFH at 2 years of follow-up (p=0,043; OR 0,029, 95% CI 0,050–1,06) and 5 years of follow-up (p 0,027, OR 0,252; 95% CI 0,069 – 0,915). Emergency department (ED) admission related to HF decompensations was significantly reduced at 2 years of follow-up (p=0,035, OR 0,22, 95% CI 0,048 – 1,0) and at 5 years of follow-up (p=0,001, OR 0,15, 95% CI 0,044 – 0,55).
There was no difference on cardiovascular or all-cause mortality.
Conclusion
CHF patients with CIEDs and improving on NYHA class have less NSVT episodes, HFH and HF decompensations with ED admission, both at 2 and 5 years of follow-up.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- F Duarte
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - M.I Barradas
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - L Oliveira
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - C Serena
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - R Dourado
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - A Fontes
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - A Monteiro
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - C Machado
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - E Santos
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - N Pelicano
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - A Tavares
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - M Pacheco
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - D Martins
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
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20
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Barradas Da Silva M, Duarte F, Oliveira L, Serena C, Fontes A, Monteiro A, Machado C, Dourado R, Santos E, Pelicano N, Pacheco M, Tavares A, Martins D. Non-sustained ventricular tachycardia on remote patient monitoring in heart failure patients. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Non-sustained ventricular tachycardia (NSVT) is commonly found in patients with structural heart disease and was historically obtained from registers of external ambulatory monitoring. The advent of remote patient monitoring (RPM) in Cardiac implantable electronic devices (CIEDs) has made it possible to detect asymptomatic NSVT in Heart Failure (HF) patients more frequently, but its impact in real world is uncertain.
Purpose
To determine the clinical impact of NSVT detection in RPM in ischemic and non-ischemic chronic heart failure patients with reduced ejection fraction (HFrEF) and CIEDs.
Methods
We retrospectively enrolled 121 consecutive patients with HFrEF, CIEDs and RPM. Patients were evaluated through routine episodic CIEDs interrogation, routine clinical evaluations and continuous monitoring data obtained from CIEDs and transmitted remotely to the care team and divided into NSVT positive (Group 1) and negative groups (Group 2). Primary endpoint was admissions to the emergency department by HF decompensation and secondary endpoint was the occurrence of arrhythmic events. A sub-analysis of non-ischemic HF was also performed.
Results
NSVT was detected in 78 (72,2%) patients. The mean number of episodes of NSVT was 611,68±3271,25 during the follow-up period or 2,445±16,688 in 24 hours. Mean age was 62,40±13,218 years, 71,9% were males and mean follow-up period was 56,30±39,37 months. Fifty-eight patients (47,9%) had transvenous implantable cardioverter defibrillator (ICD), 48 (39,7%) implantable cardiac resynchronization therapy (CRT) defibrillator (CRT-D), 14 (11,6%) subcutaneous ICD (S-ICD) and 1 (0,8%) CRT pacemaker (CRT-P). Medium left ventricular ejection fraction (LVEF) was 34,70±12,53%, 25 (23,14%) were in NYHA III-IV and 46 (39,0%) were ischemic (29 (37,7%) in Group 1 and 11 (37,9%) in Group 2). NSVT was associated with the occurrence of sustained ventricular tachycardia (VT) (1,88±0,186episodes of VT in group 1 and 0,03±0,186 in group 2, p=0,012), ventricular fibrillation (VF) (1,44±5,325 episodes of VT in group 1 and 0,03±0,186 in group 2, p=0,011) and admissions to the emergency department by HF decompensation at 5 years (r=0,310, p=0,011). A sub-analysis in non-ischemic HF patients also showed correlation between NSVT and VT (r=0,602, p<0,05) and admissions to the emergency department by HF decompensation at 5 years (r=0,382, p=0,014).
Conclusions
On remote patient monitoring with CIEDs, NSVT in HF patients was associated with arrhythmic events and may serve as a predictor for HF decompensations.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
| | - F Duarte
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - L Oliveira
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - C Serena
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - A Fontes
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - A Monteiro
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - C Machado
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - R Dourado
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - E Santos
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - N Pelicano
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - M Pacheco
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - A Tavares
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - D Martins
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
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21
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Barradas Da Silva M, Duarte F, Oliveira L, Serena C, Fontes A, Monteiro A, Machado C, Dourado R, Santos E, Pelicano N, Pacheco M, Tavares A, Martins D. Prognostic significance of non-sustained ventricular tachycardia on stored electrograms of heart failure patients with cardiovascular implantable electronic devices. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Non-sustained ventricular tachycardia (NSVT) is commonly found in patients with structural heart disease and was historically obtained from registers of external ambulatory monitoring. The advent of Cardiac implantable electronic devices (CIEDs) has made it possible to detect asymptomatic NSVT in Heart Failure (HF) patients more frequently, but its true impact in real world is uncertain, and often does not lead to a change in clinical intervention.
Purpose
To determine the prognostic significance of NSVT detection on stored electrograms of CIEDs in HF patients with systolic left ventricle dysfunction.
Methods
We retrospectively enrolled 132 consecutive HF patients (mean age 67,5±11,1 years, males 72,0%) with systolic left ventricle dysfunction and CIEDs (biventricular pacemakers with or without cardiac defibrillators). Patients were evaluated through CIEDs interrogation and clinical evaluations and divided into NSVT positive (Group 1) and negative groups (Group 2). Mean follow-up period was 62,8±7,1 months.
Results
NSVT was detected in 51 (38,6%) patients. 70 (53,0%) had implantable cardiac resynchronization therapy (CRT) defibrillator (CRT-D), 37 (28,0%) transvenous implantable cardioverter defibrillator (ICD), 13 (9,8%) CRT pacemaker (CRT-P) and 12 (9,1%) subcutaneous ICD (S-ICD). Medium left ventricular ejection fraction (LVEF) was 31,1±7,9%, 20,6% were in NYHA III-IV and 47,0% were ischemic (49% Group 1 and 45,7% Group 2, p=0,708). Dyslipidemia was more prevalent in Group 2 (p=0,042). In total 11 (8,3%) patients died, 2 (1,5%) from sudden cardiac death and 5 (3,8%) from cardiovascular death. NSVT was associated with CIEDs treatments (hazard ratio [HR]2,52; 95% confidence interval [CI]1,2–5,1; p=0,001), ventricular fibrillation (VF) (HR: 3,71, 95% CI: 1,19–11,58; p=0,018), sustained ventricular tachycardia (VT) (HR: 9,06, 95% CI: 2,82–29,12; p<0,05) and composite outcome of VT, VF, HF re-admissions and related admissions to emergency department (ED) and death by all causes (HR: 2,52; 95% CI: 1,20–5,10; p=0,011). NSVT at 1 year was associated with HF readmissions at 1 year (p=0,004).
Conclusions
On extended monitoring possible with CIEDs, NSVT in HF patients was associated with a worse prognosis and may serve as a predictor of significant arrhythmic events, HF hospitalizations and mortality. These findings enhances the importance of remote monitoring and optimization of therapeutic modalities in these patients along with a close supervision.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
| | - F Duarte
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - L Oliveira
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - C Serena
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - A Fontes
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - A Monteiro
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - C Machado
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - R Dourado
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - E Santos
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - N Pelicano
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - M Pacheco
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - A Tavares
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - D Martins
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
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Tavares A, Mesquita A, Magalhães D, Salgado M, Braga F. 193P Adjuvant endocrine therapy in patients with breast cancer: Relationship between side effects, quality of life and treatment adherence. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.474] [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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23
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Martins da Costa A, Teixeira R, Vilela EM, Tavares A, Torres S, Sampaio F, Teixeira M, Fontes-Carvalho R, Pedro Nunes J. Suppression of tumorigenicity 2 after exercise: a systematic review. Monaldi Arch Chest Dis 2021; 92. [PMID: 34461703 DOI: 10.4081/monaldi.2021.1839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 07/12/2021] [Indexed: 11/23/2022] Open
Abstract
Exercise is a pivotal physiological activity, associated with benefits. Whilst the importance of physical activity is consensual along different steps of the cardiovascular (CV) continuum, there has been interest in assessing the CV adaptations to vigorous exercise. Indeed, exercise can be associated with increases in cardiac biomarkers, though the scope of this observation remains elusive. Interleukin 1 receptor related protein, Suppression of tumorigenicity 2 (ST2) is a biomarker related to the pathophysiology of fibrosis, having shown promise in the study of heart failure. Knowledge of ST2 kinetics could improve understanding of the mechanistic pathways related to CV adaptations to exercise. To assess the current state-of-the-art concerning ST2 levels after exercise in healthy individuals. A systematic review was carried out on three databases (Pubmed, ISI Web of Science and Scopus), up to October 2020, using the queries "ST2" or "ST-2" + "exercise" or "running". A total of six studies were included in the review, encompassing 349 subjects (73% male gender) in which ST2 was assessed. Most studies reported increases in ST2 levels after exercise. Three studies, encompassing a total of 219 individuals, described a cut-off level of 35 ng/dL for ST2. In these, 92.7% of subjects had ST2 levels above this cut-off after exercise (running in all studies). Most studies report increased levels of ST2 after exercise, with an important number of individuals exceeding the 35 ng/dL threshold. Given the small number of individuals represented and the lack of imaging data and long-term follow-up, further prospective larger studies should target this.
