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Bebiano LB, Presa R, Vieira F, Lourenço BN, Pereira RF. Bioinspired and Photo-Clickable Thiol-Ene Bioinks for the Extrusion Bioprinting of Mechanically Tunable 3D Skin Models. Biomimetics (Basel) 2024; 9:228. [PMID: 38667239 PMCID: PMC11048463 DOI: 10.3390/biomimetics9040228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 04/07/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024] Open
Abstract
Bioinks play a fundamental role in skin bioprinting, dictating the printing fidelity, cell response, and function of bioprinted 3D constructs. However, the range of bioinks that support skin cells' function and aid in the bioprinting of 3D skin equivalents with tailorable properties and customized shapes is still limited. In this study, we describe a bioinspired design strategy for bioengineering double crosslinked pectin-based bioinks that recapitulate the mechanical properties and the presentation of cell-adhesive ligands and protease-sensitive domains of the dermal extracellular matrix, supporting the bioprinting of bilayer 3D skin models. Methacrylate-modified pectin was used as a base biomaterial enabling hydrogel formation via either chain-growth or step-growth photopolymerization and providing independent control over bioink rheology, as well as the mechanical and biochemical cues of cell environment. By tuning the concentrations of crosslinker and polymer in bioink formulation, dermal constructs were bioprinted with a physiologically relevant range of stiffnesses that resulted in strikingly site-specific differences in the morphology and spreading of dermal fibroblasts. We also demonstrated that the developed thiol-ene photo-clickable bioinks allow for the bioprinting of skin models of varying shapes that support dermis and epidermis reconstruction. Overall, the engineered bioinks expand the range of printable biomaterials for the extrusion bioprinting of 3D cell-laden hydrogels and provide a versatile platform to study the impact of material cues on cell fate, offering potential for in vitro skin modeling.
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Affiliation(s)
- Luís B. Bebiano
- i3S—Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen, 208, 4200-135 Porto, Portugal
- INEB—Instituto de Engenharia Biomédica, Universidade do Porto, Rua Alfredo Allen, 208, 4200-135 Porto, Portugal
| | - Rafaela Presa
- i3S—Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen, 208, 4200-135 Porto, Portugal
- INEB—Instituto de Engenharia Biomédica, Universidade do Porto, Rua Alfredo Allen, 208, 4200-135 Porto, Portugal
- ICBAS—Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Rua Jorge de Viterbo Ferreira, 228, 4050-313 Porto, Portugal
| | - Francisca Vieira
- i3S—Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen, 208, 4200-135 Porto, Portugal
- INEB—Instituto de Engenharia Biomédica, Universidade do Porto, Rua Alfredo Allen, 208, 4200-135 Porto, Portugal
| | - Bianca N. Lourenço
- i3S—Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen, 208, 4200-135 Porto, Portugal
- INEB—Instituto de Engenharia Biomédica, Universidade do Porto, Rua Alfredo Allen, 208, 4200-135 Porto, Portugal
| | - Rúben F. Pereira
- i3S—Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen, 208, 4200-135 Porto, Portugal
- INEB—Instituto de Engenharia Biomédica, Universidade do Porto, Rua Alfredo Allen, 208, 4200-135 Porto, Portugal
- ICBAS—Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Rua Jorge de Viterbo Ferreira, 228, 4050-313 Porto, Portugal
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Honório S, Batista M, Santos J, Serrano J, Petrica J, Vieira F, Martins J. External and internal load during the effort tests in different ages in young futsal players: association between leg power, shot speed and fatigue levels. Comparative Exercise Physiology 2023. [DOI: 10.3920/cep220041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
Abstract
Futsal is a sports game that features high intensity movements with change of speed or direction, present in several actions during the game. With this study is intended to analyse, compare and evaluate the predictive factor of leg power on shooting speed and fatigue levels in young futsal athletes in order to establish effort patterns in these ages, to prescribe training sessions adequately in terms of external/internal load. The study had 32 participants, male, aged between 12 and 17 years (Mean = 14.56}1.66). Participants were evaluated in relation to their lower limb power through the Chronojump system, the speed was measured through a radar placed on the goal line, and in relation to their fatigue levels through the Running Anaerobic Sprint Test (RAST). To identify the differences between groups, the tests of Kruskal Wallis and Mann Whitney were used, and also a simple linear regression tests for predictive values between variables. In relation to the shots speed, higher values were found in the older groups (P≤0.001), which is directly and significantly related to the higher values of lower limb power, also verified in the older athletes (P≤0.001). In relation to the fatigue levels, it increases as the age of the athletes is higher, verifying that the power of the lower limbs is a predictor variable of the fatigue index (P≤0.001). The analysis conducted indicate that there are significant differences in the association between shooting speed, lower limb power and fatigue indices according to the players levels studied.
