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Nogueira S, Rodrigues D, Barros M, Menezes J, Guimarães-Pereira L. Chronic pain after breast surgery: incidence, risk factors and impact on quality of life. Rev Esp Anestesiol Reanim (Engl Ed) 2024:S2341-1929(24)00002-7. [PMID: 38242359 DOI: 10.1016/j.redare.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 04/07/2023] [Indexed: 01/21/2024]
Abstract
INTRODUCTION AND OBJECTIVES Breast cancer is the most frequently diagnosed malignancy, and chronic pain after breast surgery (CPBS) is an increasingly recognized therapy-related problem. We evaluated CPBS incidence, characteristics, associated factors, and impact on patient quality of life (QoL). MATERIALS AND METHODS Six-month observational prospective study conducted in patients undergoing breast surgery in a tertiary university hospital. Data were collected using several questionnaires: Pain Catastrophizing Scale, Brief Pain Inventory-Short Form, Douleur Neuropathique 4 Questionnaire, and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire and its Breast Cancer Module. RESULTS A total of 112 patients completed the study. Approximately, one third (34.8%) developed CPBS, and almost all with potentially neuropathic pain. CPBS interfered with patients' daily life and reduced their QoL. Diabetes (p = 0.028), catastrophizing (p = 0.042), and acute postoperative pain severity (p < 0.001) were associated with CPBS. CONCLUSIONS This study broadens our understanding of CPBS and shows the impact of this syndrome. Healthcare workers need to be aware of CPBS and take steps to prevent and treat it, and provide patients with adequate information.
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Affiliation(s)
- S Nogueira
- Department of Anaesthesiology, Centro Hospitalar Universitário São João, Alameda Prof. Hernâni Monteiro, Porto, Portugal.
| | - D Rodrigues
- Department of Anaesthesiology, Centro Hospitalar Universitário São João, Alameda Prof. Hernâni Monteiro, Porto, Portugal
| | - M Barros
- Department of Anaesthesiology, Centro Hospitalar Universitário São João, Alameda Prof. Hernâni Monteiro, Porto, Portugal
| | - J Menezes
- Department of Medicine Faculty of Medicine of the University of Porto, Alameda Prof. Hernâni Monteiro, Porto, Portugal
| | - L Guimarães-Pereira
- Department of Anaesthesiology, Centro Hospitalar Universitário São João, Alameda Prof. Hernâni Monteiro, Porto, Portugal; Cardiovascular R&D Centre - UnIC@RISE, Surgery and Physiology Department, Faculty of Medicine of the University of Porto, UnIC, CIM-FMUP, R. Dr. Plácido da Costa, Porto, Portugal
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Hamza MA, Cohen JD, Chen L, Rodrigues D, Mossahebi S, Biswal NC, Zakhary M, Kunaprayoon D, Rana ZH, Molitoris JK. Concurrent Radiation and Deep Hyperthermia Therapy for the Treatment of Recurrent Prostate Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e389. [PMID: 37785308 DOI: 10.1016/j.ijrobp.2023.06.2511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Robustpreclinical and clinical data have established hyperthermia as an effective radiosensitizer which can be used in the setting of recurrent disease to enhance the therapeutic window. We present a single institution experience examining outcomes in recurrent prostate cancer (RPCA) patients treated with concurrent deep hyperthermia (DHT) and radiation (RT). We hypothesized that concurrent DHT and RT would be well tolerated and would provide durable local control without unexpected toxicity. MATERIALS/METHODS Consecutive RPCA patients treated with concurrent DHT and pelvic RT were retrospectively analyzed. Patients received twice weekly DHT treatments in addition to daily or twice daily (BID) RT. DHT was delivered using a concentric ring radiofrequency phased array system to a target temperature of 40-43°C. Acute and late treatment associated toxicities, graded per Common Terminology Criteria for Adverse Events (CTCAE) v5.0, were evaluated. Survival and control outcomes were evaluated using the Kaplan-Meier method. RESULTS Eighteen patients were included for analysis. Median patient age was 69 yrs (64-82 yrs). Fifteen (83%) patients had received prior RT and 12 (67%) patients had undergone radical prostatectomy. At time of treatment, two patients had RPCA which had dedifferentiated to a small cell phenotype. Eight (44%) patients had extra-pelvic disease at time of treatment. Seventeen (94%) patients received proton RT, while 1 (6%) received photon RT. Median RT dose was 49 Gy (range 30-73.8 Gy). Five (28%) patients received BID RT. Fifteen (83%) patients also received sequential or concurrent systemic therapy including androgen deprivation therapy or chemotherapy. A total of 142 DHT treatments were administered (median of 7.5 treatments). Fourteen (78%) patients completed ≥ 75% of planned DHT treatments. Reasons for inability to complete treatment included discomfort and abnormal vital signs during DHT. Only one patient reported Grade 2 pain and pruritus attributed to concurrent RT and DHT. One acute Grade 3 RT toxicity (diarrhea) was reported. No late Grade 3+ toxicities occurred. Of ten patients (56%) treated with curative intent, 8 (44%) had no reported failures at 2-year follow up while two had distant failure and biochemical failure respectively. Three (17%) patients were treated with palliative intent for disease related pain; two reported partial relief and one reported complete pain relief. With a median follow-up of 27 months (1-46 months), 2-year failure free survival was 41.4% (95% CI: 27.8-55%), local control was 76.5% (95% CI 66.2-86.8%) and overall survival was 70.9% (95% CI 58.4-83.3%). CONCLUSION Our results suggest that concurrent RT and DHT is well tolerated and allows for safe escalation of local therapy for RPCA, providing patients with durable local control and palliation with an acceptable toxicity profile. Prospective validation is warranted.
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Affiliation(s)
- M A Hamza
- Department of Radiation Oncology, University of Maryland Medical Center, Baltimore, MD
| | - J D Cohen
- Department of Radiation Oncology, University of Maryland Medical Center, Baltimore, MD
| | - L Chen
- Georgetown University, Washington D.C., DC
| | - D Rodrigues
- University of Maryland School of Medicine, Baltimore, MD
| | - S Mossahebi
- Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD
| | - N C Biswal
- University of Maryland School of Medicine, Baltimore, MD
| | - M Zakhary
- Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD
| | - D Kunaprayoon
- Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD
| | - Z H Rana
- Department of Radiation Oncology, University of Maryland Medical Center, Baltimore, MD
| | - J K Molitoris
- Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD
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de Lima RB, Görgens EB, da Silva DAS, de Oliveira CP, Batista APB, Caraciolo Ferreira RL, Costa FRC, Ferreira de Lima RA, da Silva Aparício P, de Abreu JC, da Silva JAA, Guimaraes AF, Fearnside PM, Sousa TR, Perdiz R, Higuchi N, Berenguer E, Resende AF, Elias F, de Castilho CV, de Medeiros MB, de Matos Filho JR, Sardinha MA, Freitas MAF, da Silva JJ, da Cunha AP, Santos RM, Muelbert AE, Guedes MC, Imbrózio R, de Sousa CSC, da Silva Aparício WC, da Silva E Silva BM, Silva CA, Marimon BS, Junior BHM, Morandi PS, Storck-Tonon D, Vieira ICG, Schietti J, Coelho F, Alves de Almeida DR, Castro W, Carvalho SPC, da Silva RDSA, Silveira J, Camargo JL, Melgaço K, de Freitas LJM, Vedovato L, Benchimol M, de Oliveira de Almeida G, Prance G, da Silveira AB, Simon MF, Garcia ML, Silveira M, Vital M, Andrade MBT, Silva N, de Araújo RO, Cavalheiro L, Carpanedo R, Fernandes L, Manzatto AG, de Andrade RTG, Magnusson WE, Laurance B, Nelson BW, Peres C, Daly DC, Rodrigues D, Zopeletto AP, de Oliveira EA, Dugachard E, Barbosa FR, Santana F, do Amaral IL, Ferreira LV, Charão LS, Ferreira J, Barlow J, Blanc L, Aragão L, Sist P, de Paiva Salomão R, da Silva ASL, Laurance S, Feldpausch TR, Gardner T, Santiago W, Balee W, Laurance WF, Malhi Y, Phillips OL, da Silva Zanzini AC, Rosa C, Tadeu Oliveira W, Pereira Zanzini L, José Silva R, Mangabeira Albernaz AL. Giants of the Amazon: How does environmental variation drive the diversity patterns of large trees? Glob Chang Biol 2023; 29:4861-4879. [PMID: 37386918 DOI: 10.1111/gcb.16821] [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] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 04/13/2023] [Accepted: 06/02/2023] [Indexed: 07/01/2023]
Abstract
For more than three decades, major efforts in sampling and analyzing tree diversity in South America have focused almost exclusively on trees with stems of at least 10 and 2.5 cm diameter, showing highest species diversity in the wetter western and northern Amazon forests. By contrast, little attention has been paid to patterns and drivers of diversity in the largest canopy and emergent trees, which is surprising given these have dominant ecological functions. Here, we use a machine learning approach to quantify the importance of environmental factors and apply it to generate spatial predictions of the species diversity of all trees (dbh ≥ 10 cm) and for very large trees (dbh ≥ 70 cm) using data from 243 forest plots (108,450 trees and 2832 species) distributed across different forest types and biogeographic regions of the Brazilian Amazon. The diversity of large trees and of all trees was significantly associated with three environmental factors, but in contrasting ways across regions and forest types. Environmental variables associated with disturbances, for example, the lightning flash rate and wind speed, as well as the fraction of photosynthetically active radiation, tend to govern the diversity of large trees. Upland rainforests in the Guiana Shield and Roraima regions had a high diversity of large trees. By contrast, variables associated with resources tend to govern tree diversity in general. Places such as the province of Imeri and the northern portion of the province of Madeira stand out for their high diversity of species in general. Climatic and topographic stability and functional adaptation mechanisms promote ideal conditions for species diversity. Finally, we mapped general patterns of tree species diversity in the Brazilian Amazon, which differ substantially depending on size class.
