1
|
Oliveira D, Ferreira RM, Gomes CM, Vaz C. Geiser Sign in a patient with rheumatoid arthritis. Clin Rheumatol 2024; 43:1785-1786. [PMID: 38573480 DOI: 10.1007/s10067-024-06952-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Revised: 03/18/2024] [Accepted: 03/25/2024] [Indexed: 04/05/2024]
Affiliation(s)
- Daniela Oliveira
- Rheumatology Department, University Hospital Center of São João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, Portugal.
| | - Raquel Miriam Ferreira
- Rheumatology Department, University Hospital Center of São João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
- Department of Medicine of Faculty of Medicine, University of Porto, Porto, Portugal
| | - Carlos Marques Gomes
- Rheumatology Department, University Hospital Center of São João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
- Department of Medicine of Faculty of Medicine, University of Porto, Porto, Portugal
| | - Carlos Vaz
- Rheumatology Department, University Hospital Center of São João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, Portugal
- Department of Medicine of Faculty of Medicine, University of Porto, Porto, Portugal
| |
Collapse
|
2
|
Oliveira D, Carneiro MCCG, Moreira FTC. SERS biosensor with plastic antibodies for detection of a cancer biomarker protein. Mikrochim Acta 2024; 191:238. [PMID: 38570401 PMCID: PMC10991021 DOI: 10.1007/s00604-024-06327-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 03/23/2024] [Indexed: 04/05/2024]
Abstract
Surface-enhanced Raman scattering (SERS) is a powerful method for detecting breast cancer-specific biomarkers due to its extraordinary enhancement effects obtained by localized surface plasmon resonance (LSPR) in metallic nanostructures at hotspots. In this research, gold nanostars (AuNSs) were used as SERS probes to detect a cancer biomarker at very low concentrations. To this end, we combined molecularly imprinted polymers (MIPs) as a detection layer with SERS for the detection of the biomarker CA 15-3 in point-of-care (PoC) analysis. This required two main steps: (i) the deposition of MIPs on a gold electrode, followed by a second step (ii) antibody binding with AuNSs containing a suitable Raman reporter to enhance Raman signaling (SERS). The MPan sensor was prepared by electropolymerization of the monomer aniline in the presence of CA 15-3. The template molecule was then extracted from the polymer using sodium dodecyl sulfate (SDS). In parallel, a control material was prepared in the absence of the protein (NPan). Surface modification for the control was performed using electrochemical techniques such as cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS). The performance of the sensor was evaluated using the SERS technique, in which the MPan sensor is first incubated with the protein and then exposed to the SERS probe. Under optimized conditions, the device showed a linear response to CA 15-3 concentrations from 0.016 to 248.51 U mL-1 in a PBS buffer at pH 7.4 in 1000-fold diluted serum. Overall, this approach demonstrates the potential of SERS as an optical reader and opens a new avenue for biosensing applications.
Collapse
Affiliation(s)
- Daniela Oliveira
- CIETI - LabRISE-School of Engineering, Polytechnic of Porto, R. Dr. António Bernardino de Almeida, 431, 4249-015, Porto, Portugal
| | - Mariana C C G Carneiro
- CIETI - LabRISE-School of Engineering, Polytechnic of Porto, R. Dr. António Bernardino de Almeida, 431, 4249-015, Porto, Portugal
| | - Felismina T C Moreira
- CIETI - LabRISE-School of Engineering, Polytechnic of Porto, R. Dr. António Bernardino de Almeida, 431, 4249-015, Porto, Portugal.
| |
Collapse
|
3
|
Oliveira D, Maia S, Balacó I, Coelho P, Almeida S, Venâncio M, Saraiva J, Nishimura G, Sousa SB. Pachydysostosis of the fibula in a case of familial adenomatous polyposis. Eur J Med Genet 2024; 68:104913. [PMID: 38286305 DOI: 10.1016/j.ejmg.2024.104913] [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: 06/21/2023] [Revised: 10/09/2023] [Accepted: 01/20/2024] [Indexed: 01/31/2024]
Abstract
BACKGROUND Familial Adenomatous Polyposis (FAP) is a colorectal cancer (CRC) predisposition syndrome caused by germline APC mutations and characterised by an increased risk of CRC and colonic polyps and, in certain forms, of specific prominent extraintestinal manifestations, namely osteomas, soft tissue tumours and dental anomalies. Pachydysostosis of the fibula is a rare clinical entity defined by unilateral bowing of the distal portion of the fibula and elongation of the entire bone, without affectation of the tibia. CLINICAL REPORT We report a 17-year-old male, who presented with a non-progressive bowing of the right leg detected at 18 months of age caused by a fibula malformation (later characterized as pachydysostosis) and a large exophytic osteoma of the left radius, noticed at the age of 15 years, without gastrointestinal symptoms. There was no relevant family history. Detailed characterisation revealed multiple osteomas, skin lesions and dental abnormalities, raising the hypothesis of FAP. This diagnosis was confirmed by genetic testing [c.4406_4409dup p.(Ala1471Serfs*17) de novo mutation in the APC gene] and endoscopic investigation (multiple adenomas throughout the colon, ileum and stomach). DISCUSSION This case report draws attention to the phenotypic spectrum of skeletal manifestations of FAP: this patient has a congenital fibula malformation, not previously associated with this syndrome, but which is likely to have been its first manifestation in this patient. This clinical case also illustrates the challenges in the early diagnosis of FAP, especially without family history, and highlights the importance of a multidisciplinary approach and the adequate study of rare skeletal abnormalities.
Collapse
Affiliation(s)
- Daniela Oliveira
- Medical Genetics Unit, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; University Clinic of Genetics, Faculty of Medicine, Universidade de Coimbra, Coimbra, Portugal; Clinical Academic Center of Coimbra, Coimbra, Portugal.
| | - Sofia Maia
- Medical Genetics Unit, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; University Clinic of Genetics, Faculty of Medicine, Universidade de Coimbra, Coimbra, Portugal; Clinical Academic Center of Coimbra, Coimbra, Portugal
| | - Inês Balacó
- Paediatric Ortopedic Unit, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Paulo Coelho
- Radiology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Susana Almeida
- Paediatric Gastroenterology Unit, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Margarida Venâncio
- Medical Genetics Unit, Hospital Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
| | - Jorge Saraiva
- Medical Genetics Unit, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Clinical Academic Center of Coimbra, Coimbra, Portugal; University Clinic of Pediatrics, Faculty of Medicine, Universidade de Coimbra, Coimbra, Portugal
| | - Gen Nishimura
- Intractable Disease Center, Saitama Medical University Moroyama Campus, Japan
| | - Sérgio B Sousa
- Medical Genetics Unit, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; University Clinic of Genetics, Faculty of Medicine, Universidade de Coimbra, Coimbra, Portugal; Clinical Academic Center of Coimbra, Coimbra, Portugal.
| |
Collapse
|
4
|
Oliveira D, Martins A, Martins F, Rato M, Pinheiro F, Fonseca D, Vaz C, Mariz E, Costa L. Wunderlich syndrome as a rare complication of polyarteritis nodosa: a case report. Reumatismo 2024; 76. [PMID: 38523579 DOI: 10.4081/reumatismo.2024.1669] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 01/02/2024] [Indexed: 03/26/2024] Open
Abstract
Spontaneous subcapsular and perirenal hemorrhage, known as Wunderlich syndrome (WS), is a rare clinical manifestation of polyarteritis nodosa (PAN). We report a case of a 48-year-old male with a history of recurrent episodes of leg muscle tenderness and dysesthesia, bilateral flank pain, painful nodular skin lesions in the lower limbs, weight loss, and difficult-to-control arterial hypertension. The abdominopelvic computed tomography angiography showed a large left perirenal hematoma, leading to the patient's admission to the intensive care unit. After the exclusion of infectious or neoplastic foci, the patient was diagnosed with PAN and started intravenous methylprednisolone pulses with a good response. Since WS is a rare initial clinical manifestation of PAN, an early diagnosis and aggressive treatment will significantly improve clinical outcomes.
Collapse
Affiliation(s)
- D Oliveira
- Rheumatology Department, São João University Hospital Center, Porto; Center for Health Technology and Services Research, Faculty of Medicine, University of Porto.
| | - A Martins
- Rheumatology Department, São João University Hospital Center, Porto.
| | - F Martins
- Rheumatology Department, University Hospital Center of the Algarve, Faro.
| | - M Rato
- Rheumatology Department, São João University Hospital Center, Porto; Department of Medicine, Faculty of Medicine, University of Porto.
| | - F Pinheiro
- Rheumatology Department, São João University Hospital Center, Porto.
| | - D Fonseca
- Rheumatology Department, Vila Nova de Gaia/Espinho Hospital Center, Gaia.
| | - C Vaz
- Rheumatology Department, São João University Hospital Center, Porto; Center for Health Technology and Services Research, Faculty of Medicine, University of Porto; Department of Medicine, Faculty of Medicine, University of Porto.
| | - E Mariz
- Rheumatology Department, São João University Hospital Center, Porto; Department of Medicine, Faculty of Medicine, University of Porto.
| | - L Costa
- Rheumatology Department, São João University Hospital Center, Porto.
| |
Collapse
|
5
|
Nicolau R, Oliveira D, Pacheco J, Madureira P. An Uncommon Presentation of Secondary Syphilis. J Rheumatol 2024:jrheum.2024-0119. [PMID: 38490675 DOI: 10.3899/jrheum.2024-0119] [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: 03/17/2024]
Abstract
Syphilis is a chronic venereal disease caused by Treponema pallidum (TP). Destructive arthritis is rare in its primary and secondary stages but can occur in the tertiary stage and its congenital form.
Collapse
Affiliation(s)
- Rafaela Nicolau
- Rafaela Nicolau MD, Rheumatology Unit, Centro Hospitalar Tondela-Viseu, Viseu, and Faculty of Medicine, University of Porto, Porto
| | - Daniela Oliveira
- Daniela Oliveira, MD, Faculty of Medicine, University of Porto, and Rheumatology Department, Centro Hospitalar e Universitário São João, Porto
| | - João Pacheco
- João Pacheco, MD, Anatomical Pathology Department, Centro Hospitalar e Universitário São João, Porto
| | - Pedro Madureira
- Pedro Madureira, MD, Faculty of Medicine, University of Porto, and Rheumatology Department, Centro Hospitalar e Universitário São João, Porto, Portugal
| |
Collapse
|
6
|
Martins A, Oliveira D, Nicolau R, Rocha TM, Bernardo A, Costa L, Pimenta S, Bernardes M. Correction to: What is the association of depression with clinical response to therapy in patients with psoriatic arthritis treated with biologic disease-modifying antirheumatic drugs? Clin Rheumatol 2024; 43:1275. [PMID: 38289571 DOI: 10.1007/s10067-024-06875-x] [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: 02/20/2024]
Affiliation(s)
- Ana Martins
- Rheumatology Department, Centro Hospitalar Universitário de São João, Porto, Portugal.
- Medicine Department, Faculty of Medicine, University of Porto, Porto, Portugal.
- Rheumatology Department, Centro Hospitalar Universitário de São João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.
| | - Daniela Oliveira
- Rheumatology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
- Medicine Department, Faculty of Medicine, University of Porto, Porto, Portugal
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, Portugal
| | - Rafaela Nicolau
- Medicine Department, Faculty of Medicine, University of Porto, Porto, Portugal
- Rheumatology Department, Centro Hospitalar Tondela-Viseu, Viseu, Portugal
| | - Teresa Martins Rocha
- Rheumatology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
- Medicine Department, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Alexandra Bernardo
- Rheumatology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Lúcia Costa
- Rheumatology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Sofia Pimenta
- Rheumatology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
- Medicine Department, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Miguel Bernardes
- Rheumatology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
- Medicine Department, Faculty of Medicine, University of Porto, Porto, Portugal
| |
Collapse
|
7
|
Costa E, Cunha-Santos F, Dourado E, Oliveira D, Falzon L, Romão V, Duarte AC, Cordeiro A, Santiago T, Sepriano A. Systematic literature review to inform the Portuguese recommendations for the management of Raynaud's phenomenon and digital ulcers in systemic sclerosis and other connective tissue diseases. ARP Rheumatol 2024:AR230341. [PMID: 38306796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/04/2024]
Abstract
OBJECTIVE To perform a systematic literature review (SLR) aimed at evaluating the efficacy and safety of pharmacological and non-pharmacological treatments for Raynaud's phenomenon (RP) and digital ulcers (DU) in patients with systemic sclerosis (SSc) and other connective tissue diseases (CTD), in order to inform the Portuguese recommendations for managing RP and DU in these patients. METHODS A SLR was conducted until May 2022 to identify studies assessing the efficacy and safety of pharmacological and non-pharmacological interventions for RP and DU in SSc and other CTD. Eligible study designs included randomized controlled trials (RCTs), controlled clinical trials, and their extensions for assessing efficacy and safety of interventions. Observational studies with a comparator were included for evaluating the efficacy and safety of non-pharmacological interventions and safety of pharmacological interventions. The risk of bias of each study was assessed using standard tools. RESULTS Out of 71 publications meeting the inclusion criteria, 59 evaluated pharmacological and 12 non-pharmacological interventions. We found moderate quality evidence supporting the efficacy of calcium channel blockers, phosphodiesterase-5 inhibitors, and intravenous prostacyclin analogues in reducing RP frequency, severity, and duration. Intravenous iloprost had a small to moderate effect size in improving DU healing. Phosphodiesterase-5 inhibitors were effective in reducing total DU count, new DU occurrence, and enhancing DU healing. Bosentan effectively prevented new DU in SSc patients. No new safety concerns were associated with these treatments. The studies on non-pharmacological interventions were, in general, of low quality, and had a small sample size. Warming measures decreased frequency and duration of RP attacks; laser therapy improved RP-related outcomes; local oxygen-ozone therapy improved RP outcomes as an add-on therapy; bone marrow mononuclear cell implantation improved DU-associated pain; periarterial sympathectomy and vascular bypass reduced DU number and finger amputation risk. CONCLUSION The available evidence supports the efficacy and safety of pharmacological interventions, namely nifedipine, sildenafil, iloprost, and bosentan in treating RP and DU in patients with SSc and other CTD. Scarce and low-quality evidence does support the use of some non-pharmacological interventions but with only a modest effect size. This SLR underscores the limited availability of high-quality evidence for determining the optimal treatment.