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Affiliation(s)
- S. Honório
- SHERU – Sports, Health and Exercise Research Unit, Polytechnic Institute of Castelo Branco, Rua Prof. Faria de Vasconcelos, 6000-266 Castelo Branco, Portugal
| | - M. Batista
- SHERU – Sports, Health and Exercise Research Unit, Polytechnic Institute of Castelo Branco, Rua Prof. Faria de Vasconcelos, 6000-266 Castelo Branco, Portugal
| | - J. Santos
- SHERU – Sports, Health and Exercise Research Unit, Polytechnic Institute of Castelo Branco, Rua Prof. Faria de Vasconcelos, 6000-266 Castelo Branco, Portugal
| | - J. Serrano
- SHERU – Sports, Health and Exercise Research Unit, Polytechnic Institute of Castelo Branco, Rua Prof. Faria de Vasconcelos, 6000-266 Castelo Branco, Portugal
| | - J. Petrica
- SHERU – Sports, Health and Exercise Research Unit, Polytechnic Institute of Castelo Branco, Rua Prof. Faria de Vasconcelos, 6000-266 Castelo Branco, Portugal
| | - F. Vieira
- Institute Piaget/ISEIT, Kinesiolab – Laboratory of Human Movement Analysis, RECI – Research in Education and Community Intervention, 2805-059 Almada, Portugal
| | - J. Martins
- University of Beira Interior, Centre for Research in Sport, Health and Human Development (CIDESD), 6201-001 Covilhã, Portugal
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Zaghini C, Ahmad B, Pasquini B, Azze-Natel R, Falsarella P, Rahal-Jr A, Vieira F, Gobbo-Garcia R. Use of hemostatic matrices in renal biopsy pathways: Why and why not? EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)02745-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Vieira F, Kang J, Ferreira L, Mizuno S. Hydrostatic pressure mimicking diurnal spinal movements maintains anabolic turnover in bovine nucleus pulposus cells in vitro. Eur Cell Mater 2021; 42:246-263. [PMID: 34618349 DOI: 10.22203/ecm.v042a18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Treatment strategies for progressive intervertebral-disc degeneration often alleviate pain and other symptoms. With the goal of developing strategies to promote the regeneration of the nucleus pulposus (NP), the present study tried to identify the biological effects of hydrostatic (HP) and osmotic pressures on NP cells. The study hypothesis was that a repetitive regimen of cyclic HP followed by constant HP in high-osmolality medium would increase anabolic molecules in NP cells. Bovine NP cells/clusters were enclosed within semi-permeable membrane pouches and incubated under a regimen of cyclic HP for 2 d followed by constant HP for 1 d, repeated 6 times over 18 d. NP cells showed a significantly increased expression of anabolic genes over time: aggrecan, chondroitin sulfate N-acetylgalactosaminyltransferase 1, hyaluronan synthase 2, collagen type 2 (p < 0.05). In addition, the expression of catabolic or degenerative genes (matrix metalloproteinase 13, collagen type 1) and cellular characteristic genes (proliferating cell nucleic antigen, E-cadherin) was suppressed. The amount of sulfated glycosaminoglycan increased significantly at day 18 compared to day 3 (p < 0.01). Immunostaining revealed deposition of extracellular-matrix molecules and localization of other specific molecules corresponding to their genetic expression. An improved understanding of how cells respond to physicochemical stresses will help to better treat the degenerating disc using either cell- or gene-based therapies as well as other potential matrix-enhancing therapies. Efforts to apply these tissue-engineering and regenerative-medicine strategies will need to consider these important physicochemical stresses that may have a major impact on the survivability of such treatments.
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Affiliation(s)
| | | | | | - S Mizuno
- Department of Orthopedic Surgery, Brigham and Women's Hospital, 60 Fenwood Road, Boston, MA 02115, USA.smizuno@ bwh.harvard.edu
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Regala J, Ferreira P, Vieira F. Traumatic brain injury in forensic psychiatry. Eur Psychiatry 2021. [PMCID: PMC9480373 DOI: 10.1192/j.eurpsy.2021.1895] [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 Assessment of neuropsychiatric sequelae of traumatic brain injury (TBI) brings about challenges in the forensic setting, comprising analysis of neurobiological variables, preinjury variables (personality/psychiatric disturbances), postinjury psychosocial, allowing the expert witness to provide clear and appropriate explanations, so the court can decide with justice, particularly in civil law cases. Objectives Discuss the main clinical and neuroimagiologic aspects to consider in civil litigation of TBI cases. Methods Comprehensive literature review. Results Although accurate predictions are difficult, some generalizations can be made. Recovery from hypoxic and diffuse axonal injury (DAI) takes longer and is less complete than focal contusions. Posttraumatic amnesia is the main predictor of long-term cognitive outcome. In moderate/severe TBI (m/sTBI) occurs chronic lesion expansion (axonal degeneration) and brain atrophy. DAI topography determinates the cognitive disfunction pattern yet underestimated in conventional neuroimaging. Diffusion-Tension-Imaging (DTI) may be valuable to outcome predictions in m/sTBI: structural disconnection within the Default Mode and the Salience Networks are linked to attention and executive impairments; hippocampus and fornix damage correlates with memory/learning impairments. Conversely, DTI findings can be misleading in mild TBI (mTBI), and case-by-case analysis seldomly prove its scientific validity. Conclusions To elaborate formulations within reasonable medical certainty, outcome predictions should not be made until at least six months following the TBI, considering that most mTBI symptoms resolve in few months, and up to 1-½ years, when m/sTBI neuropathologic changes stabilize. The neurobiological underpinnings are fundamental for causality formulations, however atypical outcomes in mTBI are frequently predicated upon non–brain-injury psychiatric conditions and psychosocial factors. Disclosure No significant relationships.