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Affiliation(s)
| | - Eric Bastos Görgens
- Departamento de Engenharia Florestal, Universidade Federal do Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
| | | | | | | | - Rinaldo L Caraciolo Ferreira
- Laboratório de Manejo de Florestas Naturais "José Serafim Feitoza Ferraz", Departamento de Ciência Florestal, Universidade Federal Rural de Pernambuco, Recife, Brazil
| | - Flavia R C Costa
- Coordenação de Pesquisas em Biodiversidade, Instituto Nacional de Pesquisas da Amazônia, Manaus, Brazil
| | | | | | | | - José Antônio Aleixo da Silva
- Laboratório de Manejo de Florestas Naturais "José Serafim Feitoza Ferraz", Departamento de Ciência Florestal, Universidade Federal Rural de Pernambuco, Recife, Brazil
| | - Aretha Franklin Guimaraes
- Programa de Pós-Graduação em Botânica Aplicada, Departamento de Biologia, Universidade Federal de Lavras, Lavras, Brazil
| | - Philip M Fearnside
- Instituto Nacional de Pesquisas da Amazônia, Av. André Araújo, Manaus, Brazil
| | - Thaiane R Sousa
- Programa de Pós-Graduação em Ecologia, Instituto Nacional de Pesquisas da Amazônia, Manaus, Brazil
| | - Ricardo Perdiz
- Programa de Pós-Graduação em Botânica, Instituto Nacional de Pesquisas da Amazônia (INPA), Manaus, Brazil
| | - Niro Higuchi
- Instituto Nacional de Pesquisas da Amazônia-Coordenação de Pesquisas em Silvicultura Tropical, Manaus, Brazil
| | - Erika Berenguer
- Environmental Change Institute, School of Geography and the Environment, University of Oxford, Oxford, UK
- Lancaster Environment Centre, Lancaster University, Lancaster, UK
| | | | - Fernando Elias
- Programa de Pós-Graduação em Ecologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
| | | | | | | | - Maurício Alves Sardinha
- Programa de Pós-Graduação em Biodiversidade e Biotecnologia-Rede Bionorte, Universidade Federal do Amapá, Macapá, Brazil
| | | | - José Jussian da Silva
- Instituto Federal de Educação Ciência e Tecnologia do Amapá, Laranjal do Jari, Brazil
| | | | - Renan Mendes Santos
- Laboratório de Manejo Florestal, Universidade do Estado do Amapá, Macapá, Brazil
| | | | | | - Reinaldo Imbrózio
- Instituto Nacional de Pesquisas da Amazônia, Av. André Araújo, Manaus, Brazil
| | | | | | | | | | - Beatriz Schwantes Marimon
- Faculdade de Ciências Agrárias, Biológicas e Sociais Aplicadas, Universidade do Estado de Mato Grosso, Nova Xavantina, Brazil
| | - Ben Hur Marimon Junior
- Faculdade de Ciências Agrárias, Biológicas e Sociais Aplicadas, Universidade do Estado de Mato Grosso, Nova Xavantina, Brazil
| | - Paulo S Morandi
- Universidade do Estado de Mato Grosso, Campus de Nova Xavantina, Nova Xavantina, Brazil
| | - Danielle Storck-Tonon
- Programa de Pós-Graduação em Ambiente e Sistemas de Produção Agrícola, Universidade do Estado de Mato Grosso, Tangará da Serra, Brazil
| | | | - Juliana Schietti
- Departamento de Biologia, Universidade Federal do Amazonas, Manaus, Brazil
| | - Fernanda Coelho
- Department of Forestry, University of Brasilia, Brasilia, Brazil
| | - Danilo R Alves de Almeida
- Department of Forest Sciences, "Luiz de Queiroz" College of Agriculture, University of São Paulo (USP/ESALQ), Piracicaba, Brazil
| | - Wendeson Castro
- Laboratório de Botânica e Ecologia Vegetal, Universidade Federal do Acre, Rio Branco, Brazil
| | | | | | - Juliana Silveira
- Lancaster Environment Centre, Lancaster University, Lancaster, UK
| | | | | | | | | | - Maíra Benchimol
- Laboratório de Ecologia Aplicada à Conservação, Universidade Estadual de Santa Cruz, Salobrinho, Brazil
| | | | | | | | - Marcelo Fragomeni Simon
- Programa de Pós-Graduação em Ecologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
| | | | - Marcos Silveira
- Museu Universitário, Universidade Federal do Acre, Rio Branco, Brazil
| | - Marcos Vital
- Universidade Federal de Roraima (UFRR), Boa Vista, Brazil
| | - Maryane B T Andrade
- Instituto Nacional de Pesquisas da Amazônia, Av. André Araújo, Manaus, Brazil
| | | | | | | | - Rainiellen Carpanedo
- Universidade Federal de Mato Grosso (UFMT), Núcleo de Estudos da Biodiversidade da Amazônia Mato-grossense, Sinop, Brazil
| | | | | | | | - William E Magnusson
- Instituto Nacional de Pesquisas da Amazônia, Av. André Araújo, Manaus, Brazil
| | - Bill Laurance
- James Cook University, Douglas, Queensland, Australia
| | - Bruce Walker Nelson
- Instituto Nacional de Pesquisas da Amazônia, Av. André Araújo, Manaus, Brazil
| | | | - Douglas C Daly
- Institute of Systematic Botany, The New York Botanical Garden, Bronx, New York, USA
| | - Domingos Rodrigues
- Universidade Federal de Mato Grosso, Instituto de Ciências Naturais, Humanas e Sociais, Sinop, Brazil
| | | | | | | | | | - Flavia Santana
- Instituto Nacional de Pesquisas da Amazônia, Av. André Araújo, Manaus, Brazil
| | - Iêda Leão do Amaral
- Instituto Nacional de Pesquisas da Amazônia, Av. André Araújo, Manaus, Brazil
| | | | - Leandro S Charão
- Facultad de Ingeniería y Ciencias, Universidad Autónoma de Tamaulipas, Victoria, Mexico
| | - Joice Ferreira
- Embrapa Amazônia Oriental, Rede Amazônia Sustentável, Belém, Brazil
| | - Jos Barlow
- Lancaster Environment Centre, Lancaster University, Lancaster, UK
| | - Lilian Blanc
- Unité Propre de Recherche Biens et Services des Écosystèmes Forestiers Tropicaux: l'Enjeu du Changement Global (BSEF), CIRAD, Montpellier, France
| | - Luiz Aragão
- National Institute for Space Research (INPE), São José dos Campos, Brazil
| | - Plinio Sist
- Centre de Coopération International en Recherche Agronomique pour le Développement (CIRAD), Paris, France
| | | | | | - Susan Laurance
- Centre for Tropical Environmental and Sustainability Science (TESS), College of Marine and Environmental Sciences, James Cook University, Douglas, Queensland, Australia
| | | | - Toby Gardner
- Stockholm Environment Institute, Stockholm, Sweden
| | | | | | - William F Laurance
- Centre for Tropical Environmental and Sustainability Science (TESS), College of Marine and Environmental Sciences, James Cook University, Douglas, Queensland, Australia
| | - Yadvinder Malhi
- Environmental Change Institute, School of Geography and the Environment, University of Oxford, Oxford, UK
| | | | - Antônio Carlos da Silva Zanzini
- Setor de Ecologia e Manejo da Vida Silvestre, Departamento de Ciências Florestais, Universidade Federal de Lavras, Lavras, MG, Brazil
| | - Clarissa Rosa
- Coordenação de Pesquisas em Biodiversidade, Instituto Nacional de Pesquisas da Amazônia, Manaus, Brazil
| | - Wagner Tadeu Oliveira
- CESAM - Centro de Estudos do Ambiente e do Mar, Departamento de Biologia, Collaborating Researcher, University of Aveiro, Aveiro, Portugal
| | - Lucas Pereira Zanzini
- Departamento de Engenharia Florestal, Universidade do Estado de Mato Grosso, Cáceres, MT, Brazil
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Silva MR, Rodrigues D, Machado-Rodrigues A, Nogueira H, Gama A, Padez C. Household Food Insecurity In Portuguese Children. Clin Nutr ESPEN 2023. [DOI: 10.1016/j.clnesp.2022.09.207] [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: 03/29/2023]
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Campbell JR, Chan ED, Anderson LF, Bonnet M, Brode SK, Cegielski JP, Guglielmetti L, Singla R, Fox GJ, Skrahina A, Rodrigues D, Kuksa L, Viiklepp P, Menzies D. Association of smoking and alcohol use with rifampin-resistant TB treatment outcomes. Int J Tuberc Lung Dis 2023; 27:338-340. [PMID: 37035974 DOI: 10.5588/ijtld.22.0678] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2023] Open
Affiliation(s)
- J R Campbell
- Department of Medicine & Department of Global and Public Health, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada, McGill International TB Centre, Montreal, QC, Canada, Respiratory Epidemiology and Clinical Research Unit, Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - E D Chan
- Department of Medicine, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, CO, USA, Department of Academic Affairs, National Jewish Health, Denver, CO, USA, Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - L F Anderson
- Strategic Information for Response, Global Malaria Programme, World Health Organization, Geneva, Switzerland
| | - M Bonnet
- University of Montpellier, Recherches Translationnelles sur le VIH et les Maladies Infectieuses, Institut de Recherche pour le Developpement, Institut national de la santé et de la recherche médicale (INSERM), Montpellier, France, Epicentre, Paris, France
| | - S K Brode
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON Canada, Department of Medicine, Division of Respirology, University Health Network, Toronto, ON Canada, Department of Medicine, University of Toronto, Toronto, ON Canada
| | - J P Cegielski
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - L Guglielmetti
- Sorbonne Université, Centre d´Immunologie et des Maladies Infectieuses (Cimi-Paris), INSERM, U1135, Paris, France, Assistance Publique Hôpitaux de Paris Centre National de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux, Laboratoire de Bactériologie-Hygiène, Hôpital Pitié-Salpêtrière, Paris, France
| | - R Singla
- Department of TB and Respiratory Diseases, National Institute of TB and Respiratory Diseases, New Delhi, India
| | - G J Fox
- University of Sydney, Sydney, NSW, Australia
| | - A Skrahina
- Republican Research and Practical Centre for Pulmonology and Tuberculosis, Minsk, Belarus
| | - D Rodrigues
- Instituto Clemente Ferreira, São Paulo, SP, Brazil
| | - L Kuksa
- Department of MDR TB, Riga East University Hospital, Riga, Latvia
| | - P Viiklepp
- Department of Registries, National Institute for Health Development, Tallinn, Estonia
| | - D Menzies
- McGill International TB Centre, Montreal, QC, Canada, Respiratory Epidemiology and Clinical Research Unit, Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC, Canada, Department of Epidemiology, Biostatistics, and Occupational Health, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
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Rodrigues D, Sharkey L. The needs of carers of children and adults with ID during COVID-19 pandemic. Ir Med J 2023; 116:752. [PMID: 37555697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 08/10/2023]
