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Cruz JT, de Carvalho LM, Ferreira MR, Nunes C, Casero M, Marzal A. Avian Haemosporidian Infection in Wildlife Rehabilitation Centres of Portugal: Causes, Consequences, and Genetic Diversity. Animals (Basel) 2024; 14:1216. [PMID: 38672371 PMCID: PMC11047687 DOI: 10.3390/ani14081216] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 04/16/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024] Open
Abstract
In the last decade, over 40% of bird species in Europe have experienced poor and bad conservation status, with more than 30% of bird species in mainland Portugal threatened with extinction. Along with anthropogenic factors, parasites and pathogens such as avian haemosporidians have been suggested to be responsible for these avian population declines. Wildlife rehabilitation centres play an essential role in species conservation and preservation. Moreover, animals admitted for rehabilitation can provide valuable information regarding transmission and pathogenicity of many diseases that affect wild birds that are rarely sampled in nature. However, reports of haemosporidians in captive birds are still limited. Here, we explored the prevalence and genetic diversity of avian haemosporidians in 89 birds from 29 species admitted to rehabilitation centres in Portugal, showing an overall infection prevalence of 30.3%. The prevalence of infection was higher in Strigiformes and in birds admitted to rehabilitation centres due to debilitating diseases. Remarkably, 30% of the infected bird species have not been found to harbour malaria parasites in preceding studies. We detected 15 different haemosporidian lineages infecting a third of bird species sampled. Notably, 2 out of these 15 detected haemosporidian lineages have not been obtained previously in other studies. Furthermore, we also identified nine new host-parasite interactions representing new host records for these haemosporidian parasites. Finally, our results revealed that birds infected with haemosporidians require longer rehabilitation treatments, which increase the economic costs for rehabilitation and may impair their survival prospects. These findings emphasise the importance of integrating haemosporidian infection considerations into rehabilitation protocols, highlighting the challenges posed by these infections in avian conservation and rehabilitation, including economic and logistical demands.
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Affiliation(s)
- João T. Cruz
- Centre for Interdisciplinary Research in Animal Health (CIISA), Faculty of Veterinary Medicine (FMV-ULisboa), University of Lisbon, 1300-477 Lisbon, Portugal; (J.T.C.); (L.M.d.C.)
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), 1300-477 Lisbon, Portugal
| | - Luís Madeira de Carvalho
- Centre for Interdisciplinary Research in Animal Health (CIISA), Faculty of Veterinary Medicine (FMV-ULisboa), University of Lisbon, 1300-477 Lisbon, Portugal; (J.T.C.); (L.M.d.C.)
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), 1300-477 Lisbon, Portugal
| | - Mariana Ribeiro Ferreira
- Centre for Studies and Rehabilitation of Wild Animals of Castelo Branco (CERAS), Quercus ANCN, Rua Tenente Valadim, 17, 6000-284 Castelo Branco, Portugal;
| | - Carolina Nunes
- Wildlife Rehabilitation Centre of Santo André (CRASSA), Quercus ANCN, Moinho Novo, Galiza, 7500-022 Vila Nova de Santo André, Portugal;
| | - María Casero
- Wildlife Rehabilitation and Investigation Centre of the Ria Formosa (RIAS), Parque Natural da Ria Formosa, 8700-194 Olhão, Portugal;
| | - Alfonso Marzal
- Department of Anatomy, Cellular Biology and Zoology, University of Extremadura, 06006 Badajoz, Spain
- Wildlife Research Group, San Martin National University, Tarapoto 22021, Peru
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Chandrasekaran V, Wellens S, Bourguignon A, Djidrovski I, Fransen L, Ghosh S, Mazidi Z, Murphy C, Nunes C, Singh P, Zana M, Armstrong L, Dinnyés A, Grillari J, Grillari-Voglauer R, Leonard MO, Verfaillie C, Wilmes A, Zurich MG, Exner T, Jennings P, Culot M. Evaluation of the impact of iPSC differentiation protocols on transcriptomic signatures. Toxicol In Vitro 2024:105826. [PMID: 38615723 DOI: 10.1016/j.tiv.2024.105826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 04/09/2024] [Indexed: 04/16/2024]
Abstract
Human induced pluripotent stem cells (iPSC) have the potential to produce desired target cell types in vitro and allow for the high-throughput screening of drugs/chemicals at population level thereby minimising the cost of drug discovery and drug withdrawals after clinical trials. There is a substantial need for the characterisation of the iPSC derived models to better understand and utilise them for toxicological relevant applications. In our study, iPSC (SBAD2 or SBAD3 lines obtained from StemBANCC project) were differentiated towards toxicologically relevant cell types: alveolar macrophages, brain capillary endothelial cells, brain cells, endothelial cells, hepatocytes, lung airway epithelium, monocytes, podocytes and renal proximal tubular cells. A targeted transcriptomic approach was employed to understand the effects of differentiation protocols on these cell types. Pearson correlation and principal component analysis (PCA) separated most of the intended target cell types and undifferentiated iPSC models as distinct groups with a high correlation among replicates from the same model. Based on PCA, the intended target cell types could also be separated into the three germ layer groups (ectoderm, endoderm and mesoderm). Differential expression analysis (DESeq2) presented the upregulated genes in each intended target cell types that allowed the evaluation of the differentiation to certain degree and the selection of key differentiation markers. In conclusion, these data confirm the versatile use of iPSC differentiated cell types as standardizable and relevant model systems for in vitro toxicology.
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Affiliation(s)
- Vidya Chandrasekaran
- Division of Molecular and Computational Toxicology, Department of Chemistry and Pharmaceutical Sciences, Amsterdam Institute for Molecules, Medicines and Systems, Vrije Universiteit Amsterdam, De Boelelaan 1108, 1081HZ Amsterdam, the Netherlands
| | - Sara Wellens
- University of Artois, UR 2465, Laboratoire de la Barrière Hémato-Encéphalique (LBHE), Faculté des sciences Jean Perrin, Rue Jean Souvraz SP18, F-62300 Lens, France
| | | | - Ivo Djidrovski
- Biosciences Institute, Faculty of Medical Sciences, Newcastle University, UK
| | - Leonie Fransen
- Toxicology Department, Radiation, Chemical and Environmental Hazards (RCE) Directorate, UK Health Security Agency, Harwell Campus, OX11 0RQ, UK
| | - Sreya Ghosh
- Department of Development and Regeneration, Stem Cell Institute, KU Leuven, Leuven, Belgium
| | - Zahra Mazidi
- Evercyte GmbH, Vienna, Austria; Institute of Molecular Biotechnology, University of Natural Resources and Life Sciences, Vienna, Austria
| | - Cormac Murphy
- Division of Molecular and Computational Toxicology, Department of Chemistry and Pharmaceutical Sciences, Amsterdam Institute for Molecules, Medicines and Systems, Vrije Universiteit Amsterdam, De Boelelaan 1108, 1081HZ Amsterdam, the Netherlands
| | - Carolina Nunes
- Department of Biomedical Sciences, University of Lausanne, Lausanne, Switzerland; Swiss Centre for Applied Human Toxicology (SCAHT), University of Basel, Basel, Switzerland
| | - Pranika Singh
- Edelweiss Connect GmbH, Technology Park Basel, Hochbergerstrasse 60C, 4057 Basel, Switzerland; Division of Molecular and Systems Toxicology, Department of Pharmaceutical Sciences, University of Basel, Klingelbergstrasse 50, 4056 Basel, Switzerland
| | | | - Lyle Armstrong
- Biosciences Institute, Faculty of Medical Sciences, Newcastle University, UK
| | - András Dinnyés
- BioTalentum Ltd, Gödöllő, Hungary; HCEMM-USZ StemCell Research Group, Hungarian Centre of Excellence for Molecular Medicine, Szeged, Hungary; Department of Cell Biology and Molecular Medicine, University of Szeged, Szeged, Hungary
| | - Johannes Grillari
- Institute of Molecular Biotechnology, University of Natural Resources and Life Sciences, Vienna, Austria; Ludwig Boltzmann Institute for Traumatology in cooperation with AUVA, Vienna, Austria
| | | | - Martin O Leonard
- Toxicology Department, Radiation, Chemical and Environmental Hazards (RCE) Directorate, UK Health Security Agency, Harwell Campus, OX11 0RQ, UK
| | - Catherine Verfaillie
- Department of Development and Regeneration, Stem Cell Institute, KU Leuven, Leuven, Belgium
| | - Anja Wilmes
- Division of Molecular and Computational Toxicology, Department of Chemistry and Pharmaceutical Sciences, Amsterdam Institute for Molecules, Medicines and Systems, Vrije Universiteit Amsterdam, De Boelelaan 1108, 1081HZ Amsterdam, the Netherlands
| | - Marie-Gabrielle Zurich
- Department of Biomedical Sciences, University of Lausanne, Lausanne, Switzerland; Swiss Centre for Applied Human Toxicology (SCAHT), University of Basel, Basel, Switzerland
| | | | - Paul Jennings
- Division of Molecular and Computational Toxicology, Department of Chemistry and Pharmaceutical Sciences, Amsterdam Institute for Molecules, Medicines and Systems, Vrije Universiteit Amsterdam, De Boelelaan 1108, 1081HZ Amsterdam, the Netherlands.
| | - Maxime Culot
- University of Artois, UR 2465, Laboratoire de la Barrière Hémato-Encéphalique (LBHE), Faculté des sciences Jean Perrin, Rue Jean Souvraz SP18, F-62300 Lens, France.
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3
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Nunes C, Anckaert J, De Vloed F, De Wyn J, Durinck K, Vandesompele J, Speleman F, Vermeirssen V. HTSplotter: An end-to-end data processing, analysis and visualisation tool for chemical and genetic in vitro perturbation screening. PLoS One 2024; 19:e0296322. [PMID: 38181013 PMCID: PMC10769073 DOI: 10.1371/journal.pone.0296322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 12/11/2023] [Indexed: 01/07/2024] Open
Abstract
In biomedical research, high-throughput screening is often applied as it comes with automatization, higher-efficiency, and more and faster results. High-throughput screening experiments encompass drug, drug combination, genetic perturbagen or a combination of genetic and chemical perturbagen screens. These experiments are conducted in real-time assays over time or in an endpoint assay. The data analysis consists of data cleaning and structuring, as well as further data processing and visualisation, which, due to the amount of data, can easily become laborious, time-consuming and error-prone. Therefore, several tools have been developed to aid researchers in this process, but these typically focus on specific experimental set-ups and are unable to process data of several time points and genetic-chemical perturbagen screens. To meet these needs, we developed HTSplotter, a web tool and Python module that performs automatic data analysis and visualization of visualization of eitherendpoint or real-time assays from different high-throughput screening experiments: drug, drug combination, genetic perturbagen and genetic-chemical perturbagen screens. HTSplotter implements an algorithm based on conditional statements to identify experiment types and controls. After appropriate data normalization, including growth rate normalization, HTSplotter executes downstream analyses such as dose-response relationship and drug synergism assessment by the Bliss independence (BI), Zero Interaction Potency (ZIP) and Highest Single Agent (HSA) methods. All results are exported as a text file and plots are saved in a PDF file. The main advantage of HTSplotter over other available tools is the automatic analysis of genetic-chemical perturbagen screens and real-time assays where growth rate and perturbagen effect results are plotted over time. In conclusion, HTSplotter allows for the automatic end-to-end data processing, analysis and visualisation of various high-throughput in vitro cell culture screens, offering major improvements in terms of versatility, efficiency and time over existing tools.
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Affiliation(s)
- Carolina Nunes
- Lab for Computational Biology, Integromics and Gene Regulation (CBIGR), Cancer Research Institute Ghent (CRIG), Ghent, Belgium
- Pediatric Precision Oncology Lab (PPOL), Cancer Research Institute Ghent (CRIG), Ghent, Belgium
- Department of Biomolecular Medicine, Ghent University, Ghent, Belgium
- Department of Biomedical Molecular Biology, Ghent University, Ghent, Belgium
| | - Jasper Anckaert
- Department of Biomolecular Medicine, Ghent University, Ghent, Belgium
- OncoRNALab, Cancer Research Institute Ghent (CRIG), Ghent, Belgium
| | - Fanny De Vloed
- Pediatric Precision Oncology Lab (PPOL), Cancer Research Institute Ghent (CRIG), Ghent, Belgium
- Department of Biomolecular Medicine, Ghent University, Ghent, Belgium
| | - Jolien De Wyn
- Pediatric Precision Oncology Lab (PPOL), Cancer Research Institute Ghent (CRIG), Ghent, Belgium
- Department of Biomolecular Medicine, Ghent University, Ghent, Belgium
| | - Kaat Durinck
- Pediatric Precision Oncology Lab (PPOL), Cancer Research Institute Ghent (CRIG), Ghent, Belgium
- Department of Biomolecular Medicine, Ghent University, Ghent, Belgium
| | - Jo Vandesompele
- Department of Biomolecular Medicine, Ghent University, Ghent, Belgium
- OncoRNALab, Cancer Research Institute Ghent (CRIG), Ghent, Belgium
| | - Frank Speleman
- Pediatric Precision Oncology Lab (PPOL), Cancer Research Institute Ghent (CRIG), Ghent, Belgium
- Department of Biomolecular Medicine, Ghent University, Ghent, Belgium
| | - Vanessa Vermeirssen
- Lab for Computational Biology, Integromics and Gene Regulation (CBIGR), Cancer Research Institute Ghent (CRIG), Ghent, Belgium
- Pediatric Precision Oncology Lab (PPOL), Cancer Research Institute Ghent (CRIG), Ghent, Belgium
- Department of Biomolecular Medicine, Ghent University, Ghent, Belgium
- Department of Biomedical Molecular Biology, Ghent University, Ghent, Belgium
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Guerreiro T, Forjaz G, Antunes L, Bastos J, Mayer A, Aguiar P, Araújo A, Nunes C. Lung cancer survival and sex-specific patterns in Portugal: A population-based analysis. Pulmonology 2023; 29 Suppl 4:S70-S79. [PMID: 34642125 DOI: 10.1016/j.pulmoe.2021.09.001] [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: 05/08/2021] [Revised: 08/10/2021] [Accepted: 09/05/2021] [Indexed: 10/20/2022] Open
Abstract
INTRODUCTION In Portugal, lung cancer (LC) is the first cause of cancer-related death and of death and disability combined. This study aims to analyze the overall survival (OS) and relative survival (RS) of patients diagnosed with LC in 2009-2011 by socio-demographic and tumor characteristics, and analyze sex-specific patterns. METHODS We estimated 5-year OS using the Kaplan-Meier method and 5-year net survival through the RS framework. Cox regression modeling was used to determine the hazard ratio (HR) of death associated with each independent variable. FINDINGS For the 11,523 cases analyzed, median 5-year OS was 264 days (95% confidence interval [CI]: 254.8-273.2), the cumulative OS was 13.6% and RS was 15.1%. Males had a lower median survival (237 days; 95% CI: 228.2-245.7) compared to females (416 days; 95% CI: 384.4-447.6) (p < 0.0001) and lower 5-year RS proportions (12.1% vs. 24.9%). RS progressively decreased with age (41.7% for age-group <40 to 7.2% for ≥80) and stage (66.6% for stage I to 2.4% for stage IV). As predictors of decreased survival, we identified male gender, increasing age >50, histologic types (squamous cell carcinoma, non-small cell lung cancer not otherwise specified, other unspecified and small cell lung cancer), and increasing stage. Compared to women, the risk of death in men was 37.7% higher (HR = 1.386; 95% CI: 1.295-1.484). CONCLUSIONS The differences between OS and RS were small, reflecting the high lethality of LC. Male gender and older age are factors related to poor prognosis. Histology also plays a role in survival prognosis and varies with gender, but the factor related to the worst survival is stage. Although the study reflects data from a decade ago, and major changes occurred in diagnosis, staging and treatment, particularly for advanced disease, as LC mortality is strongly correlated with late stage diagnosis, all efforts should be made to secure early diagnosis and improve survival prospects.
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Affiliation(s)
- T Guerreiro
- NOVA National School of Public Health, NOVA University of Lisbon, Portugal.
| | - G Forjaz
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA; Azores Oncological Centre, Azores, Portugal
| | - L Antunes
- Cancer Epidemiology Group, IPO Porto Research (CI-IPOP), Portuguese Institute of Oncology Francisco Gentil, Porto, Portugal
| | - J Bastos
- Portuguese Institute of Oncology Francisco Gentil, Coimbra, Portugal
| | - A Mayer
- Portuguese Institute of Oncology Francisco Gentil, Lisbon, Portugal
| | - P Aguiar
- NOVA National School of Public Health, NOVA University of Lisbon, Portugal; Public Health Research Center, NOVA University of Lisbon, Portugal
| | - A Araújo
- University Hospital Center of Porto, Porto, Portugal; Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
| | - C Nunes
- NOVA National School of Public Health, NOVA University of Lisbon, Portugal; Public Health Research Center, NOVA University of Lisbon, Portugal
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Pinheiro Â, Martins I, Bento A, Escórcio R, Nunes C, Varela A, Nunes J, Afonso CA, Silva Pereira C. Rosin from Pinus pinaster Portuguese forests shows a regular profile of resin acids. Front Plant Sci 2023; 14:1268887. [PMID: 37965022 PMCID: PMC10640998 DOI: 10.3389/fpls.2023.1268887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 09/18/2023] [Indexed: 11/16/2023]
Abstract
Pinus pinaster forestry occupies >20% of the forest ecosystem area in the continental territory of Portugal with a high impact on the national economy. This species' major derived non-wood product is oleoresin, the raw material for rosin production. Rosin comprises mainly a blend of resin acids and has broad industrial and pharmaceutical applications. Oleoresin production in Portugal has been progressively reduced due to low-cost producers in other countries; currently, it reaches only 2% of the existing P. pinaster trees. To support this value chain, the chemical fingerprint of rosin derived from the national forest requires focused analysis. In the present study, we collected oleoresin within seven geographically distinct pure P. pinaster forests in two consecutive collection years. A high-resolution nuclear magnetic resonance (NMR) method was used to quantify the diversity of resin acids in the corresponding rosin samples. Overall, the acquired data highlighted that the profile of resin acids in P. pinaster rosin produced in Portugal is highly regular, regardless of the forest location, having as the major constituents abietic acid and dehydroabietic acid. The diversity of resin acids is possibly influenced, to a minor extent, by some edaphoclimatic factors.