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Rocha G, de Lima FF, Machado AP, Guimarães H, Proença E, Carvalho C, Martins LG, Martins T, Freitas A, Dias CP, Silva A, Barroso A, Diogo I, Cassiano G, Ramos H, Abrantes MM, Costa P, Salazar A, Vieira F, Fontes D, Barroso R, Marques T, Santos V, Scortenschi E, Santos C, Vilela F, Quintas C. Small for gestational age very preterm infants present a higher risk of developing bronchopulmonary dysplasia. J Neonatal Perinatal Med 2020; 12:419-427. [PMID: 31256077 DOI: 10.3233/npm-180129] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Several studies assessed the influence of a low birth weight on bronchopulmonary dysplasia (BPD), but not all could find a significant association. Our aim was to assess the association between low birth weight and BPD in preterm infants, prospectively recruited at 11 level III Portuguese neonatal centers. METHODS Obstetrical and neonatal data on mothers and preterm infants with gestational ages between 24 and 30 weeks, born during 2015 and 2016 after a surveilled pregnancy, were analyzed. Neonates were considered small for gestational age (SGA) when their birthweight was below the 10th centile of Fenton's growth chats and BPD was defined as the dependency for oxygen therapy until 36 weeks of corrected age. Statistical analysis was performed using IBM SPSS® statistics 23 and a p-value <0.05 was considered statistically significant. RESULTS Out of 614, a total of 494 preterm infants delivered from 410 women were enrolled in the study; 40 (8.0%) infants with SGA criteria. SGA were more often associated with a single pregnancy, had greater use of antenatal corticosteroids, increased prevalence of gestational hypertensive disorders, C-section, rupture of membranes below 18 hours, rate of intubation in the delivery room, use of surfactant treatment, oxygen therapy, mechanical ventilation need, BPD, cystic periventricular leukomalacia, nosocomial sepsis and pneumonia; had lower prevalence of chorioamnionitis, and lower Apgar scores. The multivariate analysis by logistic regression, adjusted for BPD risk factors revealed a significant association between SGA and BPD: OR = 5.2 [CI: 1.46-18.58]; p = 0.01. CONCLUSION The results of this study increase the scientific evidence that SGA is an independent risk factor for BPD.
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Affiliation(s)
- G Rocha
- Department of Neonatology, Centro Hospitalar São João, Porto, Portugal
| | - F Flor de Lima
- Department of Neonatology, Centro Hospitalar São João, Porto, Portugal.,Faculty of Medicine, University of Porto, Porto, Portugal
| | - A Paula Machado
- Department of Obstetrics and Gynaecology, Centro Hospitalar São João, Porto, Portugal
| | - H Guimarães
- Department of Neonatology, Centro Hospitalar São João, Porto, Portugal.,Faculty of Medicine, University of Porto, Porto, Portugal
| | - E Proença
- Centro Materno Infantil do Norte, Porto, Portugal
| | - C Carvalho
- Centro Materno Infantil do Norte, Porto, Portugal
| | - L G Martins
- Centro Materno Infantil do Norte, Porto, Portugal
| | - T Martins
- Hospital Pedro Hispâno, Matosinhos, Portugal
| | - A Freitas
- Hospital da Senhora da Oliveira, Guimarães, Portugal
| | - C P Dias
- Hospital da Senhora da Oliveira, Guimarães, Portugal
| | - A Silva
- Hospital de Braga, Braga, Portugal
| | | | - I Diogo
- Centro Hospitalar Lisboa Central, Maternidade Dr Alfredo da Costa, Lisboa, Portugal
| | - G Cassiano
- Centro Hospitalar Lisboa Central, Maternidade Dr Alfredo da Costa, Lisboa, Portugal
| | - H Ramos
- Centro Hospitalar Lisboa Central, Maternidade Dr Alfredo da Costa, Lisboa, Portugal
| | - M M Abrantes
- Centro Hospitalar Lisboa Norte, Hospital de Santa Maria, Lisboa, Portugal
| | - P Costa
- Centro Hospitalar Lisboa Norte, Hospital de Santa Maria, Lisboa, Portugal
| | - A Salazar
- Centro Hospitalar Lisboa Ocidental, Hospital São Francisco Xavier, Lisboa, Portugal
| | - F Vieira
- Centro Hospitalar Lisboa Ocidental, Hospital São Francisco Xavier, Lisboa, Portugal
| | - D Fontes
- Centro Hospitalar Lisboa Ocidental, Hospital São Francisco Xavier, Lisboa, Portugal
| | - R Barroso
- Hospital Prof. Dr Fernando Fonseca, Amadora, Portugal
| | - T Marques
- Hospital Prof. Dr Fernando Fonseca, Amadora, Portugal
| | - V Santos
- Centro Hospitalar do Algarve, Hospital de Faro, Faro, Portugal
| | - E Scortenschi
- Centro Hospitalar do Algarve, Hospital de Faro, Faro, Portugal
| | - C Santos
- Centro Hospitalar do Algarve, Hospital de Faro, Faro, Portugal
| | - F Vilela
- Centro Hospitalar do Algarve, Hospital de Faro, Faro, Portugal
| | - C Quintas
- Centro Hospitalar de Vila Nova de Gaia/Espinho, Hospital de Vila Nova de Gaia, Vila Nova de Gaia, Portugal
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Costa JM, Rodrigues AP, Fernandes D, Costeira F, Vieira F, Gonçalves R, Teixeira M, Soares JB. Adenocarcinoma is not always the diagnosis - colon neoplasia in patient with long-standing ulcerative colitis under long-term prednisone maintenance therapy. Clin Res Hepatol Gastroenterol 2019; 43:362-364. [PMID: 30553755 DOI: 10.1016/j.clinre.2018.11.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 11/27/2018] [Accepted: 11/30/2018] [Indexed: 02/04/2023]
Affiliation(s)
- J M Costa
- Department of Gastroenterology, Department of Radiology, Department of Pathology, Hospital de Braga, Braga, Portugal.