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Patel V, Rodrigues D. A282 RISK FACTORS ASSOCIATED WITH UNSUCCESSFUL HIGH-RESOLUTION MANOMETRY: FAILURE IS COMMON BUT WHAT CAN WE CHANGE. J Can Assoc Gastroenterol 2023. [PMCID: PMC9991398 DOI: 10.1093/jcag/gwac036.282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
Background High-resolution manometry (HRM) is a diagnostic tool used to evaluate esophageal motor function and diagnose motility disorders. A standardized protocol is used to make an accurate diagnosis based on the Chicago Classification. Some existing literature suggests that incomplete or imperfect manometry tests are common, however; there remains a paucity of data to evaluate risk factors for failure to help clinicians determine when a study may be difficult to perform. Purpose Our goal was to quantify how often failed tests occurred and determine specific factors that may be associated with failed HRM. Method We retrospectively evaluated records for HRM tests performed over 1 year at our academic centre. Based on clinical experience, we identified several factors that may be associated with the success of HRM testing including the following: indications and symptoms leading to testing, patient’s age and biological sex, previous esophageal manometry history, previous esophageal/gastric surgery, previous septal repair/deviated septum, history of significant nausea/vomiting, history of anxiety/depression, history of irritable bowel syndrome, and medication use (opioids, proton pump inhibitors, calcium channel blockers, nitrates). We then compared patients with successful HRM vs. unsuccessful HRM with regard to our pre-specified risk factors. Result(s) 29 HRM tests were unsuccessful from a total of 152 that were performed (19% failure rate). Reasons for failure included the inability to pass the probe through LES (55%) and the inability to tolerate the manometry probe for a minimum of 10 saline swallows (45%). After separating the failed cases from successful tests, both groups had a similar distribution of age and sex. Specific symptoms and indications did not have a significant association with unsuccessful tests. A previous history of failed manometry was associated with unsuccessful HRM (OR: 15, 95% CI 1.88 to 183.8, p=0.0156). Conversely, PPI usage was associated with fewer failed HRM tests (OR: 0.37, 95% CI 0.16 to 0.90, p=0.0343). Other medical history or medication use was not found to be associated with testing failure in our study. Conclusion(s) HRM is useful for diagnosing esophageal motility disorders, but incomplete tests are common. Although this study did not identify any factors in a patient’s medical history that could be used to predict failure in patients who have never had testing, further investigations may identify if PPI therapy can make HRM testing more tolerable. Additionally, the association between previous failed HRM and repeat failures suggests that endoscopic probe placement techniques should be considered instead of retrying conventional probe placement. Please acknowledge all funding agencies by checking the applicable boxes below None Disclosure of Interest None Declared
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Affiliation(s)
- V Patel
- Queen's University, Kingston, Canada
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Cuenca-Gómez JÁ, Ocaña-Losada C, Crujeiras P, Rodrigues D, Martínez-Espinosa M. Etiology of avascular necrosis of the hip and shoulder. Screening for Gaucher disease. Rev Clin Esp 2023; 223:17-24. [PMID: 36457211 DOI: 10.1016/j.rceng.2022.10.003] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 10/20/2022] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Avascular necrosis (AON) of the hip and shoulder is a little studied disease and the predisposing risk factors for its development are not well known. A high percentage of patients are diagnosed with idiopathic osteonecrosis. This study aims to investigate the prevalence of potential etiological factors for AON and to screen for Gaucher disease among patients with idiopathic AON. MATERIAL AND METHODS This retrospective, single-center, observational study was conducted on patients who had at least one episode of AON of the hip or shoulder at the Hospital de Poniente (Almería, Spain) from January 2010 to December 2019. Clinical and analytical data were collected. Patients whose medical record described no etiological factors for this disease were screened for Gaucher disease. RESULTS The study sample consisted of 81 patients, of whom 58 were male. The mean age at presentation of AON was 45.9 years. They presented with unilateral hip necrosis (n=43), bilateral hip necrosis (n=34), bilateral hip and unilateral shoulder necrosis (n=3), and unilateral shoulder necrosis (n=1). The most frequent potential etiological factors were smoking (46.9%) and obesity (17.3%). Screening for Gaucher disease was performed in ten patients, all of whom tested negative. CONCLUSIONS In our study population, the main potential etiological factors the onset of AON of the shoulder or hip were smoking and obesity. A high percentage of patients were diagnosed with idiopathic AON. We believe that a more exhaustive study of less frequent risk factors should be carried out in these cases.
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Affiliation(s)
- J Á Cuenca-Gómez
- Servicio de Medicina Interna, Hospital de Poniente, El Ejido, Almería, Spain.
| | - C Ocaña-Losada
- Servicio de Medicina Interna, Hospital de Poniente, El Ejido, Almería, Spain
| | - P Crujeiras
- Unidad de Diagnóstico y Tratamiento para Enfermedades Metabólicas Congénitas, Servicio de Neonatología, Departamento de Pediatría, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, La Coruña, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Spain; Instituto de Investigaciones Sanitarias of Santiago de Compostela (IDIS), Santiago de Compostela, La Coruña, Spain
| | - D Rodrigues
- Unidad de Diagnóstico y Tratamiento para Enfermedades Metabólicas Congénitas, Servicio de Neonatología, Departamento de Pediatría, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, La Coruña, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Spain; Instituto de Investigaciones Sanitarias of Santiago de Compostela (IDIS), Santiago de Compostela, La Coruña, Spain
| | - M Martínez-Espinosa
- Servicio de Traumatología y Cirugía Ortopédica, Hospital de Poniente, El Ejido, Almería, Spain
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Cuenca-Gómez J, Ocaña-Losada C, Crujeiras P, Rodrigues D, Martínez-Espinosa M. Etiología de la osteonecrosis avascular de cadera y hombro. Cribado de la enfermedad de Gaucher. Rev Clin Esp 2022. [DOI: 10.1016/j.rce.2022.10.006] [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: 12/23/2022]
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10
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Costa R, Aires F, Rodrigues D, Paiva A, Maciel J, Fernandes P. Results of surgery versus stereotactic body radiotherapy for lung cancer. Pulmonology 2022:S2531-0437(22)00223-9. [PMID: 36270888 DOI: 10.1016/j.pulmoe.2022.10.001] [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: 07/13/2022] [Revised: 09/21/2022] [Accepted: 10/03/2022] [Indexed: 06/16/2023] Open
Affiliation(s)
- R Costa
- Department of Cardiothoracic Surgery, Centro Hospitalar São João, Porto, Portugal, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.
| | - F Aires
- Department of Radiation Oncology, Centro Hospitalar São João, Porto, Portugal
| | - D Rodrigues
- Department of Radiation Oncology, Centro Hospitalar São João, Porto, Portugal
| | - A Paiva
- Department of Cardiothoracic Surgery, Centro Hospitalar São João, Porto, Portugal, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
| | - J Maciel
- Department of Cardiothoracic Surgery, Centro Hospitalar Universitário de Lisboa Central-Hospital Santa Marta, Lisboa, Portugal
| | - P Fernandes
- Department of Cardiothoracic Surgery, Centro Hospitalar São João, Porto, Portugal, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
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Rodrigues D, van Kampen R, van Bodegraven A, Kleinjans J, de Kok T, Jennen D. P11-25 Unraveling the molecular mechanisms of capecitabine-induced colon toxicity: a case study. Toxicol Lett 2022. [DOI: 10.1016/j.toxlet.2022.07.475] [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: 12/01/2022]
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Rodrigues D, Kataria J, Rivera D. A131 ESOPHAGEAL MUCOSAL BIOPSIES FOR THE DIAGNOSIS OF NON-EROSIVE REFLUX DISEASE: A SYSTEMATIC REVIEW AND META-ANALYSIS. J Can Assoc Gastroenterol 2022. [DOI: 10.1093/jcag/gwab049.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Non-erosive reflux disease (NERD) accounts for over half of all cases of gastroesophageal reflux disease (GERD). It is characterized by symptoms of GERD with pathologic acid exposure on ambulatory pH monitoring and no evidence of erosive esophagitis on upper endoscopy. Symptoms and negative endoscopy alone are insufficient to diagnose NERD. Ambulatory pH monitoring is limited due to availability and patient tolerance. Conventional histologic analysis of mucosal esophageal biopsies has been studied in this context but there is no clear guidance as to its utility in diagnosing NERD.
Aims
The purpose of this study was to conduct a systematic review and meta-analysis to determine the sensitivity and specificity of esophageal biopsy histology in diagnosing NERD.
Methods
Data were obtained from Embase (1947- April 2021) and Ovid MEDLINE (1946 – April 2021). We included all studies where esophageal mucosal biopsies were taken and light microscopy was used to analyze histopathology in symptomatic adult NERD patients (i.e., no evidence of erosive esophagitis and ambulatory pH testing confirmed the presence of pathologic acid exposure). Papers were sorted in duplicate. Relevant data was extracted from papers meeting inclusion criteria, including histologic abnormalities and the location of the biopsy. Sensitivities and specificities were calculated from raw data and pooled using RevMan 5.4 software, using asymptomatic patients with no significant esophageal acid exposure and/or patients with functional heartburn (i.e., symptoms but no elevated acid exposure on ambulatory pH testing) as controls.