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Affiliation(s)
- Ângela Pinheiro
- Instituto de Tecnologia Química e Biológica António Xavier, Universidade Nova de Lisboa (ITQB NOVA), Oeiras, Portugal
| | - Isabel Martins
- Instituto de Tecnologia Química e Biológica António Xavier, Universidade Nova de Lisboa (ITQB NOVA), Oeiras, Portugal
| | - Artur Bento
- Instituto de Tecnologia Química e Biológica António Xavier, Universidade Nova de Lisboa (ITQB NOVA), Oeiras, Portugal
| | - Rita Escórcio
- Instituto de Tecnologia Química e Biológica António Xavier, Universidade Nova de Lisboa (ITQB NOVA), Oeiras, Portugal
| | - Carolina Nunes
- Association BLC3 – Technology and Innovation Campus, Centre Bio R&D Unit, Rua Nossa Senhora da Conceição n2, Oliveira do Hospital, Portugal
| | - Adélia Varela
- Instituto Nacional Investigacão Agrária e Veterinária, Oeiras, Portugal
| | - João Nunes
- Association BLC3 – Technology and Innovation Campus, Centre Bio R&D Unit, Rua Nossa Senhora da Conceição n2, Oliveira do Hospital, Portugal
| | - Carlos A.M. Afonso
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Lisboa, Portugal
| | - Cristina Silva Pereira
- Instituto de Tecnologia Química e Biológica António Xavier, Universidade Nova de Lisboa (ITQB NOVA), Oeiras, Portugal
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Nunes C, Proença S, Ambrosini G, Pamies D, Thomas A, Kramer NI, Zurich MG. Integrating distribution kinetics and toxicodynamics to assess repeat dose neurotoxicity in vitro using human BrainSpheres: a case study on amiodarone. Front Pharmacol 2023; 14:1248882. [PMID: 37745076 PMCID: PMC10512064 DOI: 10.3389/fphar.2023.1248882] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 07/24/2023] [Indexed: 09/26/2023] Open
Abstract
For ethical, economical, and scientific reasons, animal experimentation, used to evaluate the potential neurotoxicity of chemicals before their release in the market, needs to be replaced by new approach methodologies. To illustrate the use of new approach methodologies, the human induced pluripotent stem cell-derived 3D model BrainSpheres was acutely (48 h) or repeatedly (7 days) exposed to amiodarone (0.625-15 µM), a lipophilic antiarrhythmic drug reported to have deleterious effects on the nervous system. Neurotoxicity was assessed using transcriptomics, the immunohistochemistry of cell type-specific markers, and real-time reverse transcription-polymerase chain reaction for various genes involved in the lipid metabolism. By integrating distribution kinetics modeling with neurotoxicity readouts, we show that the observed time- and concentration-dependent increase in the neurotoxic effects of amiodarone is driven by the cellular accumulation of amiodarone after repeated dosing. The development of a compartmental in vitro distribution kinetics model allowed us to predict the change in cell-associated concentrations in BrainSpheres with time and for different exposure scenarios. The results suggest that human cells are intrinsically more sensitive to amiodarone than rodent cells. Amiodarone-induced regulation of lipid metabolism genes was observed in brain cells for the first time. Astrocytes appeared to be the most sensitive human brain cell type in vitro. In conclusion, assessing readouts at different molecular levels after the repeat dosing of human induced pluripotent stem cell-derived BrainSpheres in combination with the compartmental modeling of in vitro kinetics provides a mechanistic means to assess neurotoxicity pathways and refine chemical safety assessment for humans.
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Affiliation(s)
- Carolina Nunes
- Department of Biomedical Sciences, University of Lausanne, Lausanne, Switzerland
- Swiss Centre for Applied Human Toxicology (SCAHT), Basel, Switzerland
| | - Susana Proença
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
- Toxicology Division, Wageningen University, Wageningen, Netherlands
| | - Giovanna Ambrosini
- Bioinformatics Competence Center, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
- Bioinformatics Competence Center, University of Lausanne, Lausanne, Switzerland
| | - David Pamies
- Department of Biomedical Sciences, University of Lausanne, Lausanne, Switzerland
- Swiss Centre for Applied Human Toxicology (SCAHT), Basel, Switzerland
| | - Aurélien Thomas
- Unit of Forensic Toxicology and Chemistry, CURML, Lausanne and Geneva University Hospitals, Geneva, Switzerland
- Faculty Unit of Toxicology, CURML, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Nynke I. Kramer
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
- Toxicology Division, Wageningen University, Wageningen, Netherlands
| | - Marie-Gabrielle Zurich
- Department of Biomedical Sciences, University of Lausanne, Lausanne, Switzerland
- Swiss Centre for Applied Human Toxicology (SCAHT), Basel, Switzerland
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Marques J, Rocha JV, Soares P, Leite A, Duarte R, Nunes C. The effect of TB patient delay on loss to follow-up in Portugal. Int J Tuberc Lung Dis 2023; 27:537-542. [PMID: 37353867 DOI: 10.5588/ijtld.22.0623] [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] [Indexed: 06/25/2023] Open
Abstract
BACKGROUND: Early identification of TB cases, followed by treatment to completion, are essential for controlling and preventing the disease. Previous studies have found some factors associated with both loss to follow-up (LTFU) and patient delay. We aim to build a causal model to investigate the association between TB patient delay and LTFU.METHODS: Pulmonary TB cases were identified using the national surveillance system in Portugal between 2008 and 2017. A directed acyclic graph was used to identify the minimal set of variables to adjust for when studying the association between delay (exposure) and LTFU (outcome). Crude and adjusted hazard were estimated using Cox regression.RESULTS: Nearly 4% of the patients did not follow up treatment. There was no association between patient delay and LTFU, even after adjustment with the minimal set of covariates. Factors associated with a higher risk of LTFU were being younger, being unemployed, living in urban areas, having HIV and the abuse of alcohol and drugs.CONCLUSION: Patient delay was not associated with LTFU, while social conditions were. Future research should investigate the underlying reasons why patients discontinue TB treatment and use these findings to develop targeted interventions that can support patients in completing their treatment regimen.
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Affiliation(s)
- J Marques
- Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - J V Rocha
- Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal, Comprehensive Health Research Centre, NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - P Soares
- Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal, Comprehensive Health Research Centre, NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - A Leite
- Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal, Comprehensive Health Research Centre, NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal, Department of Epidemiology, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal
| | - R Duarte
- EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal, Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal, Unidade de Investigação Clínica da ARS Norte, Porto, Portugal, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal, Serviço de Pneumologia, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - C Nunes
- Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal, Comprehensive Health Research Centre, NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
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Grounds GS, Dent H, Nunes C, Dhar V. Tubeless field anaesthesia for surgical removal of an aspirated endoscopy capsule. Anaesth Rep 2023; 11:e12242. [PMID: 37588044 PMCID: PMC10425334 DOI: 10.1002/anr3.12242] [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] [Accepted: 07/25/2023] [Indexed: 08/18/2023] Open
Abstract
Capsule endoscopy is a safe, minimally invasive procedure used to investigate gastrointestinal bleeding of unknown origin that persists or recurs after a negative initial endoscopy. The most common adverse effects of capsule endoscopy include abdominal pain, nausea and vomiting. Capsule pulmonary aspiration, although a rare complication, has been reported in the literature. Most reported cases resolve without further medical intervention. In these cases, the capsule is either expelled by coughing, or it re-enters the oropharynx and is then swallowed. In a small number of cases, the capsule remains in the lung, unable to be expectorated. This requires prompt diagnosis and emergency bronchoscopic removal under general anaesthesia. Due to the smooth, rounded surfaces of the capsule, it may be difficult to grasp, and consequently extraction may be technically challenging. The existing literature contains limited documentation on anaesthetic and surgical approaches for managing an aspirated endoscopy capsule. In this case report, we present the management of an aspirated endoscopy capsule in a district general hospital, in which thoracic surgery was not available. Local resources were used to manage this potentially life-threatening complication without patient transfer. In our case, we provided a tubeless field to optimise surgical access. This facilitated the successful surgical extraction of the endoscopy capsule from the left main bronchus.
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Affiliation(s)
- G. S. Grounds
- Department of AnaesthesiaKent and Canterbury HospitalCanterburyKentUK
| | - H. Dent
- Department of AnaesthesiaKent and Canterbury HospitalCanterburyKentUK
| | - C. Nunes
- Department of GastroenterologyKent and Canterbury HospitalCanterburyKentUK
| | - V. Dhar
- Department of Ear, Nose and Throat SurgeryWilliam Harvey HospitalAshfordKentUK
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Lopes C, Santos-Silva S, Nunes C, Mendes S, Costa C, Brazio E, Coutinho T, Rodrigues FT, Mesquita JR, Coelho AC, Cardoso L, Lopes AP. Morphologic and Genetic Analysis of Synhimantus ( Synhimantus) laticeps from a Long-Eared Owl ( Asio otus). Pathogens 2023; 12:pathogens12050717. [PMID: 37242387 DOI: 10.3390/pathogens12050717] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 05/11/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023] Open
Abstract
The long-eared owl (Asio otus) is a medium-sized owl species that is well-distributed in almost all of the territories in Portugal. Nematodes were found in the oral cavity of a long-eared owl (A. otus) admitted to CRASSA (Wildlife Rehabilitation Centre of Santo André). During a physical exam and stabilization of the bird, five nematodes were collected. The worms were examined and measured under light microscopy, and photos were taken. After a morphological analysis was conducted, all the nematodes (five females) were identified as Synhimantus (Synhimantus) laticeps. Two specimens were subjected to molecular analysis, which confirmed the result. This study provides a combined morphological and genetic approach to S. laticeps. To the authors' best knowledge, this is the first report including genetic sequencing of S. laticeps in a long-eared owl (A. otus) from Portugal.
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Affiliation(s)
- Carolina Lopes
- Wildlife Rehabilitation Centre of Santo André (CRASSA), Quercus, 7500-022 Vila Nova de Santo André, Portugal
| | - Sérgio Santos-Silva
- ICBAS-School of Medicine and Biomedical Sciences, Porto University, 4099-002 Porto, Portugal
| | - Carolina Nunes
- Wildlife Rehabilitation Centre of Santo André (CRASSA), Quercus, 7500-022 Vila Nova de Santo André, Portugal
| | | | | | - Erica Brazio
- Wildlife Rehabilitation Centre of Lisbon (LxCRAS), Parque Florestal de Monsanto, 1050-068 Lisboa, Portugal
| | - Teresa Coutinho
- Department of Veterinary Sciences, University of Trás-os-Montes e Alto Douro (UTAD), 5000-801 Vila Real, Portugal
| | - Filipa Teixeira Rodrigues
- Department of Veterinary Sciences, University of Trás-os-Montes e Alto Douro (UTAD), 5000-801 Vila Real, Portugal
- CECAV-Animal and Veterinary Centre, Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), University of Trás-os-Montes e Alto Douro (UTAD), 5000-801 Vila Real, Portugal
| | - João R Mesquita
- ICBAS-School of Medicine and Biomedical Sciences, Porto University, 4099-002 Porto, Portugal
- Epidemiology Research Unit (EPIUnit), Instituto de Saúde Pública da Universidade do Porto, 4050-600 Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), 4050-346 Porto, Portugal
| | - Ana Cláudia Coelho
- Department of Veterinary Sciences, University of Trás-os-Montes e Alto Douro (UTAD), 5000-801 Vila Real, Portugal
- CECAV-Animal and Veterinary Centre, Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), University of Trás-os-Montes e Alto Douro (UTAD), 5000-801 Vila Real, Portugal
| | - Luís Cardoso
- Department of Veterinary Sciences, University of Trás-os-Montes e Alto Douro (UTAD), 5000-801 Vila Real, Portugal
- CECAV-Animal and Veterinary Centre, Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), University of Trás-os-Montes e Alto Douro (UTAD), 5000-801 Vila Real, Portugal
| | - Ana Patrícia Lopes
- Department of Veterinary Sciences, University of Trás-os-Montes e Alto Douro (UTAD), 5000-801 Vila Real, Portugal
- CECAV-Animal and Veterinary Centre, Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), University of Trás-os-Montes e Alto Douro (UTAD), 5000-801 Vila Real, Portugal
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Pamies D, Vujić T, Schvartz D, Boccard J, Repond C, Nunes C, Rudaz S, Sanchez JC, González-Ruiz V, Zurich MG. Digoxin Induces Human Astrocyte Reaction In Vitro. Mol Neurobiol 2023; 60:84-97. [PMID: 36223047 PMCID: PMC9758102 DOI: 10.1007/s12035-022-03057-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 09/21/2022] [Indexed: 12/30/2022]
Abstract
Astrocyte reaction is a complex cellular process involving astrocytes in response to various types of CNS injury and a marker of neurotoxicity. It has been abundantly studied in rodents but relatively poorly in human cells due to limited access to the brain. Astrocytes play important roles in cerebral energy metabolism and are also key players in neuroinflammation. Astroglial metabolic and inflammatory changes have been reported with age, leading to the hypothesis that mitochondrial metabolism and inflammatory responses are interconnected. However, the relationship between energy metabolism and astrocyte reactivity in the context of neurotoxicity is not known. We hypothesized that changes in energy metabolism of astrocytes will be coupled to their activation by xenobiotics. Astrocyte reaction and associated energy metabolic changes were assessed by immunostaining, gene expression, proteomics, metabolomics, and extracellular flux analyses after 24 h of exposure of human ReN-derived astrocytes to digoxin (1-10 µM) or TNFα (30 ng/ml) used as a positive control. Strong astrocytic reaction was observed, accompanied by increased glycolysis at low concentrations of digoxin (0.1 and 0.5 µM) and after TNFα exposure, suggesting that increased glycolysis may be a common feature of reactive astrocytes, independent of the triggering molecule. In conclusion, whether astrocyte activation is triggered by cytokines or a xenobiotic, it is strongly tied to energy metabolism in human ReN-derived astrocytes. Increased glycolysis might be considered as an endpoint to detect astrocyte activation by potentially neurotoxic compounds in vitro. Finally, ReN-derived astrocytes may help to decipher mechanisms of neurotoxicity in ascertaining the ability of chemicals to directly target astrocytes.
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Affiliation(s)
- David Pamies
- Department of Biological Sciences, University of Lausanne, Lausanne, Switzerland ,School of Pharmaceutical Sciences and Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, Geneva, Switzerland
| | - Tatjana Vujić
- Swiss Centre for Applied Human Toxicology (SCAHT), Basel, Switzerland ,School of Pharmaceutical Sciences and Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, Geneva, Switzerland
| | - Domitille Schvartz
- Swiss Centre for Applied Human Toxicology (SCAHT), Basel, Switzerland ,School of Pharmaceutical Sciences and Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, Geneva, Switzerland
| | - Julien Boccard
- Translational Biomarker Group, Department of Medicine, University of Geneva, Geneva, Switzerland ,School of Pharmaceutical Sciences and Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, Geneva, Switzerland
| | - Cendrine Repond
- Department of Biological Sciences, University of Lausanne, Lausanne, Switzerland
| | - Carolina Nunes
- Department of Biological Sciences, University of Lausanne, Lausanne, Switzerland ,School of Pharmaceutical Sciences and Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, Geneva, Switzerland
| | - Serge Rudaz
- Translational Biomarker Group, Department of Medicine, University of Geneva, Geneva, Switzerland ,School of Pharmaceutical Sciences and Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, Geneva, Switzerland
| | - Jean-Charles Sanchez
- Swiss Centre for Applied Human Toxicology (SCAHT), Basel, Switzerland ,School of Pharmaceutical Sciences and Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, Geneva, Switzerland
| | - Víctor González-Ruiz
- Translational Biomarker Group, Department of Medicine, University of Geneva, Geneva, Switzerland ,School of Pharmaceutical Sciences and Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, Geneva, Switzerland
| | - Marie-Gabrielle Zurich
- Department of Biological Sciences, University of Lausanne, Lausanne, Switzerland ,School of Pharmaceutical Sciences and Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, Geneva, Switzerland
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11
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Alves J, Nunes C. Absence among National Health Service workers during the COVID-19 pandemic in Portugal. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac130.024] [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: 11/15/2022] Open
Abstract
Abstract
Background
By March 2020, the first Covid-19 cases were detected in Portugal. While the National Health Service (NHS) faced an increased demand for health care, anecdotal evidence showed that the NHS absenteeism rose. This might be explained by outbreaks in healthcare units, COVID-19 infection due to close contact with patients, self-isolation and quarantines, and family challenges originated by lockdowns. The present work aimed to quantify the absenteeism among NHS workers during the COVID-19 pandemic in Portugal.
Methods
This study used data for the number of NHS workers and absence days (2015-2021), from the Portuguese NHS Transparency Portal and the Strategy and Planning Office. Absenteeism was compared, before and after the pandemic onset, in absolute terms, and as absence rates (number of absent days as a percentage of potential workforce days). Additionally, we performed an interrupted time series analysis, by fitting a Poisson regression model with level change. We controlled for data seasonality using Fourier terms (pairs of sine and cosine functions).
Results
From 2015 until March 2020, the average monthly absence rate was of 12.2, rising to 14.4 in the remaining period. This represented an increase of 18% in the absence rate. The interrupted time series showed an increase of 10.8% in the NHS absenteeism after the pandemic onset [Relative risk =1.10; 95% confidence interval (CI) 1.10-1.11; p < 0.01]. When accounting for seasonality in the data, the model showed an increase of 11.0% in the NHS absenteeism [Relative risk =1.11; 95% CI 1.01-1.22; p < 0.05].
Conclusions
These results highlight the excess of absence days among the NHS workers during the COVID-19 pandemic. In future healthcare crises, health professionals should be protected, by assuring a safe workplace and making protective equipment available. Only then will be possible to reduce constraints in healthcare assistance, guarantee the adequate response, and contain the absence costs.