Collapse
Affiliation(s)
| | | | | | | | | | - Vasco Romão
- Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
| | | | | | - Tânia Santiago
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | | |
Collapse
|
8
|
Martins A, Oliveira D, Nicolau R, Rocha TM, Bernardo A, Costa L, Pimenta S, Bernardes M. What is the association of depression with clinical response to therapy in patients with psoriatic arthritis treated with biologic disease-modifying antirheumatic drugs? Clin Rheumatol 2024; 43:251-258. [PMID: 37957488 DOI: 10.1007/s10067-023-06806-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 10/23/2023] [Accepted: 10/28/2023] [Indexed: 11/15/2023]
Abstract
INTRODUCTION Psoriatic arthritis (PsA) is a chronic, progressive inflammatory joint disease that is associated with higher prevalence of depression. There is limited literature about the impact of depression, particularly regarding the response to therapy. METHODS A retrospective cohort study with PsA patients that started their first biologic disease-modifying antirheumatic drugs (bDMARD) was conducted. In the majority of cases, a cutoff score of ≥ 8 in Hospital Anxiety and Depression Scale (HADS) was used to define cases of depression. In cases where patients did not complete the questionnaire, a previous diagnosis made by a psychiatrist was used to establish the presence of depression. Response to therapy 12 months after the start of bDMARD was evaluated and the switch rate to another bDMARD due to inefficacy was assessed at month 12. RESULTS A total of 129 patients (66 females, 51.2%; mean age of 47.7 ± 11.0 years and mean disease duration of 10.0 ± 7.7 years) with PsA were included. Thirty-two (24.8%) patients had depression. Patients with depression and peripheral involvement had a significantly lower ACR20/50/70 responses (p = 0.001, p = 0.002, and p = 0.001 respectively) after 12 months of therapy and a significantly worse EULAR response (p = 0.002). Furthermore, patients with depression and axial involvement had a significantly worse response based on ASDAS response criteria (p = 0.031). Switch due to ineffectiveness in the first 12 months was significantly higher in patients with depression (p = 0.002). CONCLUSION Depression in PsA is a frequent yet often understudied comorbidity. The causal relationship between depression and PsA is difficult to decrypt and further research is needed. Recognition of depressive symptoms is crucial and a multidisciplinary approach should be provided to individuals with this comorbidity. Key Points • Depression in PsA is a frequent yet often understudied comorbidity. In our study, the prevalence of depression was 24.8%. • Depression in PsA seems to be associated to lower response to therapy and higher discontinuation rates of bDMARD. • Recognition of depressive symptoms is crucial and a multidisciplinary approach should be provided to individuals with this comorbidity.
Collapse
Affiliation(s)
- Ana Martins
- Rheumatology Department, Centro Hospitalar Universitário de São João, Porto, Portugal.
- Medicine Department, Faculty of Medicine, University of Porto, Porto, Portugal.
- Rheumatology Department, Centro Hospitalar Universitário de S. João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.
| | - Daniela Oliveira
- Rheumatology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
- Medicine Department, Faculty of Medicine, University of Porto, Porto, Portugal
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, Portugal
| | - Rafaela Nicolau
- Medicine Department, Faculty of Medicine, University of Porto, Porto, Portugal
- Rheumatology Department, Centro Hospitalar Tondela-Viseu, Viseu, Portugal
| | - Teresa Martins Rocha
- Rheumatology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
- Medicine Department, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Alexandra Bernardo
- Rheumatology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Lúcia Costa
- Rheumatology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Sofia Pimenta
- Rheumatology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
- Medicine Department, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Miguel Bernardes
- Rheumatology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
- Medicine Department, Faculty of Medicine, University of Porto, Porto, Portugal
| |
Collapse
|
9
|
Pereira RL, Oliveira D, Pêgo AP, Santos SD, Moreira FTC. Electrochemical miRNA-34a-based biosensor for the diagnosis of Alzheimer's disease. Bioelectrochemistry 2023; 154:108553. [PMID: 37672968 DOI: 10.1016/j.bioelechem.2023.108553] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/25/2023] [Accepted: 08/26/2023] [Indexed: 09/08/2023]
Abstract
Alzheimer's disease (AD) is the most common dementia type and a leading cause of death and disability in the elderly. Diagnosis is expensive and invasive, urging the development of new, affordable, and less invasive diagnostic tools. The identification of changes in the expression of non-coding RNAs prompts the development of diagnostic tools to detect disease-specific blood biomarkers. Building on this idea, this work reports a novel electrochemical microRNA (miRNA) biosensor for the diagnosis of AD, based on carbon screen-printed electrodes (C-SPEs) modified with two gold nanostructures and a complementary anti-miR-34a oligonucleotide probe. This biosensor showed good target affinity, reflected on a 100 pM to 1 μM linearity range and a limit of detection (LOD) of 39 pM in buffer and 94 aM in serum. Moreover, the biosensor's response was not affected by serum compounds, indicating selectivity for miR-34a. The biosensor also detected miR-34a in the cell culture medium of a common AD model, stimulated with a neurotoxin to increase miR-34a secretion. Overall, the proposed biosensor makes a solid case for the introduction of a novel, inexpensive, and minimally invasive tool for the early diagnosis of AD, based on the detection of a circulating miRNA overexpressed in this pathology.
Collapse
Affiliation(s)
- Raquel L Pereira
- CIETI-LabRISE, School of Engineering, Polytechnic Institute, 4249-015 Porto, Portugal; CEB, Centre of Biological Engineering, Minho University, 4710-057 Braga, Portugal; LABBELS - Associate Laboratory, 4710-057 Braga/Guimarães, Portugal; i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen, 208, 4200-135 Porto, Portugal; INEB - Instituto de Engenharia Biomédica, Universidade do Porto, Porto, Portugal
| | - Daniela Oliveira
- CIETI-LabRISE, School of Engineering, Polytechnic Institute, 4249-015 Porto, Portugal; CEB, Centre of Biological Engineering, Minho University, 4710-057 Braga, Portugal; LABBELS - Associate Laboratory, 4710-057 Braga/Guimarães, Portugal
| | - Ana P Pêgo
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen, 208, 4200-135 Porto, Portugal; INEB - Instituto de Engenharia Biomédica, Universidade do Porto, Porto, Portugal; ICBAS - Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Sofia D Santos
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen, 208, 4200-135 Porto, Portugal; INEB - Instituto de Engenharia Biomédica, Universidade do Porto, Porto, Portugal
| | - Felismina T C Moreira
- CIETI-LabRISE, School of Engineering, Polytechnic Institute, 4249-015 Porto, Portugal; CEB, Centre of Biological Engineering, Minho University, 4710-057 Braga, Portugal; LABBELS - Associate Laboratory, 4710-057 Braga/Guimarães, Portugal.
| |
Collapse
|
10
|
Oliveira D, Starowicz M, Ostaszyk A, Łopusiewicz Ł, Ferreira IMPLVO, Pinto E, Krupa-Kozak U. The Improved Quality of Gluten-Free Bread Due to the Use of Flaxseed Oil Cake: A Comprehensive Study Evaluating Nutritional Value, Technological Properties, and Sensory Quality. Foods 2023; 12:4320. [PMID: 38231753 DOI: 10.3390/foods12234320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 11/24/2023] [Accepted: 11/28/2023] [Indexed: 01/19/2024] Open
Abstract
The development of gluten-free bakery products, the quality of which is comparable to the quality of regular wheat-based products, remains a technological challenge. In this study, flaxseed oil cake (FOC), a by-product of flaxseed oil extraction and a source of nutritional and functional compounds, was used as an ingredient in the experimental bread formulation as partial replacement of starches (5%, 15%, and 30%). The gluten-free breads (GFBs) were evaluated for technological parameters, nutritional value, and sensory quality. Compared with the control, all FOC-enhanced GFBs were significantly (p < 0.05) richer in proteins, fat, and dietary fibre, with an increase that was proportional to the concentration of FOC in the formulation. At low-to-moderate levels (5% and 15%), FOC improved the specific volume, texture characteristics (reduced crumb hardness, gumminess, and chewiness), and appearance of GFBs, which allowed us to ameliorate its sensory features, but at 30% of FOC, the quality of the crumb texture decreased significantly (p < 0.005). Among the experimental GFBs, FOC15% exhibited improved technological characteristics and was rated by the sensory panel as the best in terms of overall quality. The results of the conducted research highlighted the benefits of incorporating FOC into GFB as a promising approach to developing a palatable, high-quality bakery product that may be a healthier option for individuals on a gluten-free diet, offering nutritional benefits. Nevertheless, it should be emphasised that the amount of FOC in GFB requires careful regulation.
Collapse
Affiliation(s)
- Daniela Oliveira
- Institute of Animal Reproduction and Food Research, Polish Academy of Sciences, 10-748 Olsztyn, Poland
- LAQV/REQUIMTE, Laboratory of Bromatology and Hydrology, Department of Chemical Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
| | - Małgorzata Starowicz
- Institute of Animal Reproduction and Food Research, Polish Academy of Sciences, 10-748 Olsztyn, Poland
| | - Anita Ostaszyk
- Sensory Laboratory, Institute of Animal Reproduction and Food Research, Polish Academy of Sciences, 10-748 Olsztyn, Poland
| | - Łukasz Łopusiewicz
- Center of Bioimmobilisation and Innovative Packaging Materials, Faculty of Food Sciences and Fisheries, West Pomeranian University of Technology, 71-270 Szczecin, Poland
| | - Isabel M P L V O Ferreira
- LAQV/REQUIMTE, Laboratory of Bromatology and Hydrology, Department of Chemical Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
| | - Edgar Pinto
- LAQV/REQUIMTE, Laboratory of Bromatology and Hydrology, Department of Chemical Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
- Department of Environmental Health, ESS, Polytechnic of Porto, 4200-072 Porto, Portugal
| | - Urszula Krupa-Kozak
- Institute of Animal Reproduction and Food Research, Polish Academy of Sciences, 10-748 Olsztyn, Poland
| |
Collapse
|
11
|
Oliveira D, Martins A, Pinheiro F, Rato M, Fonseca D, Vaz C, Madureira P, Costa L. The clinical challenge of refractory eosinophilic fasciitis. Porto Biomed J 2023; 8:e230. [PMID: 37846301 PMCID: PMC10575353 DOI: 10.1097/j.pbj.0000000000000230] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 07/17/2023] [Accepted: 07/25/2023] [Indexed: 10/18/2023] Open
Affiliation(s)
- Daniela Oliveira
- Rheumatology Department, Centro Hospitalar Universitário São João, Porto, Portugal
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, Portugal
| | - Ana Martins
- Rheumatology Department, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Filipe Pinheiro
- Rheumatology Department, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Maria Rato
- Rheumatology Department, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Diogo Fonseca
- Rheumatology Department, Centro Hospitalar Vila Nova de Gaia/Espinho, Gaia, Portugal
| | - Carlos Vaz
- Rheumatology Department, Centro Hospitalar Universitário São João, Porto, Portugal
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, Portugal
- Department of Medicine of Faculty of Medicine, University of Porto, Porto, Portugal
| | - Pedro Madureira
- Rheumatology Department, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Lúcia Costa
- Rheumatology Department, Centro Hospitalar Universitário São João, Porto, Portugal
| |
Collapse
|
12
|
Samões B, Silva B, Martins A, Oliveira D, Rajão Martins F, Fonseca D, Costa L, Bernardes M. Hypophosphatemic osteomalacia induced by intravenous iron therapy: a case report. Joint Bone Spine 2023; 90:105586. [PMID: 37127260 DOI: 10.1016/j.jbspin.2023.105586] [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: 02/04/2023] [Revised: 03/05/2023] [Accepted: 04/18/2023] [Indexed: 05/03/2023]
Abstract
OBJECTIVE Osteomalacia is an uncommon, overlooked and debilitating metabolic bone disease with numerous aetiologies. Herein, we report an atypical cause of osteomalacia - intravenous iron therapy. METHODS Description of a case report of hypophophatemic osteomalacia induced by ferric carboxymaltose infusions. RESULTS A 70-year-old male with Rendu-Osler-Weber syndrome requiring repeated infusions of ferric carboxymaltose was admitted for disabling lower limb pain associated with persistent hypophosphatemia (1.6mg/dL) and increased urinary fractional excretion of phosphate (43%, UP04=118.3mg/dL), serum fibroblast growth factor 23 (324UA/mL), intact parathyroid hormone (110pg/mL) and bone alkaline phosphatase (40.1mcg/L). X-ray and CT of the feet showed severe diffuse bone demineralization. Feet MRI displayed a subchondral fracture of the cuneiform-navicular joints. Spine X-ray revealed dorsolumbar vertebral flattening. Somatostatin receptor PET scan excluded an occult tumor. Bone biopsy with histomorphometry confirmed the presence of osteomalacia. After excluding other causes, a diagnosis of hypophosphatemic osteomalacia induced by frequent ferric carboxymaltose infusions was made. The iron formulation was replaced by saccharated ferric oxide infusions and progressive titration of calcitriol up to 1.5mg/day and oral disodium phosphate up to 5740mg/day was started. After 6 months, there was a clear clinical and analytical improvement. CONCLUSION Osteomalacia may be a consequence of prolonged hypophosphatemia induced by recurrent ferric infusions, which is an uncommon and neglected bone adverse event of this therapy. Phosphate levels and bone symptoms should be monitored during repetitive iron infusions, maintaining a high level of suspicion for osteomalacia as it is important to identify and treat it in a timely manner, minimizing its severe morbidity.