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Affiliation(s)
| | - Rafael Teixeira
- Cardiology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho.
| | - Eduardo M Vilela
- Cardiology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho.
| | - Ana Tavares
- Cardiology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho.
| | - Susana Torres
- Cardiology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho.
| | - Francisco Sampaio
- Cardiology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho.
| | - Madalena Teixeira
- Cardiology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho.
| | - Ricardo Fontes-Carvalho
- Cardiology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho; Cardiovascular Research Center (UniC), Faculty of Medicine, University of Porto.
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24
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Tavares A, Crespo C, Ferreira L, Ribeiro MT. Left behind parents: A qualitative study on the experience of parental abduction of a child in Portugal. J Marital Fam Ther 2021; 47:595-613. [PMID: 33550596 DOI: 10.1111/jmft.12478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 11/22/2020] [Accepted: 11/25/2020] [Indexed: 06/12/2023]
Abstract
Parental abduction of a child occurs when the child is removed, by one parent, from the custody of the other parent or legally appointed guardians. The absence of the child has a profound impact on family members and significantly affects their lives. Also, parental abduction of a child is a relevant social problem which calls for further understanding. The aim of this research was to characterize the experiences of left behind parents in the context of parental abduction of a child. The data for this exploratory qualitative study were analyzed through thematic analysis of the semi-structured interviews carried out with eight male participants in Portugal. Participants' perceptions were organized around three main themes: the impact of this adverse event on different areas of their lives, recovery strategies, and perspectives regarding the future. Findings and their implications for professionals working with these families are discussed in light of the ambiguous loss and ambiguous boundaries frameworks.
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Affiliation(s)
- Ana Tavares
- CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, Lisboa, Portugal
| | - Carla Crespo
- CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, Lisboa, Portugal
| | - Luana Ferreira
- CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, Lisboa, Portugal
| | - Maria T Ribeiro
- CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, Lisboa, Portugal
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25
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Timóteo M, Tavares A, Cruz S, Campos C, Medeiros R, Sousa H. Association of Murine Double Minute 2 polymorphisms with gastric cancer: A systematic review with meta-analysis. Biomed Rep 2021; 15:69. [PMID: 34257965 DOI: 10.3892/br.2021.1445] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 04/20/2021] [Indexed: 01/09/2023] Open
Abstract
Gastric cancer (GC) is the 5th most common type of cancer, with the 3rd highest mortality rate worldwide in both sexes. Murine double minute 2 (MDM2) protein is the major negative regulator of p53, and genetic polymorphisms in this gene have shown to be associated with several types of cancer. In the present study, a literature search was performed using PubMed and Scopus with the following key word combinations 'gastric cancer AND polymorphism AND MDM2'. Studies were carefully revised according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to identify eligible studies that matched the inclusion criteria. Statistical analysis was performed to assess the association between the different genetic polymorphisms and GC risk, by calculating the odds ratios (OR) and the confidence intervals (CI), with a 5% level of significance. A total of 11 manuscripts studied MDM2 polymorphisms in GC: rs937283 (n=1), rs3730485 (n=1) and rs2279744 (n=9). Both the rs937283 and rs3730485 reports showed an association with GC; however, there was only one study on each of these polymorphisms in the literature. A meta-analysis was performed for the rs2279744 polymorphism, of which studies showed a positive association between the G allele and risk of GC, either in the dominant model (OR=1.46; 95% CI 1.21-1.75; P<0.001) or recessive model (OR 1.65; 95% CI 1.45-1.87; P<0.001). In conclusion, genetic polymorphisms in MDM2 seemed to be associated with an increased risk of GC development, nevertheless, the number of studies were relatively low and the studied populations were primarily Chinese. The present meta-analysis emphasizes the need for additional studies in other populations to corroborate the association of these polymorphisms with GC.
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Affiliation(s)
- Mafalda Timóteo
- Molecular Oncology and Viral Pathology Group (CI-IPOP), Portuguese Oncology Institute of Porto, 4200-072 Porto, Portugal
| | - Ana Tavares
- Molecular Oncology and Viral Pathology Group (CI-IPOP), Portuguese Oncology Institute of Porto, 4200-072 Porto, Portugal.,Pathology Department, Portuguese Oncology Institute of Porto, 4200-072 Porto, Portugal
| | - Sara Cruz
- Molecular Oncology and Viral Pathology Group (CI-IPOP), Portuguese Oncology Institute of Porto, 4200-072 Porto, Portugal
| | - Carla Campos
- Molecular Oncology and Viral Pathology Group (CI-IPOP), Portuguese Oncology Institute of Porto, 4200-072 Porto, Portugal.,Microbiology Service, Portuguese Oncology Institute of Porto, 4200-072 Porto, Portugal
| | - Rui Medeiros
- Molecular Oncology and Viral Pathology Group (CI-IPOP), Portuguese Oncology Institute of Porto, 4200-072 Porto, Portugal.,Virology Service, Portuguese Oncology Institute of Porto, 4200-072 Porto, Portugal.,Research Department, Portuguese League Against Cancer (Liga Portuguesa Contra o Cancro-Núcleo Regional do Norte), 4200-172 Porto, Portugal
| | - Hugo Sousa
- Molecular Oncology and Viral Pathology Group (CI-IPOP), Portuguese Oncology Institute of Porto, 4200-072 Porto, Portugal.,Virology Service, Portuguese Oncology Institute of Porto, 4200-072 Porto, Portugal
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26
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Tavares A, Crespo C, Ribeiro MT. Assessing Silent Conflict: Results from the Portuguese Version of the Silent Interparental Conflict Scale. Contemp Fam Ther 2021. [DOI: 10.1007/s10591-021-09587-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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27
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Barturen G, Babaei S, Català-Moll F, Martínez-Bueno M, Makowska Z, Martorell-Marugán J, Carmona-Sáez P, Toro-Domínguez D, Carnero-Montoro E, Teruel M, Kerick M, Acosta-Herrera M, Le Lann L, Jamin C, Rodríguez-Ubreva J, García-Gómez A, Kageyama J, Buttgereit A, Hayat S, Mueller J, Lesche R, Hernandez-Fuentes M, Juarez M, Rowley T, White I, Marañón C, Gomes Anjos T, Varela N, Aguilar-Quesada R, Garrancho FJ, López-Berrio A, Rodriguez Maresca M, Navarro-Linares H, Almeida I, Azevedo N, Brandão M, Campar A, Faria R, Farinha F, Marinho A, Neves E, Tavares A, Vasconcelos C, Trombetta E, Montanelli G, Vigone B, Alvarez-Errico D, Li T, Thiagaran D, Blanco Alonso R, Corrales Martínez A, Genre F, López Mejías R, Gonzalez-Gay MA, Remuzgo S, Ubilla Garcia B, Cervera R, Espinosa G, Rodríguez-Pintó I, De Langhe E, Cremer J, Lories R, Belz D, Hunzelmann N, Baerlecken N, Kniesch K, Witte T, Lehner M, Stummvoll G, Zauner M, Aguirre-Zamorano MA, Barbarroja N, Castro-Villegas MC, Collantes-Estevez E, de Ramon E, Díaz Quintero I, Escudero-Contreras A, Fernández Roldán MC, Jiménez Gómez Y, Jiménez Moleón I, Lopez-Pedrera R, Ortega-Castro R, Ortego N, Raya E, Artusi C, Gerosa M, Meroni PL, Schioppo T, De Groof A, Ducreux J, Lauwerys B, Maudoux AL, Cornec D, Devauchelle-Pensec V, Jousse-Joulin S, Jouve PE, Rouvière B, Saraux A, Simon Q, Alvarez M, Chizzolini C, Dufour A, Wynar D, Balog A, Bocskai M, Deák M, Dulic S, Kádár G, Kovács L, Cheng Q, Gerl V, Hiepe F, Khodadadi L, Thiel S, de Rinaldis E, Rao S, Benschop RJ, Chamberlain C, Dow ER, Ioannou Y, Laigle L, Marovac J, Wojcik J, Renaudineau Y, Borghi MO, Frostegård J, Martín J, Beretta L, Ballestar E, McDonald F, Pers JO, Alarcón-Riquelme ME. Integrative Analysis Reveals a Molecular Stratification of Systemic Autoimmune Diseases. Arthritis Rheumatol 2021; 73:1073-1085. [PMID: 33497037 DOI: 10.1002/art.41610] [Citation(s) in RCA: 70] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 12/01/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Clinical heterogeneity, a hallmark of systemic autoimmune diseases, impedes early diagnosis and effective treatment, issues that may be addressed if patients could be classified into groups defined by molecular pattern. This study was undertaken to identify molecular clusters