| | - A P Rodrigues
- Pathology Department, Hospital de Braga, Sete Fontes, São Victor, 4710-243 Braga, Portugal.
| | - D Fernandes
- Gastroenterology Department, Hospital de Braga, Sete Fontes, São Victor, 4710-243 Braga, Portugal.
| | - F Costeira
- Radiology Department, Hospital de Braga, Sete Fontes, São Victor, 4710-243 Braga, Portugal.
| | - F Vieira
- Radiology Department, Hospital de Braga, Sete Fontes, São Victor, 4710-243 Braga, Portugal.
| | - R Gonçalves
- Gastroenterology Department, Hospital de Braga, Sete Fontes, São Victor, 4710-243 Braga, Portugal.
| | - M Teixeira
- Pathology Department, Hospital de Braga, Sete Fontes, São Victor, 4710-243 Braga, Portugal.
| | - J B Soares
- Gastroenterology Department, Hospital de Braga, Sete Fontes, São Victor, 4710-243 Braga, Portugal.
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Costa JM, Costeira F, Vieira F, Dias N, Ferreira A. Remarkable dilation of the common bile duct in an elderly patient. Acta Gastroenterol Belg 2018; 81:547-548. [PMID: 30645933] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- J M Costa
- Department of Gastroenterology, Hospital de Braga, Portugal
| | - F Costeira
- Department of Radiology, Hospital de Braga, Portugal
| | - F Vieira
- Department of Radiology, Hospital de Braga, Portugal
| | - N Dias
- Department of Gastroenterology, Hospital de Braga, Portugal
| | - A Ferreira
- Department of Gastroenterology, Hospital de Braga, Portugal
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Costa JM, Costa D, Vieira F, Rolanda C. Hepatobiliary and Pancreatic: Giant hepatomegaly from hepatic hemagiomatosis. J Gastroenterol Hepatol 2017. [PMID: 28639269 DOI: 10.1111/jgh.13769] [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: 12/09/2022]
Affiliation(s)
- J M Costa
- Department of Gastroenterology, Hospital de Braga, Portugal
| | - D Costa
- Department of Gastroenterology, Hospital de Braga, Portugal.,Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Guimarães/Braga, Portugal
| | - F Vieira
- Department of Radiology, Hospital de Braga, Portugal
| | - C Rolanda
- Department of Gastroenterology, Hospital de Braga, Portugal.,Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Guimarães/Braga, Portugal
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Sá Esteves P, Loureiro D, Albuquerque E, Vieira F, Lagarto L, Neves S, Cerejeira J. Risk Factors of Increased Mortality During Hospitalization in Acutely-ill Elderly Patients with Altered State of Consciousness. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.2074] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
IntroductionA significant proportion of acutely ill hospitalised elderly patients have impaired consciousness and this has been associated with increased mortality. It remains unclear which factors underlie this relation. Identification of mortality predictors in this population is important to improve care.ObjectivesDetermine if advanced age, cognitive impairment, high burden of comorbidities and poor functional status are predictors of increased mortality during hospitalisation in acutely-ill medical hospitalised elderly patients with altered state of consciousness.MethodsAll male patients (> 65 years) admitted to a medical ward (> 48 h) between 01/03/2015 to 31/08/2015 with delirium or RASS lower than–2 were included in the study. Patients were excluded if unable to be assessed due to sensorial deficits, communication problems or medical condition precluding the evaluation. Baseline evaluation included socio-demographic variables, RASS, CAM, IQCODE-SF, DSM-IV-TR criteria for dementia, Charlson Comorbidity Index and Barthel Index. The variables were entered in a logistic regression model (significance level < 0.05).ResultsThe final sample consisted of 75 male subjects with altered state of consciousness, 14 of them died during hospitalisation. Dementia and Barthel Index were significantly associated with mortality during hospitalisation (P = 0.01 and P < 0.01, respectively). On the other hand, age and Charlson Co-morbidity Index were not associated significantly with mortality during hospitalisation (P = 0.22 and P = 0.1, respectively).ConclusionsAcutely ill elderly patients with altered state of consciousness at admission have higher risk of death during hospitalisation if they have prior dementia or poor functional status. Health care should be improved to provide better response to this type of patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Duarte M, Vieira F, Ponte A. Patterns of Long Acting Injectable Antipsychotic Prescription During Criminal Acts in a Portuguese Psychiatric Hospital. Eur Psychiatry 2016. [DOI: 10.1016/j.eurpsy.2016.01.1664] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