Key messages
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Affiliation(s)
- J Alves
- Public Health Research Centre, NOVA National School of Public Health , Lisbon, Portugal
- Comprehensive Health Research Centre, NOVA National School of Public Health , Lisbon, Portugal
| | - C Nunes
- Public Health Research Centre, NOVA National School of Public Health , Lisbon, Portugal
- Directorate-General of Health , Lisbon, Portugal
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12
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Nunes C, Depestel L, Mus L, Keller KM, Delhaye L, Louwagie A, Rishfi M, Whale A, Kara N, Andrews SR, Dela Cruz F, You D, Siddiquee A, Cologna CT, De Craemer S, Dolman E, Bartenhagen C, De Vloed F, Sanders E, Eggermont A, Bekaert SL, Van Loocke W, Bek JW, Dewyn G, Loontiens S, Van Isterdael G, Decaesteker B, Tilleman L, Van Nieuwerburgh F, Vermeirssen V, Van Neste C, Ghesquiere B, Goossens S, Eyckerman S, De Preter K, Fischer M, Houseley J, Molenaar J, De Wilde B, Roberts SS, Durinck K, Speleman F. RRM2 enhances MYCN-driven neuroblastoma formation and acts as a synergistic target with CHK1 inhibition. Sci Adv 2022; 8:eabn1382. [PMID: 35857500 PMCID: PMC9278860 DOI: 10.1126/sciadv.abn1382] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 05/26/2022] [Indexed: 05/06/2023]
Abstract
High-risk neuroblastoma, a pediatric tumor originating from the sympathetic nervous system, has a low mutation load but highly recurrent somatic DNA copy number variants. Previously, segmental gains and/or amplifications allowed identification of drivers for neuroblastoma development. Using this approach, combined with gene dosage impact on expression and survival, we identified ribonucleotide reductase subunit M2 (RRM2) as a candidate dependency factor further supported by growth inhibition upon in vitro knockdown and accelerated tumor formation in a neuroblastoma zebrafish model coexpressing human RRM2 with MYCN. Forced RRM2 induction alleviates excessive replicative stress induced by CHK1 inhibition, while high RRM2 expression in human neuroblastomas correlates with high CHK1 activity. MYCN-driven zebrafish tumors with RRM2 co-overexpression exhibit differentially expressed DNA repair genes in keeping with enhanced ATR-CHK1 signaling activity. In vitro, RRM2 inhibition enhances intrinsic replication stress checkpoint addiction. Last, combinatorial RRM2-CHK1 inhibition acts synergistic in high-risk neuroblastoma cell lines and patient-derived xenograft models, illustrating the therapeutic potential.
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Affiliation(s)
- Carolina Nunes
- Department of Biomolecular Medicine, Ghent University, Ghent, Belgium
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
| | - Lisa Depestel
- Department of Biomolecular Medicine, Ghent University, Ghent, Belgium
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
| | - Liselot Mus
- Department of Biomolecular Medicine, Ghent University, Ghent, Belgium
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
| | | | - Louis Delhaye
- Department of Biomolecular Medicine, Ghent University, Ghent, Belgium
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
- VIB-UGent Center for Medical Biotechnology, Ghent University, Ghent, Belgium
| | - Amber Louwagie
- Department of Biomolecular Medicine, Ghent University, Ghent, Belgium
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
| | - Muhammad Rishfi
- Department of Biomolecular Medicine, Ghent University, Ghent, Belgium
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
| | - Alex Whale
- Epigenetics Programme, Babraham Institute, Cambridge, UK
| | - Neesha Kara
- Epigenetics Programme, Babraham Institute, Cambridge, UK
| | | | - Filemon Dela Cruz
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Daoqi You
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Armaan Siddiquee
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Camila Takeno Cologna
- Metabolomics Expertise Center, Center for Cancer Biology (CCB), VIB, Leuven, Belgium
- Metabolomics Expertise Center, Department of Oncology, KU Leuven, Leuven, Belgium
| | - Sam De Craemer
- Metabolomics Expertise Center, Center for Cancer Biology (CCB), VIB, Leuven, Belgium
- Metabolomics Expertise Center, Department of Oncology, KU Leuven, Leuven, Belgium
| | - Emmy Dolman
- Princess Maxima Center, Utrecht, Netherlands
| | - Christoph Bartenhagen
- Center for Molecular Medicine Cologne, Cologne (CMMC), Medical Faculty, University of Cologne, Cologne, Germany
- Department of Experimental Pediatric Oncology, University Children’s Hospital of Cologne, Cologne, Germany
| | - Fanny De Vloed
- Department of Biomolecular Medicine, Ghent University, Ghent, Belgium
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
| | - Ellen Sanders
- Department of Biomolecular Medicine, Ghent University, Ghent, Belgium
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
| | - Aline Eggermont
- Department of Biomolecular Medicine, Ghent University, Ghent, Belgium
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
| | - Sarah-Lee Bekaert
- Department of Biomolecular Medicine, Ghent University, Ghent, Belgium
| | - Wouter Van Loocke
- Department of Biomolecular Medicine, Ghent University, Ghent, Belgium
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
| | - Jan Willem Bek
- Department of Biomolecular Medicine, Ghent University, Ghent, Belgium
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
| | - Givani Dewyn
- Department of Biomolecular Medicine, Ghent University, Ghent, Belgium
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
| | - Siebe Loontiens
- Department of Biomolecular Medicine, Ghent University, Ghent, Belgium
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
| | | | - Bieke Decaesteker
- Department of Biomolecular Medicine, Ghent University, Ghent, Belgium
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
| | - Laurentijn Tilleman
- NXTGNT, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | | | - Vanessa Vermeirssen
- Department of Biomolecular Medicine, Ghent University, Ghent, Belgium
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
- Department of Biomedical Molecular Biology, Ghent University, Ghent, Belgium
| | - Christophe Van Neste
- Department of Biomolecular Medicine, Ghent University, Ghent, Belgium
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
| | - Bart Ghesquiere
- Metabolomics Expertise Center, Center for Cancer Biology (CCB), VIB, Leuven, Belgium
- Metabolomics Expertise Center, Department of Oncology, KU Leuven, Leuven, Belgium
| | - Steven Goossens
- Department of Biomolecular Medicine, Ghent University, Ghent, Belgium
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
- Department of Diagnostic Sciences, Ghent University, Ghent, Belgium
| | - Sven Eyckerman
- Department of Biomolecular Medicine, Ghent University, Ghent, Belgium
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
- VIB-UGent Center for Medical Biotechnology, Ghent University, Ghent, Belgium
| | - Katleen De Preter
- Department of Biomolecular Medicine, Ghent University, Ghent, Belgium
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
| | - Matthias Fischer
- Center for Molecular Medicine Cologne, Cologne (CMMC), Medical Faculty, University of Cologne, Cologne, Germany
- Department of Experimental Pediatric Oncology, University Children’s Hospital of Cologne, Cologne, Germany
| | - Jon Houseley
- Epigenetics Programme, Babraham Institute, Cambridge, UK
| | | | - Bram De Wilde
- Department of Biomolecular Medicine, Ghent University, Ghent, Belgium
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
| | - Stephen S. Roberts
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Kaat Durinck
- Department of Biomolecular Medicine, Ghent University, Ghent, Belgium
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
| | - Frank Speleman
- Department of Biomolecular Medicine, Ghent University, Ghent, Belgium
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
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Soares P, Aguiar A, Leite A, Duarte R, Nunes C. Ecological factors associated with areas of high tuberculosis diagnosis delay. Public Health 2022; 208:32-39. [DOI: 10.1016/j.puhe.2022.04.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 04/04/2022] [Accepted: 04/27/2022] [Indexed: 10/18/2022]
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de Noronha N, Moniz M, Gama A, Laires PA, Goes AR, Pedro AR, Dias S, Soares P, Nunes C. Non-adherence to COVID-19 lockdown: who are they? A cross-sectional study in Portugal. Public Health 2022; 211:5-13. [PMID: 35988506 PMCID: PMC9271418 DOI: 10.1016/j.puhe.2022.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 06/21/2022] [Accepted: 07/04/2022] [Indexed: 11/15/2022]
Abstract
Objectives The SARS-CoV-2 virus has spread worldwide, leading governments to implement mitigation measures. Understanding the reluctance to adhere to non-pharmacological interventions might help promote adherence to these measures. This study aimed to identify factors associated with non-adherence to the first lockdown in Portugal. Study design Cross-sectional study. Methods This study used data from a Portuguese community-based survey entitled ‘COVID-19 Barometer: Social Opinion’. Data were collected on risk perception, health status and social experiences using a snowball sampling technique. The event of interest corresponded to participants who reported not staying home during the lockdown period, serving as a proxy for non-adherence to lockdown. Logistic regression was used to identify factors associated with non-adherence to the first lockdown. Results Responses from 133,601 individual questionnaires that were completed during the first week of the first lockdown in 2020 were analysed. A minority of participants (5.6%) reported non-adherence to lockdown (i.e. leaving home for reasons other than essential situations). Working in the workplace was the factor with the strongest association of non-adherence to the lockdown. Several other factors were also associated with non-adherence to the first lockdown; namely, being a man, being a student, having a low level of education, having a low income, living alone or with a high-infection-risk professional (e.g. doctor, nurse, pharmaceutical, health technician, firefighter, police officer, military, essential services worker), perceiving the risk of getting COVID-19 to be high, not having social support in case of infection, feeling agitated, sad or anxious every day, and considering the preventive measures to be unimportant or inadequate. Conclusions Non-adherence to lockdown was associated with socio-economic, trust and perception factors. Future research should investigate the mechanisms underlying these associations to help identify the population groups who are most at risk of non-adherence.
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Affiliation(s)
- N de Noronha
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal.
| | - M Moniz
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal; Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - A Gama
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal; Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - P A Laires
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal; Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - A R Goes
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal; Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - A R Pedro
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal; Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - S Dias
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal; Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - P Soares
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal; Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - C Nunes
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal; Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal
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15
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Gouveia-Fernandes S, Rodrigues A, Nunes C, Charneira C, Nunes J, Serpa J, Antunes AMM. Glycidamide and cis-2-butene-1,4-dial (BDA) as potential carcinogens and promoters of liver cancer - An in vitro study. Food Chem Toxicol 2022; 166:113251. [PMID: 35750087 DOI: 10.1016/j.fct.2022.113251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 06/15/2022] [Accepted: 06/18/2022] [Indexed: 10/18/2022]
Abstract
Acrylamide and furan are environmental and food contaminants that are metabolized by cytochrome P450 2E1 (CYP2E1), giving rise to glycidamide and cis-2-butene-1,4-dial (BDA) metabolites, respectively. Both glycidamide and BDA are electrophilic species that react with nucleophilic groups, being able to introduce mutations in DNA and perform epigenetic remodeling. However, whereas these carcinogens are primarily metabolized in the liver, the carcinogenic potential of acrylamide and furan in this organ is still controversial, based on findings from experimental animal studies. With the ultimate goal of providing further insights into this issue, we explored in vitro, using a hepatocyte cell line and a hepatocellular carcinoma cell line, the putative effect of these metabolites as carcinogens and cancer promoters. Molecular alterations were investigated in cells that survive glycidamide and BDA toxicity. We observed that those cells express CD133 stemness marker, present a high proliferative capacity and display an adjusted expression profile of genes encoding enzymes involved in oxidative stress control, such as GCL-C, GSTP1, GSTA3 and CAT. These molecular changes seem to be underlined, at least in part, by epigenetic remodeling involving histone deacetylases (HDACs). Although more studies are needed, here we present more insights towards the carcinogenic capacity of glycidamide and BDA and also point out their effect in favoring hepatocellular carcinoma progression.
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Affiliation(s)
- Sofia Gouveia-Fernandes
- NOVA Medical School Research, NOVA Medical School
- Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, Campo dos Mártires da Pátria, 130, 1169-056, Lisboa, Portugal; Instituto Português de Oncologia de Lisboa Francisco Gentil (IPOLFG), Rua Prof Lima Basto, 1099-023, Lisboa, Portugal
| | - Armanda Rodrigues
- NOVA Medical School Research, NOVA Medical School
- Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, Campo dos Mártires da Pátria, 130, 1169-056, Lisboa, Portugal; Instituto Português de Oncologia de Lisboa Francisco Gentil (IPOLFG), Rua Prof Lima Basto, 1099-023, Lisboa, Portugal
| | - Carolina Nunes
- NOVA Medical School Research, NOVA Medical School
- Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, Campo dos Mártires da Pátria, 130, 1169-056, Lisboa, Portugal; Instituto Português de Oncologia de Lisboa Francisco Gentil (IPOLFG), Rua Prof Lima Basto, 1099-023, Lisboa, Portugal
| | - Catarina Charneira
- Centro de Química Estrutural, Institute of Molecular Sciences, Departamento de Engenharia Química, Instituto Superior Técnico, Av. Rovisco Pais, 1049 001, Lisboa, Portugal
| | - João Nunes
- Centro de Química Estrutural, Institute of Molecular Sciences, Departamento de Engenharia Química, Instituto Superior Técnico, Av. Rovisco Pais, 1049 001, Lisboa, Portugal
| | - Jacinta Serpa
- NOVA Medical School Research, NOVA Medical School
- Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, Campo dos Mártires da Pátria, 130, 1169-056, Lisboa, Portugal; Instituto Português de Oncologia de Lisboa Francisco Gentil (IPOLFG), Rua Prof Lima Basto, 1099-023, Lisboa, Portugal.
| | - Alexandra M M Antunes
- Centro de Química Estrutural, Institute of Molecular Sciences, Departamento de Engenharia Química, Instituto Superior Técnico, Av. Rovisco Pais, 1049 001, Lisboa, Portugal.
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Magalhães R, Proenca MP, Araújo JP, Nunes C, Pereira AM, Sousa CT. Fabrication of FePt nanowires through pulsed electrodeposition into nanoporous alumina templates. Appl Nanosci 2022. [DOI: 10.1007/s13204-022-02454-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Nunes C, Gorczyca G, Mendoza-deGyves E, Ponti J, Bogni A, Carpi D, Bal-Price A, Pistollato F. Upscaling biological complexity to boost neuronal and oligodendroglia maturation and improve in vitro developmental neurotoxicity (DNT) evaluation. Reprod Toxicol 2022; 110:124-140. [PMID: 35378221 DOI: 10.1016/j.reprotox.2022.03.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 02/14/2022] [Accepted: 03/29/2022] [Indexed: 12/14/2022]
Abstract
Human induced pluripotent stem cell (iPSC)-derived neuronal and glial cell models are suitable to assess the effects of environmental chemicals on the developing brain. Such test systems can recapitulate several key neurodevelopmental features, such as neural stem cell formation and differentiation towards different neuronal subtypes and astrocytes, neurite outgrowth, synapse formation and neuronal network formation and function, which are crucial for brain development. While monolayer, two-dimensional (2D) cultures of human iPSC-neuronal or glial derivatives are generally suited for high-throughput testing, they also show some limitations. In particular, differentiation towards myelinating oligodendrocytes can only be achieved after extended periods in differentiation. In recent years, the implementation of three-dimensional (3D) neuronal and glial models obtained from human iPSCs has been shown to compensate for such limitations, enabling robust differentiation towards both neuronal and glial cell populations, myelination and formation of more mature neuronal network activity. Here we compared the differentiation capacity of human iPSC-derived neural stem cells cultured either as 2D monolayer or as 3D neurospheres, and assessed chlorpyrifos (CPF) effects. Data indicate that 3D neurospheres differentiate towards neurons and oligodendroglia more rapidly than 2D cultures; however, the 2D model is more suitable to assess neuronal functionality by analysis of spontaneous electrical activity using multielectrode array. Moreover, 2D and 3D test systems are diversely susceptible to CPF treatment. In conclusion, the selection of the most suitable in vitro test system (either 2D or 3D) should take into account the context of use and intended research goals ('fit for purpose' principle).
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Affiliation(s)
- Carolina Nunes
- Department of Biomedical Sciences, University of Lausanne, CH-1005 Lausanne, Switzerland
| | - Gabriela Gorczyca
- Department of Endocrinology, Institute of Zoology and Biomedical Research, Faculty of Biology, Jagiellonian University in Krakow, Kraków, Poland
| | | | - Jessica Ponti
- European Commission, Joint Research Centre (JRC), Ispra, Italy
| | - Alessia Bogni
- European Commission, Joint Research Centre (JRC), Ispra, Italy
| | - Donatella Carpi
- European Commission, Joint Research Centre (JRC), Ispra, Italy
| | - Anna Bal-Price
- European Commission, Joint Research Centre (JRC), Ispra, Italy
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18
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Nunes C, Singh P, Mazidi Z, Murphy C, Bourguignon A, Wellens S, Chandrasekaran V, Ghosh S, Zana M, Pamies D, Thomas A, Verfaillie C, Culot M, Dinnyes A, Hardy B, Wilmes A, Jennings P, Grillari R, Grillari J, Zurich MG, Exner T. An in vitro strategy using multiple human induced pluripotent stem cell-derived models to assess the toxicity of chemicals: A case study on paraquat. Toxicol In Vitro 2022; 81:105333. [PMID: 35182771 DOI: 10.1016/j.tiv.2022.105333] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 12/04/2021] [Accepted: 02/11/2022] [Indexed: 01/03/2023]
Abstract
Most OECD guidelines for chemical risk assessment include tests performed on animals, raising financial, ethical and scientific concerns. Thus, the development of human-based models for toxicity testing is highly encouraged. Here, we propose an in vitro multi-organ strategy to assess the toxicity of chemicals. Human induced pluripotent stem cells (hiPSCs)-derived models of the brain, blood-brain barrier, kidney, liver and vasculature were generated and exposed to paraquat (PQ), a widely employed herbicide with known toxic effects in kidneys and brain. The models showed differential cytotoxic sensitivity to PQ after acute exposure. TempO-Seq™ analysis with a set of 3565 probes revealed the deregulation of oxidative stress, unfolded protein response and Estrogen Receptor-mediated signaling pathways, in line with the existing knowledge on PQ mechanisms of action. The main advantages of this strategy are to assess chemical toxicity on multiple tissues/organs in parallel, exclusively in human cells, eliminating the interspecies bias, allowing a better evaluation of the differential sensitivity of the models representing the diverse organs, and increasing the chance to identify toxic compounds. Furthermore, although we focused on the mechanisms of action of PQ shared by the different models, this strategy would also allow for organ-specific toxicity testing, by including more cell type-specific probes for TempO-Seq analyses. In conclusion, we believe this strategy will participate in the further improvement of chemical risk assessment for human health.