Collapse
Affiliation(s)
- Beatriz Samões
- Rheumatology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, R. Conceição Fernandes, 4434-502 Vila Nova de Gaia, Portugal.
| | - Bruna Silva
- Rheumatology Department, Centro Hospitalar Universitário do S. João, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Ana Martins
- Rheumatology Department, Centro Hospitalar Universitário do S. João, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Daniela Oliveira
- Rheumatology Department, Centro Hospitalar Universitário do S. João, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal; Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, R. Dr. Plácido da Costa, 4200-450 Porto, Portugal
| | - Frederico Rajão Martins
- Rheumatology Department, Centro Hospitalar Universitário do Algarve, R. Leão Penedo, 8000-386 Faro, Portugal
| | - Diogo Fonseca
- Rheumatology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, R. Conceição Fernandes, 4434-502 Vila Nova de Gaia, Portugal
| | - Lúcia Costa
- Rheumatology Department, Centro Hospitalar Universitário do S. João, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Miguel Bernardes
- Rheumatology Department, Centro Hospitalar Universitário do S. João, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal; Department of Medicine, Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| |
Collapse
|
13
|
Oliveira D, Fernandes S, Miguel I, Fragoso S, Vaz F. Is There a Role for Risk-Reducing Bilateral Breast Surgery in BRCA1/2 Ovarian Cancer Survivors? An Observational Study. Curr Oncol 2023; 30:7810-7817. [PMID: 37754482 PMCID: PMC10528403 DOI: 10.3390/curroncol30090567] [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: 06/19/2023] [Revised: 08/16/2023] [Accepted: 08/21/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Risk-reducing surgeries are an option for cancer risk management in BRCA1/2 individuals. However, while adnexectomy is commonly recommended in breast cancer (BC) survivors, risk-reducing bilateral breast surgery (RRBBS) is controversial in ovarian cancer (OC) survivors due to relapse rates and mortality. METHODS We conducted a retrospective analysis of BRCA1/2-OC survivors, with OC as first cancer diagnosis. RESULTS Median age at OC diagnosis for the 69 BRCA1/2-OC survivors was 54 years. Median overall survival was 8 years, being significantly higher for BRCA2 patients than for BRCA1 patients (p = 0.011). Nine patients (13.2%) developed BC at a median age of 61 years. The mean overall BC-free survival was 15.5 years (median not reached). Eight patients (11.8%) underwent bilateral mastectomy (5 simultaneous with BC treatment; 3 RRBBS) at a median age of 56.5 years. The median time from OC to bilateral mastectomy/RRBBS was 5.5 years. CONCLUSIONS This study adds evidence regarding a lower BC risk after BRCA1/2-OC and higher survival for BRCA2-OC patients. A comprehensive analysis of the competing risks of OC mortality and recurrence against the risk of BC should be individually addressed. Surgical BC risk management may be considered for longer BRCA1/2-OC disease-free survivors. Ultimately, these decisions should always be tailored to patients' characteristics and preferences.
Collapse
Affiliation(s)
- Daniela Oliveira
- Medical Genetics Unit, Centro Hospitalar e Universitário de Coimbra, 3000-602 Coimbra, Portugal;
- University Clinic of Genetics, Faculdade de Medicina, Universidade de Coimbra, 3000-548 Coimbra, Portugal
- Clinical Academic Center of Coimbra, 3004-561 Coimbra, Portugal
| | - Sofia Fernandes
- Familial Cancer Risk Clinic, Instituto Português de Oncologia de Lisboa Francisco Gentil, 1099-023 Lisboa, Portugal; (S.F.); (I.M.)
| | - Isália Miguel
- Familial Cancer Risk Clinic, Instituto Português de Oncologia de Lisboa Francisco Gentil, 1099-023 Lisboa, Portugal; (S.F.); (I.M.)
- Medical Oncology Service, Instituto Português de Oncologia de Lisboa Francisco Gentil, 1099-023 Lisboa, Portugal
| | - Sofia Fragoso
- Molecular Pathobiology Research Unit, Instituto Português de Oncologia de Lisboa Francisco Gentil, 1099-023 Lisboa, Portugal;
| | - Fátima Vaz
- Familial Cancer Risk Clinic, Instituto Português de Oncologia de Lisboa Francisco Gentil, 1099-023 Lisboa, Portugal; (S.F.); (I.M.)
- Medical Oncology Service, Instituto Português de Oncologia de Lisboa Francisco Gentil, 1099-023 Lisboa, Portugal
| |
Collapse
|
14
|
Martins A, Pimenta S, Oliveira D, Martins F, Samões B, Costa L. Severe and life-threatening onset of systemic lupus erythematosus. Reumatol Clin (Engl Ed) 2023; 19:402-403. [PMID: 37661117 DOI: 10.1016/j.reumae.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 09/12/2022] [Indexed: 09/05/2023]
Abstract
Macrophage activation syndrome (MAS) is a potentially life-threatening complication of rheumatic diseases. We report a unique case of a previously healthy 20-year-old female presenting with MAS as first presentation of systemic lupus erythematosus. Remission was achieved with hydroxychloroquine, intravenous methylprednisolone pulse followed by oral prednisolone and cyclosporine. However, the management of MAS is still challenging, and the mortality rate remains high.
Collapse
Affiliation(s)
- Ana Martins
- Department of Rheumatology, Centro Hospitalar Universitário de São João, Porto, Portugal; Department of Medicine, Faculdade de Medicina da Universidade do Porto, Porto, Portugal.
| | - Sofia Pimenta
- Department of Rheumatology, Centro Hospitalar Universitário de São João, Porto, Portugal; Department of Medicine, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Daniela Oliveira
- Department of Rheumatology, Centro Hospitalar Universitário de São João, Porto, Portugal; Department of Medicine, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | | | - Beatriz Samões
- Department of Rheumatology, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Lúcia Costa
- Department of Rheumatology, Centro Hospitalar Universitário de São João, Porto, Portugal
| |
Collapse
|
15
|
Martins A, Oliveira D, Martins FR, Nicolau R, Pinheiro FO, Rato MS, Pimenta S, Costa L, Bernardes M. Immune-mediated skin lesions related to biological disease-modifying antirheumatic drugs: a 22-year experience of a tertiary center. ARP Rheumatol 2023:AO230124. [PMID: 37728114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
INTRODUCTION Immune-mediated skin lesions (IMSL) can be very disabling leading to treatment discontinuation. Although these lesions have rarely been previously described, the true incidence is unknown. OBJECTIVE To explore the cumulative incidence, management and outcomes of IMSL related to bDMARD in a large cohort of patients with chronic inflammatory rheumatic diseases. To explore possible associations and risk factors for IMSL development. METHODS A retrospective single-center study of patients with rheumatoid arthritis (RA), spondylarthritis (SpA) and psoriatic arthritis (PsA) that had been treated with at least one bDMARD for at least 6 months was conducted. IMSL related to bDMARD characteristics and outcomes were collected. RESULTS A total of 989 patients with RA, SpA and PsA were included. Twenty-seven patients (2.7%) presented IMSL potentially related to bDMARD, being psoriasis the most common IMSL (n=12, 44.4%), followed by drug-induced lupus erythematosus (n=6), alopecia areata (n=3) and leukocytoclastic vasculitis (n=2). IMSL led to withdrawal of bDMARD in 18 of the 27 patients (66.7%). Patients with IMSL had younger age at diagnosis (p=0.038), longer disease duration (p=0.018), longer duration of bDMARD treatment (p=0.008), and higher number of previous bDMARDs (p < 0.001) than patients without IMSL. In the group of patients with IMSL there was a significantly higher percentage of patients treated with adalimumab (p < 0.001). In multivariate regression model, the number of previous bDMARDs (OR 2.13, 95%CI 1.47-3.10, p < 0.001) and treatment with adalimumab (OR 4.60, 95%CI 1.96-10.80 , p < 0.001) were statistically significant predictive factors for IMSL development. CONCLUSION In our study, IMSL related to bDMARDs had an estimated cumulative incidence of 2.7%. Younger age at diagnosis, longer disease duration, longer duration of bDMARD treatment, higher number of previous bDMARDs and treatment with adalimumab were independently associated with an increased risk of IMSL development.
Collapse
Affiliation(s)
- Ana Martins
- Centro Hospitalar Universitário São João, Porto, Portugal
| | | | | | | | | | | | - Sofia Pimenta
- Centro Hospitalar Universitário São João, Porto, Portugal
| | - Lúcia Costa
- Centro Hospitalar Universitário São João, Porto, Portugal
| | | |
Collapse
|
16
|
Rainho R, Oliveira D, Bernardes M, Costa L, Vaz C, Fonseca JA, Jácome C. Content validity of a patient-reported experience measure (CQRA-PREM) for patients with rheumatoid arthritis in Portugal. ARP Rheumatol 2023:AO230100. [PMID: 37728137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
TBackground: The evaluation of perceptions of patients with rheumatoid arthritis (RA) has a positive influence in their health outcomes and overall experience of care. The Commissioning for Quality in Rheumatoid Arthritis Patient-Reported Experience Measure (CQRA-PREM) was developed to provide the perceptions and the feedback of the patients with RA to the health professionals team. This PREM is already validated and in use in the United Kingdom (UK) and Netherlands. In Portugal, there is no validated PREM to evaluate the experience of patients with RA. OBJECTIVE To translate, cultural adapt and validate the content of the CQRA-PREM for the Portuguese population. METHODS A qualitative study using focus groups was conducted to evaluate CQRA-PREM content validity. The CQRA-PREM was first translated and cultural adapted to Portuguese by two researchers, and after back translation, a panel of experts agreed on the preliminary Portuguese version of CQRA-PREM. Patients with RA were recruited from a rheumatology center at a tertiary university hospital center to participate in focus group meetings. Before the focus group they filled in the preliminary version of CQRA-PREM, with its 7 domains and 24 items (Likert scale 1-5). RESULTS Twelve participants (median 54 (45-58) years old; 92% female) were included in two focus groups. All domains of the questionnaire had medians of 3 or above. Seven major themes and six subthemes emerged. Participants considered the questionnaire as very clear and simple and with adequate questions. Patients pointed as extremely important being treated with dignity and respect and considered the awareness of the multidisciplinary team and the presentation of support programs and organizations as areas for improvement. CONCLUSION The Portuguese version of the CQRA-PREM is acceptable and its content is valid in the perspective of patients with RA to assess the quality of care provided by the healthcare services.