Results
The search yielded 2871 studies after the removal of duplicates, of which 158 were eligible for full text review. In total, 12 papers met our stringent inclusion criteria and contained raw data that allowed for sensitivity calculations. Histological abnormalities that were commonly reported included gross morphological scores, papillary elongation, basal cell hyperplasia and dilated intraepithelial spaces. Biopsies were taken at <3cm in 5 studies, ≥3cm in 5 studies, and at multiple sites in 2 studies, and all were reviewed by a blinded pathologist. When assessing for the presence of any abnormality in the histological analysis, biopsies taken at <3cm had a pooled sensitivity of 0.70 (95% CI 0.64 – 0.75) and specificity of 0.72 (95% CI 0.63 – 0.77). Biopsies taken at ≥3cm revealed a pooled sensitivity of 0.39 (95% CI 0.32 – 0.47) and specificity of 0.63 (95% CI 0.51 – 0.74).
Conclusions
Esophageal mucosal biopsies have poor sensitivity and specificity at diagnosing non-erosive gastroesophageal reflux disease. Biopsies taken below 3cm appear to have a higher sensitivity and specificity than those taken more proximally.
Funding Agencies
None
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Affiliation(s)
| | - J Kataria
- Queen’s University, Kingston, ON, Canada
| | - D Rivera
- Queen’s University, Kingston, ON, Canada
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Ricci M, Rodrigues D, Reed DE. A135 DO VISCOUS SWALLOWS IMPROVE THE DIAGNOSTIC YIELD OF HIGH-RESOLUTION MANOMETRY? J Can Assoc Gastroenterol 2022. [PMCID: PMC8859382 DOI: 10.1093/jcag/gwab049.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background Esophageal motility disorders are diagnosed using high-resolution esophageal manometry (HR-EMS) using the Chicago Classification (CC V4.0) which is based on a series of 10 normal saline swallows (LS). Viscous swallows (VS; thickened liquid/applesauce) are often performed during esophageal manometry; however, they were not included within the framework of CC V4.0. Previous literature has suggested inconsistency between LS and VS in up to 25% of studies, yet it remains unclear whether routine use of VS offers any benefit to LS alone in diagnosing manometric abnormalities according to the CC V4.0. Aims To determine if the routine use of VS improves the diagnostic yield in HR-EMS Methods A retrospective analysis of all HR-EMS studies performed between December 2020 and July 2021 at Kingston Health Sciences Centre was completed. Demographic information including age, sex, indication for HR-EMS, surgical history, and chronic narcotic use was documented. Each study (consisting of 10 LS and 10 VS) was reviewed independently by a Gastroenterology Fellow and Neurogastroenterologist. A manometric diagnosis using CC V4.0 was made for both LS and VS. Descriptive statistics were performed. Results A total of 101 HR-EMS studies were reviewed (33 male, 68 female, age range 26 to 90 years). The most common indication for HR-EMS was dysphagia (87/101) with 23/101 having 2 indications, 30/101 having 3 indications, and 43/101 patients having >3 indications. Prior upper GI tract surgery and chronic narcotic use was recorded in 9/101 and 8/101 patients, respectively. Two HR-EMS studies were excluded due to incomplete protocol. In total, 38.4% (38/99) had normal HR-EMS for both LS and VS. LS and VS that resulted in a CC V4.0 diagnosis were concordant in 37.4%(37/99) and discordant in 24.2% (24/99). Of the 24 discordant studies, 6 had a CC V4.0 diagnosis for LS (4 esophagogastric outflow obstruction (EGJOO), 1 ineffective esophageal motility (IEM), 1 diffuse esophageal spasm) and normal VS. Ten studies had normal LS and a CC V4.0 diagnosis for VS (9 IEM, 1 EGJOO). Eight had differing CC V4.0 diagnoses for LS and VS. Conclusions LS and VS resulted in concordant diagnoses in the majority of cases. However, there were discordant results in approximately 25% of cases. In nearly half of these studies, the LS was within normal limits whereas VS yielded a diagnosis of an esophageal motility disorder which may be of clinical significance to the patient’s management. The addition of VS to HR-EMS protocol may increase diagnostic yield in symptomatic patients. Funding Agencies None
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Affiliation(s)
- M Ricci
- Queen’s University, Kingston, ON, Canada
| | | | - D E Reed
- Queen’s University, Kingston, ON, Canada
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Parvizian MK, Zhang M, Edwards M, Bhoey P, Hookey L, Rodrigues D. A102 INDICATION FOR ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY AND ASSOCIATION WITH HEMORRHAGE: A SYSTEMATIC REVIEW AND META-ANALYSIS. J Can Assoc Gastroenterol 2022. [DOI: 10.1093/jcag/gwab049.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Hemorrhage is a complication associated with up to 2% of cases of Endoscopic Retrograde Cholangiopancreatography (ERCP), most commonly following sphincterotomy. Studies investigating risk factors associated with hemorrhage, such as ERCP indication, have been conflicting.
Aims
We performed a systematic review and meta-analysis to determine the association between the indication for ERCP and ERCP-associated hemorrhage.
Methods
A systematic search of MEDLINE, EMBASE, and CENTRAL was done from inception until September 2021 for studies reporting on factors associated with ERCP-associated hemorrhage (both immediate and delayed) in adults. Exclusion criteria included: pediatric patients, no outcome of interest, did not investigate hemorrhage risk factors, inappropriate study design (basic science, reviews, and case reports/series), or if no English text was available. A DerSimonian and Laird random-effects meta-analysis was performed to generate pooled Odds Ratios (OR) with 95% Confidence Intervals (CIs) for each procedural indication in relation to hemorrhage.
Results
952 records were identified of which 17 were included in our quantitative analysis. Common indications included acute cholangitis, choledocholithiasis, Sphincter of Oddi dysfunction (SOD), acute pancreatitis, chronic pancreatitis, and malignancy-associated duct obstruction. Rates of hemorrhage varied in the included studies (median 2.2%; IQR 1.7–6.9). Sphincterotomy rates also differed in the included studies (median 100%; IQR 71.1–100). Five studies did not report on antiplatelet or anticoagulant use with the remaining reporting varying rates of antiplatelet (median 8.3%; IQR 0–26.5) and anticoagulant (median 0.8%; IQR 0–2.25) use. Hemorrhage was significantly associated with acute cholangitis (OR 2.48; 95% CI 1.62–3.78) and choledocholithiasis (OR 1.76; 95% CI 1.06–2.94) but not SOD (OR 1.38; 95% CI 0.74–2.58), malignancy (OR 0.68; 95% CI 0.29–1.59), acute pancreatitis (OR 1.08; 95% CI 0.30–3.82), or chronic pancreatitis (OR 0.56; 95% CI 0.16–1.99).
Conclusions
Acute cholangitis and choledocholithiasis were associated with increased hemorrhage, whereas SOD, malignancy, acute pancreatitis, and chronic pancreatitis were not. Providers should consider procedural indication when counselling patients on hemorrhage risk in ERCP.
Funding Agencies
None
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Affiliation(s)
| | - M Zhang
- McMaster University, Hamilton, ON, Canada
| | - M Edwards
- Medicine, Queen’s University, Kingston, ON, Canada
| | - P Bhoey
- Medicine, Queen’s University, Kingston, ON, Canada
| | - L Hookey
- Medicine, Queen’s University, Kingston, ON, Canada
| | - D Rodrigues
- Medicine, Queen’s University, Kingston, ON, Canada
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Reed DE, Beyak MJ, Rodrigues D, Vanner S, Paterson WG. A80 CANADIAN NEUROGASTROENTEROLOGY NETWORK (CNN) SURVEY ON PH/MOTILITY TESTING IN CANADA. J Can Assoc Gastroenterol 2022. [PMCID: PMC8859369 DOI: 10.1093/jcag/gwab049.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Anecdotal reports suggest that access to pH/motility testing is problematic in Canada, but to date there is little data documenting this. Aims To assess the volume and accessibility of motility lab testing in Canada. Methods The CNN developed a questionnaire directed at the scope, volume and accessibility of pH/motility testing in Canadian labs. Fifty-three labs were identified using lists provided by companies that supply pH/motility recording equipment in Canada. Of these, 12 labs were excluded (10 had incorrect or absent contact information, 1 had recently closed and 1 had just opened). Questionnaires were sent in early 2020 to the remaining 41 labs, and respondents were asked to use data from their last fiscal year pre-pandemic. Results 26 completed questionnaires were returned (i.e., 63% response rate, but representing ~ 51% of active labs): 23 adult units (7 community, 15 academic and 1 private) and 3 academic pediatric units. Of the adult units, 6 performed studies in children <12 yrs old. All 3 pediatric units provided both esophageal and anorectal high-resolution manometry (HRM) and pH/Impedance recording, with wait times of < 3 months. All 23 adult labs provided esophageal HRM, but just 50% performed anorectal manometry and only 3 anorectal manometry with biofeedback. Ambulatory pH/Impedance was performed in all but 1 adult unit. 15 of 23 adult centres reported access to colon transit studies and only one performed colonic manometry. No units performed antroduodenal manometry. Five units offered Bravo wireless pH recording and 4 performed ENDOFLIP. In adult units, the median number of procedures per year were as follows: esophageal HRMs - 278 (range: 50–1140); pH/impedance - 225 (range: 40–634); anorectal manometry - 90 (range: 10–450). Corresponding median wait times in months were as follows: esophageal HRM - 4 (range: 0.5–14); pH/Impedance - 4.5 (range: 0.5–14); anorectal manometry - 4.6 (range: 2–9). Only 6 of the 23 adult units met recommended wait time targets of <2 months. Testing was performed by a nurse in ~ 80% of centres, while testing was done by technicians in 2 units and physicians in 3 units. 8 units accepted referrals from primary care physicians, whereas the remainder only accepted specialist referrals. 50% screened referrals for appropriateness and restricted access accordingly. Conclusions The scope of motility and pH testing across Canada is variable, with lower GI testing lacking in many regions. Wait times vary significantly across labs and the majority of centres exceed recommended limits of 2 months. The reasons underlying the identified limitations to pH/motility testing access warrant further study. Funding Agencies None
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Affiliation(s)
- D E Reed
- Queen’s University, Kingston, ON, Canada
| | - M J Beyak
- Queen’s University, Kingston, ON, Canada
| | | | - S Vanner
- Queen’s University, Kingston, ON, Canada
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Silva MR, Rosado-Marques V, Nogueira H, Rodrigues D, Machado-Rodrigues A, Gama A, Padez C. Household food insecurity in portuguese young children after the financial crisis. Clin Nutr ESPEN 2021. [DOI: 10.1016/j.clnesp.2021.09.155] [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: 10/19/2022]
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17
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Serino M, Cardoso C, Carneiro RJ, Ferra J, Aguiar F, Rodrigues D, Redondo M, van Zeller M, Drummond M. OSA patients not treated with PAP - Evolution over 5 years according to the Baveno classification and cardiovascular outcomes. Sleep Med 2021; 88:1-6. [PMID: 34710706 DOI: 10.1016/j.sleep.2021.09.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 08/21/2021] [Accepted: 09/13/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The evolution of patients with obstructive sleep apnea (OSA) non-eligible for PAP-therapy at diagnosis is unknown. Currently, the severity of OSA is based on the apnea-hypopnea index (AHI), but its prognostic relevance has raised concerns. The Baveno classification may allow a better stratification of severity and therapeutic guidance in OSA. METHODS Patients with AHI≥5/h in 2015, classified into Baveno groups A and B and non-eligible for PAP therapy at diagnosis and over 5 years, were analyzed. Patients were reclassified into Baveno groups (A-D) and changes in groups over 5 years were explored. Patients in Baveno groups C and D, who developed major cardiovascular comorbidities (CVC) or end-organ damage (EOD group), were compared with patients in Baveno groups A and B (non-EOD group). To identify predictors of the development of major CVC or EOD, a logistic regression analysis was performed. RESULTS There were 76 patients, 58% male, mean age 51.9 ± 10.1 years, mean body mass index (BMI) of 30.3 ± 5.0 kg/m2 and median AHI of 8.9 (5.9-12.0) events/h. At diagnosis, 46% and 54% of patients were classified into Baveno group A and group B, respectively. In total, 21% of patients developed major CVC or EOD (Baveno group C or D); higher age (p = 0.011) and BMI (p = 0.004) and a higher percentage of central apneas (p = 0.012) at diagnosis significantly predicted it, while sex, sleepiness, insomnia, AHI, ODI and T90 were not. CONCLUSIONS A significant percentage of patients non-eligible for PAP-therapy at diagnosis of OSA developed CVC or EOD; higher age and BMI and a higher percentage of central apneas were significant predictors.