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Affiliation(s)
- Carolina Nunes
- Department of Biomedical Sciences, University of Lausanne, Rue du Bugnon 7, 1005 Lausanne, Switzerland; Swiss Centre for Applied Human Toxicology (SCAHT), University of Basel, Missionsstrasse 64, 4055 Basel, Switzerland
| | - Pranika Singh
- Edelweiss Connect GmbH, Technology Park Basel, Hochbergerstrasse 60C, 4057 Basel, Switzerland; Division of Molecular and Systems Toxicology, Department of Pharmaceutical Sciences, University of Basel, Klingelbergstrasse 50, 4056 Basel, Switzerland
| | - Zahra Mazidi
- Evercyte GmbH, Vienna, Austria; Institute of Molecular Biotechnology, Department of Biotechnology, BOKU - University of Natural Resource and Life science (BOKU), Vienna, Austria
| | - Cormac Murphy
- Division of Molecular and Computational Toxicology, Department of Chemistry and Pharmaceutical Sciences, AIMMS, Vrije Universiteit Amsterdam, De Boelelaan 1108, 1081 HZ Amsterdam, the Netherlands
| | - Aurore Bourguignon
- BioTalentum Ltd, Gödöllő, Hungary; Department of Physiology and Animal Health, Institute of Physiology and Animal Nutrition, Hungarian University of Agriculture and Life Sciences, Gödöllö, Hungary
| | - Sara Wellens
- University of Artois, UR 2465, Laboratoire de la Barrière Hémato-Encéphalique (LBHE), Faculté des sciences Jean Perrin, Rue Jean Souvraz SP18, F-62300 Lens, France
| | - Vidya Chandrasekaran
- Division of Molecular and Computational Toxicology, Department of Chemistry and Pharmaceutical Sciences, AIMMS, Vrije Universiteit Amsterdam, De Boelelaan 1108, 1081 HZ Amsterdam, the Netherlands
| | - Sreya Ghosh
- Department of Development and Regeneration, Stem Cell Institute, KU Leuven, Leuven, Belgium
| | | | - David Pamies
- Department of Biomedical Sciences, University of Lausanne, Rue du Bugnon 7, 1005 Lausanne, Switzerland; Swiss Centre for Applied Human Toxicology (SCAHT), University of Basel, Missionsstrasse 64, 4055 Basel, Switzerland
| | - Aurélien Thomas
- Unit of Forensic Toxicology and Chemistry, CURML, Lausanne and Geneva University Hospitals, Geneva, Switzerland; Faculty Unit of Toxicology, CURML, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Catherine Verfaillie
- Department of Development and Regeneration, Stem Cell Institute, KU Leuven, Leuven, Belgium
| | - Maxime Culot
- University of Artois, UR 2465, Laboratoire de la Barrière Hémato-Encéphalique (LBHE), Faculté des sciences Jean Perrin, Rue Jean Souvraz SP18, F-62300 Lens, France
| | - Andras Dinnyes
- BioTalentum Ltd, Gödöllő, Hungary; Department of Physiology and Animal Health, Institute of Physiology and Animal Nutrition, Hungarian University of Agriculture and Life Sciences, Gödöllö, Hungary; Department of Cell Biology and Molecular Medicine, University of Szeged, Szeged, Hungary
| | - Barry Hardy
- Edelweiss Connect GmbH, Technology Park Basel, Hochbergerstrasse 60C, 4057 Basel, Switzerland
| | - Anja Wilmes
- Division of Molecular and Computational Toxicology, Department of Chemistry and Pharmaceutical Sciences, AIMMS, Vrije Universiteit Amsterdam, De Boelelaan 1108, 1081 HZ Amsterdam, the Netherlands
| | - Paul Jennings
- Division of Molecular and Computational Toxicology, Department of Chemistry and Pharmaceutical Sciences, AIMMS, Vrije Universiteit Amsterdam, De Boelelaan 1108, 1081 HZ Amsterdam, the Netherlands
| | | | - Johannes Grillari
- Evercyte GmbH, Vienna, Austria; Institute of Molecular Biotechnology, Department of Biotechnology, BOKU - University of Natural Resource and Life science (BOKU), Vienna, Austria; Ludwig Boltzmann Institute for Traumatology Research Center in cooperation with AUVA, Vienna, Austria
| | - Marie-Gabrielle Zurich
- Department of Biomedical Sciences, University of Lausanne, Rue du Bugnon 7, 1005 Lausanne, Switzerland; Swiss Centre for Applied Human Toxicology (SCAHT), University of Basel, Missionsstrasse 64, 4055 Basel, Switzerland.
| | - Thomas Exner
- Edelweiss Connect GmbH, Technology Park Basel, Hochbergerstrasse 60C, 4057 Basel, Switzerland; Seven Past Nine d.o.o., Hribljane 10, 1380 Cerknica, Slovenia.
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19
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Cardoso T, Rodrigues PP, Nunes C, Almeida M, Cancela J, Rosa F, Rocha-Pereira N, Ferreira I, Seabra-Pereira F, Vaz P, Carneiro L, Andrade C, Davis J, Marçal A, Friedman ND. Prospective international validation of the predisposition, infection, response and organ dysfunction (PIRO) clinical staging system among intensive care and general ward patients. Ann Intensive Care 2021; 11:180. [PMID: 34950977 PMCID: PMC8702585 DOI: 10.1186/s13613-021-00966-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 12/04/2021] [Indexed: 11/17/2022] Open
Abstract
Background Stratifying patients with sepsis was the basis of the predisposition, infection, response and organ dysfunction (PIRO) concept, an attempt to resolve the heterogeneity in treatment response. The purpose of this study is to perform an independent validation of the PIRO staging system in an international cohort and explore its utility in the identification of patients in whom time to antibiotic treatment is particularly important. Methods Prospective international cohort study, conducted over a 6-month period in five Portuguese hospitals and one Australian institution. All consecutive adult patients admitted to selected wards or the intensive care, with infections that met the CDC criteria for lower respiratory tract, urinary, intra-abdominal and bloodstream infections were included. Results There were 1638 patients included in the study. Patients who died in hospital presented with a higher PIRO score (10 ± 3 vs 8 ± 4, p < 0.001). The observed mortality was 3%, 15%, 24% and 34% in stage I, II, III and IV, respectively, which was within the predicted intervals of the original model, except for stage IV patients that presented a lower mortality. The hospital survival rate was 84%. The application of the PIRO staging system to the validation cohort resulted in a positive predictive value of 97% for stage I, 91% for stage II, 85% for stage III and 66% for stage IV. The area under the receiver operating characteristics curve (AUROC) was 0.75 for the all cohort and 0.70 if only patients with bacteremia were considered. Patients in stage III and IV who did not have antibiotic therapy administered within the desired time frame had higher mortality rate than those who have timely administration of antibiotic. Conclusions To our knowledge, this is the first external validation of this PIRO staging system and it performed well on different patient wards within the hospital and in different types of hospitals. Future studies could apply the PIRO system to decision-making about specific therapeutic interventions and enrollment in clinical trials based on disease stage. Supplementary Information The online version contains supplementary material available at 10.1186/s13613-021-00966-7.
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Affiliation(s)
- T Cardoso
- Intensive Care Unit (UCIP) and Hospital Infection Control Committee, Hospital de Santo António, Oporto University Hospital Center, University of Porto, Largo Prof. Abel Salazar, 4099-001, Porto, Portugal.
| | - P P Rodrigues
- Department of Community Medicine, Information and Health Decision Sciences & CINTESIS, Faculty of Medicine, University of Porto, Rua Dr. Plácido Costa, s/n, 4200-450, Porto, Portugal
| | - C Nunes
- Intensive Care Unit and Hospital Infection Control Committee, Hospital de Bragança, Northeastern Local Health Unit, Av. Abade Baçal, 5301-852, Bragança, Portugal
| | - M Almeida
- Neurocritical Care Unit and Hospital Infection Control Committee, Hospital de São Marcos, Sete Fontes - São Vitor, 4710-243, Braga, Portugal.,Intensive Care Unit (UCIP), Hospital de Santo António, Oporto University Hospital Center, Largo Prof. Abel Salazar, 4099-001, Porto, Portugal
| | - J Cancela
- Internal Medicine Department, Hospital Pedro Hispano, Matosinhos Local Health Unit, R. Dr. Eduardo Torres, Sra. da Hora, Portugal
| | - F Rosa
- Internal Medicine Department, Hospital Pedro Hispano, Matosinhos Local Health Unit, R. Dr. Eduardo Torres, Sra. da Hora, Portugal
| | - N Rocha-Pereira
- Infectious Diseases Department, São João Hospital Center, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
| | - I Ferreira
- Internal Medicine Department, Hospital de Santo António, Oporto University Hospital Center, Largo Prof. Abel Salazar, 4099-001, Porto, Portugal
| | - F Seabra-Pereira
- Intensive Care Unit (UCIP), Hospital de Santo António, Oporto University Hospital Center, Largo Prof. Abel Salazar, 4099-001, Porto, Portugal.,Intensive Care Unit and Internal Medicine Department, Hospital da Prelada, Rua de Sarmento de Beires, 4250-449, Porto, Portugal
| | - P Vaz
- Internal Medicine Department and Hospital Infection Control Committee, Hospital de Bragança, Northeastern Local Health Unit, Av. Abade Baçal, 5301-852, Bragança, Portugal
| | - L Carneiro
- Internal Medicine Department, Hospital Pedro Hispano, Matosinhos Local Health Unit, R. Dr. Eduardo Torres, Sra. da Hora, Portugal
| | - C Andrade
- Internal Medicine Department, Hospital Pedro Hispano, Matosinhos Local Health Unit, R. Dr. Eduardo Torres, Sra. da Hora, Portugal.,Internal Medicine Department, Hospital de Santo António, Oporto University Hospital Center, Largo Prof. Abel Salazar, 4099-001, Porto, Portugal
| | - J Davis
- Department of Renal Medicine, Barwon Health, Geelong, VIC, 3220, Australia
| | - A Marçal
- Internal Medicine Department, Hospital Pedro Hispano, Matosinhos Local Health Unit, R. Dr. Eduardo Torres, Sra. da Hora, Portugal.,Internal Medicine Department, Hospital de Santo António, Oporto University Hospital Center, Largo Prof. Abel Salazar, 4099-001, Porto, Portugal
| | - N D Friedman
- Department of Infectious Diseases, Barwon Health, Geelong, VIC, 3220, Australia
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20
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Almeida Santos J, Soares P, Leite A, Duarte R, Nunes C. Patient and healthcare delays in critical and non-critical pulmonary tuberculosis incidence areas in Portugal: are there differences? Public Health 2021; 201:41-47. [PMID: 34742116 DOI: 10.1016/j.puhe.2021.09.033] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 08/08/2021] [Accepted: 09/26/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVES To characterize patient, healthcare, and total delay in diagnosing pulmonary tuberculosis (PTB) in critical (higher PTB incidence) and non-critical (lower PTB incidence) areas and their determinants considering clinical and sociodemographic factors. STUDY DESIGN Retrospective cohort study. METHODS Data was retrieved from the Portuguese National Tuberculosis Surveillance System (SVIG-TB). Were included in the study all active PTB patients (n = 11,762) notified between 2008 and 2017. Spatial analysis was used to define critical and non-critical areas. Kaplan-Meier estimator, logrank test, and Cox regression were conducted, stratified by area. RESULTS PTB cases in critical areas (n = 6594, 56.1%) presented longer patient median delay (41 vs 31days), shorter healthcare median delay (7 vs 10 days), and longer total median delay (63 vs 61days) t.han non-critical areas. Patient and total delay increased in both areas over time, while healthcare delay only increased in non-critical areas. Icn both areas, being from a high TB incidence country and alcohol abuse were associated with longer patient delays. Being female, older age, and oncologic diseases were associated with longer healthcare delays. Respiratory diseases were only associated with a longer healthcare delay in non-critical areas. Being female, older, and from a high TB incidence country were associated with a longer total delay in both areas. CONCLUSIONS Patient delay was significantly longer in critical areas, and healthcare delay was significantly longer in non-critical areas. Several factors associated with longer delays have been identified, most of which are shared by critical and non-critical areas. Differences in patient and healthcare delay, for example, by sex, age, or country of birth, highlight the need for targeted public health interventions to help reduce these differences.
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Affiliation(s)
- J Almeida Santos
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560 Lisboa, Portugal; National Health Institute Dr. Ricardo Jorge, Avenida Padre Cruz, 1600-560 Lisboa, Portugal; Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria, 1169-056 Lisboa, Portugal.
| | - P Soares
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560 Lisboa, Portugal; Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria, 1169-056 Lisboa, Portugal.
| | - A Leite
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560 Lisboa, Portugal; Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria, 1169-056 Lisboa, Portugal.
| | - R Duarte
- Centro Hospitalar de Vila Nova de Gaia, Rua Conselheiro Veloso da Cruz, 4400-092 Vila Nova de Gaia, Portugal; Faculdade de Medicina da Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal.
| | - C Nunes
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560 Lisboa, Portugal; Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria, 1169-056 Lisboa, Portugal.
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21
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Goes AR, Soares P, Moniz M, Gama A, Pedro AR, Laires P, Dias S, Nunes C. Factors associated with motivation to avoid meeting family and friends during the COVID-19 pandemic. Eur J Public Health 2021. [PMCID: PMC8574604 DOI: 10.1093/eurpub/ckab164.850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background The widespread adherence to behaviours that prevent the transmission of the SARS-CoV-2 virus depends on human will. There is a paucity of research on the factors that influence adherence to social distancing. Available research suggests that it varies with the specific behaviour and that reducing contact with family and friends is the hardest one. This study aims to identify factors associated with motivation to avoid meeting with family and friends during the second lockdown of the COVID-19 pandemic in Portugal. Methods We used data from a community-based survey, “COVID-19 Barometer: Social Opinion”, which includes sociodemographics, psychosocial variables, and subjective health and wellbeing indicators from 20th February to 19th March 2021. We included 1336 participants who answered the question “To what extent is it easy for you to avoid visiting family and friends?”. Logistic regression analysis was used to identify factors associated with difficulty to avoid visiting family and friends. Results Preliminary data shows that 38.4% (513) had difficulties avoiding meeting with family and friends. Those with greater difficulty were the ones who have less education, higher negative emotionality, do not work remotely, have more difficulties to stay home and practice physical distancing and consider the Government's measures inadequate. Contrarily, those who have less difficulty avoiding visiting friends and family are older and have low risk perception of COVID-19 infection. Conclusions This study suggests higher difficulty in avoiding visiting friends and family for those whose routines demand not staying at home, with low agreement with Government measures, and struggle with higher negative emotionality, confirming the personal costs of these behaviours and the importance of habits. Older people had less difficulty, suggesting that these measures may be closer to their usual routines. Interventions should consider the specificities of social interaction. Key messages Social distancing comes at an enormous cost to people's livelihoods and it also depends on people living circumstances. Interventions to improve adherence to social distancing should consider the specificity of social interaction and the potential dissonance created by the overall routines.
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Affiliation(s)
- AR Goes
- Public Health Research Center, NOVA National School of Public Health, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - P Soares
- Public Health Research Center, NOVA National School of Public Health, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - M Moniz
- Public Health Research Center, NOVA National School of Public Health, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - A Gama
- Public Health Research Center, NOVA National School of Public Health, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - AR Pedro
- Public Health Research Center, NOVA National School of Public Health, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - P Laires
- Public Health Research Center, NOVA National School of Public Health, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - S Dias
- Public Health Research Center, NOVA National School of Public Health, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - C Nunes
- Public Health Research Center, NOVA National School of Public Health, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
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22
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Vales L, Soares P, Nunes C, Lopes S. Healthcare system delay and utilization in tuberculosis patients in Portuguese high-incidence region. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
In Portugal, the Tâmega e Sousa region (TeS) has a high incidence of tuberculosis (TB) [27.4 and 43.8 per 100.000 inhabitants in sub-regions Baixo Tâmega (BxT) and Vale do Sousa Sul (VSS), 2017]. Delay in TB diagnosis leads to increased transmission, which may lead to more people infected. This study aimed to describe healthcare system delay among TB patients and healthcare utilization from symptoms onset to diagnosis in TeS.
Methods
We analysed pulmonary TB cases notified in BxT and VSS in 2014-7 in the national surveillance system (SVIG-TB). Concomitantly, we analysed healthcare utilisation from patients in a retrospective study (URBAN-TB) about TB delays in 2019-20. We characterised demographics of patients from each data source and comorbidities from SVIG-TB. We calculated median overall delay until diagnosis (days); and healthcare delay overall and by patient characteristics, for each sub-region. Delay was calculated only when relevant dates were recorded. Healthcare utilisation from symptoms onset to diagnosis was described using the frequency of each first contact provider and the average number of visits until diagnosis.
Results
Included 139 patients from BxT and 206 from VSS (83% male, 53% aged 40-59y, and 17% with silicosis). Global delays were 48 and 75 days (n = 57/132; BxT and VSS). Healthcare delays were 7 and 8 days (n = 76/180; BxT and VSS). In both ACES, healthcare delays were longer for patients aged 60-79y, with COPD and aged 0-19y. Healthcare utilisation analysis included 38 patients (89% male; 55% aged 40-59y; n = 17/21). Primary care (n = 15; 39%) and emergency department (ED) (n = 9; 24%) were frequent points of first contact. The average number of visits until diagnosis was higher for patients from ED (3.9) and lower for patients from TB specialised units (1.3).