Collapse
Affiliation(s)
- Raquel Rainho
- Faculty of Medicine, University of Porto, Porto, Portugal
| | | | | | - Lúcia Costa
- Centro Hospitalar Universitário São João, Porto, Portugal
| | - Carlos Vaz
- Faculty of Medicine, University of Porto, Porto, Portugal
| | | | - Cristina Jácome
- Faculty of Medicine of the University of Porto, Porto, Portugal
| |
Collapse
|
17
|
Guimarães F, Ferreira M, Soares C, Parente H, Matos CO, Costa R, Oliveira D, Abreu C, Teixeira R, Azevedo S, Dias JM, Araújo F, Ferreira CC, Santos FC, Fontes T, Faria M, Silva L, Chícharo A, Nero P, Santos H, Sepriano A, Santos-Faria D, Tavares-Costa J. Cycling versus swapping strategies in psoriatic arthritis: results from the rheumatic diseases Portuguese register. ARP Rheumatol 2023:AO230010. [PMID: 37728133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
OBJECTIVE To compare the 2-year retention rate between a second tumor necrosis factor alpha inhibitor (TNFi) and secukinumab (SEK) or ustekinumab (UST), in Psoriatic Arthritis (PsA) patients with previous inadequate response to their first TNFi. METHODS Prospective longitudinal cohort study with a follow-up period of 2 years using the Nationwide Portuguese Reuma.pt database. Patients with a clinical diagnosis of PsA who also fulfill the CASPAR classification criteria, with previous treatment failure to a first-line TNFi and having started a second biotechnological drug (TNFi, SEK or UST) were included. The Cycling group was defined as switching from a first TNFi to a second TNFi, and the Swapping group as switching from a first TNFi to SEK or UST. Sociodemographic data, disease characteristics, disease activity scores and physical function at baseline and after 6, 12 and 24 months were recorded. Cox-proportional hazards regression was used to compare retention rates between Cycling and Swapping groups. To obtain a predictor model of 2-year discontinuation, a multivariable Cox regression model was performed. RESULTS In total, 439 patients were included, 58% were female, with a mean age (standard deviation) of 49 (12) years. Globally, 75.6% initiated a second TNFi (Cycling group), and 24.4% started SEK/UST (Swapping group). The retention rates after 6, 12 and 24 months were 72%/66%/59% in the Cycling group; and 77%/66%/59% in the Swapping group. There were no significant differences in retention rates between both strategies (HR: 1.06, 95% CI 0.72-1.16). After 2 years of follow-up, 34.4% of patients discontinued their second biologic, mainly due to inefficacy (72.8%), with no differences found between groups. Baseline treatment with glucocorticoids was the only predictor of discontinuation after 2 years of follow-up (HR:1.668, 95% CI 1.154-2.409). CONCLUSIONS After failure of a first TNF inhibitor, Cycling and Swapping strategies result in similar retention rates suggesting that both are acceptable in the management of patients with psoriatic arthritis.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Lígia Silva
- Centro Hospitalar Trás-os-Montes e Alto Douro
| | | | | | | | | | | | | |
Collapse
|
18
|
Oliveira D, Costa L, Vaz C. Freiberg disease: A rare cause of chronic foot pain. Reumatol Clin (Engl Ed) 2023; 19:348. [PMID: 37286270 DOI: 10.1016/j.reumae.2022.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 11/24/2022] [Indexed: 06/09/2023]
Affiliation(s)
- Daniela Oliveira
- Rheumatology Department, University Hospital Center of São João, Porto, Portugal; Department of Medicine of Faculty of Medicine, University of Porto, Porto, Portugal; Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, Portugal.
| | - Lúcia Costa
- Rheumatology Department, University Hospital Center of São João, Porto, Portugal
| | - Carlos Vaz
- Rheumatology Department, University Hospital Center of São João, Porto, Portugal; Department of Medicine of Faculty of Medicine, University of Porto, Porto, Portugal; Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, Portugal
| |
Collapse
|
19
|
Martins A, Oliveira D, Martins FR, Rato MS, Pinheiro FO, Fonseca D, Garcia S, Fernandes BM, Pimenta S, Vaz C, Costa L, Bernardes M. The impact of antinuclear antibodies seroconversion induced by anti-tumor necrosis factor α agents on the clinical outcomes in rheumatic patients. ARP Rheumatol 2023:AO220277. [PMID: 37178156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
INTRODUCTION Anti-tumor necrosis factor α (anti-TNFα) agents can potentially induce the anti-nuclear antibodies (ANA) development over time. Evidence of the real impact of these autoantibodies on clinical response to treatment in rheumatic patients is still scarce. OBJECTIVES To explore the impact of ANA seroconversion induced by anti-TNFα therapy on clinical outcomes in biologic-naïve patients with Rheumatoid arthritis (RA), axial spondylarthritis (axSpA) and psoriatic arthritis (PsA). METHODS An observational retrospective cohort study enrolling biologic-naïve patients with RA, axSpA and PsA who started their first anti-TNFα agent was conducted for 24 months(M). Sociodemographic data, laboratory findings, disease activity and physical function scores were collected at baseline, 12M and 24M. To examine the differences between the groups with and without ANA seroconversion, independent samples t-tests, Mann-Whitney U-tests and chi-square tests were performed. Linear and logistic regression models were used to assess the effects of ANA seroconversion on the clinical response to treatment. RESULTS A total of 432 patients with RA (N=185), axSpA (N=171) and PsA (N=66) were included. ANA seroconversion rate at 24M was 34.6%, 64.3% and 63.6% for RA, axSpA and PsA, respectively. Regarding sociodemographic and clinical data in RA and PsA patients, no statistically significant differences between groups with and without ANA seroconversion were found. In axSpA patients, ANA seroconversion was more frequent in patients with higher body mass index (p=0.017) and significantly less frequent in patients treated with etanercept (p=0.01). Regarding disease activity, DAS28 for RA patients and ASDAS-CRP for axSpA patients were significantly higher in ANA seroconversion group at 12M (p=0.017 and p=0.009, respectively). For PsA patients, CDAI was significantly higher in ANA seroconversion group at 24M (p=0.043). Overall switching rate of biologic disease-modifying antirheumatic drugs (bDMARD) was significantly higher in the ANA seroconversion group over time (p=0.025). For RA patients, ANA seroconversion predicted DAS28 (β=-0.21, 95%CI[-1.86;-0.18], p=0.017) at 12M. CONCLUSIONS ANA seroconversion induced by anti-TNFα agents could interfere in clinical response of patients with rheumatic diseases. The presence of these autoantibodies can be considered as a potential predictor of poor treatment response and higher need for bDMARD switching over time.
Collapse
Affiliation(s)
- Ana Martins
- Centro Hospitalar Universitário São João, Porto, Portugal
| | | | | | | | | | - Diogo Fonseca
- Centro Hospitalar Vila Nova de Gaia/Espinho, Gaia, Portugal
| | - Salomé Garcia
- Centro Hospitalar Universitário São João, Porto, Portugal
| | | | - Sofia Pimenta
- Centro Hospitalar Universitário São João, Porto, Portugal
| | - Carlos Vaz
- Centro Hospitalar Universitário São João, Porto, Portugal
| | - Lúcia Costa
- Centro Hospitalar Universitário São João, Porto, Portugal
| | | |
Collapse
|
20
|
Oliveira D, Assis A, Hora JB, Moreira A, Melo J, Rocha A, Nahas S, Carnevale F. Abstract No. 40 Embolization of the Superior and Middle Rectal Arteries for the Treatment of Symptomatic Hemorrhoidal Disease using the Combination of Metallic Coils and Microspheres. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023] Open
|
21
|
Carvalho RMS, Oliveira D, Pesquita C. Knowledge Graph Embeddings for ICU readmission prediction. BMC Med Inform Decis Mak 2023; 23:12. [PMID: 36658526 PMCID: PMC9850812 DOI: 10.1186/s12911-022-02070-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 03/31/2022] [Accepted: 11/28/2022] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Intensive Care Unit (ICU) readmissions represent both a health risk for patients,with increased mortality rates and overall health deterioration, and a financial burden for healthcare facilities. As healthcare became more data-driven with the introduction of Electronic Health Records (EHR), machine learning methods have been applied to predict ICU readmission risk. However, these methods disregard the meaning and relationships of data objects and work blindly over clinical data without taking into account scientific knowledge and context. Ontologies and Knowledge Graphs can help bridge this gap between data and scientific context, as they are computational artefacts that represent the entities of a domain and their relationships to each other in a formalized way. METHODS AND RESULTS We have developed an approach that enriches EHR data with semantic annotations to ontologies to build a Knowledge Graph. A patient's ICU stay is represented by Knowledge Graph embeddings in a contextualized manner, which are used by machine learning models to predict 30-days ICU readmissions. This approach is based on several contributions: (1) an enrichment of the MIMIC-III dataset with patient-oriented annotations to various biomedical ontologies; (2) a Knowledge Graph that defines patient data with biomedical ontologies; (3) a predictive model of ICU readmission risk that uses Knowledge Graph embeddings; (4) a variant of the predictive model that targets different time points during an ICU stay. Our predictive approaches outperformed both a baseline and state-of-the-art works achieving a mean Area Under the Receiver Operating Characteristic Curve of 0.827 and an Area Under the Precision-Recall Curve of 0.691. The application of this novel approach to help clinicians decide whether a patient can be discharged has the potential to prevent the readmission of [Formula: see text] of Intensive Care Unit patients, without unnecessarily prolonging the stay of those who would not require it. CONCLUSION The coupling of semantic annotation and Knowledge Graph embeddings affords two clear advantages: they consider scientific context and they are able to build representations of EHR information of different types in a common format. This work demonstrates the potential for impact that integrating ontologies and Knowledge Graphs into clinical machine learning applications can have.
Collapse
Affiliation(s)
- Ricardo M. S. Carvalho
- grid.9983.b0000 0001 2181 4263LASIGE, Faculty of Sciences, University of Lisbon, Lisbon, Portugal
| | - Daniela Oliveira
- grid.9983.b0000 0001 2181 4263LASIGE, Faculty of Sciences, University of Lisbon, Lisbon, Portugal
| | - Catia Pesquita
- grid.9983.b0000 0001 2181 4263LASIGE, Faculty of Sciences, University of Lisbon, Lisbon, Portugal
| |
Collapse
|
22
|
Nicolau R, Martins A, Oliveira D, Samões B, Martins F, Pinheiro F, Rato M, Bernardes M, Costa L. Impact de l’infection par le SARS-CoV-2 sur l’activité de la maladie des patients atteints de rhumatisme psoriasique sous bDMARD : données réelles. Rev Rhum Ed Fr 2022. [PMCID: PMC9758747 DOI: 10.1016/j.rhum.2022.10.401] [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] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Introduction L’infection par le SARS-CoV-2 peut entraîner une inflammation sévère et il a été suggéré d’induire des poussées de rhumatisme psoriasique (RP). Cependant, l’impact sur l’activité de la maladie et la réponse aux DMARD biologiques modificateurs de la maladie (bDMARD) reste inconnu. Patients et méthodes Nous avons réalisé une analyse rétrospective incluant tous les patients atteints de RP, répondant aux critères CASPAR et sous biothérapie, suivis dans le service de rhumatologie d’un CHU universitaire tertiaire. Les données démographiques et cliniques, y compris la survenue d’une infection par le SARS-CoV-2, ont été collectées à partir de notre base de données nationale (reuma.pt). L’activité de la maladie (CDAI, SDAI, DAS28 4v, BASDAI, ASDAS) et les réponses aux bDMARD (réponses EULAR, ASDAS, ASAS, ACR et PsARC) ont été évaluées avant et après l’infection par le SARS-Cov-2. Résultats Au total, 102 patients atteints de RP ont été inclus. Cinquante-deux étaient des femmes (51 %). L’âge moyen était de 53 ± 11,09 ans et la durée médiane de la maladie était de 15 ans [min 2, max 47]. Au total, 54 (53 %) patients avaient une atteinte axiale prédominante, 26 (26 %) périphérique et 36 (37 %) enthésopathique. Le bDMARD le plus utilisé était l’étanercept (n = 28, 27,5 %) suivi de l’adalimumab (n = 22, 21,6 %) et du sécukinumab (n = 18, 17,6 %). La prévalence de l’infection par le SARS-CoV-2 était de 15,7 % (n = 16). Soixante-trois pour cent ont reçu le vaccin BNT162b2 (Pfizer/BioNtech), 31 % ont reçu l’ARNm-1273 (Moderna), 13 % ont reçu l’AZD1222 (AstraZeneca) et 13 % ont reçu l’AD26.COV2.S (Janssen/Johnson & Johnson). Soixante-trois pour cent étaient infectés avant toute vaccination, 13 % après la première dose et 25 % après la seconde. Les symptômes les plus fréquents étaient l’anosmie (65 %), la dysgueusie (56 %) et la toux (56 %). Tous les patients se sont complètement remis de l’infection, sans nécessiter d’hospitalisation. Quel que soit le score utilisé, la différence entre l’activité moyenne de la maladie après l’infection par le SARS-CoV-2 et celle au départ n’a pas atteint la signification statistique. Au départ et après l’infection, les paramètres moyens de l’activité de la maladie étaient respectivement : CDAI 8,6 ± 5,7 vs 8,6 ± 5,7, p = 0,997 ; SDAI 9,3 ± 6,6 contre 9,2 ± 6,1, p = 0,928 ; DAS 28 4v 2,9 ± 1,2 contre 2,9 ± 1,2, p = 0,818 ; BASDAI 3,6 ± 2,6 contre 3,2 ± 2,7, p = 0,506 ; ASDAS 2,2 ± 1,2 contre 2,2 ± 1, p = 0,721. Le nombre de patients ne répondant pas aux bDMARD (selon EULAR, ASDAS, ASAS, ACR et PsARC) avant l’infection n’était pas différent de celui post-infection. Conclusion Notre étude suggère que l’infection par le SARS-CoV-2 n’a aucun impact négatif sur l’activité de la maladie PSA et les réponses bDMARD. Cependant, d’autres études sont encore nécessaires pour mieux comprendre les effets à long terme de l’infection par le SARS-CoV-2.