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Affiliation(s)
- M Serino
- Department of Pneumology, Centro Hospitalar São João, Porto, Portugal.
| | - C Cardoso
- Department of Pneumology, Centro Hospitalar São João, Porto, Portugal
| | - R J Carneiro
- Department of Pneumology, Centro Hospitalar Oeste, Hospital Torres Vedras, Torres Vedras, Portugal
| | - J Ferra
- Department of Pneumology, Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, LisboaVedras, Portugal
| | - F Aguiar
- Department of Pneumology, Hospital de Braga, Braga, Portugal
| | - D Rodrigues
- Pulmonology Department, Centro Hospitalar Universitário São João, Sleep and Non-Invasive Ventilation Unit, Centro Hospitalar Universitário São João, Porto, Portugal
| | - M Redondo
- Pulmonology Department, Centro Hospitalar Universitário São João, Sleep and Non-Invasive Ventilation Unit, Centro Hospitalar Universitário São João, Porto, Portugal
| | - M van Zeller
- Sleep and Non-Invasive Ventilation Unit, Centro Hospitalar Universitário São João, Faculty of Medicine, University of Porto, Porto, Portugal
| | - M Drummond
- Sleep and Non-Invasive Ventilation Unit, Centro Hospitalar Universitário São João, Faculty of Medicine, University of Porto, Porto, Portugal
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Price T, Cehic G, Wachter E, Sebben R, Reid J, Alawawdeh A, McGregor M, Kirkwood I, Rodrigues D, Neuhaus S, Maddern G. 1106P Phase I study of hepatic intralesional rose bengal disodium (PV10), an autolytic immunotherapy, in metastatic neuroendocrine neoplasms. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Rodrigues D, Jeremias D, Laginhas C, Sequeira A. Challenges in schizoaffetive disorder therapeutic – a case report of a patient with hiperprolactinemia. Eur Psychiatry 2021. [PMCID: PMC9480387 DOI: 10.1192/j.eurpsy.2021.2107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction The only FDA approval therapeutic for schizoaffective disorder is paliperidone. Hiperprolactinemia is one of the most frequent side effects induced by first generation antipsychotics (FGA) or by second generation antipsychotic (SGA), such as risperidone and paliperidone. Prolactin related symptoms (PRS) include amenorrhea, galactorrhea, gynecomastia and fluctuations in psychotic symptoms. Objectives To report the case of a patient with schizoaffective disorder difficult to manage due to symptom resistance and PRS, that improved symptomatology when prolactin serum levels were reduced. Methods Clinical-demographic data collected by clinical interview and clinical process consultation. Non-systematic literature review, searching “psychosis”; “prolactin”; “antipsychotic”; “schizoaffective disorder” on Pubmed database. Results We report the case of 33 years-old female, admitted to our psychiatry inpatient unit for persecutory delusions, loosening of association, auditory hallucinations, and irritability with functional impairment. Symptoms began 13 years before. She was medicated with paliperidone 100mg IM monthly, lithium 800mg daily and clozapine 225mg daily. When admitted she wasn’t adhering to oral medication. On physical examination presented some PRS. The serum presented hyperprolactinemia and lithium in non-therapeutic levels. Initially was re-introduced the previous therapeutic without improval. It was made a therapeutic switch to associate aripiprazole 400mg IM monthly and clozapine 225mg daily, and lithium 800mg daily resulting in prolactine normalization and subsequent improval of psychotic symptoms previously presented. Conclusions This case reports challenges in management of patients diagnosed with Schizoaffetive Disorder due to therapeutic refractoriness and side effects. PRS can be ruling, therefore impacting therapeutic choices. We propose a possible role of combination of clozapine and aripiprazole in this scenario. Disclosure No significant relationships.
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Aires F, Rodrigues D, Marques M, Pinto M. P-166 Operative versus nonoperative treatment for stage 0 rectal cancer following chemoradiation therapy. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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21
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Souček P, Rodrigues D, Beneš O, Delpech S, Rodrigues A, Konings R. Electrochemical measurements of LiF-CaF2-ThF4 melt and activity coefficient of ThF4 in LiF-CaF2 eutectic melt. Electrochim Acta 2021. [DOI: 10.1016/j.electacta.2021.138198] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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22
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Jeremias D, Moura A, Rodrigues D, Laginhas C, Isaac J, Albuquerque R. Mental health in pandemic times - a review. Eur Psychiatry 2021. [PMCID: PMC9471940 DOI: 10.1192/j.eurpsy.2021.832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Any outbreak of pandemic dimension will most likely produce a serious amount of distress and prejudice to anyone, in particular when it comes to mental health. The pandemic impact in primary care and in the psychiatric emergency department are some of the topics discussed in this review. Objectives It aims to review, evaluate and reflect over the impact of a deadly coronavirus pandemic on mental health, as well as presenting possible long-term challenges and potential ways to approach it. Methods A non-systematic literary review was performed on the Pubmed, PsycInfo and Cochrane databases using the key words “covid-19”, “psychiatry”, “self-isolation” and “telepsychiatry”. Results Globally and, as expected, there has been a general increase in need for psychiatric assessment and treatment due to the COVID-19 pandemic. Conclusions The role of psychiatry has faced quite some challenges in such a short period of time: the rise of telepsychiatry; the management of patients with both a psychiatric disorder and an infection with the new coronavirus and the need to provide an adequate psychiatric assistance in the emergency room has become the new normal.
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Laginhas C, Jeremias D, Rodrigues D, Medinas R, Moura N, Pereira C. Hopelessness in patients with schizophrenia. Eur Psychiatry 2021. [PMCID: PMC9471236 DOI: 10.1192/j.eurpsy.2021.1419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Individuals with schizophrenia have a shortened average life expectancy, with a lifetime risk of suicide around 5%. Objectives Here we present a case of a patient diagnosed with schizophrenia who developed depressive symptoms with suicidal ideation, reactive to psychotic symptoms. Considering this specific case, the factors that contribute to the increased risk of suicide in these patients are reviewed. Methods Relevant clinical information was extracted from the patient’s clinical process. In addition, we searched PubmedR database with the terms “Schizophrenia”, “Hopelessness” and “Suicide”. Results A 40-year-old male patient, single and unemployed presents a progressive psychotic condition, with 20 years of evolution, with an impact on social and work behaviour. As a background he has a history of depressive episodes with suicidal ideation at the age of 36, following psychotic symptoms. This is a patient with preserved cognitive functioning combined with a high level of education, who understands the impact of his reality on his functioning. In this context, he develops feelings of hopelessness, that are the risk factor for suicide, most consistently reported in patients with schizophrenia. Conclusions This case assesses a patient with schizophrenia who has several factors, that contribute to an increased risk of suicide, focusing on hopelessness. In the future, it may be interesting to study in more detail the individual weight of each factor, so that it is possible to accurately predict the individual risk of each patient and, consequently, it is possible to implement preventive strategies.