for reclassifying systemic autoimmune diseases independently of clinical diagnosis. METHODS Unsupervised clustering of integrated whole blood transcriptome and methylome cross-sectional data on 955 patients with 7 systemic autoimmune diseases and 267 healthy controls was undertaken. In addition, an inception cohort was prospectively followed up for 6 or 14 months to validate the results and analyze whether or not cluster assignment changed over time. RESULTS Four clusters were identified and validated. Three were pathologic, representing "inflammatory," "lymphoid," and "interferon" patterns. Each included all diagnoses and was defined by genetic, clinical, serologic, and cellular features. A fourth cluster with no specific molecular pattern was associated with low disease activity and included healthy controls. A longitudinal and independent inception cohort showed a relapse-remission pattern, where patients remained in their pathologic cluster, moving only to the healthy one, thus showing that the molecular clusters remained stable over time and that single pathogenic molecular signatures characterized each individual patient. CONCLUSION Patients with systemic autoimmune diseases can be jointly stratified into 3 stable disease clusters with specific molecular patterns differentiating different molecular disease mechanisms. These results have important implications for future clinical trials and the study of nonresponse to therapy, marking a paradigm shift in our view of systemic autoimmune diseases.
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Affiliation(s)
- Guillermo Barturen
- Pfizer-University of Granada-Junta de Andalucía Centre for Genomics and Oncological Research, Granada, Spain
| | | | | | - Manuel Martínez-Bueno
- Pfizer-University of Granada-Junta de Andalucía Centre for Genomics and Oncological Research, Granada, Spain
| | | | - Jordi Martorell-Marugán
- Pfizer-University of Granada-Junta de Andalucía Centre for Genomics and Oncological Research, Granada, Spain
| | - Pedro Carmona-Sáez
- Pfizer-University of Granada-Junta de Andalucía Centre for Genomics and Oncological Research, Granada, Spain
| | - Daniel Toro-Domínguez
- Pfizer-University of Granada-Junta de Andalucía Centre for Genomics and Oncological Research, Granada, Spain
| | - Elena Carnero-Montoro
- Pfizer-University of Granada-Junta de Andalucía Centre for Genomics and Oncological Research, Granada, Spain
| | - María Teruel
- Pfizer-University of Granada-Junta de Andalucía Centre for Genomics and Oncological Research, Granada, Spain
| | - Martin Kerick
- Institute of Parasitology and Biomedicine "López Neyra", Spanish National Research Council, Granada, Spain
| | - Marialbert Acosta-Herrera
- Institute of Parasitology and Biomedicine "López Neyra", Spanish National Research Council, Granada, Spain
| | - Lucas Le Lann
- Université de Brest, Centre Hospitalier Universitaire de Brest, INSERM, and Labex IGO, Brest, France
| | - Christophe Jamin
- Université de Brest, Centre Hospitalier Universitaire de Brest, INSERM, and Labex IGO, Brest, France
| | | | | | | | | | | | | | | | | | | | | | | | - Concepción Marañón
- Pfizer-University of Granada-Junta de Andalucía Centre for Genomics and Oncological Research, Granada, Spain
| | - Tania Gomes Anjos
- Pfizer-University of Granada-Junta de Andalucía Centre for Genomics and Oncological Research, Granada, Spain
| | - Nieves Varela
- Pfizer-University of Granada-Junta de Andalucía Centre for Genomics and Oncological Research, Granada, Spain
| | | | | | | | | | | | | | | | | | - Ana Campar
- Centro Hospitalar do Porto, Porto, Portugal
| | | | | | | | | | | | | | - Elena Trombetta
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Gaia Montanelli
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Barbara Vigone
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Tianlu Li
- Bellvitge Biomedical Research Institute, Barcelona, Spain
| | | | - Ricardo Blanco Alonso
- Hospital Universitario Marqués de Valdecilla, IDIVAL, Universidad de Cantabria, Santander, Spain
| | | | - Fernanda Genre
- Hospital Universitario Marqués de Valdecilla, IDIVAL, Universidad de Cantabria, Santander, Spain
| | - Raquel López Mejías
- Hospital Universitario Marqués de Valdecilla, IDIVAL, Universidad de Cantabria, Santander, Spain
| | - Miguel A Gonzalez-Gay
- Hospital Universitario Marqués de Valdecilla, IDIVAL, Universidad de Cantabria, Santander, Spain
| | - Sara Remuzgo
- Hospital Universitario Marqués de Valdecilla, IDIVAL, Universidad de Cantabria, Santander, Spain
| | - Begoña Ubilla Garcia
- Hospital Universitario Marqués de Valdecilla, IDIVAL, Universidad de Cantabria, Santander, Spain
| | - Ricard Cervera
- Hospital Clínic and Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Gerard Espinosa
- Hospital Clínic and Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Ignasi Rodríguez-Pintó
- Hospital Clínic and Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Ellen De Langhe
- Katholieke Universiteit Leuven and Universitair Ziekenhuis Leuven, Leuven, Belgium
| | - Jonathan Cremer
- Katholieke Universiteit Leuven and Universitair Ziekenhuis Leuven, Leuven, Belgium
| | - Rik Lories
- Katholieke Universiteit Leuven and Universitair Ziekenhuis Leuven, Leuven, Belgium
| | - Doreen Belz
- Klinikum der Universitaet zu Koeln, Cologne, Germany
| | | | | | | | | | | | | | | | | | - Nuria Barbarroja
- Reina Sofia University Hospital and University of Cordoba, Cordoba, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Aurélie De Groof
- Université Catholique de Louvain and Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Julie Ducreux
- Université Catholique de Louvain and Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Bernard Lauwerys
- Université Catholique de Louvain and Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Anne-Lise Maudoux
- Université Catholique de Louvain and Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Divi Cornec
- Université de Brest, Centre Hospitalier Universitaire de Brest, INSERM, and Labex IGO, Brest, France
| | | | - Sandrine Jousse-Joulin
- Université de Brest, Centre Hospitalier Universitaire de Brest, INSERM, and Labex IGO, Brest, France
| | | | - Bénédicte Rouvière
- Université de Brest, Centre Hospitalier Universitaire de Brest, INSERM, and Labex IGO, Brest, France
| | - Alain Saraux
- Université de Brest, Centre Hospitalier Universitaire de Brest, INSERM, and Labex IGO, Brest, France
| | - Quentin Simon
- Université de Brest, Centre Hospitalier Universitaire de Brest, INSERM, and Labex IGO, Brest, France
| | | | | | | | | | | | | | | | | | | | | | - Qingyu Cheng
- Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Velia Gerl
- Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Falk Hiepe
- Charité Universitätsmedizin Berlin, Berlin, Germany
| | | | - Silvia Thiel
- Charité Universitätsmedizin Berlin, Berlin, Germany
| | | | | | | | | | | | | | - Laurence Laigle
- Institut de Recherches Internationales Servier, Suresnes, France
| | | | | | - Yves Renaudineau
- Université de Brest, Centre Hospitalier Universitaire de Brest, INSERM, and Labex IGO, Brest, France
| | | | | | - Javier Martín
- Institute of Parasitology and Biomedicine "López Neyra", Spanish National Research Council, Granada, Spain
| | - Lorenzo Beretta
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | | | - Jacques-Olivier Pers
- Université de Brest, Centre Hospitalier Universitaire de Brest, INSERM, and Labex IGO, Brest, France
| | - Marta E Alarcón-Riquelme
- Pfizer-University of Granada-Junta de Andalucía Centre for Genomics and Oncological Research, Granada, Spain, and Karolinska Institutet, Stockholm, Sweden
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Magalhães D, Vilaça M, Cipriano É, Tavares A, Silva D, Cirnes L, Magalhães H, Estevinho F. 9P Lung cancer mutational state assessed by NGS in a Portuguese center. J Thorac Oncol 2021. [DOI: 10.1016/s1556-0864(21)01851-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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29
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Garcia S, Tavares A, Peixoto P, Costa F, Saraiva D, Varzim P, Monteiro A, Fontes M, Pinto G. PO-1073: Dosimetric Predictors of Survival in Esophageal Cancers Treated with Preoperative Chemoradiation. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01090-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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30
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Bing R, Andrews J, Williams M, Clark T, Semple S, Van Beek E, Lucatelli C, Sellers S, Leipsic J, Tavares A, Stephens A, Koglin N, Dweck M, Newby D. Thrombus formation on bioprosthetic aortic valves. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0290] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
18F-GP1 is a novel radiotracer with a high affinity for the platelet glycoprotein IIb/IIIa receptor. Subclinical bioprosthetic valve thrombus has been postulated as a trigger for accelerated valve degeneration.