Conclusions
Our results suggest that in TeS it is important to avoid ED as a point of first contact of TB patients and to facilitate the diagnosis in young, older and COPD patients.
Key messages
Emergency department is a relevant point of first contact and may be included in efforts to reduce tuberculosis delay. Policies to reduce tuberculosis delay may target younger, older and COPD patients.
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Affiliation(s)
- L Vales
- NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - P Soares
- NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - C Nunes
- NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - S Lopes
- NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
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23
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Lopes S, Soares P, Gama A, Pedro AR, Moniz M, Laires P, Goes AR, Nunes C, Dias S. Factors associated with avoidance of emergency department visits in Portugal during the pandemic. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Avoiding an emergency department (ED) visit risks irreversible negative consequences for patients' health. EDs are a frequent access point to the Portuguese health system. Previous studies have shown that patients may avoid visiting ED during the pandemic. This study aims to identify factors associated with avoidance of ED visits in Portugal during the COVID-19 pandemic.
Methods
We used data from a community-based survey, “COVID-19 Barometer: Social Opinion”, which includes healthcare utilisation, health status, and risk perception in Portugal from 11th April 2020 to 16th April 2021. We included respondents that reported having needed ED care. Data were collected on sociodemographics, health status (comorbidities, mental health), risk perception (COVID-19 and complications), level of trust in health services and self-assessment of the severity of the reason for ED visit. The outcome of interest was the decision to avoid ED care. We used logistic regression to identify factors associated with the decision to avoid ED.
Results
Preliminary data showed that 914 respondents reported needing ED care (74.8% female; mean age 43 years). From those, 224 (25%) decided to avoid ED care. ED visits avoidance was higher during lockdowns (28%). People reporting specific comorbidities (cardiac, autoimmune, respiratory) avoided ED more than those without them. Perception of no severe reason for ED visit, poor mental health, perception of higher risk of COVID-19 and complications, and low trust in health services response to the pandemic were associated with higher odds of ED visit avoidance.
Conclusions
People avoiding ED visits represented a considerable share. The decision to avoid ED visit was associated with clinical characteristics, but the perception of risk and assessment of the context and health system response also played a role in decision making.
Key messages
The effect of avoided ED visits on health should be a research and policy concern. People with certain comorbidities or perception of high risk of COVID-19 and complications may be closely monitored.
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Affiliation(s)
- S Lopes
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - P Soares
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - A Gama
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - AR Pedro
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - M Moniz
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - P Laires
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - AR Goes
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - C Nunes
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - S Dias
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
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Almeida Santos J, Duarte R, Nunes C. The impact of age when screening for latent tuberculosis infection - is it a problem? Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Older population in developed countries represents a large reservoir of tuberculosis (TB) infection. Knowledge if age can contribute to false negative results in the immunological tests available for screening latent TB infections (LTBI) is critical to improve their usefulness in Public Health strategies for TB control. The aim of this study was to ascertain whether age was a risk factor for false negative (FN) results in the tuberculin skin test (TST) and in an interferon gamma release assay (IGRA).
Methods
Retrospective cohort study carried out using data from the Portuguese National Tuberculosis Surveillance system (2008-2015). Were included all active pulmonary TB cases with an IGRA (n = 597) and/or TST (n = 6185) result. TST outcomes were interpreted using a 5mm (TST-5mm) and 10mm (TST-10mm) cutoff. Logistic regression analysis crude and sex-adjusted was used to evaluate the association of age to the risk of FN results.
Results
Patients with a TST result presented a mean age of 42.7 years and patients with an IGRA result presented a median age of 45.5 years. TST-5mm, TST-10mm and IGRA had 36.5%, 43.9% and 24.5% FN results, respectively. Older patients presented a statistically significant association with the risk of FN TST results, regardless of using a 5mm [71-80years: OR 2.209; >80years: OR 2.491; p < 0.001] or 10mm [71-80years: OR 1.986; >80years: OR 2.308; p < 0.001] cut-off. Age was not a predictive factor for FN IGRA results. However, older patients presented a significant association with indeterminate IGRA results [71-80years: OR 3.808; >80years: OR 5.214; p < 0.001].
Conclusions
When using TST as part of the Public Health strategies for screening elderly patients, healthcare professionals should bear in mind that there is an increased risk of obtaining a FN result. On the other hand, age did not show an association with the occurrence of FN IGRA results, which suggests that this test could perform better when screening for LTBI in older patients.
Key messages
TST in elderly people is associated with false negative results thus, when using this test for screening for LTBI, a negative result should be interpreted with caution. IGRA was not associated with false negative results in elderly people, however indeterminate results can occur more frequently, thus performing better in this population group.
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Affiliation(s)
- J Almeida Santos
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
- National Health Institute Dr. Ricardo Jorge, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - R Duarte
- Centro Hospitalar de Vila Nova de Gaia, Vila Nova de Gaia, Portugal
- Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - C Nunes
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
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Almeida Santos J, Nunes C. Space-time analysis of pulmonary tuberculosis hospitalizations in mainland Portugal (2002-2016). Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.257] [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: 11/12/2022] Open
Abstract
Abstract
Background
Tuberculosis (TB) imposes a great pressure on healthcare resources, particularly in terms of hospital-based treatment and extended hospitalization. Understanding the space-time clustering of pulmonary TB (PTB) hospitalizations leads to a richer knowledge to assist decision makers in Public Health to develop strategic interventions to reduce these hospitalizations. Our objective was to identify space-time clusters of PTB hospitalizations at municipality level in mainland Portugal.
Methods
Ecologic study using data from nationwide hospitalization database of Portugal. All patients with a diagnosis of PTB (primary or secondary) and reference to place of residence were included in the study (n = 22760). Space-time analysis was used to define clusters with high rates of hospitalizations at the municipality level between 2002 and 2016.
Results
Overall hospitalization rate was 17.7/105population/year, with hospitalization rates decreasing by 64.9% during this period (2002:29.4/105; 2016:9.6/105). Space-time analysis of the overall period identified five different clusters, with the clusters in Lisboa and Porto metropolitan areas presenting the highest hospitalization rates (51.5/105 and 43.6/105population, respectively). In a more recent period (2011-2016), were identified four clusters with Lisboa metropolitan area and a northeast rural region presenting the highest hospitalization rates (27.6/105 and 46.2/105population, respectively).
Conclusions
PTB hospitalization rates in continental Portugal presented a constant decrease between 2002 and 2016. We identified a cluster of PTB hospitalizations in a rural region of northeast mainland Portugal, an area where the incidence of TB is below 20/105population. A closer look is needed to understand the reasons behind this high number of hospitalizations. Our results show that space-time analysis can be a resource to monitor the dynamic of the disease and identify possible areas needing Public Health intervention.
Key messages
Pulmonary tuberculosis hospitalizations are decreasing in mainland Portugal, with the two major urban areas (Lisboa and Porto) presenting the clusters with highest hospitalization rates. A cluster of hospitalizations for pulmonary tuberculosis was identified in a rural region in the northeast of mainland Portugal, an area with a low incidence of tuberculosis.
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Affiliation(s)
- J Almeida Santos
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
- National Health Institute Dr. Ricardo Jorge, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - C Nunes
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
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De Wyn J, Zimmerman MW, Weichert-Leahey N, Nunes C, Cheung BB, Abraham BJ, Beckers A, Volders PJ, Decaesteker B, Carter DR, Look AT, De Preter K, Van Loocke W, Marshall GM, Durbin AD, Speleman F, Durinck K. MEIS2 Is an Adrenergic Core Regulatory Transcription Factor Involved in Early Initiation of TH-MYCN-Driven Neuroblastoma Formation. Cancers (Basel) 2021; 13:cancers13194783. [PMID: 34638267 PMCID: PMC8508013 DOI: 10.3390/cancers13194783] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 09/20/2021] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Neuroblastoma is a pediatric tumor originating from the sympathetic nervous system responsible for 10–15% of all childhood cancer deaths. Half of all neuroblastoma patients present with high-risk disease, of which nearly 50% relapse and die of their disease. In addition, standard therapies cause serious lifelong side effects and increased risk for secondary tumors. Further research is crucial to better understand the molecular basis of neuroblastomas and to identify novel druggable targets. Neuroblastoma tumorigenesis has to this end been modeled in both mice and zebrafish. Here, we present a detailed dissection of the gene expression patterns that underlie tumor formation in the murine TH-MYCN-driven neuroblastoma model. We identified key factors that are putatively important for neuroblastoma tumor initiation versus tumor progression, pinpointed crucial regulators of the observed expression patterns during neuroblastoma development and scrutinized which factors could be innovative and vulnerable nodes for therapeutic intervention. Abstract Roughly half of all high-risk neuroblastoma patients present with MYCN amplification. The molecular consequences of MYCN overexpression in this aggressive pediatric tumor have been studied for decades, but thus far, our understanding of the early initiating steps of MYCN-driven tumor formation is still enigmatic. We performed a detailed transcriptome landscaping during murine TH-MYCN-driven neuroblastoma tumor formation at different time points. The neuroblastoma dependency factor MEIS2, together with ASCL1, was identified as a candidate tumor-initiating factor and shown to be a novel core regulatory circuit member in adrenergic neuroblastomas. Of further interest, we found a KEOPS complex member (gm6890), implicated in homologous double-strand break repair and telomere maintenance, to be strongly upregulated during tumor formation, as well as the checkpoint adaptor Claspin (CLSPN) and three chromosome 17q loci CBX2, GJC1 and LIMD2. Finally, cross-species master regulator analysis identified FOXM1, together with additional hubs controlling transcriptome profiles of MYCN-driven neuroblastoma. In conclusion, time-resolved transcriptome analysis of early hyperplastic lesions and full-blown MYCN-driven neuroblastomas yielded novel components implicated in both tumor initiation and maintenance, providing putative novel drug targets for MYCN-driven neuroblastoma.
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Affiliation(s)
- Jolien De Wyn
- Department for Biomolecular Medicine, Ghent University, Medical Research Building (MRB1), Corneel Heymanslaan 10, B-9000 Ghent, Belgium; (J.D.W.); (C.N.); (A.B.); (P.-J.V.); (B.D.); (K.D.P.); (W.V.L.); (F.S.)
| | - Mark W. Zimmerman
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02215, USA; (M.W.Z.); (N.W.-L.); (A.T.L.)
| | - Nina Weichert-Leahey
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02215, USA; (M.W.Z.); (N.W.-L.); (A.T.L.)
| | - Carolina Nunes
- Department for Biomolecular Medicine, Ghent University, Medical Research Building (MRB1), Corneel Heymanslaan 10, B-9000 Ghent, Belgium; (J.D.W.); (C.N.); (A.B.); (P.-J.V.); (B.D.); (K.D.P.); (W.V.L.); (F.S.)
| | - Belamy B. Cheung
- Lowy Cancer Research Centre, Children’s Cancer Institute Australia for Medical Research, UNSW Sydney, Randwick, NSW 2031, Australia; (B.B.C.); (D.R.C.); (G.M.M.)
- School of Women’s and Children’s Health, UNSW Sydney, Randwick, NSW 2031, Australia
| | - Brian J. Abraham
- Department of Computational Biology, St. Jude Children’s Research Hospital, Memphis, TN 38105-3678, USA;
| | - Anneleen Beckers
- Department for Biomolecular Medicine, Ghent University, Medical Research Building (MRB1), Corneel Heymanslaan 10, B-9000 Ghent, Belgium; (J.D.W.); (C.N.); (A.B.); (P.-J.V.); (B.D.); (K.D.P.); (W.V.L.); (F.S.)
| | - Pieter-Jan Volders
- Department for Biomolecular Medicine, Ghent University, Medical Research Building (MRB1), Corneel Heymanslaan 10, B-9000 Ghent, Belgium; (J.D.W.); (C.N.); (A.B.); (P.-J.V.); (B.D.); (K.D.P.); (W.V.L.); (F.S.)
| | - Bieke Decaesteker
- Department for Biomolecular Medicine, Ghent University, Medical Research Building (MRB1), Corneel Heymanslaan 10, B-9000 Ghent, Belgium; (J.D.W.); (C.N.); (A.B.); (P.-J.V.); (B.D.); (K.D.P.); (W.V.L.); (F.S.)
| | - Daniel R. Carter
- Lowy Cancer Research Centre, Children’s Cancer Institute Australia for Medical Research, UNSW Sydney, Randwick, NSW 2031, Australia; (B.B.C.); (D.R.C.); (G.M.M.)
- School of Biomedical Engineering, University of Technology Sydney, Ultimo, NSW 2007, Australia
| | - Alfred Thomas Look
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02215, USA; (M.W.Z.); (N.W.-L.); (A.T.L.)
| | - Katleen De Preter
- Department for Biomolecular Medicine, Ghent University, Medical Research Building (MRB1), Corneel Heymanslaan 10, B-9000 Ghent, Belgium; (J.D.W.); (C.N.); (A.B.); (P.-J.V.); (B.D.); (K.D.P.); (W.V.L.); (F.S.)
| | - Wouter Van Loocke
- Department for Biomolecular Medicine, Ghent University, Medical Research Building (MRB1), Corneel Heymanslaan 10, B-9000 Ghent, Belgium; (J.D.W.); (C.N.); (A.B.); (P.-J.V.); (B.D.); (K.D.P.); (W.V.L.); (F.S.)
| | - Glenn M. Marshall
- Lowy Cancer Research Centre, Children’s Cancer Institute Australia for Medical Research, UNSW Sydney, Randwick, NSW 2031, Australia; (B.B.C.); (D.R.C.); (G.M.M.)
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
| | - Adam D. Durbin
- Department of Oncology, Division of Molecular Oncology, St. Jude Children’s Research Hospital, Memphis, TN 38105-3678, USA;
| | - Frank Speleman
- Department for Biomolecular Medicine, Ghent University, Medical Research Building (MRB1), Corneel Heymanslaan 10, B-9000 Ghent, Belgium; (J.D.W.); (C.N.); (A.B.); (P.-J.V.); (B.D.); (K.D.P.); (W.V.L.); (F.S.)
| | - Kaat Durinck
- Department for Biomolecular Medicine, Ghent University, Medical Research Building (MRB1), Corneel Heymanslaan 10, B-9000 Ghent, Belgium; (J.D.W.); (C.N.); (A.B.); (P.-J.V.); (B.D.); (K.D.P.); (W.V.L.); (F.S.)
- Correspondence: ; Tel.: +32-9-332-24-51
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Durinck K, Zimmerman M, Weichert-Leahey N, Dewyn J, Van Loocke W, Nunes C, Beckers A, Decaesteker B, Volders PJ, Van Neste C, Cheung B, Carter D, Look TA, Marshall G, De Preter K, Durbin A, Speleman F. Abstract 2481: Time-resolved transcriptome analysis of murine TH-MYCN driven neuroblastoma identifies MEIS2 as early initiating factor and novel core gene regulatory circuitry constituent. Cancer Res 2021. [DOI: 10.1158/1538-7445.am2021-2481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: Neuroblastoma (NB) is a pediatric malignancy arising from peripheral neuronal sympathoblasts and exhibiting remarkable clinical and genetic heterogeneity. Patients older than 18 months have a poor prognosis with tumors presenting with highly recurrent segmental copy number alterations and MYCN amplification in half of these high-risk cases. The mechanism by which MYCN contributes to the development of neuroblastoma is unresolved and direct targeting of this key oncogene is not currently possible.
Experimental Procedures: Our discovery efforts focused on identifying cooperating interactors and vulnerabilities in the MYCN regulatory network. MYCN-driven NBs can be modeled in mice with morphologic and genomic features that recapitulate human MYCN amplified NBs. Thus, this model serves as a valid tool for cross-species genomic analysis. Using this model, we performed a time-resolved analysis of the dynamic transcriptional changes of protein coding genes during murine TH-MYCN driven neuroblastoma development, focusing on timepoints representing tumor initiation and early tumor growth. We triangulated expression changes of key genes with publicly available exome-wide CRISPR-cas9 knockout analyses on a panel of human neuroblastoma cell lines and patient survival data. This unique data resource uncovered the relevance of MEIS2 as putative early cooperating initiating factor for neuroblastoma. Analysis of the genome-wide binding profile of MEIS2 in MYCN-amplified NB cell lines showed a striking overlap with enhancer-driven gene expression in regions of open chromatin, providing evidence that MEIS2 is a novel member of the adrenergic neuroblastoma core-regulatory circuitry. CRISPR-Cas9 mediated deletion of MEIS2 in animal models suppresses establishment of neuroblastoma tumors, indicating its putative requirement for tumor initiation. MEIS2, as a member of the CRC binds to several master regulators of gene expression, including the FOXM1 locus.
Summary and conclusion: In conclusion, we present an in-depth characterization of the dynamic transcriptome profiles of TH-MYCN driven murine premalignant and established tumors and integrate with both primary human neuroblastoma tumor expression data, epigenetic and functional genomics data to identify and validate candidate cooperating dependencies suitable for targeting as a precision medicine approach in neuroblastoma.