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Jeremias D, Laginhas C, Rodrigues D, Moura A. Diagnostic challenges presented by women with anorexia nervosa and elevated rates of autistic traits. Eur Psychiatry 2021. [PMCID: PMC9480318 DOI: 10.1192/j.eurpsy.2021.1852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
IntroductionThe link between autism spectrum disorder (ASD) and anorexia nervosa (AN) firstly emerged in the 80’s. Given the overlap in behavioural and cognitive features between these two seemingly different disorders, AN has been hypothesized to be a female phenotype of ASD.ObjectivesThis report aims to describe a clinical case of an anorexic female patient diagnosed later in life with ASD, while presenting a bibliographic review on the subject.MethodsAfter gaining consent, detailed information about the case history was collected and medical records were analysed and reviewed. A non-systematic literary review was performed on the Pubmed and Cochrane databases using the key words “anorexia nervosa”, “females”, “comorbidity” and “autism spectrum disorder”.ResultsThe current case report is of a 28-year-old female, whose extremely low body weight and complete food refusal for three days prompted her first hospitalization in a psychiatric unit with the admission diagnosis of anorexia nervosa. However, long-term impairments in social interaction and flexibility, emotional difficulties and sensory processing overload were acknowledged and the primary diagnosis of ASD was then considered.ConclusionsAs illustrated in this case, the diagnosis of ASD should always be considered in females with eating disorders, in particular AN, regardless of age. As this neurodevelopmental condition appears to present differently in females, they also seem more likely to go underdiagnosed. Also, due to poorer treatment outcomes in females with both ASD and AN, the importance of developing a specialized approach and prompt referral of these patients is highlighted.DisclosureNo significant relationships.
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Rodrigues D, Kundra A, Hookey L, Montague S. A131 POINT OF CARE ULTRASOUND CHANGES THE NEEDLE INSERTION LOCATION FROM AN ANATOMICALLY LANDMARKED SITE DURING BEDSIDE PARACENTESIS. J Can Assoc Gastroenterol 2021. [DOI: 10.1093/jcag/gwab002.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Paracentesis is a bedside procedure to obtain ascitic fluid from the peritoneum. It is traditionally performed using anatomic landmarking and percussion to ascertain a safe drainage site. The serious complication rate has been reported as less than 2%. Point-of-care ultrasound (POCUS) has been adopted into education and clinical use and has been shown to improve the safety of certain procedures such as central line insertion and thoracentesis. However, the evidence supporting its use is limited.
Aims
We aimed to assess if POCUS would yield a user-preferred site for needle insertion compared to conventional landmarking, defined as a >5cm change in location.
Methods
Adult patients under the care of gastroenterology or general internal medicine at Kingston Health Sciences Centre undergoing paracentesis were consecutively enrolled between January and September of 2020. Physicians performing the procedure were enrolled based on availability. An anatomic site was selected 4cm superiorly and 2-4cm medially to the anterior superior ileac spine and confirmed with dullness to percussion. POCUS was then employed to determine if there was an alternative user-preferred site. Patient and operator demographic data and procedure-related information were collected.
Results
A total of 30 individual patients and 24 operators were enrolled, comprising 45 unique procedure combinations. Operators were primarily in their PGY 1 and 2 years of training (33% and 31% respectively). Per procedure, patients mean age was 61, and most of the ascites was due to cirrhosis (84%) predominantly due to EtOH (47%) and NAFLD (34%). As per indication, 29% of procedures were for diagnostic purposes alone. In total, users primarily preferred the POCUS site which resulted in a change in needle insertion site >5cm from the anatomic site in 69% of cases. The average depth of fluid was greater at the POCUS site vs. the anatomic site (5.4cm+/-2.8 vs 3.0cm+/-2.5, p<0.005). On average, POCUS deflected the needle insertion site superiorly and laterally to the anatomic site. Operators listed that per procedure the POCUS site was chosen to avoid adjacent organs (38%), optimize fluid pocket (61%) and due to abdominal wall issues (primarily issues with pannus; 11.5%). Importantly 6 cases were aborted due to a lack of an appropriate fluid pocket, despite clinical and/or prior radiographic evidence of ascites.
Conclusions
Overall, POCUS changes the needle insertion site from the conventional anatomic site for most procedures, due to user-perceived safety concerns. POCUS also prevented an attempt at paracentesis in 6 cases that were deemed unsafe. Therefore, POCUS plays an important role in bedside paracentesis. This research supports the use of POCUS in paracentesis and argues for continued training with POCUS throughout medical school and residency.
Funding Agencies
None
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Affiliation(s)
- D Rodrigues
- Gastroenterology, University of Toronto Faculty of Medicine, Kingston, ON, Canada
| | - A Kundra
- Department of Internal Medicine, Queen’s University, Brampton, ON, Canada
| | - L Hookey
- Queen’s University, Kingston, ON, Canada
| | - S Montague
- Department of Internal Medicine, Queen’s University, Brampton, ON, Canada
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Hoang NH, Rodrigues D, Bonvin D. On the computation of extents of reaction with a limited number of measurements. Comput Chem Eng 2021. [DOI: 10.1016/j.compchemeng.2020.107014] [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: 11/28/2022]
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Pelissari S, Sinhorin V, Castoldi L, de Vasconcelos L, Rodrigues D, Ribeiro E, Kerkhoff J, Sinhorin A. Methanolic Extract of Rhinella marina Poison: Chemical Composition, Antioxidant and Immunomodulatory Activities. J BRAZIL CHEM SOC 2021. [DOI: 10.21577/0103-5053.20210057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
This study investigated the chemical composition, immunomodulatory and antioxidant activities, and histopathological analysis of mice tissues treated with methanolic extract from R. marina poison. Marinobufagin, telecinobufagin and bufalin were identified in the chemical profile. The biochemical results demonstrated an effect between doses in the period of 7 days, an immunomodulatory effect was observed regarding the production capacity of interleukin (IL)-12p70 and tumor necrosis factor (TNF)-α at 7 and 30 days, respectively. The lower dose suggests better bioactivity to the treated animal than the higher dose. Histopathological analyses of the lung, heart, kidney and liver showed tissue damage in all organs, mainly in the lung, and were proportional to the dose and the treatment period. We observed that the treatment modulated cytokine production, and therefore this effect may be related to the tissue damage observed. This study demonstrates a positive effect in the antioxidant and immune system, indicating that the molecules found in the extract have biotechnological potential.
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Silva MR, Rosado-Marques V, Nogueira H, Machado-Rodrigues A, Rodrigues D, Gama A, Padez C. Food (IN)security in Portuguese preschool and school children in time of financial crisis. Clin Nutr ESPEN 2020. [DOI: 10.1016/j.clnesp.2020.09.614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Silva I, Andrade S, Almeida S, Barbosa K, Bispo M, Silva J, Gonçalves V, Rodrigues M, Pribul B, Rodrigues D, Fialho A, Assis R, Cabral C. E. coli O157:H7 outbreak and hemolytic uremic syndrome in a day care center in Brazil. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.372] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Molitoris J, Snider J, Koroulakis A, DeCesaris C, Siddiqui O, Kowalski E, Rodrigues D, Nichols E, Vujaskovic Z. Concurrent Hyperthermia With Pencil Beam Scanning Proton Therapy: Largest Institutional Experience to Date. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2384] [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: 11/25/2022]
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Molitoris J, Rodrigues D, Snider J, Rao A, Mossahebi S, Zakhary M, Biswal N, Lehman K, Vujaskovic Z. Concurrent Deep Locoregional Thermal Therapy With Pencil Beam Scanning Proton Therapy Results in Modest Toxicity With the Promise of Increased Efficacy. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Basu T, Karpe A, Mathur Y, Patel A, Kendre P, Katna R, Raut N, Rodrigues D, Yadav R, Nayak D, Ambulkar I, Gawde S. 937P Outcome, patterns of failure and toxicity profile following adjuvant intensity modulated radiotherapy for oral cavity squamous cell carcinomas. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Carvalho L, Ferreira T, Frutuoso L, Matos L, Castro T, Rodrigues D, Oliveira V, Gonçalves G, Nora M, Scigliano H. Large mucinous cystic neoplasm of the pancreas during pregnancy: a case report. J Surg Case Rep 2020; 2020:rjaa085. [PMID: 32665837 PMCID: PMC7342093 DOI: 10.1093/jscr/rjaa085] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 12/13/2019] [Accepted: 03/19/2020] [Indexed: 12/18/2022] Open
Abstract
Mucinous cystic neoplasms (MCNs) of the pancreas occurring during pregnancy constitute a rare condition requiring special management due to its large size, malignant potential and the risk of fetal growth restriction. The key points to manage MCNs are to perform a correct diagnosis, accurately evaluate the grade of malignant potential in order to establish the right time for pancreatic surgery and to choose the most appropriate fetal mode of delivery. We describe a case of an incidental abdominal mass detected in a third-trimester pregnant woman. At surgery, a huge pancreatic cystic tumour was found and a distal pancreatectomy with splenic preservation was performed. The histopathological analysis revealed an MCN of the pancreas with low-grade dysplasia. To our knowledge, this is the largest pancreatic MCN detected in a pregnant woman reported in the literature and one of the few successfully resected after vaginal delivery.
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Affiliation(s)
- Lúcia Carvalho
- Department of General Surgery, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal
| | - Tiago Ferreira
- Department of General Surgery, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal
| | - Luísa Frutuoso
- Department of General Surgery, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal
| | - Leonor Matos
- Department of General Surgery, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal
| | - Tiago Castro
- Department of General Surgery, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal
| | - Domingos Rodrigues
- Department of General Surgery, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal
| | - Vera Oliveira
- Department of General Surgery, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal
| | - Gil Gonçalves
- Department of General Surgery, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal
| | - Mário Nora
- Department of General Surgery, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal
| | - Horácio Scigliano
- Anatomical Pathology Laboratory Dr. Albino Oliveira (Unilabs), Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal
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Rodrigues D, Aires F, Marques M, Pinto M. P-276 Neutrophil/lymphocyte ratio (NLR) predicts survival after curative treatments for rectal cancer patients. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.358] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Rodrigues D, Lourenssen S, Bechara R, Blennerhassett MG. A132 SMOOTH MUSCLE BIOPSIES FROM POEM PROCEDURES FOR ACHALASIA SHOW LACK OF FUNCTIONAL INNERVATION. J Can Assoc Gastroenterol 2020. [DOI: 10.1093/jcag/gwz047.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Idiopathic achalasia is a disease of the esophagus causing impaired peristalsis and absent lower esophageal sphincter relaxation. The etiopathogenesis of the disease is unclear but most histopathologic studies from surgical resections show an absence of nitric oxide-producing neurons in the myenteric plexus. The peroral endoscopic myotomy (POEM) procedure has evolved in the last decade to treat achalasia and has provided a unique way to sample diseased tissue from an otherwise inaccessible tissue compartment.