Purpose
To determine the feasibility of 18F-GP1 positron-emission tomography-computed tomography (PET-CT) for the detection of subclinical bioprosthetic aortic valve thrombus.
Methods
(i) Explanted degenerated aortic valve prostheses underwent histology and imaging. (ii) In a prospective observational study, patients with bioprosthetic aortic valve replacement (AVR) underwent echocardiography and 18F-GP1 PET-CT. Valves were assessed for hypoattenuating leaflet thickening (HALT), hypo-attenuation affection leaflet motion (HAM) and GP1 uptake.
Results
(i) GP1 correlated with thrombus on explanted valves (Figure). (ii) The first 6 patients (Table) were asymptomatic and had normally functioning surgical bioprostheses on echocardiography. At a median of 166 (range 122–189) days post-AVR, no patients had HALT or HAM on CT. There was avid focal GP1 uptake on the leaflets of all 6 patients which appeared most prominent along the leaflet edges (Figure). Only one patient had focal uptake in the valve frame, remote from the leaflets. In a separate cohort undergoing 18F-GP1 PET-CT for other conditions, there was no uptake on normal, native aortic valves (n=8).
Conclusion
For the first time, we demonstrate that 18F-GP1 PET-CT is a highly sensitive method of assessing platelet activation on bioprosthetic aortic valves. Despite the absence of CT evidence, early thrombus appeared to be a universal finding on recently implanted valve prostheses. The biological and clinical implications of subclinical bioprosthetic aortic valve thrombus have yet to be established.
GP1 uptake in AVR
Funding Acknowledgement
Type of funding source: Foundation. Main funding source(s): British Heart Foundation
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Affiliation(s)
- R Bing
- University of Edinburgh, Edinburgh, United Kingdom
| | - J Andrews
- University of Edinburgh, Edinburgh, United Kingdom
| | - M Williams
- University of Edinburgh, Edinburgh, United Kingdom
| | - T Clark
- University of Edinburgh, Edinburgh, United Kingdom
| | - S Semple
- University of Edinburgh, Edinburgh, United Kingdom
| | - E Van Beek
- University of Edinburgh, Edinburgh, United Kingdom
| | - C Lucatelli
- University of Edinburgh, Edinburgh, United Kingdom
| | - S Sellers
- University of British Columbia, Vancouver, Canada
| | - J Leipsic
- University of British Columbia, Vancouver, Canada
| | - A Tavares
- University of Edinburgh, Edinburgh, United Kingdom
| | | | - N Koglin
- Life Molecular Imaging, Berlin, Germany
| | - M Dweck
- University of Edinburgh, Edinburgh, United Kingdom
| | - D Newby
- University of Edinburgh, Edinburgh, United Kingdom
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Gonçalves HM, Silva J, Pintado Maury I, Tavares A, Campos C, Sousa H, Jacinto A, Aguiar P, Caldeira L, Medeiros R. The prevalence and risk-factors of oral HPV DNA detection among HIV-infected men between men who have sex with men and heterosexual men. Infect Dis (Lond) 2020; 53:19-30. [PMID: 32915107 DOI: 10.1080/23744235.2020.1811373] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND Human papillomavirus (HPV)-associated oropharyngeal carcinomas are becoming more common with epidemiological impact on human immunodeficiency virus (HIV)- positive individuals. Objective: We evaluated prevalence and risk factors for oral HPV DNA among HIV-infected men who have sex with men (MSM) or heterosexual men. Methods: This cross-sectional hospital-based study included 255 HIV-infected men with different sexual orientation 142 MSM and 113 heterosexual men, who answered a self-administered questionnaire on sociodemographic, clinical and behavioural data. Oral swab and mouthwash samples were analysed by polymerase chain reaction and genotyped by AnyplexTM II 28 (Seegene®). Results: Oral HPV was detected in 17.6% (95% Confidence Interval (CI) 13.5-22.8%), 17.6% in MSM and 17.7% in heterosexual men (p = .984). Multiple HPV infections were detected in 86.7% of HPV-positive men. HPV 56 (13.7%) was the most prevalent high-risk genotype, HPV 66 (7.8%) and HPV 70 (12.3%) were the most prevalent probable HR and low-risk HPV genotypes (12.3% and 7.1%, respectively). At multivariable analysis models, oral HPV was associated with >100 lifetime sexual partners (Odds Ratio (OR) 3.73; 95% CI 1.42-9.77) or lifetime tongue-kissing partners (OR 3.20; 95% CI 1.22-8.39) and lower education level (OR 2.90; 95% CI 1.08-7.78 and 2.74; 95% CI 1.04-7.27, respectively). Conclusions: Oral HPV prevalence was similar between HIV-infected MSM and heterosexual men. Oral HPV was associated with lifetime sexual partners, lifetime tongue-kissing partners and being undergraduate, independently of sexual orientation.