Citation Format: Kaat Durinck, Mark Zimmerman, Nina Weichert-Leahey, Jolien Dewyn, Wouter Van Loocke, Carolina Nunes, Anneleen Beckers, Bieke Decaesteker, Pieter-Jan Volders, Christophe Van Neste, Belamy Cheung, Daniel Carter, Thomas A. Look, Glenn Marshall, Katleen De Preter, Adam Durbin, Franki Speleman. Time-resolved transcriptome analysis of murine TH-MYCN driven neuroblastoma identifies MEIS2 as early initiating factor and novel core gene regulatory circuitry constituent [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 2481.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Belamy Cheung
- 3Children's Cancer institute Australia for Medical Research, Sydney, Australia
| | - Daniel Carter
- 3Children's Cancer institute Australia for Medical Research, Sydney, Australia
| | | | - Glenn Marshall
- 3Children's Cancer institute Australia for Medical Research, Sydney, Australia
| | | | - Adam Durbin
- 4St. Jude Children's Research Hospital, Memphis, TN
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Cruz L, Silva A, Lopes J, Damas D, Lourenço J, Costa A, Silva F, Sousa J, Galego O, Nunes C, Veiga R, Machado C, Rodrigues B, Cecilia C, Almendra L, Bras A, Santo G, Machado E, Sargento-Freitas J. Early Cerebrovascular Ultrasonography as a Predictor of Hemorrhagic Transformation After Thrombectomy. J Stroke Cerebrovasc Dis 2021; 30:105922. [PMID: 34157670 DOI: 10.1016/j.jstrokecerebrovasdis.2021.105922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 03/25/2021] [Accepted: 05/26/2021] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVES To determine the predictive value of early transcranial color-coded sonography (TCCS) for intracranial hemorrhage (ICH) in patients with large artery occlusion (LAO) stroke of carotid circulation, who were submitted to endovascular therapy (EVT) with successful reperfusion. MATERIALS AND METHODS Retrospective study evaluating a cohort of consecutive stroke patients with LAO of the carotid circulation that were recanalyzed with EVT. We measured angle-corrected peak systolic velocities, end-diastolic velocities and mean flow velocities (PSV, EDV and MFV) of the symptomatic and asymptomatic middle cerebral artery (MCA). The ratio between MFV of the symptomatic MCA and MFV of the asymptomatic MCA (MCA-Ra) was calculated. Parenchymal hematoma in the 24 hours control CT was considered as ICH. Univariate associations and multivariate analyses were used to identify early independent predictors for ICH among TCCS findings. RESULTS We included 234 patients, mean age 72.5 (SD 12.6) years, 52.1% male. The mean time between recanalization and TCCS was 12.3 hours (range 3-22). Patients who developed postinterventional ICH showed a higher MCA-Ra (1.02 ± 0.26 vs 1.16 ± 0,21, p = 0.036). In multivariate analysis, only higher MCA-Ra remained independently associated with postinterventional ICH (OR: 6.778, 95%CI: 1.152-39.892, p = 0.034). A value of MCA-Ra ≥ 1,05 was associated with ICH, showing a sensitivity of 81.3% and a specificity of 65.9%; the AUC based of the ROC analysis was 0.688 (95% CI 0.570-0.806). CONCLUSION TCCS performed within the first 24 hours after stroke onset can help to predict hemorrhagic transformation in patients with LAO.
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Affiliation(s)
- L Cruz
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - A Silva
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - J Lopes
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - D Damas
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - J Lourenço
- Faculdade de Medicina da Universidade de Coimbra, Coimbra, Portugal
| | - A Costa
- Faculdade de Medicina da Universidade de Coimbra, Coimbra, Portugal
| | - F Silva
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - J Sousa
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - O Galego
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - C Nunes
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - R Veiga
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - C Machado
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - B Rodrigues
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - C Cecilia
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - L Almendra
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - A Bras
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - G Santo
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - E Machado
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - J Sargento-Freitas
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Faculdade de Medicina da Universidade de Coimbra, Coimbra, Portugal
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Pamies D, Sartori C, Schvartz D, González-Ruiz V, Pellerin L, Nunes C, Tavel D, Maillard V, Boccard J, Rudaz S, Sanchez JC, Zurich MG. Neuroinflammatory Response to TNFα and IL1β Cytokines Is Accompanied by an Increase in Glycolysis in Human Astrocytes In Vitro. Int J Mol Sci 2021; 22:4065. [PMID: 33920048 PMCID: PMC8071021 DOI: 10.3390/ijms22084065] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/02/2021] [Accepted: 04/06/2021] [Indexed: 01/11/2023] Open
Abstract
Astrogliosis has been abundantly studied in rodents but relatively poorly in human cells due to limited access to the brain. Astrocytes play important roles in cerebral energy metabolism, and are also key players in neuroinflammation. Astroglial metabolic and inflammatory changes as a function of age have been reported, leading to the hypothesis that mitochondrial metabolism and inflammatory responses are interconnected in supporting a functional switch of astrocytes from neurotrophic to neurotoxic. This study aimed to explore the metabolic changes occurring in astrocytes during their activation. Astrocytes were derived from human ReN cell neural progenitors and characterized. They were activated by exposure to tumor necrosis factor alpha (TNFα) or interleukin 1β (IL1β) for 24 h. Astrocyte reaction and associated energy metabolic changes were assessed by immunostaining, gene expression, proteomics, metabolomics and extracellular flux analyses. ReN-derived astrocytes reactivity was observed by the modifications of genes and proteins linked to inflammation (cytokines, nuclear factor-kappa B (NFκB), signal transducers and activators of transcription (STATs)) and immune pathways (major histocompatibility complex (MHC) class I). Increased NFκB1, NFκB2 and STAT1 expression, together with decreased STAT3 expression, suggest an activation towards the detrimental pathway. Strong modifications of astrocyte cytoskeleton were observed, including a glial fibrillary acidic protein (GFAP) decrease. Astrogliosis was accompanied by changes in energy metabolism characterized by increased glycolysis and lactate release. Increased glycolysis is reported for the first time during human astrocyte activation. Astrocyte activation is strongly tied to energy metabolism, and a possible association between NFκB signaling and/or MHC class I pathway and glycolysis is suggested.
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Affiliation(s)
- David Pamies
- Department of Biomedical Sciences, University of Lausanne, CH-1005 Lausanne, Switzerland; (D.P.); (C.S.); (L.P.); (C.N.); (D.T.); (V.M.)
- Swiss Centre for Applied Human Toxicology (SCAHT), 4055 Basel, Switzerland; (D.S.); (V.G.-R.); (J.B.); (S.R.); (J.-C.S.)
| | - Chiara Sartori
- Department of Biomedical Sciences, University of Lausanne, CH-1005 Lausanne, Switzerland; (D.P.); (C.S.); (L.P.); (C.N.); (D.T.); (V.M.)
| | - Domitille Schvartz
- Swiss Centre for Applied Human Toxicology (SCAHT), 4055 Basel, Switzerland; (D.S.); (V.G.-R.); (J.B.); (S.R.); (J.-C.S.)
- Translational Biomarker Group, Department of Internal Medicine Specialties, University of Geneva, CH-1211 Genève, Switzerland
| | - Víctor González-Ruiz
- Swiss Centre for Applied Human Toxicology (SCAHT), 4055 Basel, Switzerland; (D.S.); (V.G.-R.); (J.B.); (S.R.); (J.-C.S.)
- Analytical Sciences, Institute of Pharmaceutical Sciences of Western Switzerland and School of Pharmaceutical Sciences, University of Geneva, CH-1211 Genève, Switzerland
| | - Luc Pellerin
- Department of Biomedical Sciences, University of Lausanne, CH-1005 Lausanne, Switzerland; (D.P.); (C.S.); (L.P.); (C.N.); (D.T.); (V.M.)
- INSERM U1082, Faculté de Médecine et de Pharmacie, Université de Poitiers, F-86021 Poitiers, France
| | - Carolina Nunes
- Department of Biomedical Sciences, University of Lausanne, CH-1005 Lausanne, Switzerland; (D.P.); (C.S.); (L.P.); (C.N.); (D.T.); (V.M.)
- Swiss Centre for Applied Human Toxicology (SCAHT), 4055 Basel, Switzerland; (D.S.); (V.G.-R.); (J.B.); (S.R.); (J.-C.S.)
| | - Denise Tavel
- Department of Biomedical Sciences, University of Lausanne, CH-1005 Lausanne, Switzerland; (D.P.); (C.S.); (L.P.); (C.N.); (D.T.); (V.M.)
- Swiss Centre for Applied Human Toxicology (SCAHT), 4055 Basel, Switzerland; (D.S.); (V.G.-R.); (J.B.); (S.R.); (J.-C.S.)
| | - Vanille Maillard
- Department of Biomedical Sciences, University of Lausanne, CH-1005 Lausanne, Switzerland; (D.P.); (C.S.); (L.P.); (C.N.); (D.T.); (V.M.)
- Swiss Centre for Applied Human Toxicology (SCAHT), 4055 Basel, Switzerland; (D.S.); (V.G.-R.); (J.B.); (S.R.); (J.-C.S.)
| | - Julien Boccard
- Swiss Centre for Applied Human Toxicology (SCAHT), 4055 Basel, Switzerland; (D.S.); (V.G.-R.); (J.B.); (S.R.); (J.-C.S.)
- Analytical Sciences, Institute of Pharmaceutical Sciences of Western Switzerland and School of Pharmaceutical Sciences, University of Geneva, CH-1211 Genève, Switzerland
| | - Serge Rudaz
- Swiss Centre for Applied Human Toxicology (SCAHT), 4055 Basel, Switzerland; (D.S.); (V.G.-R.); (J.B.); (S.R.); (J.-C.S.)
- Analytical Sciences, Institute of Pharmaceutical Sciences of Western Switzerland and School of Pharmaceutical Sciences, University of Geneva, CH-1211 Genève, Switzerland
| | - Jean-Charles Sanchez
- Swiss Centre for Applied Human Toxicology (SCAHT), 4055 Basel, Switzerland; (D.S.); (V.G.-R.); (J.B.); (S.R.); (J.-C.S.)
- Translational Biomarker Group, Department of Internal Medicine Specialties, University of Geneva, CH-1211 Genève, Switzerland
| | - Marie-Gabrielle Zurich
- Department of Biomedical Sciences, University of Lausanne, CH-1005 Lausanne, Switzerland; (D.P.); (C.S.); (L.P.); (C.N.); (D.T.); (V.M.)
- Swiss Centre for Applied Human Toxicology (SCAHT), 4055 Basel, Switzerland; (D.S.); (V.G.-R.); (J.B.); (S.R.); (J.-C.S.)
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Jácome C, Almeida R, Pereira AM, Araújo L, Correia MA, Pereira M, Couto M, Lopes C, Chaves Loureiro C, Catarata MJ, Santos LM, Ramos B, Mendes A, Pedro E, Cidrais Rodrigues JC, Oliveira G, Aguiar AP, Arrobas AM, Costa J, Dias J, Todo Bom A, Azevedo J, Ribeiro C, Alves M, Pinto PL, Neuparth N, Palhinha A, Marques JG, Martins P, Trincão D, Neves A, Todo Bom F, Santos MA, Branco J, Loyoza C, Costa A, Silva Neto A, Silva D, Vasconcelos MJ, Teixeira MF, Ferreira-Magalhães M, Taborda Barata L, Carvalhal C, Santos N, Sofia Pinto C, Rodrigues Alves R, Moreira AS, Morais Silva P, Fernandes R, Ferreira R, Alves C, Câmara R, Ferraz de Oliveira J, Bordalo D, Calix MJ, Marques A, Nunes C, Menezes F, Gomes R, Almeida Fonseca J. Asthma App Use and Interest Among Patients With Asthma: A Multicenter Study. J Investig Allergol Clin Immunol 2021; 30:137-140. [PMID: 32327403 DOI: 10.18176/jiaci.0456] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- C Jácome
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto (FMUP), Porto, Portugal
| | - R Almeida
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto (FMUP), Porto, Portugal
| | - A M Pereira
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto (FMUP), Porto, Portugal.,Allergy Unit, Instituto and Hospital CUF, Porto, Portugal
| | - L Araújo
- Allergy Unit, Instituto and Hospital CUF, Porto, Portugal
| | - M A Correia
- Allergy Unit, Instituto and Hospital CUF, Porto, Portugal
| | - M Pereira
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto (FMUP), Porto, Portugal.,MEDIDA - Medicina, Educação, Investigação, Desenvolvimento e Avaliação, Porto, Portugal
| | - M Couto
- Allergy Unit, Instituto and Hospital CUF, Porto, Portugal
| | - C Lopes
- Unidade de Imunoalergologia, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal.,Imunologia Básica e Clínica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - C Chaves Loureiro
- Serviço de Pneumologia A, Hospital Universitário de Coimbra, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - M J Catarata
- Serviço de Pneumologia A, Hospital Universitário de Coimbra, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - L M Santos
- Serviço de Pneumologia A, Hospital Universitário de Coimbra, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - B Ramos
- Serviço de Pneumologia A, Hospital Universitário de Coimbra, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - A Mendes
- Serviço de Imunoalergologia, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisboa, Portugal
| | - E Pedro
- Serviço de Imunoalergologia, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisboa, Portugal
| | - J C Cidrais Rodrigues
- Serviço de Pediatria, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal
| | - G Oliveira
- Serviço de Pediatria, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal
| | - A P Aguiar
- Serviço de Pediatria, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal
| | - A M Arrobas
- Serviço de Pneumologia B, Hospital Geral, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - J Costa
- Serviço de Pneumologia B, Hospital Geral, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - J Dias
- Serviço de Pneumologia B, Hospital Geral, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - A Todo Bom
- Serviço de Imunoalergologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - J Azevedo
- Serviço de Imunoalergologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - C Ribeiro
- Serviço de Imunoalergologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - M Alves
- Serviço de Imunoalergologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - P L Pinto
- Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
| | - N Neuparth
- Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal.,Pathophysiology, CEDOC, Integrated Pathophysiological Mechanisms Research Group, Nova Medical School, Lisboa, Portugal
| | - A Palhinha
- Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
| | - J G Marques
- Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
| | - P Martins
- Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal.,Pathophysiology, CEDOC, Integrated Pathophysiological Mechanisms Research Group, Nova Medical School, Lisboa, Portugal
| | - D Trincão
- Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
| | - A Neves
- Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
| | - F Todo Bom
- Serviço de Pneumologia, Hospital Beatriz Ângelo, Loures, Portugal
| | - M A Santos
- Serviço de Pneumologia, Hospital Beatriz Ângelo, Loures, Portugal
| | - J Branco
- Serviço de Pneumologia, Hospital Beatriz Ângelo, Loures, Portugal
| | - C Loyoza
- Serviço de Imunoalergologia, Hospital Amato Lusitano, Unidade Local de Saúde de Castelo Branco, Castelo Branco, Portugal
| | - A Costa
- Serviço de Pediatria, Hospital da Senhora da Oliveira, Guimarães, Portugal
| | - A Silva Neto
- Serviço de Pediatria, Hospital da Senhora da Oliveira, Guimarães, Portugal
| | - D Silva
- Serviço de Imunoalergologia, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - M J Vasconcelos
- Serviço de Imunoalergologia, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - M F Teixeira
- Serviço de Pediatria, Centro Materno Infantil do Norte, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - M Ferreira-Magalhães
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto (FMUP), Porto, Portugal.,Serviço de Pediatria, Centro Materno Infantil do Norte, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - L Taborda Barata
- Serviço de Imunoalergologia, Hospital Pêro da Covilhã, Centro Hospitalar Universitário Cova da Beira, Covilhã, Portugal
| | - C Carvalhal
- Serviço de Imunoalergologia, Hospital Pêro da Covilhã, Centro Hospitalar Universitário Cova da Beira, Covilhã, Portugal
| | - N Santos
- Serviço de Imunoalergologia, Centro Hospitalar Universitário do Algarve, Portimão, Portugal
| | - C Sofia Pinto
- Serviço de Pneumologia, Hospital São Pedro de Vila Real, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - R Rodrigues Alves
- Unidade de Imunoalergologia, Hospital do Divino Espirito Santo, Ponta Delgada, Portugal
| | - A S Moreira
- Unidade de Imunoalergologia, Hospital do Divino Espirito Santo, Ponta Delgada, Portugal
| | | | - R Fernandes
- Serviço de Pediatria, Departamento de Pediatria, Hospital de Santa Maria, Centro Hospitalar Universitário de Lisboa Norte, Lisboa, Portugal.,Laboratório de Farmacologia Clínica e Terapêutica, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Portugal
| | - R Ferreira
- Serviço de Pediatria, Departamento de Pediatria, Hospital de Santa Maria, Centro Hospitalar Universitário de Lisboa Norte, Lisboa, Portugal
| | - C Alves
- Serviço de Pneumologia, Hospital Nossa Senhora do Rosário, Centro Hospitalar Barreiro Montijo, Barreiro, Portugal
| | - R Câmara
- Serviço de Pneumologia, Hospital Nossa Senhora do Rosário, Centro Hospitalar Barreiro Montijo, Barreiro, Portugal
| | | | - D Bordalo
- Serviço de Pediatria, Unidade Hospitalar de Famalicão, Centro Hospitalar do Médio Ave, Vila Nova de Famalicão, Portugal
| | - M J Calix
- Serviço de Pediatria, Hospital de São Teotónio, Centro Hospitalar Tondela-Viseu, Viseu, Portugal
| | - A Marques
- Serviço de Pediatria, Hospital de São Teotónio, Centro Hospitalar Tondela-Viseu, Viseu, Portugal
| | - C Nunes
- Imunoalergologia, Centro de Imunoalergologia do Algarve, Portimão, Portugal
| | - F Menezes
- Serviço de Pneumologia, Hospital Garcia de Orta, Almada, Portugal
| | - R Gomes
- Serviço de Pneumologia, Hospital Garcia de Orta, Almada, Portugal
| | - J Almeida Fonseca
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto (FMUP), Porto, Portugal.,Allergy Unit, Instituto and Hospital CUF, Porto, Portugal.,MEDIDA - Medicina, Educação, Investigação, Desenvolvimento e Avaliação, Porto, Portugal.,Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
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Eley C, Lundgren PT, Kasza G, Truninger M, Brown C, Hugues VL, Izso T, Teixeira P, Syeda R, Ferré N, Kunszabo A, Nunes C, Hayes C, Merakou K, McNulty C. Teaching young consumers in Europe: a multicentre qualitative needs assessment with educators on food hygiene and food safety. Perspect Public Health 2021; 142:175-183. [PMID: 33461394 PMCID: PMC9047106 DOI: 10.1177/1757913920972739] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM Foodborne illnesses have a significant global burden and can be life-threatening, with higher risk in vulnerable groups such as children. SafeConsume is an EU-funded, transdisciplinary project aiming to improve consumers' food safety behaviour. Developing educational resources on food safety for use in schools has potential to improve teaching of our young consumers. The aim of this study was to explore school educators' attitudes, behaviours and knowledge towards food hygiene, safety and education. METHODS Focus groups and interviews in England, France, Portugal and Hungary explored educator knowledge, skills, intentions and beliefs around educating young people (11-18 years) about food safety. Data were analysed using NVivo and emerging themes were applied to the Theoretical Domains Framework. RESULTS A total of 48 educators participated. Knowledge, confidence and skills to teach food safety to young people varied depending on background and training. Educators reported they had a role to teach food safety to young people, were positive about delivering education and optimistic they could improve students' food safety behaviour. Barriers to teaching included lack of national curriculum coverage, limited time and money, and lack of facilities. Educators reported that social influences (family, celebrity chefs, public health campaigns and social media) were important opportunities to improve young peoples' awareness of food safety and consequences of foodborne illness. CONCLUSION Educator food safety expertise varied; training could help to optimise educator knowledge, confidence and skills. Ministries of Health and Education need encouragement to get food safety incorporated further into school curricula across Europe, so schools will be motivated to prioritise these topics.