Collapse
Affiliation(s)
- R. Nicolau
- Rhumatologie, Centro Hospitalar Tondela – Viseu, Epe, Viseu, Portugal,Auteur correspondant
| | - A. Martins
- Rhumatologie, Centro Hospitalar Universitário de São-João, Porto, Portugal
| | - D. Oliveira
- Rhumatologie, Centro Hospitalar Universitário de São-João, Porto, Portugal
| | - B. Samões
- Département de rhumatologie, Centro Hospitalar Vila Nova de Gaia e Espinho, Vila Nova de Gaia
| | - F. Martins
- Rhumatologie, Centro Hospitalar Universitário do Algarve, Algarve, Portugal
| | - F. Pinheiro
- Rhumatologie, Centro Hospitalar e Universitário de São-João, Porto, Portugal
| | - M. Rato
- Rhumatologie, Centro Hospitalar e Universitário de São-João, Porto, Portugal
| | - M. Bernardes
- Rhumatologie, Centro Hospitalar São-João, Porto, Portugal
| | - L. Costa
- Rhumatologie, Centro Hospitalar De São-João, E.P.E., Porto, Portugal
| |
Collapse
|
23
|
Oliveira D, Correia BP, Sharma S, Moreira FTC. Molecular Imprinted Polymers on Microneedle Arrays for Point of Care Transdermal Sampling and Sensing of Inflammatory Biomarkers. ACS Omega 2022; 7:39039-39044. [PMID: 36340138 PMCID: PMC9631719 DOI: 10.1021/acsomega.2c04789] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 10/13/2022] [Indexed: 06/16/2023]
Abstract
The skin interstitial fluid (ISF) contains biomarkers that complement other biofluids such as blood, sweat, saliva, and urine. It can be sampled in a minimally invasive manner and used either for point of care testing or real time, continuous monitoring of analytes, the latter using microneedle arrays. The analytes present in the skin ISF are indicative of both systemic and local (i.e., skin) physiology. In this paper, we describe combining microneedle technology with molecularly imprinted polymers to demonstrate the potential of transdermal electrochemical sensing. The molecularly imprinted polymer employed here is easy to produce; it can be thought of as plastic antibody. Its synthesis is scalable, and the resulting sensor has a short measurement time (6 min), with high accuracy and a low limit of detection. It provides the requisite specificity to detect the proinflammatory cytokine IL-6. IL-6 is present in the skin ISF with other cytokines and is implicated in many clinical states including neurodegenerative diseases and fatal pneumonia from SARSCoV 2. The ability to mass produce microneedle arrays and plastic antibodies will allow for low-cost transdermal sensing devices. The transdermal sensors were able to detect IL-6 at concentrations as low as 1 pg/mL in artificial skin ISF, indicating its utility for routine point of care, bloodless measurements in simpler settings, worldwide.
Collapse
Affiliation(s)
- Daniela Oliveira
- BioMark
Sensor Research, ISEP, School of Engineering,
Polytechnic Institute, Porto 4200-072, Portugal
- CEB,
Centre of Biological Engineering, Minho
University, Braga 4704-553, Portugal
- LABBELS
- Associate Laboratory, Braga, 4806-909 Guimarães, Portugal
| | - Barbara P Correia
- BioMark
Sensor Research, ISEP, School of Engineering,
Polytechnic Institute, Porto 4200-072, Portugal
- CEB,
Centre of Biological Engineering, Minho
University, Braga 4704-553, Portugal
- LABBELS
- Associate Laboratory, Braga, 4806-909 Guimarães, Portugal
| | - Sanjiv Sharma
- Department
of Biomedical Engineering, Faculty of Science and Engineering, Swansea University, Swansea SA1 8EN, U.K.
| | - Felismina Teixeira Coelho Moreira
- BioMark
Sensor Research, ISEP, School of Engineering,
Polytechnic Institute, Porto 4200-072, Portugal
- CEB,
Centre of Biological Engineering, Minho
University, Braga 4704-553, Portugal
- LABBELS
- Associate Laboratory, Braga, 4806-909 Guimarães, Portugal
| |
Collapse
|
24
|
Oliveira D, Vaz C. Crowned dens syndrome as a rare cause of severe cervical pain. Reumatol Clin (Engl Ed) 2022; 18:495-496. [PMID: 36210143 DOI: 10.1016/j.reumae.2022.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 02/10/2022] [Indexed: 06/16/2023]
Affiliation(s)
- Daniela Oliveira
- Rheumatology Department, University Hospital Center of São João, Porto, Portugal; Department of Medicine of Faculty of Medicine, University of Porto, Porto, Portugal; Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, Portugal.
| | - Carlos Vaz
- Rheumatology Department, University Hospital Center of São João, Porto, Portugal; Department of Medicine of Faculty of Medicine, University of Porto, Porto, Portugal
| |
Collapse
|
25
|
d'Aquin M, Kirstein F, Oliveira D, Schimmler S, Urbanek S. FAIREST: A Framework for Assessing Research Repositories. Data Intelligence 2022. [DOI: 10.1162/dint_a_00159] [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: 11/04/2022] Open
Abstract
Abstract
The open science movement has gained significant momentum within the last few years. This comes along with the need to store and share research artefacts, such as publications and research data. For this purpose, research repositories need to be established. A variety of solutions exist for implementing such repositories, covering diverse features, ranging from custom depositing workflows to social media-like functions.
In this article, we introduce the FAIREST principles, a framework inspired by the well- known FAIR principles, but designed to provide a set of metrics for assessing and selecting solutions for creating digital repositories for research artefacts. The goal is to support decision makers in choosing such a solution when planning for a repository, especially at an institutional level. The metrics included are therefore based on two pillars: (1) an analysis of established features and functionalities, drawn from existing dedicated, general purpose and commonly used solutions, and (2) a literature review on general requirements for digital repositories for research artefacts and related systems. We further describe an assessment of 11 widespread solutions, with the goal to provide an overview of the current landscape of research data repository solutions, identifying gaps and research challenges to be addressed.
Collapse
Affiliation(s)
- Mathieu d'Aquin
- LORIA, Université de Lorraine, CNRS, INRIA, 54506, Vandœuvre-lès-Nancy, France
| | - Fabian Kirstein
- Fraunhofer FOKUS and Weizenbaum Institute for the Networked Society, 10623 Berlin, Germany
| | - Daniela Oliveira
- LaSIGE, Faculdade de Ciecias, Universidade de Lisboa 1749-016 Lisboa, Portugal
| | - Sonja Schimmler
- Fraunhofer FOKUS and Weizenbaum Institute for the Networked Society, 10623 Berlin, Germany
| | - Sebastian Urbanek
- Fraunhofer FOKUS and Weizenbaum Institute for the Networked Society, 10623 Berlin, Germany
| |
Collapse
|
26
|
Shi H, Silva M, Giovanini L, Capecci D, Czech L, Fernandes J, Oliveira D. Lumen: A machine learning framework to expose influence cues in texts. Front Comput Sci 2022. [DOI: 10.3389/fcomp.2022.929515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Phishing and disinformation are popular social engineering attacks with attackers invariably applying influence cues in texts to make them more appealing to users. We introduce Lumen, a learning-based framework that exposes influence cues in text: (i) persuasion, (ii) framing, (iii) emotion, (iv) objectivity/subjectivity, (v) guilt/blame, and (vi) use of emphasis. Lumen was trained with a newly developed dataset of 3K texts comprised of disinformation, phishing, hyperpartisan news, and mainstream news. Evaluation of Lumen in comparison to other learning models showed that Lumen and LSTM presented the best F1-micro score, but Lumen yielded better interpretability. Our results highlight the promise of ML to expose influence cues in text, toward the goal of application in automatic labeling tools to improve the accuracy of human-based detection and reduce the likelihood of users falling for deceptive online content.
Collapse
|
27
|
Sposito AC, Breder I, Barreto J, Breder J, Bonilha I, Lima M, Oliveira A, Wolf V, Luchiari B, do Carmo HR, Munhoz D, Oliveira D, Coelho-Filho OR, Coelho OR, Matos-Souza JR, Moura FA, de Carvalho LSF, Nadruz W, Quinaglia T, Kimura-Medorima ST. Evolocumab on top of empagliflozin improves endothelial function of individuals with diabetes: randomized active-controlled trial. Cardiovasc Diabetol 2022; 21:147. [PMID: 35933413 PMCID: PMC9356512 DOI: 10.1186/s12933-022-01584-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 07/28/2022] [Indexed: 12/02/2022] Open
Abstract
Background Sodium-glucose cotransporter 2 inhibitors (SGLT2i) improve endothelial dysfunction and reduce cardiovascular events in individuals with type 2 diabetes (T2D). Proprotein convertase subtilisin/kexin 9 (PCSK9i) inhibitors reduce cardiovascular events in high-risk patients. Whether the addition of PCSK9i to SGLT2i treatment adds benefits is not known. Objectives To assess the PCSK9-i effect on the endothelial function of T2D individuals under treatment with SGLT2-i. Methods Individuals with T2D were randomized in a 1:1 ratio to a 16-week treatment with either empagliflozin (E) or empagliflozin plus evolocumab (EE). The primary endpoint was post-treatment change from baseline in flow-mediated dilation (FMD) at 1-min. Secondary outcomes included changes in plasma levels of nitric oxide metabolites and isoprostane. Results A total of 110 patients were enrolled, the mean age was 58 years, and 71% were men. The median post-treatment change in FMD at 1-min was 2.7% (interquartile range [IQR]: 0.9%) and 0.4% (IQR: 0.9%) in the EE and E groups, respectively (p < 0.001). There was a greater increase in plasma levels of nitrate [5.9 (16.5) vs. 2.6 (11.8); p = 0.001] and nitrite [0.14 (0.72) vs. 0.02 (0.74); p = 0.025] in the EE group than in the E group, respectively. Isoprostane reduction was more pronounced in the EE group when compared to the E group [−1.7 (5.9) vs. −1.1 (5.3); p < 0.001). Conclusions In individuals with T2D, the addition of evolocumab on top of empagliflozin improves endothelial function. Supplementary Information The online version contains supplementary material available at 10.1186/s12933-022-01584-8.
Collapse
Affiliation(s)
- Andrei C Sposito
- Division of Cardiology, State University of Campinas (Unicamp), Campinas, Sao Paulo, 13084-971, Brazil. .,Brazilian Heart Study Group, State University of Campinas (Unicamp), Campinas, Sao Paulo, 13084-971, Brazil.
| | - Ikaro Breder
- Division of Cardiology, State University of Campinas (Unicamp), Campinas, Sao Paulo, 13084-971, Brazil
| | - Joaquim Barreto
- Division of Cardiology, State University of Campinas (Unicamp), Campinas, Sao Paulo, 13084-971, Brazil
| | - Jessica Breder
- Division of Cardiology, State University of Campinas (Unicamp), Campinas, Sao Paulo, 13084-971, Brazil
| | - Isabella Bonilha
- Division of Cardiology, State University of Campinas (Unicamp), Campinas, Sao Paulo, 13084-971, Brazil
| | - Marcus Lima
- Division of Cardiology, State University of Campinas (Unicamp), Campinas, Sao Paulo, 13084-971, Brazil
| | - Alessandra Oliveira
- Division of Cardiology, State University of Campinas (Unicamp), Campinas, Sao Paulo, 13084-971, Brazil
| | - Vaneza Wolf
- Division of Cardiology, State University of Campinas (Unicamp), Campinas, Sao Paulo, 13084-971, Brazil
| | - Beatriz Luchiari
- Division of Cardiology, State University of Campinas (Unicamp), Campinas, Sao Paulo, 13084-971, Brazil
| | - Helison R do Carmo
- Division of Cardiology, State University of Campinas (Unicamp), Campinas, Sao Paulo, 13084-971, Brazil
| | - Daniel Munhoz
- Division of Cardiology, State University of Campinas (Unicamp), Campinas, Sao Paulo, 13084-971, Brazil
| | - Daniela Oliveira
- Division of Cardiology, State University of Campinas (Unicamp), Campinas, Sao Paulo, 13084-971, Brazil
| | - Otavio R Coelho-Filho
- Division of Cardiology, State University of Campinas (Unicamp), Campinas, Sao Paulo, 13084-971, Brazil
| | - Otavio R Coelho
- Division of Cardiology, State University of Campinas (Unicamp), Campinas, Sao Paulo, 13084-971, Brazil
| | - Jose Roberto Matos-Souza
- Division of Cardiology, State University of Campinas (Unicamp), Campinas, Sao Paulo, 13084-971, Brazil
| | - Filipe A Moura
- Division of Cardiology, State University of Campinas (Unicamp), Campinas, Sao Paulo, 13084-971, Brazil.,Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, USA
| | - Luiz Sergio F de Carvalho
- Division of Cardiology, State University of Campinas (Unicamp), Campinas, Sao Paulo, 13084-971, Brazil
| | - Wilson Nadruz
- Division of Cardiology, State University of Campinas (Unicamp), Campinas, Sao Paulo, 13084-971, Brazil
| | - Thiago Quinaglia
- Division of Cardiology, State University of Campinas (Unicamp), Campinas, Sao Paulo, 13084-971, Brazil
| | - Sheila T Kimura-Medorima
- Division of Cardiology, State University of Campinas (Unicamp), Campinas, Sao Paulo, 13084-971, Brazil
| | | |
Collapse
|
28
|
Martins A, Pimenta S, Rato M, Oliveira D, Martins FR, Pinheiro FO, Fonseca D, Costa L. Pseudo-pseudo Meigs syndrome: an uncommon onset of Systemic Lupus Erythematosus. ARP Rheumatol 2022:RC220147. [PMID: 36056947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Serositis is seen in approximately 12% of patients with systemic lupus erythematosus (SLE), usually in the form of pleuritis or pericarditis. Peritoneal serositis with ascites is an extremely rare manifestation of SLE and ascites as initial manifestation of SLE is even rarer. Here, we describe a previously healthy 48-year-old female with periumbilical abdominal pain, constitutional symptoms, ascites, pleural effusions and raised CA-125 level as an initial manifestation of SLE, which led up to the diagnosis of pseudo-pseudo Meigs syndrome. PPMS is a rare manifestation of SLE and awareness of this entity among clinicians is crucial to ensure an early recognition and prompt treatment.