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Affiliation(s)
- Helena M Gonçalves
- Public Health Unit, Agrupamento de Centros de Saúde (ACES), Lisboa Ocidental e Oeiras, Lisbon, Portugal
| | - Jani Silva
- Molecular Oncology & Viral Pathology Group, IPO-Porto Research Center (CI-IPOP), Portuguese Oncology Institute of Porto (IPO-Porto), Porto, Portugal
| | - Inês Pintado Maury
- Infectious Disease Service, Centro Hospitalar Lisboa Norte, EPE, Hospital de Santa Maria, Lisbon, Portugal
| | - Ana Tavares
- Virology Service, Portuguese Oncology Institute of Porto, Porto, Portugal
| | - Carla Campos
- Virology Service, Portuguese Oncology Institute of Porto, Porto, Portugal
| | - Hugo Sousa
- Molecular Oncology & Viral Pathology Group, IPO-Porto Research Center (CI-IPOP), Portuguese Oncology Institute of Porto (IPO-Porto), Porto, Portugal.,Virology Service, Portuguese Oncology Institute of Porto, Porto, Portugal
| | - Amado Jacinto
- Public Health Unit, Agrupamento de Centros de Saúde (ACES), Lisboa Ocidental e Oeiras, Lisbon, Portugal
| | - Pedro Aguiar
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal
| | - Luís Caldeira
- ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Rui Medeiros
- Molecular Oncology & Viral Pathology Group, IPO-Porto Research Center (CI-IPOP), Portuguese Oncology Institute of Porto (IPO-Porto), Porto, Portugal.,Infectious Disease Service, Centro Hospitalar Lisboa Norte, EPE, Hospital de Santa Maria, Lisbon, Portugal.,Virology Service, Portuguese Oncology Institute of Porto, Porto, Portugal.,Nacional School of Public Heath, New University of Lisbon, Lisbon, Portugal.,FP-ENAS Research Unit, UFP Energy, Environment and Health Research Unit, CEBIMED Fernando Pessoa University, Porto, Portugal.,LPCC, Research Department, Portuguese League Against Cancer (LPPC - NRN), Porto, Portugal
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Tavares A, Magalhães D, Soares A, Laranjinha J, Mesquita A, Duarte F, Abreu R, Magalhães H, Braga F, Sottomayor C, Salgado M. 1772P Impact assessment of SARS-CoV-2 testing on cancer patients undergoing immunosuppressive treatment. Ann Oncol 2020. [PMCID: PMC7506417 DOI: 10.1016/j.annonc.2020.08.1836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Vilaca M, Silva D, Magalhães D, Cipriano E, Tavares A, Estevinho F, Magalhães H. P-108 Perioperative chemotherapy in locally advanced, resectable gastric cancer: A single-center experience. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Vilaca M, Silva D, Magalhães D, Cipriano E, Tavares A, Peixoto R, Salgado M, Mesquita A, Sottomayor C. P-106 Liver metastasis in colorectal cancer: Management and survival outcomes of liver metastasectomy in a single-center analysis. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.188] [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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Joaquim A, Antunes P, Garcia C, Amarelo A, Duarte B, Vieira M, Viamonte S, Tavares A, Lopes R, Mendanha P, Martins MI, Leão I, Marinho J, Capela A, Afreixo V, Helguero L, Alves A. Effects Of Community-based Supervised Exercise In The Body Composition And Strength Of Breast Cancer Survivors. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000679204.66171.87] [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: 11/21/2022]
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Bernardo C, Santos J, Costa C, Tavares A, Amaro T, Marques I, Gouveia MJ, Félix V, Afreixo V, Brindley PJ, Costa JM, Amado F, Helguero L, Santos LL. Estrogen receptors in urogenital schistosomiasis and bladder cancer: Estrogen receptor alpha-mediated cell proliferation. Urol Oncol 2020; 38:738.e23-738.e35. [PMID: 32507545 DOI: 10.1016/j.urolonc.2020.04.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Revised: 03/30/2020] [Accepted: 04/21/2020] [Indexed: 01/22/2023]
Abstract
Estrogen-like metabolites have been identified in S. haematobium, the helminth parasite that causes urogenital schistosomiasis (UGS) and in patients´ blood and urine during UGS. Estrogen receptor (ER) activation is enriched in the luminal molecular subtype bladder cancer (BlaCa). To date, the significance of ER to these diseases remains elusive. We evaluated ERα and ERβ expression in UGS-related BlaCa (n = 27), UGS-related non-malignant lesions (n = 35), and noninfected BlaCa (n = 80). We investigated the potential of ERα to recognize S. haematobium-derived metabolites by docking and molecular dynamics simulations and studied ERα modulation in vitro using 3 BlaCa cell lines, T24, 5637 and HT1376. ERα was expressed in tumor and stromal cells in approximately 20% noninfected cases and in 30% of UGS-related BlaCa, predominantly in the epithelial cells. Overall, ERα expression was associated with features of tumor aggressiveness such as high proliferation and p53 positive expression. ERα expression correlated with presence of schistosome eggs. ERβ was widely expressed in both cohorts but weaker in UGS-related cases. molecular dynamics simulations of the 4 most abundant S. haematobium-derived metabolites revealed that smaller metabolites have comparable affinity for the ERα active state than 17β-estradiol, while the larger metabolites present higher affinity. Our in vitro findings suggested that ERα activation promotes proliferation in ERα expressing BlaCa cells and that this can be reverted with anti-estrogenic therapy. In summary, we report differential ER expression between UGS-related BlaCa and noninfected BlaCa and provide evidence supporting a role of active ERα during UGS and UGS-induced carcinogenesis.
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Affiliation(s)
- Carina Bernardo
- Hormones and Cancer Lab, Department of Medical Sciences, Institute of Biomedicine, iBiMED, University of Aveiro, Aveiro, Portugal; Experimental Pathology and Therapeutics, Research Center, Portuguese Oncology Institute - Porto (IPO-Porto), Porto, Portugal
| | - Júlio Santos
- Urology Department, Hospital Américo Boavida, Luanda, Angola; Center for the Study of Animal Science, CECA/ICETA, University of Porto, Porto, Portugal
| | - Céu Costa
- Fernando Pessoa Energy, Environment and Health Research Unit/Biomedical Research Center (FP-ENAS/CEBIMED), Faculty of Health Sciences, Fernando Pessoa University, Porto, Portugal
| | - Ana Tavares
- Experimental Pathology and Therapeutics, Research Center, Portuguese Oncology Institute - Porto (IPO-Porto), Porto, Portugal
| | - Teresina Amaro
- Department of Pathology, Hospital Pedro Hispano, Matosinhos, Portugal
| | - Igor Marques
- Department of Chemistry, CICECO - Aveiro Institute of Materials, University of Aveiro, Aveiro, Portugal
| | - Maria João Gouveia
- Center for the Study of Animal Science, CECA/ICETA, University of Porto, Porto, Portugal; Department of Infectious Diseases, R&D Unit, INSA-National Health Institute Dr. Ricardo Jorge, Porto, Portugal
| | - Vítor Félix
- Department of Chemistry, CICECO - Aveiro Institute of Materials, University of Aveiro, Aveiro, Portugal
| | - Vera Afreixo
- Center for Research and Development in Mathematics and Applications (CIDMA), Department of Mathematics, Aveiro, Portugal
| | - Paul J Brindley
- Department of Microbiology, Immunology & Tropical Medicine, and Research Center for Neglected Diseases of Poverty, School of Medicine & Health Sciences, George Washington University, Washington, DC, USA
| | - José Manuel Costa
- Center for the Study of Animal Science, CECA/ICETA, University of Porto, Porto, Portugal; Department of Infectious Diseases, R&D Unit, INSA-National Health Institute Dr. Ricardo Jorge, Porto, Portugal
| | - Francisco Amado
- Mass Spectrometry Group, QOPNA, Department of Chemistry, University of Aveiro, Aveiro, Portugal
| | - Luisa Helguero
- Hormones and Cancer Lab, Department of Medical Sciences, Institute of Biomedicine, iBiMED, University of Aveiro, Aveiro, Portugal
| | - Lúcio L Santos
- Experimental Pathology and Therapeutics, Research Center, Portuguese Oncology Institute - Porto (IPO-Porto), Porto, Portugal; Department of Surgical Oncology, Portuguese Oncology Institute - Porto (IPO-Porto), Rua Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal.
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Santos R, Tavares A. Ultrasound analyses of hamstrings muscle morphology changes whit sport. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa040.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction Physical activities and sports can change muscle morphology. Changes caused by regular physical exercise can be assessed by ultrasound parameters such as the pennation angle, cross-sectional area, echo-intensity and muscle thickness.
Objectives This study aims to characterise and evaluate the morphological changes of the hamstring muscles through ultrasound parameters such as the pennation angle, fascicle length, cross-sectional area, echo-intensity and muscle thickness, and verify the existence of morphological changes between the dominant and non-dominant limb.
Methodology Twenty-two young female divided in two groups (control group=11; athletes group=11) were submitted to an ultrasound examination at 50% of the posterior region of the thigh, for the semimembranosus and long portion of the femoral biceps muscles in the longitudinal and in a panoramic view.