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Affiliation(s)
- C Eley
- Primary Care and Interventions Unit, Public Health England, 4th Floor, Twyver House, Gloucester GL1 1DQ, UK
| | | | - G Kasza
- National Food Chain Safety Office, Budapest, Hungary
| | | | - C Brown
- Primary Care and Interventions Unit, Public Health England, Gloucester, UK
| | | | - T Izso
- National Food Chain Safety Office, Budapest, Hungary
| | - P Teixeira
- Universidade Católica Portuguesa, Lisboa, Portugal
| | - R Syeda
- Primary Care and Interventions Unit, Public Health England, Gloucester, UK
| | - N Ferré
- Nice University Hospital, Nice, France
| | - A Kunszabo
- National Food Chain Safety Office, Budapest, Hungary
| | - C Nunes
- University of Lisbon, Lisboa, Portugal
| | - C Hayes
- Primary Care and Interventions Unit, Public Health England, Gloucester, UK
| | - K Merakou
- National School of Public Health, University of West Attica, Egaleo, Attica, Greece
| | - Cam McNulty
- Primary Care and Interventions Unit, Public Health England, Gloucester, UK
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32
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Moraes S, Marinho A, Lima S, Granja A, Araújo JP, Reis S, Sousa CT, Nunes C. Targeted nanostructured lipid carriers for doxorubicin oral delivery. Int J Pharm 2021; 592:120029. [PMID: 33130218 DOI: 10.1016/j.ijpharm.2020.120029] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 10/24/2020] [Accepted: 10/26/2020] [Indexed: 01/12/2023]
Abstract
The treatment with anticancer drugs remains a challenge, as available drugs still entail the risk of deleterious off-target effects. The present study describes folic acid conjugated nanostructured lipid carriers (NLCs) as an effective doxorubicin delivery approach targeted to breast cancer cells. Two distinct NLCs formulations were designed and optimized leading to an encapsulation efficiency over than 65%. Cytotoxic and targeting potential of NLCs were studied in vitro, using MDA-MB-231 cell line. Results showed an enhanced cellular uptake of conjugated NLCs. In vitro release studies, mimicking the path in the body after oral administration, show that all formulations would reach the tumor microenvironment bearing 50% of the encapsulated doxorubicin. Moreover, NLCs demonstrated storage stability at 25 °C for at least 42 days. Overall, results revealed that the developed NLCs enable the possibility of oral administration and are a promising approach for the targeted delivery of doxorubicin to breast cancer cells.
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Affiliation(s)
- S Moraes
- IFIMUP, Faculty of Sciences of Porto University, Portugal; LAQV, REQUIMTE, Faculty of Pharmacy of Porto University, Portugal
| | - A Marinho
- LAQV, REQUIMTE, Faculty of Pharmacy of Porto University, Portugal
| | - S Lima
- LAQV, REQUIMTE, Faculty of Pharmacy of Porto University, Portugal
| | - A Granja
- LAQV, REQUIMTE, Faculty of Pharmacy of Porto University, Portugal
| | - J P Araújo
- IFIMUP, Faculty of Sciences of Porto University, Portugal
| | - S Reis
- LAQV, REQUIMTE, Faculty of Pharmacy of Porto University, Portugal
| | - C T Sousa
- IFIMUP, Faculty of Sciences of Porto University, Portugal
| | - C Nunes
- LAQV, REQUIMTE, Faculty of Pharmacy of Porto University, Portugal.
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33
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Santos J, Duarte R, Nunes C. Host factors associated to false negative and indeterminate results in an interferon‐γ release assay in patients with active tuberculosis. Pulmonology 2020; 26:353-362. [DOI: 10.1016/j.pulmoe.2019.11.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 11/04/2019] [Accepted: 11/11/2019] [Indexed: 02/05/2023] Open
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Carvalho V, Esteves P, Nunes C, Araújo D, Helsen W, Travassos B. Observe and make a call: football referee’s assessment is context sensitive. INT J PERF ANAL SPOR 2020. [DOI: 10.1080/24748668.2020.1820194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- V. Carvalho
- Department of Sport Sciences, Universidade Da Beira Interior, Covilhã, Portugal
| | - P.T. Esteves
- Polytechnic Institute of Guarda, Portugal
- CreativeLab, Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, Portugal
| | - C. Nunes
- Department of Mathematics and Center of Mathematics and Applications, Universidade Da Beira Interior, Covilhã, Portugal
| | - D. Araújo
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Portugal
| | - W.F. Helsen
- KU Leuven, Department of Movement Sciences, Research Group for Movement Control and Neuroplasticity, Leuven, Belgium
| | - B. Travassos
- Department of Sport Sciences, Universidade Da Beira Interior, Covilhã, Portugal
- CreativeLab, Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, Portugal
- Portugal Football School, Portuguese Football Federation, FPF, Oeiras, Portugal
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Moniz M, Soares P, Nunes C. Tuberculosis among immigrants: risk factors associated with a delayed diagnosis in Portugal. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
A timely diagnosis is a key factor to TB control, since delayed diagnosis increases transmission, severity and mortality rates. However, immigrants have a higher risk of delay due to difficulties in the access to the healthcare services. Hence, the aim of this study is to identify risk factors associated with delays in immigrants and compare the results with the national population.
Methods
We carried out a retrospective study to analyse all pulmonary TB cases notified in Portugal having a passive case finding, between 2008 and 2017. Global delay was defined as the number of days between symptoms onset and diagnosis date and divided into patient delay (time between symptoms onset and first appointment date) and healthcare services delay (time between first appointment date and diagnosis date). A descriptive analysis was performed, and factors associated with each delay were identified using a Cox regression. Analyses were stratified by country of origin: immigrants (born outside of Portugal) and nationals (Portuguese population).
Results
Our results were consistent with previous studies and showed that the immigrant population was younger, had a higher proportion of HIV infection and had a smaller proportion of alcoholics, drug addicts, inmates, homeless and individuals living in community residencies compared to nationals. Immigrants had higher patient delay (44 vs. 36 days) compared to nationals. Different risk factors were associated with the delay in immigrants and nationals. Alcohol addiction was the only significant variable in both populations and was associated with lower delay in health services.
Conclusions
Immigrants have higher global delay, attributable to a higher patient delay. The risk factors related to TB diagnosis delay have an heterogeneous association in immigrant and nationals. Hence, tailored interventions should be implemented to decrease the delay among immigrants.
Key messages
Different risk factors were identified for the patient and healthcare services delay among immigrants and nationals, which highlight the importance to analyse each component of TB diagnosis delay. Immigrants have higher patient delay compared to nationals, hence tailored interventions should be implemented to facilitate access to healthcare services in this population.
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Affiliation(s)
- M Moniz
- NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - P Soares
- Public Health Research Centre, NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - C Nunes
- Public Health Research Centre, NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
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Lutfor Rahman M, Nunes C, Aguiar P. Factors related to tuberculosis delays: Evidence from nationwide retrospective study in Portugal. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Globally, tuberculosis (TB) remains one of the top 10 causes of deaths and the leading cause from a single infectious agent. Delayed TB diagnosis and/or treatment may result in the transmission of bacilli, increasing infectivity, the risk of severe disease states, morbidity and mortality. It is essential to identify the factors that prolong delays in TB services so that health planners can initiate necessary measures to control TB infections.
Methods
A nationwide retrospective study was conducted from 2010 until 2013 to analyze tuberculosis delays under the setting of the Portuguese National Tuberculosis Control Programme. There were 16824 participants who were from 25 administrative districts under 7 regions and were originated from 70 countries in the world. The log-rank test, Cox's regression, and the Kaplan-Meier method have employed to analyze TB delay data.
Results
The median of patients` delay was 34 days with interquartile ranges (IQR) 50 days. Alcohol addicted people with TB infection were delayed by 40 days with 95% CI 37.73-42.28 whereas the non-addicted people took 33 days with 95% CI 32.35-33.65. The median diagnostic delay was 12 days with an IQR of 38 days. The female participants were delayed more than that of male (median delay for female 17 days with 95% CI 15.80-18.19) in TB diagnosis. Further, comorbidities e.g. lung cancer affected TB candidates were delayed more than their counterparts (median delay 37 days with 95% CI 23.29-50.70). The median of public health delays was 63 days with IQR 72 days. The females were delayed more than that of males (median delay 68 days with 95% CI 66.06-69.94). The adjusted Cox's regression identifies the features - older age, female, drug addiction, and community residence as potential factors that might affect TB delays.
Conclusions
It is essential to emphasize on the influencing dynamics - older age, female patients, HIV patients, alcohol addiction, and comorbidities to minimize TB delays.
Key messages
To minimize spreading risk of TB infections the dynamics of TB delays e.g. older age, female patients, drug, and alcohol addiction, comorbidities should be prioritized in the TB control programs. Special attention should be given to other lung diseases while diagnosing TB infections.
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Affiliation(s)
- M Lutfor Rahman
- Institute of Statistical Research & Training, University of Dhaka, Dhaka, Bangladesh
| | - C Nunes
- National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
| | - P Aguiar
- National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
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dos P, Luís S, Nunes C. Heat waves and mortality: developing a local prediction model based on two kinds of heat waves. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Heat waves (HW) will tend to have a higher impact on mortality due to climate change. The aim of this study was to develop a tailored model to predict local mortality associated to HW.
Methods
In this ecological study, daily temperature and daily mortality were collected from May to October of 1980 to 2017 in Coimbra, Portugal. Two definitions of HW were used: more than two consecutive days of maximum temperature (MaxT) or minimum temperature (MinT) above percentile 95 for the periods in question. Attributable general mortalities with 13 and 30 lag days were calculated and then converted to attributable general mortality rates adjusted to the resident population. Bivariate and multivariate analyses with SPSS statistics were performed with the following independent variables for each HW: MaxT, diurnal temperature variation (DTV), mean of the mean daily temperatures, month, ageing index (AI), ordinal number of the HW for that year (ONHW), duration, overlapping of another HW and existence of a public health contingency plan.
Results
The multivariate analyses returned a R2=0,19 for the MaxT model (MaxTM) for both 13 and 30 lag days and a R2=0,51 for the MinT model (MinTM) with 13 lag days and R2=0,45 for 30 lag days. DTV was the only variable with statistical significance in the MaxTM (p < 0,023; β = 0,44 for 13 lag days and p < 0,024; β = 0,43 for 30 lag days). In the MinTM model two variables had statistical significance: AI (p < 0,008; β = 1,72 for 13 lag days and p < 0,037; β = 0,44 for 30 lag days) and ONHW (p < 0,038; β= -0,44 for 30 lag days).
Conclusions
MaxTM and MinTM had different predictability potentials with different statistical significant independent variables. This may mean HW defined by MaxT have impact in a distinct way from HW defined by MinT. Further development of these models that include acclimatization indexes and causes of mortality may help local public health services to create more efficient, selective contingency plans.
Key messages
Minimum and maximum temperature defined heat waves may impact mortality differently. Local heat wave/mortality models may contribute to more efficient, selective contingency plans than regional models.
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Affiliation(s)
| | - Santos Luís
- Public Health Unit, Pinhal Interior Norte Primary Healthcare Cluster/ARS Centro, Oliveira do Hospital, Portugal
| | - C Nunes
- Public Health Research Centre, NOVA National School of Public Health/Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
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Leite A, Soares P, Santos J, Nunes C. Delays in the diagnosis of pulmonary tuberculosis in critical and non-critical areas in Portugal. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.791] [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: 11/12/2022] Open
Abstract
Abstract
Background
Delays in diagnosing tuberculosis lead to longer infectious periods, posing a challenge in tuberculosis control. This is particularly relevant in high incidence areas (critical). Thus, the objectives of this work were to characterize tuberculosis diagnosis delay and its components (patient delay and health delay) in incidence critical and non-critical areas in Portugal, as well as associated factors.
Methods
Notified cases of pulmonary tuberculosis diagnosed due to symptoms (passive screening) in the Portuguese Tuberculosis Surveillance System were analysed (2008-2017). Patient, health and overall delays were calculated. Factors associated with each delays' components were identified utilising Cox regression, while adjusting for sex, age and education level. Analyses were stratified by area type (critical and non-critical).
Results
Median (1st-3rd quartile - Q1-Q3) delays in patient, health and overall delay in critical areas were: 40 (Q1-Q3: 21-76), 8 (Q1-Q3:1-31), and 65 (Q1-Q3: 40-105) days, respectively; similar delays in non-critical areas were 32 (Q1-Q3:16-63); 9 (Q1-Q3: 1-34) and 58 (Q1-Q3: 35-98), respectively. More recent cases, adults younger than 65 years and alcoholic presented longer patient delays (both areas); healthcare professionals and patients with HIV infection presented shorter patient delays (only critical areas). Tuberculosis high-risk groups (males, alcohol dependency, homelessness, community residency) presented shorter health delays in both areas; drug use also presented shorter health delays but only in critical areas. Existing comorbidities was associated with longer health delays in both areas.
Conclusions
Patient delays increased between 2008 and 2017. Groups with longer/shorter delays differed between delay type and area type. Intervening in tuberculosis diagnosis delays requires different action for critical and non-critical areas, targeting health literacy from the general population and training of healthcare professionals.
Key messages
Delays in diagnosing in Portugal are mainly driven by delays in patient seeking care and are longer in areas of higher tuberculosis incidence. Intervening in tuberculosis diagnosis delays in Portugal requires different action in different areas, targeting health literacy in the general population and training of professionals.
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Affiliation(s)
- A Leite
- Public Health Research Centre, NOVA National School of Public Health, Lisbon, Portugal
- Public Health Unit, Primary Healthcare Cluster, Amadora, Portugal
| | - P Soares
- Public Health Research Centre, NOVA National School of Public Health, Lisbon, Portugal
| | - J Santos
- Public Health Research Centre, NOVA National School of Public Health, Lisbon, Portugal
| | - C Nunes
- Public Health Research Centre, NOVA National School of Public Health, Lisbon, Portugal
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Affiliation(s)
- C. Santos
- Department of Mathematics and Physical Sciences, Polytechnic Institute of Beja, Beja, Portugal
- CMA- Center of Mathematics and its Applications, Faculty of Science and Technology, New University of Lisbon, Portugal
| | - C. Nunes
- Department of Mathematics and Center of Mathematics and Applications, University of Beira Interior, Covilhã, Portugal
| | - C. Dias
- Polytechnic Institute of Portalegre, Portalegre, Portugal
- CMA- Center of Mathematics and its Applications, Faculty of Science and Technology, New University of Lisbon, Portugal
| | - J.T. Mexia
- Department of Mathematics, Faculty of Science and Technology, New University of Lisbon, Portugal
- CMA- Center of Mathematics and its Applications, Faculty of Science and Technology, New University of Lisbon, Portugal
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Martins C, Vidal A, De Boevre M, De Saeger S, Nunes C, Torres D, Goios A, Lopes C, Alvito P, Assunção R. Burden of disease associated with dietary exposure to carcinogenic aflatoxins in Portugal using human biomonitoring approach. Food Res Int 2020; 134:109210. [PMID: 32517894 DOI: 10.1016/j.foodres.2020.109210] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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: 02/17/2020] [Revised: 03/27/2020] [Accepted: 03/29/2020] [Indexed: 12/11/2022]
Abstract
Human biomonitoring is an important tool to assess human exposure to chemicals, contributing to describe trends of exposure over time and to identify population groups that could be under risk. Aflatoxins are genotoxic and carcinogenic food contaminants causing hepatocellular carcinoma, the third leading cause of cancer deaths worldwide. In Portugal, scarce data are available regarding exposure to aflatoxins and no previous study used human biomonitoring data to comprehensively characterize the associated burden of disease. 24 h urine and first-morning urine paired samples were collected by 94 participants and were analyzed by liquid chromatography-tandem mass spectrometry for the quantitative determination of aflatoxins (B1, B2, G1, G2 and M1). Deterministic and probabilistic models were developed to assess the Portuguese exposure to aflatoxins and to estimate the health impact of this exposure, estimating the attributed Disability-Adjusted Life Years (DALYs). Aflatoxins were detected in a maximum of 13% (AFB1), 16% (AFB2), 1% (AFG1), 2% (AFG2) and 19% (AFM1) of the urine samples. Data obtained through the probabilistic approach revealed an estimated mean probable daily intake of 13.43 ng/kg body weight per day resulting in 0.13 extra cases of hepatocellular carcinoma, corresponding to mean annual DALYs of 172.8 for the Portuguese population (10291027 inhabitants). The present study generated for the first time and within a human biomonitoring study, reliable and crucial data to characterize the burden associated to the exposure to aflatoxins of the Portuguese population. The obtained results constitute an imperative support to risk managers in the establishment of preventive policy measures that contribute to ensure public health protection.