IntroductionUnder the Portuguese law, criminal offenders that are designated as non-criminal responsible – “inimputáveis”, similar those in the United States of America found “not guilty by reason of insanity”, are forced to be committed to inpatient forensic units either in psychiatric hospitals or prison hospitals for mandatory security measures.Objectives/aimsTo evaluate if patients committed in a regional forensic inpatient unit (RFIU) who had a psychiatric history preceding the crime, were under long acting injectable antipsychotic (LAIA) in during the period of the crime.MethodsDuring September/October 2015, patients committed to the RFIU in Centro Hospitalar Psiquiátrico de Lisboa were characterized using medical and court records regarding clinical and demographic variables. The type of crime and previous number of criminal acts were also accounted for.ResultsWe included 33 patients in the study. During time of the crime, 25 patients (75.8%) had history of previous psychiatric appointments, with an average of 3 commitments to the psychiatric inpatient units. The majority (n = 17; 68%) had a diagnose of “schizophrenia, schizotypal and delusional disorders” (F20–29; ICD 10) and committed “crimes against life” (n = 13; 52%). They had an average of 0.8 previous criminal acts. During the crime, 7 patients (28%) were taking LAIA. Those, 16% (n = 4) were doing an unknown antipsychotic and 12% (n = 3) were doing Haloperidol.ConclusionsDespite several studies showing the clinical and rehabilitative benefit of using LAIA early in the disease course, most of the patients in our study, who were already being followed in outpatient psychiatric units, did not benefit from them.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Neves I, Peres D, Vieira F, Devesa I. How to keep alive the “Clean Your Hands” campaign in a hospital setting: six years after. Antimicrob Resist Infect Control 2015. [PMCID: PMC4475147 DOI: 10.1186/2047-2994-4-s1-p146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Vieira F, Devesa I, Peres D, Neves I. Evaluation of a campaign to reduce the catheter associated urinary infection. Antimicrob Resist Infect Control 2015. [PMCID: PMC4475035 DOI: 10.1186/2047-2994-4-s1-p216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Vieira F, Neves I, Devesa I, Peres D. Monitoring hospital hygiene by luminescence methodology. Antimicrob Resist Infect Control 2015. [PMCID: PMC4474625 DOI: 10.1186/2047-2994-4-s1-p30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Pinheiro HT, Di Dario F, Gerhardinger LC, de Melo MRS, de Moura RL, Reis RE, Vieira F, Zuanon J, Rocha LA. Brazilian aquatic biodiversity in peril. Science 2015; 350:1043-4. [DOI: 10.1126/science.350.6264.1043-a] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Neves I, Alves V, Duraes A, Abreu RC, Jordão S, Guimaraes M, Soares MJ, Peres D, Vieira F, Devesa I. Implementation of a hospital antibiotic stewardship program: first results. Antimicrob Resist Infect Control 2015. [PMCID: PMC4475119 DOI: 10.1186/2047-2994-4-s1-p180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Devesa I, Neves I, Peres D, Vieira F, Poças G. The impact of hand hygiene in the primary care: to go beyond the hospital setting. Antimicrob Resist Infect Control 2015. [PMCID: PMC4475165 DOI: 10.1186/2047-2994-4-s1-p161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Lemvik G, Rudolf F, Vieira F, Sodemann M, Østergaard L, Rodrigues A, Gomes V, Aaby P, Wejse C. Decline in overall, smear-negative and HIV-positive TB incidence while smear-positive incidence stays stable in Guinea-Bissau 2004-2011. Trop Med Int Health 2014; 19:1367-76. [PMID: 25145557 DOI: 10.1111/tmi.12378] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To calculate Tuberculosis (TB) incidence rates in Guinea-Bissau over an 8-year period. METHODS Since 2003, a surveillance system has registered all TB cases in six suburban districts of Bissau. In this population-based prospective follow-up study, 1205 cases of pulmonary TB were identified between January 2004 and December 2011. Incidence rates were calculated using census data from the Bandim Health and Demographic Surveillance System (HDSS). RESULTS The overall incidence of pulmonary TB was 279 per 100,000 person-years of observation; the male incidence being 385, and the female 191. TB incidence rates increased significantly with age in both sexes, regardless of smear or HIV status. Despite a peak with unknown cause of 352 per 100,000 in 2007, the overall incidence of pulmonary TB declined over the period. The incidence of HIV infected TB cases declined significantly from 108 to 39 per 100,000, while the incidence of smear-positive TB cases remained stable; the overall figure was 188 per 100,000. CONCLUSIONS Overall incidence of pulmonary TB in Guinea-Bissau has declined from 2004 to 2011. The decline was also seen in the subgroups of smear-negative and HIV-positive TB cases, probably due to antiretroviral treatment. Smear-positive TB incidence remains stable over the period.