Collapse
Affiliation(s)
- Ana Martins
- Rheumatology, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Sofia Pimenta
- Rheumatology, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Maria Rato
- Rheumatology, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Daniela Oliveira
- Rheumatology, Centro Hospitalar Universitário São João, Porto, Portugal
| | | | | | - Diogo Fonseca
- Rheumatology, Centro Hospitalar Vila Nova de Gaia / Espinho - Unit 1, Vila Nova de Gaia, Portugal
| | - Lúcia Costa
- Rheumatology, Centro Hospitalar Universitário São João, Porto, Portugal
| |
Collapse
|
29
|
Nunes DA, Ferreira-Gomes J, Vaz C, Oliveira D, Pimenta S, Neto F, Martins de Matos D. Analysis of chronic pain descriptions for base-pathology prediction: the case of rheumatoid arthritis versus spondylitis pathology prediction based on pain descriptions. DOR 2022. [DOI: 10.24875/dor.m22000014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|
30
|
Sun R, Yuan X, He P, Zhu Q, Chen A, Gregio A, Oliveira D, Li X. Learning Fast and Slow: Propedeutica for Real-Time Malware Detection. IEEE Trans Neural Netw Learn Syst 2022; 33:2518-2529. [PMID: 34723811 DOI: 10.1109/tnnls.2021.3121248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Existing malware detectors on safety-critical devices have difficulties in runtime detection due to the performance overhead. In this article, we introduce Propedeutica, a framework for efficient and effective real-time malware detection, leveraging the best of conventional machine learning (ML) and deep learning (DL) techniques. In Propedeutica, all software start executions are considered as benign and monitored by a conventional ML classifier for fast detection. If the software receives a borderline classification from the ML detector (e.g., the software is 50% likely to be benign and 50% likely to be malicious), the software will be transferred to a more accurate, yet performance demanding DL detector. To address spatial-temporal dynamics and software execution heterogeneity, we introduce a novel DL architecture (DeepMalware) for Propedeutica with multistream inputs. We evaluated Propedeutica with 9115 malware samples and 1338 benign software from various categories for the Windows OS. With a borderline interval of [30%, 70%], Propedeutica achieves an accuracy of 94.34% and a false-positive rate of 8.75%, with 41.45% of the samples moved for DeepMalwareanalysis. Even using only CPU, Propedeutica can detect malware within less than 0.1 s.
Collapse
|
31
|
Hohmann L, Oliveira D, Sigurjónsdóttir K, Bosch A, Borg Å, Vallon-Christersson J, Staaf J. 17P Clinicopathological and transcriptomic characterization of luminal HER2-enriched breast cancer. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.03.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
32
|
Staaf J, Oliveira D, Vallon-Christersson J, Ehrencrona H, Kvist A, Borg Å. 150P Molecular characteristics of breast cancer patients subjected to screening for germline predisposition in a population-based observational study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.03.167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
|
33
|
Cardoso DP, Oliveira D, Antunes B, Saraiva R, Angus K, Gallardo E, Rosário F. Portuguese Validated Versions of the Alcohol Use Disorders Identification Test: A Systematic Review Protocol. ACTA MEDICA PORT 2022; 35:264-269. [PMID: 34409933 DOI: 10.20344/amp.15765] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 04/28/2021] [Accepted: 05/18/2021] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Alcohol consumption ranks among the top ten risk factors contributing to the global disease burden. Several international organizations recommend the use of the Alcohol Use Disorders Identification Test to screen for at-risk drinkers. However, a fully validated Portuguese version of this test is lacking. The aim of this study is to systematically review validated versions of the Alcohol Use Disorders Identification Test in the Portuguese language, the documented problems and solutions in its application and proposed cut-offs to identify at-risk drinkers. MATERIAL AND METHODS A systematic search will be performed in Ovid MEDLINE, CINAHL, PsycINFO, ÍndexRMP, LILACS, African Journals Online and SciELO databases, along with grey literature searches to identify validation studies of the AUDIT in Portuguese. Two authors will independently extract data and assess the studies' methodological quality, using QUADAS-2 and CASP checklists. DISCUSSION This review will compare different validation studies of the Alcohol Use Disorders Identification Test in Portuguese-speaking countries, reporting, where possible, the psychometric properties, performance characteristics, suggested cut-offs and any documented limitations and suggestions. The results of this review could be used to propose an update of the alcohol screening and brief intervention guidelines in Portugal. The results could also prove useful to support the implementation of alcohol screening delivery by healthcare providers in Portugal and other official Portuguese-speaking countries. CONCLUSION This review will provide important information on the validity of the Alcohol Use Disorders Identification Test as a screening tool for at-risk drinking in Portugal and other official Portuguese speaking countries.
Collapse
Affiliation(s)
- Diogo Phalempin Cardoso
- Unidade de Saúde Familiar Tondela. Agrupamento de Centros de Saúde Dão Lafões. Viseu. Portugal
| | - Daniela Oliveira
- Unidade de Saúde Familiar Grão Vasco. Agrupamento de Centros de Saúde Dão Lafões. Viseu. Portugal
| | - Beatriz Antunes
- Unidade de Saúde Familiar Vouzela. Agrupamento de Centros de Saúde Dão Lafões. Viseu. Portugal
| | - Rosa Saraiva
- Serviço de Epidemiologia e Saúde Pública. Centro Hospitalar Universitário Cova da Beira. Covilhã. Comissão Executiva para a Área de Missão Problemas Ligados ao Álcool. Centro Académico e Clínico das Beiras. Covilhã. Portugal
| | - Kathryn Angus
- Institute for Social Marketing & Health. Faculty of Health Sciences & Sport. University of Stirling. Stirling. Scotland. Reino Unido
| | - Eugenia Gallardo
- Comissão Executiva para a Área de Missão Problemas Ligados ao Álcool. Centro Académico e Clínico das Beiras. Covilhã. Centro de Investigação em Ciências da Saúde. Faculdade de Ciências da Saúde. Universidade da Beira Interior. Covilhã. Laboratório de Fármaco-Toxicologia. Universidade da Beira Interior. Covilhã. Portugal
| | - Frederico Rosário
- Unidade de Saúde Familiar Tondela. Agrupamento de Centros de Saúde Dão Lafões. Viseu. Comissão Executiva para a Área de Missão Problemas Ligados ao Álcool. Centro Académico e Clínico das Beiras. Covilhã. Equipa de Projeto em Investigação. Agrupamento de Centros de Saúde Dão Lafões. Viseu. Portugal
| |
Collapse
|
34
|
Oliveira D, d’Aquin M. Extracting data models from background knowledge graphs. Knowl Based Syst 2022. [DOI: 10.1016/j.knosys.2021.107818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
35
|
Amini S, Pereira P, Roulet J, Oliveira D, Rocha M. Degree of Conversion of Resin-Based Luting Materials Containing Alternative Photoinitiators. Dent Mater 2022. [DOI: 10.1016/j.dental.2021.12.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
36
|
Oliveira D, Rocha M, Zoidis P, Pereira P, Ribeiro A. The effect of different pulp capping methods on the intrapulpal temperature when using light-cured procedures. J Clin Exp Dent 2022; 14:e633-e638. [PMID: 36046163 PMCID: PMC9422968 DOI: 10.4317/jced.59779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 06/26/2022] [Indexed: 11/13/2022] Open
Abstract
Background To evaluate the intra-pulpal temperature during different direct pulp capping methods and light-cured procedures.
Material and Methods Class I preparations 5 mm long, 4 mm wide and 4 mm deep were performed in extracted third molars, leaving 0.5 mm of dentin at the pulpal floor with a 1 mm diameter of pulp exposure. Teeth were placed in a customized oral cavity chamber simulator in which the initial temperature was standardized at 36oC. The overall temperature variations (oC) in the pulp chamber during the light-activation processes were recorded live using an infrared camera (FLIR ONE PRO, FLIR Systems). The liners and bases evaluated were: Dycal (Dentisply), TheraCal LC (Bisco), Biodentin (Septodent), Vitrebond Plus (3M/ESPE), and Fuji IX GP (GC), followed by restoration with a bulk fill composite (EvoCeram Bulk Fill, Ivoclar Vivadent). All light-activation procedures were performed with the VALO Grand (Ultradent) light-curing unit. A power analysis was conducted to determine the sample size to provide a power of at least 0.8 with α=0.05. Statistical analyses were performed using ANOVA and Tukey’s test for multiple comparisons.
Results The intrapulpal temperature increased above a 10oC to 20oC threshold difference for all liners and bases that were light cured. When added as second layers, neither of those could provide thermal insulation following additional light-activated procedures (p=0.25). The higher the number of procedures requiring light-activation, the longer the pulp temperature remained in those increased temperature thresholds.
Conclusions For direct pulp capping procedures, a reduced number light activation procedures should be indicated to reduce the time intra-pulpal temperature rises above a 10oC threshold. Key words:Liner, base, calcium hydroxide, glass ionomer, dental adhesive, bulkfill composite.
Collapse
|
37
|
Floriani F, Brandfon B, Sawczuk NJ, Lopes G, Rocha M, Oliveira D. Color difference between the vita classical shade guide and composite veneers using the dual-layer technique. J Clin Exp Dent 2022; 14:e615-e620. [PMID: 36046166 PMCID: PMC9422970 DOI: 10.4317/jced.59759] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 06/06/2022] [Indexed: 11/28/2022] Open
Abstract
Background The purpose of this in vitro study was to evaluate the color difference between the Vita Classical Shade Guide and composite veneers using the dual-layer technique.
Material and Methods Thirty samples were fabricated using a custom-made mold (Easy Layering Shade Guide Kit, 3M) using two resin composites: Filtek Supreme Ultra (3M); and Estelite Omega (Tokuyama) (n=3). The composite veneers were made by layering the different enamel and body or dentin shades from each composite. The color measurements were taken using a spectrophotometer (Vita Easyshade V®, Vita Zahnfabrik). The ΔE00 between the Vita Classical Shade Guide (Vita Zahnfabrik) and the composite veneers were calculated using the CIEDE2000 formula.
Results For the composite veneers using Filtek Supreme Ultra, the best match for A1 Vita shade was achieved layering either EA1 with DA2 or DA3; EA2 with DA1 or DA2 (ΔE00= 1.53 ~ 1.96 ± 0.4). For A2 Vita shade the best match would be EA3 with DA3 or EA3 with DA2 (ΔE00= 1.40 ~ 1.85 ± 0.1); or for A3 Vita shade the best match would be EA3 with DA2 2.50±(0.6). For the composite veneers using Estelite Omega, the were no best match for neither A1, A2 or A3 Vita shade (ΔE00> 2.5).
Conclusions The combination of enamel and dentin shades from Filtek Supreme Ultra provided acceptable color match for A1, A2 and A3 shades from the Vita Shade Guide, while Estelite Omega did not provide acceptable color match for any of the Vita Shade Guide standard shades tested. Key words:Color, color matching, optical properties, resin composite, layering.
Collapse
|
38
|
Rocha M, Ottenga M, Zoidis P, Pontes S, Reis A, Oliveira D. Effect of dental headlights spectrum on the polymerization and working time of light-cured resin composites. J Clin Exp Dent 2022; 14:e492-e498. [PMID: 35765356 PMCID: PMC9233914 DOI: 10.4317/jced.59628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Accepted: 05/23/2022] [Indexed: 11/17/2022] Open
Abstract
Background The use of dental headlights is a common practice to better illuminate the operatory field and achieve excellence in restorative dentistry. However, visible light-cured dental materials can have reduced working time under headlight illumination. The aim of this study was to evaluate the influence of the spectral irradiance power of two dental headlights on the degree of polymerization and working time of light-curable dental composites.
Material and Methods Two headlights, StarLight Nano 3 (StarMed) (SN) and Zeon Endevour XL (Orascoptic) (ZE) were characterized using a spectrophotometer coupled to an integrating sphere (MARC® Light Collector, BlueLight Analytics). The degree of conversion of the two composites, Filtek Supreme (3M) and Tetric Prime (Ivoclar Vivadent), was evaluated using an FTIR spectroscope (NicoletTM iS20, Thermo Fisher).
Results Both headlights emitted a significant amount of blue light. The Zeon headlamp without filter emitted a broader spectrum with lower blue intensity and higher CRI than the White LED of the Nano 3. The Zeon headlamp with the blue blocking filter emitted a broader spectrum than the Orange LED of the Nano 3. There were no differences in the degree of conversion and working time of the Filtek Supreme and Tetric Prime composites when illuminated by the different headlamps. Both Zeon and the White LED of the Nano 3 were capable to cure the composites within only 5-10 minutes of irradiation. There were no changes in the degree of conversion of the composites when the Orange LED of the Nano 3 or the blue blocking filter of the Zeon were used.
Conclusions Both headlights reduced the working time of light-cured materials. The use of orange filters prevented the composite polymerization and maintained the working time. Key words:Surgical Headlight, degree of conversion, working time, light-curing.
Collapse
|
39
|
Rodrigues M, Teles P, Pirraco R, Oliveira D, Costa P. Evaluation of fractionation schemes in breast cancer radiotherapy and dosimetric study of the main organs at risk. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00396-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
40
|
Yamada C, Vasques C, Coutinho R, Maldaun M, Baldotto C, Viola F, Maluf F, Santos V, Pessoa C, Pacheco P, Matias D, Oliveira D, Peria F, de Jesus R, Rebelatto T, Malheiros S. EPID-07. EPIDEMIOLOGICAL CHARACTERISTICS AND SURVIVAL OF PATIENTS WITH DIFFUSE GLIOMA IN BRAZIL: PRELIMINARY RESULTS OF A MULTICENTRIC RETROSPECTIVE STUDY - LACOG 0619. Neuro Oncol 2021. [DOI: 10.1093/neuonc/noab196.340] [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
INTRODUCTION
In Brazil, most of the 9,196 deaths due to brain cancers in 2017 were gliomas. There is a dearth of epidemiological data on diffuse glioma in Brazil.