Results 22 athletes with a mean age of 22.25 years were evaluated. There were significant differences between the two groups in muscle morphology. The athletes group showed a higher value for muscle thickness, cross-sectional area, pennation angle and fascicle length and a lower value for muscle echo-intensity. This group also showed higher values for these parameters when dominant limb is compared with non-dominant.
Conclusion Physical exercise causes changes in muscle morphology and ultrasound is a good method for the musculoskeletal assessment of athlete’s performance, since it is an imaging modality that allows to carry out comparative bilateral studies for athletes performance follow up and for preventive strategies against the sedentarism.
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Affiliation(s)
- R Santos
- Instituto Politécnico de Coimbra, ESTeSC – Coimbra Health School, Portugal
| | - A Tavares
- Instituto Politécnico de Coimbra, ESTeSC – Coimbra Health School, Portugal
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Alves A, Viamonte S, Amarelo A, Garcia C, Antunes P, Duarte B, Vieira M, Teixeira M, Tavares A, Lopes R, Mendanha P, Martins M, Leão II, Marinho JCL, Helguero L, Capela A, Joaquim A. Effects of community-based supervised exercise in the quality of life, physical fitness, and functioning of breast cancer survivors. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.e24035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e24035 Background: Physical exercise is recommended to cancer patients. We aim to evaluate the efficacy of a low-cost community-based supervised exercise program in early breast cancer survivors after primary treatment. Methods: A single-arm clinical trial, controled by a run-in period, of a 16-weeks intervention consisting of 3 weekly sessions of combined aerobic and strength exercise at moderate to vigorous intensity in group classes of no more than 20 participants. Participants were evaluated at weeks 1, 8 and 16 (M1, M2 and M3) of the run-in period and 8 and 16 of the experimental phase (M4 and M5) for quality of life (QoL) (EORTC QLQ-C30), handgrip strength, sit-to-stand (STS) test and maximal aerobic capacity. Results: Of the 82 participants, 25 completed the program and evaluations. Median age was 58 years (39-73), 64% underwent mastectomy, 48% had axillary lymph node dissection, 80% was treated with radiotherapy, 80% with chemotherapy and 84% with hormonotherapy. Median time from surgery was 13 months (4-107). Physical functioning domain of QoL improved significantly following 8 (p = 0.04) and 16 weeks (p = 0.03) of exercise training. Handgrip strength in surgical and non-surgical limbs increased after 8 weeks and maintained after 16 weeks of control phase, further increasing after 8 weeks (p = 0.01) and 16 weeks of exercise (p = 0.00). Lower-limb strength also increased after 16 weeks of exercise (p = 0.01), and maintained during control (p = 0.09). Additionally, maximal aerobic capacity tended to further increase after exercise training (p = 0.06), after increasing during control phase (p = 0.02). Conclusions: A low-cost community-based supervised exercise program improves physical fitness and functioning in breast cancer survivors after primary treatment. Clinical trial information: NCT04024280 . [Table: see text]
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Affiliation(s)
- Alberto Alves
- Research Center in Sports Sciences, Health Sciences and Human Development, Vila Real, Portugal
| | - Sofia Viamonte
- Centro de Reabilitacao do Norte, Vila Nova De Gaia, Portugal
| | - Anabela Amarelo
- Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova De Gaia, Portugal
| | | | | | - Barbara Duarte
- Associacao de Investigacao e Cuidados de Suporte em Oncologia, Vila Nova De Gaia, Portugal
| | | | - Madalena Teixeira
- Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova De Gaia, Portugal
| | - Ana Tavares
- Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova De Gaia, Portugal
| | | | | | | | - Inês Isabel Leão
- Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova De Gaia, Portugal
| | | | - Luisa Helguero
- Institute of Biomedicine-iBiMED, Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
| | - Andreia Capela
- Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova De Gaia, Portugal
| | - Ana Joaquim
- Centro Hospitalar Vila Nova Gaia e Espinho, Vila Nova De Gaia, Portugal
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Tavares A, Wen X, Maciel J, Carneiro F, Dinis-Ribeiro M. Occult Tumour Cells in Lymph Nodes from Gastric Cancer Patients: Should Isolated Tumour Cells Also Be Considered? Ann Surg Oncol 2020; 27:4204-4215. [PMID: 32367500 DOI: 10.1245/s10434-020-08524-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Regional lymph node metastasis is an important prognostic factor for patients with gastric cancer. Occult tumour cells (OTCs), including either micrometastases (MMs) or isolated tumour cells (ITCs), may be a key factor in the development of cancer recurrence in pN0 patients. AIMS We aimed to determine the frequency and prognostic significance for disease recurrence of OTCs. MATERIALS AND METHODS This retrospective cohort study included all consecutive patients with pN0 gastric adenocarcinoma between January 2000 and December 2011 (n = 73). Immunohistochemistry using the pan-cytokeratin antibody AE1/AE3 was used to detect OTCs in 1257 isolated lymph nodes. RESULTS OTCs were identified in 30 patients (41%), including 20 cases with MMs (27%) and 10 cases with ITCs (14%). Disease recurrence and cancer-related death were observed in 24 (33%) and 20 patients (27%), respectively, and both were significantly associated with the detection of OTCs. A significant difference was also observed for the mean survival time between patients with OTCs and those without OTCs [100 vs 158 months (p = 0.015)]. The presence of OTCs was statistically significantly associated with the Lauren classification, tumour size and lymphatic permeation. Multivariate analyses revealed that only age, T stage and the presence of ITCs in lymph nodes were independent factors for recurrence. The presence of ITCs increased the risk for recurrence by 11.1-fold. CONCLUSIONS In a significant proportion of patients diagnosed as stage pN0, OTCs may be identified in lymph nodes if carefully searched for, which can negatively affect their prognosis. The presence of ITCs was found to be an independent factor for recurrence and after proper validation should be considered during lymph node assessment for prognosis definition.
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Affiliation(s)
- A Tavares
- Department of General Surgery, Centro Hospitalar de Vila Nova de Gaia/Espinho, Porto, Portugal. .,Faculty of Medicine, University of Porto, Porto, Portugal.
| | - X Wen
- Institute of Molecular Pathology and Immunology, University of Porto (Ipatimup), Porto, Portugal.,Institute for Research Innovation in Health (i3S), University of Porto, Porto, Portugal.,Department of Pathology, Centro Hospitalar Vila Nova de Gaia/Espinho, Porto, Portugal
| | - J Maciel
- Department of General Surgery, Centro Hospitalar de Vila Nova de Gaia/Espinho, Porto, Portugal.,Faculty of Health Sciences, Universidade Fernando Pessoa, Porto, Portugal
| | - F Carneiro
- Institute of Molecular Pathology and Immunology, University of Porto (Ipatimup), Porto, Portugal.,Institute for Research Innovation in Health (i3S), University of Porto, Porto, Portugal.,Department of Pathology, Centro Hospitalar Universitário São João (CHUSJ), Porto, Portugal.,Department of Pathology, Faculty of Medicine, University of Porto (FMUP), Porto, Portugal
| | - M Dinis-Ribeiro
- Department of Gastroenterology, Oncology Portuguese Institute of Porto, Porto, Portugal.,MEDCIDS/CINTESIS Faculty of Medicine, University of Porto, Porto, Portugal
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Bule YP, Silva J, Carrilho C, Campos C, Sousa H, Tavares A, Medeiros R. Human papillomavirus prevalence and distribution in self-collected samples from female university students in Maputo. Int J Gynaecol Obstet 2020; 149:237-246. [PMID: 32086940 DOI: 10.1002/ijgo.13126] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 09/27/2019] [Revised: 12/18/2019] [Accepted: 02/19/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To characterize human papillomavirus (HPV) prevalence and distribution among female university students in Maputo, Mozambique, and evaluate the determinants of HPV infection. METHODS A cross-sectional study among 504 female university students between February and April 2017. Cervicovaginal self-collected samples were analyzed for HPV genotypes by polymerase chain reaction-restriction fragment length polymorphism and AnyplexTM II HPV28 Detection kit (Seegene® ). RESULTS The prevalence of any HPV genotype was 28.6% (144/504). Single and multiple HPV infections were detected in 76 (15.1%) and 68 (13.5%) participants, respectively. Prevalence of high-risk HPV was significantly higher than that of low-risk HPV (P<0.001). HPV16 was the most frequent genotype, followed by HPV58, HPV66, HPV52, HPV18, HPV56, HPV61, and HPV70. The prevalence of genotypes covered by the bivalent, quadrivalent, and nonavalent vaccine was 14.3%, 15.9%, and 23.4%, respectively. Number of sexual partners over lifetime and in the past 12 months was associated with HPV infection (P<0.001 and P=0.039, respectively). CONCLUSIONS Knowledge of HPV genotype-specific prevalence among young women is important to set up strategies for HPV vaccination. The findings suggest that introduction of the nonavalent HPV vaccine might be the way forward in the present low-resource setting. In addition, self-sampling was useful for HPV detection and genotyping.