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Affiliation(s)
- G Lemvik
- Bandim Health Project, INDEPTH network, Bissau, Guinea-Bissau; Bandim Health Project, Statens Serum Institut, Copenhagen, Denmark; Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
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Varago FC, Moutacas VS, Carvalho BC, Serapião RV, Vieira F, Chiarini-Garcia H, Brandão FZ, Camargo LS, Henry M, Lagares MA. Comparison of Conventional Freezing and Vitrification with Dimethylformamide and Ethylene Glycol for Cryopreservation of Ovine Embryos. Reprod Domest Anim 2014; 49:839-44. [DOI: 10.1111/rda.12376] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Accepted: 06/14/2014] [Indexed: 11/30/2022]
Affiliation(s)
- FC Varago
- Veterinary School of the Federal University of Minas Gerais (UFMG); Belo Horizonte MG, Brazil
| | - VS Moutacas
- Veterinary School of the Federal University of Minas Gerais (UFMG); Belo Horizonte MG, Brazil
| | - BC Carvalho
- EMBRAPA Juiz de Fora; Juiz de Fora MG, Brazil
| | - RV Serapião
- EMBRAPA Juiz de Fora; Juiz de Fora MG, Brazil
| | - F Vieira
- Biological Science Institute of the Federal University of Minas Gerais; Belo Horizonte MG, Brazil
| | - H Chiarini-Garcia
- Biological Science Institute of the Federal University of Minas Gerais; Belo Horizonte MG, Brazil
| | - FZ Brandão
- Veterinary Medicine Faculty of the Federal Fluminense University; Niterói, RJ Brazil
| | - LS Camargo
- EMBRAPA Juiz de Fora; Juiz de Fora MG, Brazil
| | - M Henry
- Veterinary School of the Federal University of Minas Gerais (UFMG); Belo Horizonte MG, Brazil
| | - MA Lagares
- Veterinary School of the Federal University of Minas Gerais (UFMG); Belo Horizonte MG, Brazil
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Neves I, Alves V, Peres D, Vieira F, Devesa I. P047: Fighting MRSA in an high endemic level hospital. Antimicrob Resist Infect Control 2013. [PMCID: PMC3688446 DOI: 10.1186/2047-2994-2-s1-p47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
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Neves I, Vieira F, Peres D, Devesa I, Alves V. P186: Infection control plan management in primary care. Antimicrob Resist Infect Control 2013. [PMCID: PMC3688116 DOI: 10.1186/2047-2994-2-s1-p186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
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Vieira F, Veiga V, Carita AI, Petroski EL. Morphological and physical fitness characteristics of under-16 Portuguese male handball players with different levels of practice. J Sports Med Phys Fitness 2013; 53:169-176. [PMID: 23584324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
AIM The aim of this study was to compare the morphology and physical fitness of 104 under-16 male handball athletes with different competitive levels in function of their bone maturation. METHODS Athletes were divided into two groups, 59 competed in the NL-national league, with higher competitive level (14.06±0.66 years) and 45 competed in the RL-regional league (14.24±0.60 years). The morphology was evaluated by measuring body mass, height, sitting height, arm span, four lengths, four breadths, five girths and eleven skinfolds. The physical fitness assessment used eight tests (20-m shuttle run; 30-m sprint; sit-and-reach; horizontal and vertical jump with counter movement; overhead medicine ball throw-3 kg; handgrip; handball specific agility test). Bone age was determined using the TW3 method. RESULTS In morphological terms, NL athletes showed greater dimensions for all anthropometric variables except for hand length (transversal and longitudinal), biepicondylar femur breadth, mid-thigh girth and skinfolds. In physical fitness terms, these athletes have better results for VO2max, velocity, agility, arm strength and handgrip than athletes competing in the RL. Maturational differences explain the morphological profile superiority of NL athletes in terms of arm span, lower limb length, biacromial breadth and physical fitness profile for VO2max and arm strength. CONCLUSION Maturation should be considered as a covariate when one intends to distinguish the morphological characteristics and physical fitness of under-16 athletes with different levels of practice.
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Affiliation(s)
- F Vieira
- Biomechanics and Functional Morphology Laboratory Neuromechanics Research Group of Human Movement (CIPER), Faculty of Human Kinetics, T echnical University of Lisbon, Lisbon, Portugal.