METHODS
LACOG 0619 is a multicentric retrospective cohort study, which included patients from nine tertiary oncology centers. Patients aged ≥18 years with histologically proven astrocytoma, oligodendroglioma, oligoastrocytoma or glioblastoma diagnosed from June 2010 to June 2019 were included. The study protocol was approved by each Institutional Review Board.
RESULTS
642 patients were included in the analysis. Median age was 51.0 (19-91) years. Most patients were male (n=364, 56.8%), 175 (27.3%) had ECOG 0-1, and 480 (74.8%) had private healthcare insurance. Neurological symptoms were present in 568 (88.5%) patients at diagnosis, and 263 (41.0%) had a history of seizure before surgery. Regarding histology, 361 (56.2%) had glioblastoma, 162 (25.2%) had astrocytoma, 90 (14.0%) had oligodendroglioma, and 23 (3.6%) had glioma NOS. Gross total resection was performed in 168 (26.2%), subtotal resection in 292 (45.5%), biopsy in 108 (16.8%), conventional radiotherapy in 380 (59.2%), and hypofractionation in 44 (6.9%) patients. Concomitant chemoradiotherapy was administered to 370 (57.6%) patients, mostly with temozolamide (n=362, 97.8%). Furthermore, 434 (67.7%) patients received maintenance chemotherapy, 398 with temozolamide (< 6 cycles in 112 [28.4%], 6 cycles in 75 [18.8%], and >6 cycles in 214 [3.8%]). Median follow-up was 29 months (26-33). Median OS according to histology was: 35 months (95%CI 26-46) for glioblastoma, 91 months (95%CI 35-NR) for glioma NOS, and not reached for astrocytoma and oligodendroglioma. Median OS by number of temozolamide maintenance cycles was 18 months (95%CI 15-24) for < 6 cycles and not reached for 6 cycles or more.
CONCLUSIONS
This is the first multicentric cohort evaluating Brazilian patients with diffuse glioma, providing important data on epidemiology, treatment patterns, and survival in the country.
Collapse
Affiliation(s)
- Camilla Yamada
- Latin American Cooperative Oncology Group -LACOG, Sao Paulo, Brazil
| | - Carolina Vasques
- Hospital Beneficência Portuguesa de São Paulo, Sao Paulo, Brazil
| | - Rodrigo Coutinho
- Hospital Beneficência Portuguesa de São Paulo, Sao Paulo, Brazil
| | | | | | - Fabiana Viola
- Centro de Pesquisa Clinica em Oncologia, Porto Alegre, Rio Grande do Sul, Brazil
| | - Fernando Maluf
- Hospital Beneficência Portuguesa de São Paulo, Sao Paulo, Brazil
| | | | | | - Patrícia Pacheco
- Hospital de Caridade de Carazinho, Carazinho, Rio Grande do Sul, Brazil
| | - Danielli Matias
- Liga Norte Riograndense Contra o Câncer, Natal, Rio Grande do Norte, Brazil
| | | | - Fernanda Peria
- USP - Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto, Sao Paulo, Brazil
| | - Rafaela de Jesus
- Latin American Cooperative Oncology Group -LACOG, Porto Alegre, Rio Grande do Sul, Brazil
| | - Taiane Rebelatto
- Latin American Cooperative Oncology Group -LACOG, Porto Alegre, Rio Grande do Sul, Brazil
| | - Suzana Malheiros
- Hospital Israelita Albert Einstein, São Paulo, Rio Grande do Sul, Brazil
| |
Collapse
|
41
|
Caneiras C, Jácome C, Oliveira D, Moreira E, Dias CC, Mendonça L, Mayoralas-Alises S, Fonseca JA, Diaz-Lobato S, Escarrabill J, Winck JC. The Portuguese Model of Home Respiratory Care: Healthcare Professionals' Perspective. Healthcare (Basel) 2021; 9:1523. [PMID: 34828569 PMCID: PMC8623333 DOI: 10.3390/healthcare9111523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 11/07/2021] [Accepted: 11/08/2021] [Indexed: 11/16/2022] Open
Abstract
Patients' and carers' views regarding the Portuguese model of home respiratory care were recently described, yet the complementary perspective of healthcare professionals (HCPs) is still to be investigated. Thus, this study explored HCPs experience in the management of patients needing home respiratory therapies (HRT), and their perspective about the Portuguese model. A phenomenological descriptive study, using focus groups, was carried out with 28 HCPs (median 42 y, 68% female) with distinct backgrounds (57% pulmonologists, 29% clinical physiologists, 7% physiotherapists, 7% nurses). Three focus groups were conducted in three regions of Portugal. Thematic analysis was performed by two independent researchers. HCPs have in general a positive view about the organization of the Portuguese model of home respiratory care, which was revealed in four major topics: Prescription (number of references, n = 171), Implementation and maintenance (n = 162), Carer involvement (n = 65) and Quality of healthcare (n = 247). Improvements needed were related to patients' late referral, HRT prescription (usability of the medical electronic prescription system and renewals burden), patients' education, access to hospital care team, lack of multidisciplinary work and articulation between hospital, primary and home care teams. This study describes the perspective of HCPs about the Portuguese model of home respiratory care and identifies specific points where improvements and reflections are needed. This knowledge may be useful to decision makers improve the current healthcare model.
Collapse
Affiliation(s)
- Cátia Caneiras
- Microbiology Research Laboratory on Environmental Health (EnviHealthMicro Lab), Institute of Environmental Health (ISAMB), Faculty of Medicine, University of Lisbon, 1649-028 Lisbon, Portugal
- Institute for Preventive Medicine and Public Health, Faculty of Medicine, University of Lisbon, 1649-028 Lisbon, Portugal
- Healthcare Department, Nippon Gases Portugal, 2600-242 Vila Franca de Xira, Portugal
| | - Cristina Jácome
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal; (C.J.); (D.O.); (E.M.); (C.C.D.); (L.M.); (J.A.F.)
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal
| | - Daniela Oliveira
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal; (C.J.); (D.O.); (E.M.); (C.C.D.); (L.M.); (J.A.F.)
- Department of Medicine, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal;
- Rheumatology Department, Centro Hospitalar Universitário São João (CHUSJ), 4200-319 Porto, Portugal
| | - Emília Moreira
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal; (C.J.); (D.O.); (E.M.); (C.C.D.); (L.M.); (J.A.F.)
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal
| | - Cláudia Camila Dias
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal; (C.J.); (D.O.); (E.M.); (C.C.D.); (L.M.); (J.A.F.)
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal
| | - Liliane Mendonça
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal; (C.J.); (D.O.); (E.M.); (C.C.D.); (L.M.); (J.A.F.)
| | | | - João Almeida Fonseca
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal; (C.J.); (D.O.); (E.M.); (C.C.D.); (L.M.); (J.A.F.)
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal
- Allergy Unit, Instituto and Hospital CUF Porto, 4460-188 Matosinhos, Portugal
| | - Salvador Diaz-Lobato
- Healthcare Department, Nippon Gases Spain, 28020 Madrid, Spain;
- Service of Pneumology, Hospital Universitario Moncloa, 28008 Madrid, Spain
| | - Joan Escarrabill
- Programa de Atención a la Cronicidad, Hospital Clínic de Barcelona, 08036 Barcelona, Spain;
- Master Plan for Respiratory Diseases (Ministry of Health) & Observatory of Home Respiratory Therapies (FORES), 08028 Barcelona, Spain
- REDISSEC Health Services Research on Chronic Patients Network, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - João Carlos Winck
- Department of Medicine, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal;
| |
Collapse
|
42
|
Garcia S, Martins FR, Oliveira D, Samões B, Martins A, Terroso G, Costa L. Lymphocytic myocarditis in an overlap syndrome of systemic sclerosis and polymyositis. Clin Rheumatol 2021; 41:581-582. [PMID: 34518973 DOI: 10.1007/s10067-021-05917-y] [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] [Received: 08/11/2021] [Revised: 09/06/2021] [Accepted: 09/07/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Salomé Garcia
- Rheumatology Department, Centro Hospitalar Universitário de São João, Porto, Portugal.
| | | | - Daniela Oliveira
- Rheumatology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Beatriz Samões
- Rheumatology Department, Centro Hospitalar Vila Nova de Gaia E Espinho, Vila Nova de Gaia, Portugal
| | - Ana Martins
- Rheumatology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Georgina Terroso
- Rheumatology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Lúcia Costa
- Rheumatology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
| |
Collapse
|
43
|
Escrevente C, Falcão AS, Hall MJ, Lopes-da-Silva M, Antas P, Mesquita MM, Ferreira IS, Cardoso MH, Oliveira D, Fradinho AC, Ciossek T, Nicklin P, Futter CE, Tenreiro S, Seabra MC. Formation of Lipofuscin-Like Autofluorescent Granules in the Retinal Pigment Epithelium Requires Lysosome Dysfunction. Invest Ophthalmol Vis Sci 2021; 62:39. [PMID: 34313720 PMCID: PMC8322709 DOI: 10.1167/iovs.62.9.39] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose We aim to characterize the pathways required for autofluorescent granule (AFG) formation by RPE cells using cultured monolayers. Methods We fed RPE monolayers in culture with a single pulse of photoreceptor outer segments (POS). After 24 hours the cells started accumulating AFGs that were comparable to lipofuscin in vivo. Using this model, we used a variety of light and electron microscopical techniques, flow cytometry and Western blot to analyze the formation of AFGs. We also generated a mutant RPE line lacking cathepsin D by gene editing. Results AFGs seem to derive from incompletely digested POS-containing phagosomes and after 3 days are surrounded by a single membrane positive for lysosome markers. We show by various methods that lysosome-phagosome fusion is required for AFG formation, and that impairment of lysosomal pH or catalytic activity, particularly cathepsin D activity, enhances AF accumulation. Conclusions We conclude that lysosomal dysfunction results in incomplete POS degradation and enhanced AFG accumulation.
Collapse
Affiliation(s)
- Cristina Escrevente
- iNOVA4Health, CEDOC - Chronic Diseases Research Center, NOVA Medical School, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Ana S Falcão
- iNOVA4Health, CEDOC - Chronic Diseases Research Center, NOVA Medical School, Universidade Nova de Lisboa, Lisboa, Portugal
| | | | - Mafalda Lopes-da-Silva
- iNOVA4Health, CEDOC - Chronic Diseases Research Center, NOVA Medical School, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Pedro Antas
- iNOVA4Health, CEDOC - Chronic Diseases Research Center, NOVA Medical School, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Miguel M Mesquita
- iNOVA4Health, CEDOC - Chronic Diseases Research Center, NOVA Medical School, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Inês S Ferreira
- iNOVA4Health, CEDOC - Chronic Diseases Research Center, NOVA Medical School, Universidade Nova de Lisboa, Lisboa, Portugal
| | - M Helena Cardoso
- iNOVA4Health, CEDOC - Chronic Diseases Research Center, NOVA Medical School, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Daniela Oliveira
- iNOVA4Health, CEDOC - Chronic Diseases Research Center, NOVA Medical School, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Ana C Fradinho
- iNOVA4Health, CEDOC - Chronic Diseases Research Center, NOVA Medical School, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Thomas Ciossek
- Research Beyond Borders, Boehringer Ingelheim, Biberach, Germany
| | - Paul Nicklin
- Research Beyond Borders, Boehringer Ingelheim, Biberach, Germany
| | | | - Sandra Tenreiro
- iNOVA4Health, CEDOC - Chronic Diseases Research Center, NOVA Medical School, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Miguel C Seabra
- iNOVA4Health, CEDOC - Chronic Diseases Research Center, NOVA Medical School, Universidade Nova de Lisboa, Lisboa, Portugal.,UCL Institute of Ophthalmology, London, United Kingdom
| |
Collapse
|
44
|
Caneiras C, Jácome C, Moreira E, Oliveira D, Dias CC, Mendonça L, Mayoralas-Alises S, Fonseca JA, Diaz-Lobato S, Escarrabill J, Winck JC. A qualitative study of patient and carer experiences with home respiratory therapies: Long-term oxygen therapy and home mechanical ventilation. Pulmonology 2021; 28:268-275. [PMID: 34246616 DOI: 10.1016/j.pulmoe.2021.05.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/21/2021] [Accepted: 05/24/2021] [Indexed: 11/25/2022] Open
Abstract
Studies exploring the experience of patients receiving home respiratory therapies (HRT), such as long-term oxygen therapy (LTOT) and home mechanical ventilation (HMV), are still limited. This study focused on patients' and carers' experience with LTOT and HMV. An exploratory, cross-sectional qualitative study, using semi-structured focus groups, was carried out with 18 patients receiving HRT (median 71y, 78% male, 56% on both LTOT and HMV) and 6 carers (median age 67y, 67% female). Three focus groups were conducted in three regions of Portugal. Thematic analysis was performed by two independent researchers. Patients' and carers' experience was reflected in seven major topics, linked to specific time points and settings of the treatment: Initial symptoms/circumstances (n = 41), Prescription (n = 232), Implementation (n = 184), Carer involvement (n = 34), Quality of life impact (n = 301), Health care support/navigability (n = 173) and Suggestions (n = 14). Our findings demonstrate a general good perception of the HRT by patients and carers recognizing a significative quality of life impact improvement, while identifying specific points where improvements in healthcare are needed, particularly about navigability issues, articulation between the hospital, primary care and homecare teams, especially regardingprescriptionrenewal. This knowledge is crucial to promote a long-term HRT adherence and to optimize HRT delivery in line with patients' experience, needs, and values. Moreover, these key points can inform the development of a specific patient-reported experience measure (PREM) for patients on HRT, which is not currently available, and foster a more integrated respiratory care model.