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Affiliation(s)
- Yara Priscilla Bule
- Molecular Oncology & Viral Pathology Group, IPO-Porto Research Center (CI-IPOP), Portuguese Oncology Institute of Porto, Porto, Portugal
| | - Jani Silva
- Molecular Oncology & Viral Pathology Group, IPO-Porto Research Center (CI-IPOP), Portuguese Oncology Institute of Porto, Porto, Portugal
| | - Carla Carrilho
- Pathology Department, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique.,Pathology Service, Maputo Central Hospital, Maputo, Mozambique
| | - Carla Campos
- Virology Service, Portuguese Oncology Institute of Porto, Porto, Portugal
| | - Hugo Sousa
- Molecular Oncology & Viral Pathology Group, IPO-Porto Research Center (CI-IPOP), Portuguese Oncology Institute of Porto, Porto, Portugal.,Virology Service, Portuguese Oncology Institute of Porto, Porto, Portugal.,Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Ana Tavares
- Virology Service, Portuguese Oncology Institute of Porto, Porto, Portugal
| | - Rui Medeiros
- Molecular Oncology & Viral Pathology Group, IPO-Porto Research Center (CI-IPOP), Portuguese Oncology Institute of Porto, Porto, Portugal.,Virology Service, Portuguese Oncology Institute of Porto, Porto, Portugal.,FP-ENAS Research Unit, UFP Energy, Environment and Health Research Unit, CEBIMED, Biomedical Research Centre, University Fernando Pessoa, Porto, Portugal.,LPCC, Research Department - Portuguese League Against Cancer (LPPC - NRN), Porto, Portugal
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Barros M, Garrido R, Tavares A, Cunha MS. Late-onset neonatal sepsis: A cinetobacter ursingii as an infectious agent. BMJ Case Rep 2019; 12:12/10/e230779. [PMID: 31645397 DOI: 10.1136/bcr-2019-230779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
The authors report a case of a premature male newborn admitted to the neonatal intensive care unit after an emergent caesarean due to maternal pre-eclampsia and foetal bradycardia at 32 weeks of gestational age and birth weight of 1440 g. There were no infection risk factors reported. On day 3 his clinical condition deteriorated, with tachycardia and subfebrile temperature and C-reactive protein at 1.25 mg/dL. Empirical antibiotics (flucloxacillin and gentamicin) were started, with no clinical improvement and C-reactive protein increasing to a maximum of 19 mg/dL (upper normal level of 1 mg/dL) after 3 days. Blood cultures from the third to the eighth day of life were positive for Acinetobacter ursingii Targeted therapy was administered for 14 days with clinical and laboratorial improvement and he was discharged on the 28th day of life without any known sequelae. A. ursingii is emerging as an infectious agent of late-onset sepsis in immunosuppressed neonates.
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Affiliation(s)
- Mariana Barros
- Neonatology Functional Unit, Children Department, Hospital de Cascais, Dr José de Almeida, Cascais, Portugal
| | - Raquel Garrido
- Neonatology Functional Unit, Children Department, Hospital de Cascais, Dr José de Almeida, Cascais, Portugal
| | - Ana Tavares
- Neonatology Functional Unit, Children Department, Hospital de Cascais, Dr José de Almeida, Cascais, Portugal
| | - Manuel Sousa Cunha
- Neonatology Functional Unit, Children Department, Hospital de Cascais, Dr José de Almeida, Cascais, Portugal
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Cruz S, Campos C, Timóteo M, Tavares A, José Nascimento MS, Medeiros R, Sousa H. Hepatitis E virus in hematopoietic stem cell transplant recipients: A systematic review. J Clin Virol 2019; 119:31-36. [DOI: 10.1016/j.jcv.2019.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 07/30/2019] [Accepted: 08/01/2019] [Indexed: 12/28/2022]
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Fonseca TG, Carriço T, Fernandes E, Abessa DMS, Tavares A, Bebianno MJ. Impacts of in vivo and in vitro exposures to tamoxifen: Comparative effects on human cells and marine organisms. Environ Int 2019; 129:256-272. [PMID: 31146160 DOI: 10.1016/j.envint.2019.05.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 05/06/2019] [Indexed: 06/09/2023]
Abstract
Tamoxifen (TAM) is a first generation-SERM administered for hormone receptor-positive (HER+) breast cancer in both pre- and post-menopausal patients and may undergo metabolic activation in organisms that share similar receptors and thus face comparable mechanisms of response. The present study aimed to assess whether environmental trace concentrations of TAM are bioavailable to the filter feeder M. galloprovincialis (100 ng L-1) and to the deposit feeder N. diversicolor (0.5, 10, 25 and 100 ng L-1) after 14 days of exposure. Behavioural impairment (burrowing kinetic), neurotoxicity (AChE activity), endocrine disruption by alkali-labile phosphate (ALP) content, oxidative stress (SOD, CAT, GPXs activities), biotransformation (GST activity), oxidative damage (LPO) and genotoxicity (DNA damage) were assessed. Moreover, this study also pertained to compare TAM cytotoxicity effects to mussels and targeted human (i.e. immortalized retinal pigment epithelium - RPE; and human transformed endothelial cells - HeLa) cell lines, in a range of concentrations from 0.5 ng L-1 to 50 μg L-1. In polychaetes N. diversicolor, TAM exerted remarkable oxidative stress and damage at the lowest concentration (0.5 ng L-1), whereas significant genotoxicity was reported at the highest exposure level (100 ng L-1). In mussels M. galloprovincialis, 100 ng L-1 TAM caused endocrine disruption in males, neurotoxicity, and an induction in GST activity and LPO byproducts in gills, corroborating in genotoxicity over the exposure days. Although cytotoxicity assays conducted with mussel haemocytes following in vivo exposure was not effective, in vitro exposure showed to be a feasible alternative, with comparable sensitivity to human cell line (HeLa).
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Affiliation(s)
- T G Fonseca
- CIMA, Centro de Investigação Marinha e Ambiental, Universidade do Algarve, Campus Gambelas, 8005-135 Faro, Portugal; NEPEA, Núcleo de Estudos em Poluição e Ecotoxicologia, Aquática, Universidade Estadual Paulista (UNESP), Campus do Litoral Paulista, São Vicente, SP 11330-900, Brazil
| | - T Carriço
- CIMA, Centro de Investigação Marinha e Ambiental, Universidade do Algarve, Campus Gambelas, 8005-135 Faro, Portugal
| | - E Fernandes
- CIMA, Centro de Investigação Marinha e Ambiental, Universidade do Algarve, Campus Gambelas, 8005-135 Faro, Portugal
| | - D M S Abessa
- NEPEA, Núcleo de Estudos em Poluição e Ecotoxicologia, Aquática, Universidade Estadual Paulista (UNESP), Campus do Litoral Paulista, São Vicente, SP 11330-900, Brazil
| | - A Tavares
- Departamento de Ciências Biomédicas e Medicina, Universidade do Algarve, Campus Gambelas, 8005-135 Faro, Portugal
| | - M J Bebianno
- CIMA, Centro de Investigação Marinha e Ambiental, Universidade do Algarve, Campus Gambelas, 8005-135 Faro, Portugal.