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Cordovil R, Barreiros J, Vieira F, Neto C. The efficacy of safety barriers for children: absolute efficacy, time to cross and action modes in children between 19 and 75 months. Int J Inj Contr Saf Promot 2009; 16:143-51. [DOI: 10.1080/17457300903024145] [Citation(s) in RCA: 4] [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: 10/20/2022]
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Valle-Folgueral J, Mascarenhas L, Costa J, Vieira F, Soares-Fernandes J, Beleza P, Alegria C. Giant cell glioblastoma: review of the literature and illustrated case. Neurocirugia (Astur) 2008. [DOI: 10.4321/s1130-14732008000400005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Valle-Folgueral J, Mascarenhas L, Costa J, Alegria C, Vieira F, Soares-Fernandes J, Beleza P. Giant cell glioblastoma: review of the literature and illustrated case. Neurocirugia (Astur) 2008; 19:343-9. [DOI: 10.1016/s1130-1473(08)70221-5] [Citation(s) in RCA: 8] [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: 10/24/2022]
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Moreira AP, Duarte LH, Vieira F, João F, Lima JPD. Value of SPET/CT image fusion in the assessment of neuroendocrine tumours with 111In-Pentetreotide scintigraphy. ACTA ACUST UNITED AC 2005; 24:14-8. [PMID: 15701341 DOI: 10.1157/13070352] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate the impact and clinical value of anatomical-functional image fusion in the study interpretation and clinical management of patients with neuroendocrine tumours (NET) using somatostatin receptor scintigraphy (SRS) and combined transmission and emission tomography -- single-photon emission tomography/CT (SPET/CT). MATERIAL AND METHODS Twelve patients (8 female and 4 male; age range 32-74 y, mean 56 y) with proven or clinically suspected NET were studied with routine planar SRS and SPET/CT at 2 and 24 hours after injection of 111-222 MBq 111In-Pentetreotide. Seven patients came for staging/follow-up and 5 patients for primary tumour localization with staging. Analysis of fused images (SPET/CT) was done on a patient basis, with separated evaluation of SPET, low-dose CT images and fusion images. The gold standard for presence or absence of malignancy was pathology or clinical and imaging follow-up data. RESULTS SRS was negative in 6 patients and positive in 6. SPET/CT provided no additional information in 6 patients, including all 6 negative studies. SPET/CT improved localization of SPET detected lesions in 6 positive studies. It defined the extent of the disease and showed bone involvement in 3 of the 6 positive studies. SPET/CT affected the diagnostic interpretation in 6 patients (50 %) and induced changes of management in 3 (25 %). CONCLUSION The results of this study indicate that combined anatomical-functional imaging with SPET/CT significantly improves tumour localization and characterization, contributing to a better therapeutic management of patients with NET.
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Affiliation(s)
- A Paula Moreira
- Serviço de Medicina Nuclear, Hospitais da Universidade de Coimbra, Portugal.
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Samant S, Robbins KT, Kumar P, Ma JZ, Vieira F, Hanchett C. Bone or cartilage invasion by advanced head and neck cancer: intra-arterial supradose cisplatin chemotherapy and concomitant radiotherapy for organ preservation. Arch Otolaryngol Head Neck Surg 2001; 127:1451-6. [PMID: 11735813 DOI: 10.1001/archotol.127.12.1451] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Invasion of bony or cartilaginous structures by advanced upper aerodigestive tract cancer has been considered an indication for surgery on the basis of historic experience of poor responsiveness to radiation therapy. At University of Tennessee-Memphis, patients with advanced head and neck cancer have been treated on a protocol of concomitant intra-arterial (targeted) cisplatin and conventional radiation therapy. OBJECTIVE To compare the efficacy, in terms of disease control and survival, of this protocol in patients with T4 squamous cell cancers and invasion of bony or cartilaginous structures (group 1; n = 45) vs those with T4 disease but no bone or cartilage involvement (group 2; n = 90). DESIGN Subset analysis of protocol database and retrospective chart review. METHODS Treatment consisted of 4 weekly intra-arterial infusions of cisplatin (150 mg/m(2) per week), with simultaneous systemic neutralization by intravenous sodium thiosulfate (9 mg/m(2)), and concurrent radiation therapy at 180 rad (1.8 Gy) or 200 rad (2 Gy) per fraction to a planned total of 6600 to 7400 rad (66-74 Gy) to the primary site or overt nodal disease. Presence of bone or cartilage invasion was established by review of tumor diagrams of clinical findings and computed tomography or magnetic resonance imaging reports. RESULTS Of 135 patients who had T4 disease and a minimum follow-up of 9 months (median, 40 months), 45 had clinical or radiologic evidence of bone (n = 29: mandible, 12; maxilla, 9; sphenoid, 3; hyoid, 6) and/or cartilage (n = 18: thyroid, 16; cricoid, 4) invasion (some patients had involvement of more than 1 site). The rate of complete response in group 1 (66.7%) was not significantly different from that in group 2 (71.1%) (chi(2) test, P = .79). The 2-year overall actuarial survival for group 1 (46.3%; 95% confidence interval, 30.3%-62.3%) was not significantly different (generalized Wilcoxon test, P = .36) from that of group 2 (36.9%; 95% confidence interval, 25.5%-48.4%). A marked trend was noted for higher response rates in cases of cartilage invasion (81.2%) than in those with bone invasion (58.6%) (P = .15). CONCLUSION Equivalent efficacy of treatment in the 2 groups suggests that targeted chemoradiation can be a definitive therapeutic option in patients with advanced head and neck cancer invading bony or cartilaginous structures.
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Affiliation(s)
- S Samant
- Department of Otolaryngology--Head and Neck Surgery, University of Tennessee Health Sciences Center, 956 Court Ave, Suite B-222, Memphis, TN 38163, USA.