Aims
To study the effects of achalasia on innervation of smooth muscle and smooth muscle phenotype.
Methods
Patients with a diagnosis of achalasia based on high resolution manometry undergoing a POEM at Kingston general hospital were approached for enrollment between June 2017 to September 2018. Demographic information including age, symptom duration, previous treatments, and Eckhardt score was collected. Intraoperatively, biopsies of the circular smooth muscle (CSM) layer were taken at the proximal and distal extents of the myotomy and placed in formalin. Tissue was embedded in wax, sectioned and stained using immunocytochemistry (ICC) for neuronal, axonal and smooth muscle cell markers. This was compared to control tissue from patients undergoing gastroesophagectomy for adjacent malignancy.
Results
Control tissue from 3 separate esophagectomies were obtained. Samples were obtained from a total of 25 patients (13 males), with a median age of 50 (IQR 38–67). Most patients had Type 2 achalasia (19 [76%]) followed by Type 1 and 3 (2, [8%] respectively). Two cases had conflicting manometric findings. The median duration of symptoms was 3 years (IQR 1.5–10.5) and the median Eckhardt score was 6.5 (IQR 5–9). In sample tissues, no neuronal cell bodies were detected in the CSM layer. ICC for the axonal marker PGP9.5 showed that CSM of achalasia samples were almost completely devoid of axon structure, independent of the subtype of achalasia, compared to abundant axon presence in control tissues. In parallel, ICC showed that cholinergic (ChAT) or nitrergic (nNOS) axonal subtypes were absent in biopsy CSM while abundant in controls. CSM cells displayed hypertrophy with no detection of proliferation by ICC (KI67) or alterations in the phenotypic marker SM-22.
Conclusions
Preliminary results from advanced immunohistochemical techniques show the absence of functional innervation of the CSM layer of all patients with achalasia. This is characterized by a depleted excitatory and inhibitory axon population. Further studies are focused on defining differences in smooth muscle phenotype and the presence or absence of inflammatory cells within the CSM.
Funding Agencies
None
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Affiliation(s)
- D Rodrigues
- Gastroenterology, Queen’s University, Kingston, ON, Canada
| | - S Lourenssen
- Gastroenterology, Queen’s University, Kingston, ON, Canada
| | - R Bechara
- Gastroenterology, Queens University, Toronto, ON, Canada
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Lo WB, Afshari FT, Rodrigues D, Kulkarni AV. The 'mushroom': a simple and safe technique to avoid cerebrospinal fluid leak after endoscopic third ventriculostomy. Ann R Coll Surg Engl 2020; 102:312-313. [PMID: 31964159 DOI: 10.1308/rcsann.2020.0006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- W B Lo
- Birmingham Children's Hospital, Birmingham, UK
| | - F T Afshari
- Birmingham Children's Hospital, Birmingham, UK
| | - D Rodrigues
- Birmingham Children's Hospital, Birmingham, UK
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Molitoris J, Rodrigues D, Snider J, Sharma A, Mossahebi S, Zakhary M, Lehman K, Vujaskovic Z. Deep Locoregional Thermal Therapy Concurrent with Pencil Beam Scanning Proton Therapy: Initial Report of Safety and Feasibility. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.356] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Snider J, Molitoris J, Rice S, DeCesaris C, Kowalski E, Siddiqui O, Samanta S, Rodrigues D, Sharma A, Smith V, Guerrero M, Chen S, Vujaskovic Z. Concurrent Superficial Thermal Therapy and Pencil Beam Scanning Proton Therapy: Initial Clinical Experience and Safety Profile. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.355] [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: 10/26/2022]
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Samanta S, Rice S, Siddiqui O, DeCesaris C, Kowalski E, Rodrigues D, Molitoris J, Vujaskovic Z, Snider J, Nichols E. Concurrent External Thermal Therapy and Pencil Beam Scanning Proton Therapy or Photon/Electron Therapy for Recurrent Breast Cancer: Early Outcomes and Toxicity. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.2368] [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: 11/28/2022]
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Soares A, Quintela C, Rodrigues D, Magalhães H, Mesquita A, Faria G, Salgado M, Sottomayor C, Andrade F. Hepatocellular carcinoma: characteristics, outcomes, and prognostic fators. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Quintela C, Soares A, Rodrigues D, Faria G, Andrade F. The value of alfa-fetoprotein and neutrophil/lymphocyte ratio (NLR) in the prognosis of patients with hepatocellular carcinoma. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.228] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Prsa M, Tenisch E, Piccini D, Ning J, Bouchardy J, Blanche C, Sekarski N, Pavon A, Vincenti G, Rodrigues D, Stuber M, Schwitter J, Rutz T. P6114D flow CMR vs. 2D cine PC-CMR for flow volume quantification in congenital heart disease. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez116.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M Prsa
- University Hospital Centre Vaudois (CHUV), Woman-Mother-Child Department, Lausanne, Switzerland
| | - E Tenisch
- University Hospital Centre Vaudois (CHUV), Department of Radiology, Lausanne, Switzerland
| | - D Piccini
- University Hospital Centre Vaudois (CHUV), Department of Radiology, Lausanne, Switzerland
| | - J Ning
- University Hospital Centre Vaudois (CHUV), Department of Radiology, Lausanne, Switzerland
| | - J Bouchardy
- University Hospital Centre Vaudois (CHUV), Heart and Vessel Department, Lausanne, Switzerland
| | - C Blanche
- Geneva University Hospitals, Geneva, Switzerland
| | - N Sekarski
- University Hospital Centre Vaudois (CHUV), Woman-Mother-Child Department, Lausanne, Switzerland
| | - A Pavon
- University Hospital Centre Vaudois (CHUV), Heart and Vessel Department, Lausanne, Switzerland
| | - G Vincenti
- University Hospital Centre Vaudois (CHUV), Heart and Vessel Department, Lausanne, Switzerland
| | - D Rodrigues
- University Hospital Centre Vaudois (CHUV), Department of Radiology, Lausanne, Switzerland
| | - M Stuber
- University Hospital Centre Vaudois (CHUV), Department of Radiology, Lausanne, Switzerland
| | - J Schwitter
- University Hospital Centre Vaudois (CHUV), Heart and Vessel Department, Lausanne, Switzerland
| | - T Rutz
- University Hospital Centre Vaudois (CHUV), Heart and Vessel Department, Lausanne, Switzerland
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Pavon A, Masci PG, Bermano A, Vaxman A, Gotsman C, Lauriers N, Rodrigues D, Monney P, Rutz T, Eeckhout E, Muller O, Schwitter J. P158The role of left atrium in patient with myocardial infarction with ST-segment elevation (STEMI). Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez117.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- A Pavon
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| | - P G Masci
- Kings College London, School of Bioengineer and Medical Sciences, Life Sciences, King’s College, London, United Kingdom of Great Britain & Northern Ireland
| | - A Bermano
- University of Zurich, Computer Graphics lab, Zurich, Switzerland
| | - A Vaxman
- Geometric Modeling and Industrial Geometry group, Vienna University of Technology, wien, Austria
| | - C Gotsman
- Jacobs Technion-Cornell Institute at Cornell Tech, new york, United States of America
| | - N Lauriers
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| | - D Rodrigues
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| | - P Monney
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| | - T Rutz
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| | - E Eeckhout
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| | - O Muller
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| | - J Schwitter
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
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Rodrigues D, Flemming J. A229 THE USE OF INTRAVENOUS ALBUMIN IN PATIENTS WITH CIRRHOSIS: A RETROSPECTIVE ANALYSIS OF PRACTICE PATTERNS AT A TERTIARY CARE TEACHING HOSPITAL. J Can Assoc Gastroenterol 2019. [DOI: 10.1093/jcag/gwz006.228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- D Rodrigues
- Department of Medicine, Queen’s University, Kingston , ON, Canada
| | - J Flemming
- Department of Medicine, Queen’s University, Kingston , ON, Canada
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Abstract
BACKGROUND Choroidopathy is a rare manifestation of systemic lupus erythematosus (SLE). This entity is associated with active phases of severe SLE and it is frequently accompanied by acute kidney failure, central nervous system involvement and coagulopathy. PURPOSE To evaluate the choroid thickness of patients with lupus nephritis (LN) without choroidopathy, and to compare this with that of age-matched SLE patients without LN and healthy control subjects. STUDY DESIGN Cross-sectional case control study. MATERIAL AND METHODS Fifteen women with LN in remission phase (study group), 15 women with SLE in remission without LN (SLE control group), and 15 healthy women (healthy control group), without ocular diseases or significant refractive error, were recruited. Full ophthalmological examination and a macular optical coherence tomography in enhanced depth imaging mode were performed. The choroid thickness was measured at nine macular points and six lines of mean choroidal thickness were determined. A comparative analysis between the three groups was performed using the one-way ANOVA test and the paired t-test. The choroid thickness of patients under corticotherapy was also compared to that of patients without corticotherapy. Additionally, the correlation between choroid thickness and disease duration was evaluated using the Pearson analysis. RESULTS The mean macular choroidal thickness was 295.73 ± 67.62 μm in the study group, 233.34 ± 41.01 µm in the SLE control group, and 240.98 ± 37.93 μm in the control group ( p = 0.00006 and p = 0.0003, respectively). Additionally, the choroid thickness was significantly thicker than in the SLE and healthy control groups at the foveal ( p = 0.004 and p < 0.000), nasal ( p < 0.000 and p = 0.001), superior ( p = 0.002 and p < 0.000) and inferior ( p < 0.000 and p = 0.001) mean lines. The choroidal thickness in this group was not associated with the duration of the disease. The subgroup of patients with LN under corticotherapy did not reveal a significantly different choroidal thickness. CONCLUSION This study suggests a relationship between LN and choroidal changes, which may represent an increased risk for choroidopathy in these patients. Choroid thickening was not related with the duration of the disease. This thickening may be correlated with histopathological changes similar to those occurring in kidney glomeruli.