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Sousa H, Tavares A, Campos C, Marinho-Dias J, Brito M, Medeiros R, Baldaque I, Lobo C, Leça L, Monteiro P, Tavares F, Henrique R. High-Risk human papillomavirus genotype distribution in the Northern region of Portugal: Data from regional cervical cancer screening program. ACTA ACUST UNITED AC 2019; 8:100179. [PMID: 31377173 PMCID: PMC6702237 DOI: 10.1016/j.pvr.2019.100179] [Citation(s) in RCA: 10] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Revised: 07/29/2019] [Accepted: 07/31/2019] [Indexed: 12/24/2022]
Abstract
High-Risk Human papillomavirus (HR-HPV) full genotyping methods have been described as of great potential use in epidemiology and preventive strategies, including cervical cancer screening and HPV vaccination. We characterized the prevalence and distribution of HR-HPV genotypes in cervico-vaginal samples obtained from the Regional Cervical Cancer Screening Program from the Northern Region of Portugal. HR-HPV genotyping was performed using Anyplex™ II HPV-HR Detection kit in 105,458 women enrolled between August 2016 and December 2017. HR-HPVs were detected in 10,665 women (10.2%) with a prevalence ranging from 6.2 to 17.1% depending on age, and from 8.7 to 10.7% depending on geographical location. Multiple infections with two or more HR-HPVs were detected in 2736 (25.7%) of HR-HPV women ranging from 16.5 to 31.0% depending on age. Amongst HR-HPV positive women, HPV-16 (17.5%), HPV-39 (16.7%), HPV-31 (15.0%), HPV-68 (13.2%), HPV-52 (10.7%) and HPV-51 (10.6%) were the most common genotypes in our population, being HPV-16 more frequent in women aged from 30 to 45 years and HPV-39 in 50–65 years. Results also show that HPV16/18 are present in 22.1% and HPV16/18/31/33/45/52/58 in 47.6% of HR-HPV positive women. This is the largest study on HR-HPV genotyping for Cervical Cancer Screening in European populations and provides critical data for program management and vaccine policy. HPV genotyping is important for cervical cancer screening and HPV-vaccine strategies. Largest HR-HPV genotyping Cervical Cancer Screening in European populations. 105,458 women enrolled of which 10,665 (10.2%) were HR-HPV positive. Multiple infections with two or more HR-HPVs were detected in 2736 (25.7%). HPV-16, -39, −31, −68, −52 and −51, in specific rank order, were the most common in our population.
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Affiliation(s)
- Hugo Sousa
- Virology Service, Portuguese Oncology Institute of Porto FG EPE, Rua Dr. António Bernardino de Almeida, 4200-072, Porto, Portugal; Molecular Oncology & Viral Pathology Group, IPO-Porto Research Center (CI-IPOP), Portuguese Oncology Institute of Porto FG EPE, Rua Dr. António Bernardino de Almeida, 4200-072, Porto, Portugal; Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal; ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal.
| | - Ana Tavares
- Virology Service, Portuguese Oncology Institute of Porto FG EPE, Rua Dr. António Bernardino de Almeida, 4200-072, Porto, Portugal; Department of Pathology, Portuguese Oncology Institute of Porto (IPO-Porto), Rua Dr. António Bernardino de Almeida, 4200-072, Porto, Portugal
| | - Carla Campos
- Virology Service, Portuguese Oncology Institute of Porto FG EPE, Rua Dr. António Bernardino de Almeida, 4200-072, Porto, Portugal
| | - Joana Marinho-Dias
- Virology Service, Portuguese Oncology Institute of Porto FG EPE, Rua Dr. António Bernardino de Almeida, 4200-072, Porto, Portugal; Molecular Oncology & Viral Pathology Group, IPO-Porto Research Center (CI-IPOP), Portuguese Oncology Institute of Porto FG EPE, Rua Dr. António Bernardino de Almeida, 4200-072, Porto, Portugal
| | - Margarida Brito
- Virology Service, Portuguese Oncology Institute of Porto FG EPE, Rua Dr. António Bernardino de Almeida, 4200-072, Porto, Portugal
| | - Rui Medeiros
- Virology Service, Portuguese Oncology Institute of Porto FG EPE, Rua Dr. António Bernardino de Almeida, 4200-072, Porto, Portugal; Molecular Oncology & Viral Pathology Group, IPO-Porto Research Center (CI-IPOP), Portuguese Oncology Institute of Porto FG EPE, Rua Dr. António Bernardino de Almeida, 4200-072, Porto, Portugal; Research Department, Portuguese League Against Cancer (LPCC-NRNorte), Estrada Interior da Circunvalação 6657, 4200-172, Porto, Portugal
| | - Inês Baldaque
- Virology Service, Portuguese Oncology Institute of Porto FG EPE, Rua Dr. António Bernardino de Almeida, 4200-072, Porto, Portugal
| | - Cláudia Lobo
- Department of Pathology, Portuguese Oncology Institute of Porto (IPO-Porto), Rua Dr. António Bernardino de Almeida, 4200-072, Porto, Portugal
| | - Luís Leça
- Department of Pathology, Portuguese Oncology Institute of Porto (IPO-Porto), Rua Dr. António Bernardino de Almeida, 4200-072, Porto, Portugal
| | - Paula Monteiro
- Department of Pathology, Portuguese Oncology Institute of Porto (IPO-Porto), Rua Dr. António Bernardino de Almeida, 4200-072, Porto, Portugal; Cancer Biology and Epigenetics Group, IPO-Porto Research Center (CI-IPOP), Portuguese Oncology Institute of Porto FG EPE, Rua Dr. António Bernardino de Almeida, 4200-072, Porto, Portugal
| | - Fernando Tavares
- Administração Regional de Saúde do Norte I.P., Rua de Santa Catarina 1288, 4000-477, Porto, Portugal
| | - Rui Henrique
- Department of Pathology, Portuguese Oncology Institute of Porto (IPO-Porto), Rua Dr. António Bernardino de Almeida, 4200-072, Porto, Portugal; Cancer Biology and Epigenetics Group, IPO-Porto Research Center (CI-IPOP), Portuguese Oncology Institute of Porto FG EPE, Rua Dr. António Bernardino de Almeida, 4200-072, Porto, Portugal; Department of Pathology and Molecular Immunology, Institute of Biomedical Sciences Abel Salazar - University of Porto, Rua de Jorge Viterbo Ferreira, 228, 4050-313, Porto, Portugal
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Cipriano À, Soares A, Tavares A, Mesquita A, Sottomayor C. Locally advanced unresectable and metastatic pancreatic cancer – predictors of survival. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Cipriano À, Tavares A, Soares A, Mesquita A, Salgado M, Sottomayor C. The importance of laterality in colorectal cancer predicting response to therapeutics – retrospective study evaluating differences between right and left colon in stage IV colon cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Dourado R, Goncalves G, Tavares A, Fontes A, Pacheco M, Melo F, Machado C, Santos E, Ferreira S, Pelicano N, Almeida C, Serena C, Oliveira L, Martins D. P270Cardiac computed tomography after invasive coronary angiography without revascularization. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez148.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- R Dourado
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - G Goncalves
- Hospital Divino Espirito Santo, USISM, Ponta Delgada, Portugal
| | - A Tavares
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - A Fontes
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - M Pacheco
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - F Melo
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - C Machado
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - E Santos
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - S Ferreira
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - N Pelicano
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - C Almeida
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - C Serena
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - L Oliveira
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - D Martins
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
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Cipriano É, Tavares A, Soares A, Estevinho F, Sottomayor C. Non-small cell lung cancer in the elderly: A retrospective study comparing first-line treatment with single-agent vs combination chemotherapy vs tyrosine kinase inhibitor. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz065.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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50
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Raposo V, Ferreira P, Tavares A. Differences in Portuguese primary care quality: an analysis using geographical and patient satisfaction data. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz034.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- V Raposo
- Centre of Health Studies and Research, University of Coimbra, Portugal
- Centre for Business and Economics Research, University of Coimbra, Portugal
- Faculty of Economics, University of Coimbra, Portugal
| | - P Ferreira
- Centre of Health Studies and Research, University of Coimbra, Portugal
- Faculty of Economics, University of Coimbra, Portugal
| | - A Tavares
- Centre of Health Studies and Research, University of Coimbra, Portugal
- Faculty of Economics, University of Coimbra, Portugal
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