Collapse
Affiliation(s)
- Cátia Caneiras
- Microbiology Research Laboratory on Environmental Health (EnviHealthMicroLab), Faculty of Medicine, Institute of Environmental Health (ISAMB), University of Lisbon, 1649-028 Lisbon, Portugal; Institute for Preventive Medicine and Public Health, Faculty of Medicine, University of Lisbon, 1649-028 Lisbon, Portugal; Healthcare Department, Nippon Gases Portugal, 2600-242 Vila Franca de Xira, Portugal.
| | - Cristina Jácome
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal; Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal.
| | - Emília Moreira
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal; Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal.
| | - Daniela Oliveira
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal; Rheumatology Department, University Hospital Center of São João (CHUSJ), Porto, Portugal.
| | - Cláudia Camila Dias
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal; Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
| | - Liliane Mendonça
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal
| | | | - João Almeida Fonseca
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal; Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal; Allergy Unit, CUF Institute and Hospital, 4460-188 Porto, Portugal
| | - Salvador Diaz-Lobato
- Healthcare Department, Nippon Gases Spain, 28020 Madrid, Spain; Service of Pneumology, University Hospital of Moncloa, 28008 Madrid, Spain
| | - Joan Escarrabill
- Hospital Clinic of Barcelona, 08036 Barcelona, Spain; Master Plan for Respiratory Diseases (Ministry of Health) & Observatory of Home Respiratory Therapies (FORES), 08028 Barcelona, Spain; REDISSEC Health Services Research on Chronic Patients Network, Instituto de Salud Carlos III, 28029 Madrid, Spain.
| | | |
Collapse
|
45
|
Oliveira D, Martins A, Costa L, Vaz C. Vogt-Koyanagi-Harada Syndrome and polyarthritis as a rare clinical manifestation. Acta Reumatol Port 2021; 46:281-282. [PMID: 34663777] [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] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
This is the first detailed description of an erosive seronegative polyarthritis in the Vogt-Koyanagi-Harada Syndrome in Portugal.
Collapse
Affiliation(s)
| | - Ana Martins
- Reumatologia, Centro Hospitalar Universitário de S.João, Porto
| | - Lúcia Costa
- Reumatologia, Centro Hospitalar Universitário de S.João, Porto
| | - Carlos Vaz
- Reumatologia, Centro Hospitalar Universitário de S.João, Porto
| |
Collapse
|
46
|
Cansian RL, Staudt A, Bernardi JL, Puton BMS, Oliveira D, de Oliveira JV, Gomes ACC, Andrade BCOP, Leal ICR, Simas NK, Zeni J, Jungues A, Dallago RM, Backes GT, Paroul N. Toxicity and larvicidal activity on Aedes aegypti of citronella essential oil submitted to enzymatic esterification. BRAZ J BIOL 2021; 83:e244647. [PMID: 34190758 DOI: 10.1590/1519-6984.244647] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 03/10/2021] [Indexed: 11/22/2022] Open
Abstract
The essential oil of citronella (Cymbopogon winterianus) has several biological activities, among them the insect repellent action. Some studies showed that cinnamic acid esters can be applied as natural pesticides, insecticides and fungicides. In this context, the objective of the present work was to evaluate the production of esters from citronella essential oil with cinnamic acid via enzymatic esterification. Besides, the essential oil toxicity before and after esterification against Artemia salina and larvicidal action on Aedes aegypti was investigated. Esters were produced using cinnamic acid as the acylating agent and citronella essential oil (3:1) in heptane and 15 wt% NS 88011 enzyme as biocatalysts, at 70 °C and 150 rpm. Conversion rates of citronellyl and geranyl cinnamates were 58.7 and 69.0% for NS 88011, respectively. For the toxicity to Artemia salina LC50 results of 5.29 μg mL-1 were obtained for the essential oil and 4.36 μg mL-1 for the esterified oils obtained with NS 88011. In the insecticidal activity against Aedes aegypti larvae, was obtained LC50 of 111.84 μg mL-1 for the essential oil of citronella and 86.30 μg mL-1 for the esterified oils obtained with the enzyme NS 88011, indicating high toxicity of the esters. The results demonstrated that the evaluated samples present potential of application as bioinsecticide.
Collapse
Affiliation(s)
- R L Cansian
- Programa de Pós-Graduação em Engenharia de Alimentos, Universidade Regional Integrada do Alto Uruguai e das Missões - URI Erechim, Erechim, RS, Brasil
| | - A Staudt
- Programa de Pós-Graduação em Engenharia de Alimentos, Universidade Regional Integrada do Alto Uruguai e das Missões - URI Erechim, Erechim, RS, Brasil.,Laboratório de Produtos Naturais e Ensaios Biológicos - LaProNEB, Departamento de Alimentos e Produtos Naturais, Faculdade de Farmácia, Centro de Ciências da Saúde - CCS, Universidade Federal do Rio de Janeiro - UFRJ, Rio de Janeiro, RJ, Brasil
| | - J L Bernardi
- Programa de Pós-Graduação em Engenharia de Alimentos, Universidade Regional Integrada do Alto Uruguai e das Missões - URI Erechim, Erechim, RS, Brasil
| | - B M S Puton
- Programa de Pós-Graduação em Engenharia de Alimentos, Universidade Regional Integrada do Alto Uruguai e das Missões - URI Erechim, Erechim, RS, Brasil
| | - D Oliveira
- Departamento de Engenharia Química e de Alimentos, Universidade Federal de Santa Catarina - UFSC, Florianópolis, SC, Brasil
| | - J V de Oliveira
- Departamento de Engenharia Química e de Alimentos, Universidade Federal de Santa Catarina - UFSC, Florianópolis, SC, Brasil
| | - A C C Gomes
- Laboratório de Produtos Naturais e Ensaios Biológicos - LaProNEB, Departamento de Alimentos e Produtos Naturais, Faculdade de Farmácia, Centro de Ciências da Saúde - CCS, Universidade Federal do Rio de Janeiro - UFRJ, Rio de Janeiro, RJ, Brasil
| | - B C O P Andrade
- Laboratório de Produtos Naturais e Ensaios Biológicos - LaProNEB, Departamento de Alimentos e Produtos Naturais, Faculdade de Farmácia, Centro de Ciências da Saúde - CCS, Universidade Federal do Rio de Janeiro - UFRJ, Rio de Janeiro, RJ, Brasil
| | - I C R Leal
- Laboratório de Produtos Naturais e Ensaios Biológicos - LaProNEB, Departamento de Alimentos e Produtos Naturais, Faculdade de Farmácia, Centro de Ciências da Saúde - CCS, Universidade Federal do Rio de Janeiro - UFRJ, Rio de Janeiro, RJ, Brasil
| | - N K Simas
- Laboratório de Produtos Naturais e Ensaios Biológicos - LaProNEB, Departamento de Alimentos e Produtos Naturais, Faculdade de Farmácia, Centro de Ciências da Saúde - CCS, Universidade Federal do Rio de Janeiro - UFRJ, Rio de Janeiro, RJ, Brasil
| | - J Zeni
- Programa de Pós-Graduação em Engenharia de Alimentos, Universidade Regional Integrada do Alto Uruguai e das Missões - URI Erechim, Erechim, RS, Brasil
| | - A Jungues
- Programa de Pós-Graduação em Engenharia de Alimentos, Universidade Regional Integrada do Alto Uruguai e das Missões - URI Erechim, Erechim, RS, Brasil
| | - R M Dallago
- Programa de Pós-Graduação em Engenharia de Alimentos, Universidade Regional Integrada do Alto Uruguai e das Missões - URI Erechim, Erechim, RS, Brasil
| | - G T Backes
- Programa de Pós-Graduação em Engenharia de Alimentos, Universidade Regional Integrada do Alto Uruguai e das Missões - URI Erechim, Erechim, RS, Brasil
| | - N Paroul
- Programa de Pós-Graduação em Engenharia de Alimentos, Universidade Regional Integrada do Alto Uruguai e das Missões - URI Erechim, Erechim, RS, Brasil
| |
Collapse
|
47
|
Oliveira D, Miranda R, Leuschner P, Abreu N, Santos MF, Abelha A, Machado J. OpenEHR modeling: improving clinical records during the COVID-19 pandemic. Health Technol (Berl) 2021; 11:1109-1118. [PMID: 33968598 PMCID: PMC8093592 DOI: 10.1007/s12553-021-00556-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 04/26/2021] [Indexed: 12/03/2022]
Abstract
The COVID-19 pandemic had put pressure on various national healthcare systems, due to the lack of health professionals and exhaustion of those avaliable, as well as lack of interoperability and inability to restructure their IT systems. Therefore, the restructuring of institutions at all levels is essential, especially at the level of their information systems. Furthermore, the COVID-19 pandemic had arrived in Portugal at March 2020, with a breakout on the northern region. In order to quickly respond to the pandemic, the CHUP healthcare institution, known as a research center, has embraced the challenge of developing and integrating a new approach based on the openEHR standard to interoperate with the institution’s existing information and its systems. An openEHR clinical modelling methodology was outlined and adopted, followed by a survey of daily clinical and technical requirements. With the arrival of the virus in Portugal, the CHUP institution has undergone through constant changes in their working methodologies as well as their openEHR modelling. As a result, an openEHR patient care workflow for COVID-19 was developed.
Collapse
Affiliation(s)
- Daniela Oliveira
- Centro Hospitalar Universitario do Porto, Largo do Prof. Abel Salazar 4800-058, Porto, Portugal
| | - Rui Miranda
- Centro Hospitalar Universitario do Porto, Largo do Prof. Abel Salazar 4800-058, Porto, Portugal
| | - Pedro Leuschner
- Centro Hospitalar Universitario do Porto, Largo do Prof. Abel Salazar 4800-058, Porto, Portugal
| | - Nuno Abreu
- Centro Hospitalar Universitario do Porto, Largo do Prof. Abel Salazar 4800-058, Porto, Portugal
| | - Manuel Filipe Santos
- Centro Hospitalar Universitario do Porto, Largo do Prof. Abel Salazar 4800-058, Porto, Portugal
| | - Antonio Abelha
- Centro Hospitalar Universitario do Porto, Largo do Prof. Abel Salazar 4800-058, Porto, Portugal
| | - José Machado
- Escola de Engenharia, Universidade do Minho, Campus Azurum, Guimarues, 4800-058 Portugal
| |
Collapse
|
48
|
Botacin M, Aghakhani H, Ortolani S, Kruegel C, Vigna G, Oliveira D, Geus PLD, Grégio A. One Size Does Not Fit All. ACM Trans Priv Secur 2021. [DOI: 10.1145/3429741] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Malware analysis is an essential task to understand infection campaigns, the behavior of malicious codes, and possible ways to mitigate threats. Malware analysis also allows better assessment of attackers’ capabilities, techniques, and processes. Although a substantial amount of previous work provided a comprehensive analysis of the international malware ecosystem, research on regionalized, country-, and population-specific malware campaigns have been scarce. Moving towards addressing this gap, we conducted a longitudinal (2012-2020) and comprehensive (encompassing an entire population of online banking users) study of MS Windows desktop malware that actually infected Brazilian banks’ users. We found that the Brazilian financial desktop malware has been evolving quickly: it started to make use of a variety of file formats instead of typical PE binaries, relied on native system resources, and abused obfuscation techniques to bypass detection mechanisms. Our study on the threats targeting a significant population on the ecosystem of the largest and most populous country in Latin America can provide invaluable insights that may be applied to other countries’ user populations, especially those in the developing world that might face cultural peculiarities similar to Brazil’s. With this evaluation, we expect to motivate the security community/industry to seriously consider a deeper level of customization during the development of next-generation anti-malware solutions, as well as to raise awareness towards regionalized and targeted Internet threats.
Collapse
Affiliation(s)
- Marcus Botacin
- Federal University of Paraná (UFPR), UFPR, Curitiba-PR, Brazil
| | - Hojjat Aghakhani
- University of California at Santa Barbara (UCSB), UCSB, Santa Barbara, CA, USA
| | | | - Christopher Kruegel
- University of California at Santa Barbara (UCSB) and VMware, UCSB, Santa Barbara, CA, USA
| | - Giovanni Vigna
- University of California at Santa Barbara (UCSB) and VMware, UCSB, Santa Barbara, CA, USA
| | | | | | - André Grégio
- Federal University of Paraná (UFPR), UFPR, Curitiba-PR, Brazil
| |
Collapse
|
49
|
Preto K, Neto D, Tjioe K, Oliveira D. Relevance of Cone-beam computed tomography on diagnosis and surgical planning of the cementoblastoma. J Clin Exp Dent 2021; 13:e1271-e1274. [PMID: 34987720 PMCID: PMC8715555 DOI: 10.4317/jced.58869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 10/11/2021] [Indexed: 11/05/2022] Open
|
50
|
Ferretti R, Mustafa J, Oliveira E, Oliveira D. Association between hyperglycemia and inflammation in critically ill patients. Clin Nutr ESPEN 2020. [DOI: 10.1016/j.clnesp.2020.09.686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|