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Affiliation(s)
- J Braga
- 1 Centro Hospitalar de Vila Nova de Gaia Espinho, Vila Nova de Gaia, Portugal
| | - R Rothwell
- 2 Centro Hospitalar do Tâmega e Sousa, Penafiel, Portugal
| | - M Oliveira
- 1 Centro Hospitalar de Vila Nova de Gaia Espinho, Vila Nova de Gaia, Portugal
| | - D Rodrigues
- 1 Centro Hospitalar de Vila Nova de Gaia Espinho, Vila Nova de Gaia, Portugal
| | - S Fonseca
- 1 Centro Hospitalar de Vila Nova de Gaia Espinho, Vila Nova de Gaia, Portugal
| | - R Varandas
- 1 Centro Hospitalar de Vila Nova de Gaia Espinho, Vila Nova de Gaia, Portugal
| | - L Ribeiro
- 1 Centro Hospitalar de Vila Nova de Gaia Espinho, Vila Nova de Gaia, Portugal
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Rodrigues D, Borro JM, Amado J, Vaz AP. Metachronous Pulmonary Neoplasms in Lung Transplantation-When They Arise in the Donor Lung: A Case Report. Transplant Proc 2018; 50:4075-4079. [PMID: 30577319 DOI: 10.1016/j.transproceed.2018.08.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 08/01/2018] [Accepted: 08/29/2018] [Indexed: 11/26/2022]
Abstract
Lung cancer (LC) is uncommon among lung transplant recipients, being most often described in the native lung of single-lung transplant recipients. Its appearance in the transplanted lung is a very uncommon phenomenon, in which donor and recipient factors appear to be involved. We present a case of 2 distinct metachronous lung neoplasms diagnosed in the transplanted lung of a non-smoker patient with progressive massive silicosis (PMS), who underwent left unipulmonary transplantation at 39 years. The donor was a smoker and thoracic computed tomography (CT) performed before the organ collection showed no abnormalities. Thirty months after transplantation, a new node with significant avidity in positron emission tomography (PET)-CT was diagnosed in the upper left lobe (ULL). The Thoracic Surgery team chose to proceed directly to surgery with atypical resection of the nodule. Anatomopathologic study revealed an epidermoid carcinoma (pT1aNx). Multidisciplinary group decided clinical surveillance; however, 2 years later, the appearance of 2 new nodules in the ULL (PET-CT positive) was observed. It was again decided to proceed to the surgery with a second atypical resection. The anatomopathologic study of one nodule revealed pulmonary adenocarcinoma (pT1aNx), and the other was compatible with epidermoid carcinoma (pT1aNx). One month later, the patient was hospitalized with a pulmonary abscess and posteriorly developed a probable acute allograft rejection, eventually dying at the age of 44, 51 months after transplantation. This case raises relevant questions regarding the donor selection criteria and the approach to LC diagnosed in the post-transplantation period.
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Affiliation(s)
- D Rodrigues
- Pulmonology Department, Hospital Pedro Hispano, Senhora da Hora, Matosinhos, Portugal.
| | - J M Borro
- Department of Thoracic Surgery and Lung Transplantation, Coruña University Hospital, Coruña, Spain
| | - J Amado
- Pulmonology Department, Hospital Pedro Hispano, Senhora da Hora, Matosinhos, Portugal
| | - A P Vaz
- Pulmonology Department, Hospital Pedro Hispano, Senhora da Hora, Matosinhos, Portugal
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Magnusson WE, Grelle CEV, Marques MCM, Rocha CFD, Dias B, Fontana CS, Bergallo H, Overbeck GE, Vale MM, Tomas WM, Cerqueira R, Collevatti R, Pillar VD, Malabarba LR, Lins-e-Silva AC, Neckel-Oliveira S, Martinelli B, Akama A, Rodrigues D, Silveira LF, Scariot A, Fernandes GW. Effects of Brazil's Political Crisis on the Science Needed for Biodiversity Conservation. Front Ecol Evol 2018. [DOI: 10.3389/fevo.2018.00163] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Cardoso PG, Rodrigues D, Madureira TV, Rocha MJ, Rocha E. Histopathological Evaluation of Combined Impacts of the Synthetic Progestin Levonorgestrel and Temperature on the Female Zebrafish Maturation Using a Semi-quantitative Grading Analysis-Is it Enough? Bull Environ Contam Toxicol 2018; 101:417-422. [PMID: 30187092 DOI: 10.1007/s00128-018-2436-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Accepted: 08/31/2018] [Indexed: 06/08/2023]
Abstract
Pharmaceuticals contamination (e.g., synthetic progestins), and global climate change, represent two of the most stressful factors affecting aquatic species. To our knowledge, there is huge gap of data regarding the combined effects of both stressors on vertebrates' reproduction. Thus, it is crucial to implement rapid screenings of measurable histopathological alterations in fish gonads. For that, we propose: (1) an evaluation of the combined effects of progestin (levonorgestrel) and temperature on maturation of zebrafish female gonads, using a semi-quantitative method (i.e., grading) and (2) testing the robustness of the grading analysis comparatively to a quantitative method (i.e., stereology). Grading analysis showed a decrease on maturation stage of ovaries exposed to both stressors. Although grading is less robust than stereological analysis, it is recommended for a preliminary approach, since it gives a correct idea on trends and it is fast and cost-effective. For a detailed histological assessment, we recommend a stereological study.
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Affiliation(s)
- P G Cardoso
- Team of Histomorphology, Physiopathology and Applied Toxicology, Interdisciplinary Centre of Marine and Environmental Research (CIIMAR/CIMAR), University of Porto, Porto, Portugal.
| | - D Rodrigues
- Team of Histomorphology, Physiopathology and Applied Toxicology, Interdisciplinary Centre of Marine and Environmental Research (CIIMAR/CIMAR), University of Porto, Porto, Portugal
- Laboratory of Histology and Embryology, Department of Microscopy, Institute of Biomedical Sciences (ICBAS), University of Porto, Porto, Portugal
| | - T V Madureira
- Team of Histomorphology, Physiopathology and Applied Toxicology, Interdisciplinary Centre of Marine and Environmental Research (CIIMAR/CIMAR), University of Porto, Porto, Portugal
- Laboratory of Histology and Embryology, Department of Microscopy, Institute of Biomedical Sciences (ICBAS), University of Porto, Porto, Portugal
| | - M J Rocha
- Team of Histomorphology, Physiopathology and Applied Toxicology, Interdisciplinary Centre of Marine and Environmental Research (CIIMAR/CIMAR), University of Porto, Porto, Portugal
- Laboratory of Histology and Embryology, Department of Microscopy, Institute of Biomedical Sciences (ICBAS), University of Porto, Porto, Portugal
| | - E Rocha
- Team of Histomorphology, Physiopathology and Applied Toxicology, Interdisciplinary Centre of Marine and Environmental Research (CIIMAR/CIMAR), University of Porto, Porto, Portugal
- Laboratory of Histology and Embryology, Department of Microscopy, Institute of Biomedical Sciences (ICBAS), University of Porto, Porto, Portugal
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Craig A, Rodrigues D, Tran Y, Guest R, Middleton J. Daytime sleepiness and its relationships to fatigue and autonomic dysfunction in adults with spinal cord injury. J Psychosom Res 2018; 112:90-98. [PMID: 30097142 DOI: 10.1016/j.jpsychores.2018.07.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 07/12/2018] [Accepted: 07/13/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To determine the extent of daytime sleepiness in adults with spinal cord injury (SCI) and investigate the contribution of fatigue and autonomic function to sleepiness status. METHODS Participants included 45 adults with SCI attending outpatient services or living in the community and 44 able-bodied controls. The Oxford Sleep Resistance Test (OSLER) was used to assess daytime sleepiness, while eye blink rate duration (electrooculography) and the Iowa Fatigue Scale assessed fatigue. Heart rate variability (HRV) was used to assess autonomic function. Survival analysis (Kaplan Meier) was used to estimate the rate of loss in participation in the OSLER task, as a measure of daytime sleepiness. Repeated measures ANOVA was used to determine HRV differences between groups. Regression analysis was used to establish factors that contributed to daytime sleepiness. RESULTS Participants with high lesions ("T3 and above") had significantly increased daytime sleepiness. OSLER results revealed only 33% of those with high lesions remained awake during the task. Those with high lesions also had significantly reduced sympathetic activity while no differences in parasympathetic activity were found between groups. Lesion completeness had no effect. Standardized variation in heart rate, slow eye blinks, low frequency HRV and self-reported fatigue contributed to daytime sleepiness. CONCLUSION Neurological lesions at "T3 or above" have an increased risk of daytime sleepiness, impacting on independence in daily functional tasks and work performance. Autonomic imbalance alters cardiovascular control, affecting health and wellbeing. The interaction of these factors requires further investigation.
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Affiliation(s)
- A Craig
- John Walsh Centre for Rehabilitation Research, Sydney Medical School-Northern, Kolling Institute of Medical Research, The University of Sydney, RNSH, St. Leonards, NSW 2650, Australia.
| | - D Rodrigues
- John Walsh Centre for Rehabilitation Research, Sydney Medical School-Northern, Kolling Institute of Medical Research, The University of Sydney, RNSH, St. Leonards, NSW 2650, Australia
| | - Y Tran
- John Walsh Centre for Rehabilitation Research, Sydney Medical School-Northern, Kolling Institute of Medical Research, The University of Sydney, RNSH, St. Leonards, NSW 2650, Australia; Australian Institute of Health Innovation, Macquarie University, North Ryde, NSW, Australia
| | - R Guest
- John Walsh Centre for Rehabilitation Research, Sydney Medical School-Northern, Kolling Institute of Medical Research, The University of Sydney, RNSH, St. Leonards, NSW 2650, Australia
| | - J Middleton
- John Walsh Centre for Rehabilitation Research, Sydney Medical School-Northern, Kolling Institute of Medical Research, The University of Sydney, RNSH, St. Leonards, NSW 2650, Australia
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