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Affiliation(s)
- C Martins
- Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, Avenida Padre Cruz, 1649-016 Lisboa, Portugal; NOVA National School of Public Health, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560 Lisboa, Portugal; CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal; Public Health Research Centre, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560 Lisboa, Portugal.
| | - A Vidal
- Centre of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, B-9000 Ghent, Belgium
| | - M De Boevre
- Centre of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, B-9000 Ghent, Belgium
| | - S De Saeger
- Centre of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, B-9000 Ghent, Belgium
| | - C Nunes
- NOVA National School of Public Health, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560 Lisboa, Portugal; Public Health Research Centre, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560 Lisboa, Portugal
| | - D Torres
- Epidemiology Research Unit, Institute of Public Health, University of Porto, Rua das Taipas 135, 4050-091 Porto, Portugal; Faculty of Nutrition and Food Sciences, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal
| | - A Goios
- Epidemiology Research Unit, Institute of Public Health, University of Porto, Rua das Taipas 135, 4050-091 Porto, Portugal; Faculty of Nutrition and Food Sciences, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal
| | - C Lopes
- Epidemiology Research Unit, Institute of Public Health, University of Porto, Rua das Taipas 135, 4050-091 Porto, Portugal; Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - P Alvito
- Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, Avenida Padre Cruz, 1649-016 Lisboa, Portugal; CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal
| | - R Assunção
- Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, Avenida Padre Cruz, 1649-016 Lisboa, Portugal; CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal
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Pistollato F, de Gyves EM, Carpi D, Bopp SK, Nunes C, Worth A, Bal-Price A. Assessment of developmental neurotoxicity induced by chemical mixtures using an adverse outcome pathway concept. Environ Health 2020; 19:23. [PMID: 32093744 PMCID: PMC7038628 DOI: 10.1186/s12940-020-00578-x] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [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: 12/13/2019] [Accepted: 02/11/2020] [Indexed: 05/25/2023]
Abstract
BACKGROUND In light of the vulnerability of the developing brain, mixture risk assessment (MRA) for the evaluation of developmental neurotoxicity (DNT) should be implemented, since infants and children are co-exposed to more than one chemical at a time. One possible approach to tackle MRA could be to cluster DNT chemicals in a mixture on the basis of their mode of action (MoA) into 'similar' and 'dissimilar', but still contributing to the same adverse outcome, and anchor DNT assays to common key events (CKEs) identified in DNT-specific adverse outcome pathways (AOPs). Moreover, the use of human in vitro models, such as induced pluripotent stem cell (hiPSC)-derived neuronal and glial cultures would enable mechanistic understanding of chemically-induced adverse effects, avoiding species extrapolation. METHODS HiPSC-derived neural progenitors differentiated into mixed cultures of neurons and astrocytes were used to assess the effects of acute (3 days) and repeated dose (14 days) treatments with single chemicals and in mixtures belonging to different classes (i.e., lead(II) chloride and methylmercury chloride (heavy metals), chlorpyrifos (pesticide), bisphenol A (organic compound and endocrine disrupter), valproic acid (drug), and PCB138 (persistent organic pollutant and endocrine disrupter), which are associated with cognitive deficits, including learning and memory impairment in children. Selected chemicals were grouped based on their mode of action (MoA) into 'similar' and 'dissimilar' MoA compounds and their effects on synaptogenesis, neurite outgrowth, and brain derived neurotrophic factor (BDNF) protein levels, identified as CKEs in currently available AOPs relevant to DNT, were evaluated by immunocytochemistry and high content imaging analysis. RESULTS Chemicals working through similar MoA (i.e., alterations of BDNF levels), at non-cytotoxic (IC20/100), very low toxic (IC5), or moderately toxic (IC20) concentrations, induce DNT effects in mixtures, as shown by increased number of neurons, impairment of neurite outgrowth and synaptogenesis (the most sensitive endpoint as confirmed by mathematical modelling) and increase of BDNF levels, to a certain extent reproducing autism-like cellular changes observed in the brain of autistic children. CONCLUSIONS Our findings suggest that the use of human iPSC-derived mixed neuronal/glial cultures applied to a battery of assays anchored to key events of an AOP network represents a valuable approach to identify mixtures of chemicals with potential to cause learning and memory impairment in children.
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Affiliation(s)
| | | | - Donatella Carpi
- European Commission, Joint Research Centre (JRC), Ispra, Italy
| | | | - Carolina Nunes
- European Commission, Joint Research Centre (JRC), Ispra, Italy
| | - Andrew Worth
- European Commission, Joint Research Centre (JRC), Ispra, Italy
| | - Anna Bal-Price
- European Commission, Joint Research Centre (JRC), Ispra, Italy
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Martins C, Assunção R, Nunes C, Torres D, Alvito P. Are Data from Mycotoxins’ Urinary Biomarkers and Food Surveys Linked? A Review Underneath Risk Assessment. Food Reviews International 2020. [DOI: 10.1080/87559129.2019.1709200] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- C. Martins
- Food and Nutrition Department, National Institute of Health Doutor Ricardo Jorge, Lisboa, Portugal
- CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
- NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisboa, Portugal
- CISP, Centro de Investigação em Saúde Pública, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - R. Assunção
- Food and Nutrition Department, National Institute of Health Doutor Ricardo Jorge, Lisboa, Portugal
- CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
| | - C. Nunes
- NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisboa, Portugal
- CISP, Centro de Investigação em Saúde Pública, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - D. Torres
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
- Epidemiology Research Unit, Institute of Public Health, University of Porto, Porto, Portugal
| | - P. Alvito
- Food and Nutrition Department, National Institute of Health Doutor Ricardo Jorge, Lisboa, Portugal
- CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
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Martins C, Vidal A, De Boevre M, De Saeger S, Nunes C, Torres D, Goios A, Lopes C, Alvito P, Assunção R. Burden of disease attributable to exposure to aflatoxins in Portugal using Human biomonitoring data. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.286] [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
Human biomonitoring (HBM) is recognized as an important tool to assess the Human exposure to chemicals, contributing to describe trends and patterns of exposure over time and to identify population groups that could be under risk. Natural chemicals as mycotoxins, fungi metabolites that produce toxic effects in humans, are important compounds that could be found in foods usually consumed worldwide in a daily basis. Mycotoxins as aflatoxins (AFTs) are genotoxic, carcinogenic and immunosuppressive compounds. Hepatocellular carcinoma (HCC) is one of their main health toxic effects and is the third leading cause of cancer deaths worldwide. In Portugal, scarce data are available regarding exposure to AFTs and none previous study used HBM data to characterize comprehensively the burden associated to this exposure.
In the scope of the National Food, Nutrition, and Physical Activity Survey of the Portuguese General Population (2015-2016), 24h-urine samples from 94 participants were analyzed by liquid chromatography-mass spectrometry (LC-MS/MS) for the simultaneous determination of AFTs (B1, B2, G1, G2, M1). A model was developed to estimate the health impact of the exposure of Portuguese population to aflatoxins, estimating the number of cases of HCC and DALYs attributed to AFTs exposure.
AFTs were detected in 12.8% (AFB1), 16.0% (AFB2) and 19.1% (AFM1) of the 24h-urine samples. The estimated number of extra cases of HCC attributed to this exposure ranged from 17 to 65 cases/year; the associated DALYs for the Portuguese population ranged from 284 to 1802 years.
The present study generated, for the first time and within a HBM study, reliable data regarding the exposure of the Portuguese population to AFTs. These data were crucial to characterize the health impact associated to AFTs exposure and to support risk managers to establish preventive policy measures that contribute to ensure the public health protection.
Key messages
Portuguese population is exposed to aflatoxins, chemical food contaminants that may be harmful (carcinogenic, immunotoxic, mutagenic, teratogenic, hepatotoxic) to humans. Human biomonitoring studies provide realistic data on internal exposure at individual level, contributing to a more accurate estimation of the burden derived from this exposure.
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Affiliation(s)
- C Martins
- National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
- National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
- CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Aveiro, Portugal
| | - A Vidal
- Centre of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Portugal
| | - M De Boevre
- Centre of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Portugal
| | - S De Saeger
- Centre of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Portugal
| | - C Nunes
- National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
- Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - D Torres
- Epidemiology Research Unit, Institute of Public Health, University of Porto, Porto, Portugal
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - A Goios
- Epidemiology Research Unit, Institute of Public Health, University of Porto, Porto, Portugal
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - C Lopes
- Epidemiology Research Unit, Institute of Public Health, University of Porto, Porto, Portugal
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal
| | - P Alvito
- National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
- CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Aveiro, Portugal
| | - R Assunção
- National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
- CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Aveiro, Portugal
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Martins C, Vidal A, De Saeger S, Nunes C, Torres D, Goios A, Lopes C, Assunção R, Alvito P, De Boevre M. Risk assessment of Portuguese population to multiple mycotoxins: the human biomonitoring approach. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.285] [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
Mycotoxins constitute a relevant group of food contaminants with several associated health outcomes such as estrogenic, immunotoxic, nephrotoxic and teratogenic effects. Although scarce data are available in Portugal, human biomonitoring studies have been globally developed to assess the exposure to mycotoxins at individual level.
The present study concerned the analysis of mycotoxins in 24h urine and first-morning urine paired samples from 94 participants enrolled within the scope of the National Food, Nutrition, and Physical Activity Survey of the Portuguese General Population (2015-2016). Following a salt-assisted matrix extraction, urine samples were analyzed by liquid chromatography-mass spectrometry for the simultaneous determination of 37 urinary mycotoxins’ biomarkers and data obtained used to estimate the probable daily intake as well as the risk characterization applying the Hazard Quotient approach.
Results revealed the exposure of Portuguese population to zearalenone, deoxynivalenol, ochratoxin A, alternariol, citrinin and fumonisin B1 through the quantification in 24h urine and first-morning urine paired samples. Risk characterization data revealed a potential concern to some reported mycotoxins since the reference intake values were exceeded by some of the considered participants. Alternariol was identified for the first time in urine samples from a European country; however, risk characterization was not performed due to lack of reference intake value.
The present study contributed with reliable and evidence-based results, and confirmed that mycotoxins represent a burden and are part of the human exposome of the Portuguese population. Further studies are needed to shed a light on the determinants of exposure in order to contribute for the promotion of public health measures to reduce the mycotoxins’ exposure in Portugal.
Key messages
Portuguese population is exposed to mycotoxins, chemical food contaminants that may be harmful (carcinogenic, immunotoxic, mutagenic, teratogenic, hepatotoxic) for human health. Human biomonitoring studies provide realistic data on internal exposure at individual level, allowing a more accurate knowledge of the determinants of exposure to these contaminants.
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Affiliation(s)
- C Martins
- National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
- National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
- CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Aveiro, Portugal
| | - A Vidal
- Centre of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - S De Saeger
- Centre of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - C Nunes
- National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
- Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - D Torres
- Epidemiology Research Unit, Institute of Public Health, University of Porto, Porto, Portugal
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - A Goios
- Epidemiology Research Unit, Institute of Public Health, University of Porto, Porto, Portugal
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - C Lopes
- Epidemiology Research Unit, Institute of Public Health, University of Porto, Porto, Portugal
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal
| | - R Assunção
- National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
- CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Aveiro, Portugal
| | - P Alvito
- National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
- CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Aveiro, Portugal
| | - M De Boevre
- Centre of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
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Bhering M, Kritski A, Nunes C, Duarte R. Multidrug-resistant tuberculosis in Lisbon: unfavourable treatment and associated factors, 2000-2014. Int J Tuberc Lung Dis 2019; 23:1075-1081. [PMID: 31627772 DOI: 10.5588/ijtld.18.0596] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING: The incidence of tuberculosis (TB) has been decreasing in Portugal. Lisbon concentrates the largest number of cases of multidrug-resistant (MDR) TB in the country. This study aims at identifying clinical and demographic factors associated with unfavourable treatment results of patients with MDR-TB in the city.METHOD: The data on 265 MDR-TB cases, notified from 2000 to 2014 in the District of Lisbon, were collected from the Tuberculosis Surveillance System. Unfavourable cases were classified as failure, loss to follow-up (LTFU) and death. Bivariate and multivariate logistic regressions were undertaken to estimate the factors associated with unfavourable outcomes, LTFU and death.RESULTS: The proportion of unfavourable outcomes was 30.5%. These were associated mostly with being male, foreign-born and resistant to kanamycin. Death was associated with being human immunodeficiency virus-positive and resistant to kanamycin. Being foreign-born had a 4.46-fold higher odds of a LTFU outcome than did being Portuguese-born. The foreign-born patients were mostly African immigrants.CONCLUSION: The main finding in this study is that foreign-born patients are associated with a higher probability of unfavourable outcomes than Portuguese-born patients. Therefore, foreign-born patients need more careful monitoring in the control of MDR-TB.
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Affiliation(s)
- M Bhering
- School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazilian Tuberculosis Network, Rio de Janeiro, Rio de Janeiro, Brazil
| | - A Kritski
- School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazilian Tuberculosis Network, Rio de Janeiro, Rio de Janeiro, Brazil
| | - C Nunes
- National School of Public Health at the Nova University Lisbon, Lisbon
| | - R Duarte
- Pulmonology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Lisbon, Public Health Science and Medical Education Department, School of Medicine, University of Porto, Porto, Portugal
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Nunes J, Charneira C, Nunes C, Gouveia-Fernandes S, Serpa J, Morello J, Antunes AMM. A Metabolomics-Inspired Strategy for the Identification of Protein Covalent Modifications. Front Chem 2019; 7:532. [PMID: 31417895 PMCID: PMC6684772 DOI: 10.3389/fchem.2019.00532] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 04/30/2019] [Accepted: 07/11/2019] [Indexed: 11/13/2022] Open
Abstract
Identification of protein covalent modifications (adducts) is a challenging task mainly due to the lack of data processing approaches for adductomics studies. Despite the huge technological advances in mass spectrometry (MS) instrumentation and bioinformatics tools for proteomics studies, these methodologies have very limited success on the identification of low abundant protein adducts. Herein we report a novel strategy inspired on the metabolomics workflows for the identification of covalently-modified peptides that consists on LC-MS data preprocessing followed by statistical analysis. The usefulness of this strategy was evaluated using experimental LC-MS data of histones isolated from HepG2 and THLE2 cells exposed to the chemical carcinogen glycidamide. LC-MS data was preprocessed using the open-source software MZmine and potential adducts were selected based on the m/z increments corresponding to glycidamide incorporation. Then, statistical analysis was applied to reveal the potential adducts as those ions are differently present in cells exposed and not exposed to glycidamide. The results were compared with the ones obtained upon the standard proteomics methodology, which relies on producing comprehensive MS/MS data by data dependent acquisition and analysis with proteomics data search engines. Our novel strategy was able to differentiate HepG2 and THLE2 and to identify adducts that were not detected by the standard methodology of adductomics. Thus, this metabolomics driven approach in adductomics will not only open new opportunities for the identification of protein epigenetic modifications, but also adducts formed by endogenous and exogenous exposure to chemical agents.
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Affiliation(s)
- João Nunes
- Centro de Química Estrutural, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal
| | - Catarina Charneira
- Centro de Química Estrutural, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal
| | - Carolina Nunes
- CEDOC, Chronic Diseases Research Centre, Faculdade de Ciências Médicas, NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal.,Unidade de Investigação em Patobiologia Molecular do Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal
| | - Sofia Gouveia-Fernandes
- CEDOC, Chronic Diseases Research Centre, Faculdade de Ciências Médicas, NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal.,Unidade de Investigação em Patobiologia Molecular do Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal
| | - Jacinta Serpa
- CEDOC, Chronic Diseases Research Centre, Faculdade de Ciências Médicas, NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal.,Unidade de Investigação em Patobiologia Molecular do Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal
| | - Judit Morello
- Centro de Química Estrutural, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal
| | - Alexandra M M Antunes
- Centro de Química Estrutural, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal
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Martins C, Vidal A, De Boevre M, De Saeger S, Nunes C, Torres D, Goios A, Lopes C, Assunção R, Alvito P. Exposure assessment of Portuguese population to multiple mycotoxins: The human biomonitoring approach. Int J Hyg Environ Health 2019; 222:913-925. [DOI: 10.1016/j.ijheh.2019.06.010] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 04/18/2019] [Accepted: 06/24/2019] [Indexed: 12/11/2022]
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Ferreira AL, Nunes C, Mendes JG, Amorim P. Do we have today a reliable method to detect the moment of loss of consciousness during induction of general anaesthesia? Rev Esp Anestesiol Reanim (Engl Ed) 2019; 66:93-103. [PMID: 30077394 DOI: 10.1016/j.redar.2018.06.008] [Citation(s) in RCA: 5] [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] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 06/03/2018] [Accepted: 06/13/2018] [Indexed: 06/08/2023]
Abstract
This review aims to give an overview of the current state of monitoring depth of anaesthesia and detecting the moment of loss of consciousness, from the first clinical signs involved in anaesthesia to the latest technologies used in this area. Such techniques are extremely important for the development of automatic systems for anaesthesia control, including preventing intraoperative awareness episodes and overdoses. A search in the databases Pubmed and IEEE Xplore was performed using terms such anaesthetic monitoring, depth of anaesthesia, loss of consciousness, as well as anaesthesia indexes, namely BIS. Despite the several methods capable of monitoring the hypnotic state of anaesthesia, there is still no methodology to accurate detect the moment of loss of consciousness during induction of general anaesthesia.
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Affiliation(s)
- A L Ferreira
- LAETA/INEGI, Faculdade de Engenharia da Universidade do Porto, Oporto, Portugal; Centro de Investigação Clínica em Anestesiologia, Serviço de Anestesiologia, Centro Hospitalar do Porto, Oporto, Portugal.
| | - C Nunes
- Centro de Investigação Clínica em Anestesiologia, Serviço de Anestesiologia, Centro Hospitalar do Porto, Oporto, Portugal; Departamento de Ciências e Tecnologia, Universidade Aberta, Oporto, Portugal
| | - J G Mendes
- LAETA/INEGI, Faculdade de Engenharia da Universidade do Porto, Oporto, Portugal
| | - P Amorim
- Centro de Investigação Clínica em Anestesiologia, Serviço de Anestesiologia, Centro Hospitalar do Porto, Oporto, Portugal
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Affiliation(s)
- C Nunes
- Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Lisbon, Portugal
| | - L Rahman
- Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Lisbon, Portugal
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Affiliation(s)
- J Santos
- National School of Public Health, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - R Duarte
- Faculty of Medicine of University of Porto, Centro Diagnóstico Pneumológico de Vila Nova de Gaia, Lisbon, Portugal
| | - C Nunes
- National School of Public Health, Public Health Research Center, Lisbon, Portugal
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