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Doweck I, Robbins KT, Vieira F. Analysis of risk factors predictive of distant failure after targeted chemoradiation for advanced head and neck cancer. Arch Otolaryngol Head Neck Surg 2001; 127:1315-8. [PMID: 11701066 DOI: 10.1001/archotol.127.11.1315] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Distant metastasis (DM) is the most common mode of recurrence among patients with advanced head and neck carcinoma treated with intra-arterial cisplatin and radiotherapy (RADPLAT). OBJECTIVE To identify which patients are at greatest risk for DM and would benefit the most from new strategies designed to treat occult metastases. METHODS Between 1993 and 1999, 250 patients with advanced head and neck cancer were treated by RADPLAT. Excluded from the analysis were 10 patients who either did not complete the protocol or were unavailable for follow-up and 39 patients with persistent disease or local recurrence. The incidence and the risk factors for DM in these patients were evaluated in a model that included the following factors: age, T and N classification, site of tumor, histologic grade, number (0, 1, or >1) and position (high vs low) of neck levels involved, and bilateral nodal disease. Multiple stepwise logistic regression was used for the analysis. RESULTS In a univariate analysis, the following variables correlated to DM: N classification (P =.02), site of tumor (P =.01), lower neck nodes (P =.002), number of neck levels involved (P =.001), and bilateral nodal disease (P =.02). In a multivariate analysis, the most significant risk factors for DM were the number of neck levels involved and the site of the primary tumor (P<.001). The highest odds ratios for DM were among patients with multiple levels of nodal involvement (3.17) and patients with hypopharyngeal carcinoma (2.8). CONCLUSIONS Patients with more than 1 level of clinical nodal involvement and patients with hypopharyngeal carcinoma have the highest risk of developing DM as the initial site of failure and would benefit most from treatment strategies that address occult distant disease.
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Affiliation(s)
- I Doweck
- Department of Otolaryngology, Head and Neck Surgery, College of Medicine, University of Tennessee, Memphis, USA.
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Robbins KT, Kumar P, Wong FS, Hartsell WF, Flick P, Palmer R, Weir AB, Neill HB, Murry T, Ferguson R, Hanchett C, Vieira F, Bush A, Howell SB. Targeted chemoradiation for advanced head and neck cancer: analysis of 213 patients. Head Neck 2000; 22:687-93. [PMID: 11002324 DOI: 10.1002/1097-0347(200010)22:7<687::aid-hed8>3.0.co;2-w] [Citation(s) in RCA: 130] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND To determine the survival results, patterns of relapse, and organ preservation effects of a targeted chemoradiation protocol for patients with advanced (stage III-IV) carcinoma of the head and neck. METHODS Analysis of 213 patients with stage III-IV squamous cell carcinoma treated at UT Memphis between June 1993 and March 1998. Treatment included weekly intra-arterial infusions of cisplatin (150 mg/m(2)/ week x 4) rapidly delivered to the tumor bulk, simultaneous intravenous thiosulfate for systemic drug neutralization, and conventional external-beam irradiation (180-200 cGy/fraction) to a total dose of 68-72 Gy. RESULTS Tumor response, toxicity, disease control above the clavicle, pattern of relapse, and survival. There were 89 events of grade III-IV toxicity and 6 treatment-related deaths (grade V). Complete response in the primary and regional sites was obtained in 171 of 213 (80%) and 92 of 151 (61%), respectively. The rate of clearance of regional disease after neck dissection was 98%. There were 51 of 195 recurrences (26%): 11 local (5.6%), 5 regional (2.6%), and 35 distant (17.9%). The Kaplan Meier plot projections for overall and cancer-related 5-year survival was 38.8% and 53.6%, respectively, whereas disease control above the clavicle was 74.3%. CONCLUSIONS We believe this chemoradiation protocol represents an effective management scheme for patients with advanced head and neck cancer with a high rate of organ preservation and possibly improved survival.
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Affiliation(s)
- K T Robbins
- Department of Otolaryngology/Head and Neck Surgery, University of Tennessee, Memphis, College of Medicine, 956 Court Ave., Suite B226, Memphis, Tennessee, USA
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Pardal-de-Oliveira F, Vieira F. Occult papillary carcinoma of the thyroid gland with extensive osseous metastases--a case report with review of the literature. Pathol Res Pract 1999; 195:711-4; discussion 715-6. [PMID: 10549036 DOI: 10.1016/s0344-0338(99)80065-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
The authors report a case of extensive osseous metastases from a clinically occult papillary carcinoma of the thyroid gland without evidence of regional lymph node metastases. Some features of the primary tumour, namely focal "tall-cell" morphology and higher nuclear grade, raise the possibility of including such a tumour into the poorly differentiated category of thyroid carcinomas. Literature review only disclosed one similar reported case.
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Samant S, Kumar P, Wan J, Hanchett C, Vieira F, Murry T, Wong FS, Robbins KT. Concomitant radiation therapy and targeted cisplatin chemotherapy for the treatment of advanced pyriform sinus carcinoma: disease control and preservation of organ function. Head Neck 1999; 21:595-601. [PMID: 10487945 DOI: 10.1002/(sici)1097-0347(199910)21:7<595::aid-hed2>3.0.co;2-j] [Citation(s) in RCA: 76] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Squamous cell carcinoma of the pyriform sinus is an unfavorable disease which frequently presents in advanced stages. Despite aggressive "standard treatment" involving debilitating surgery and postoperative radiation therapy treatments, the survival and functional outcome for pyriform sinus carcinoma remains poor. Hence, we reviewed our experience in the management of advanced pyriform sinus carcinoma using "organ preservation" chemoradiation therapy. METHODS Twenty-five patients diagnosed with stage III/IV pyriform sinus squamous cell carcinoma treated with supradose, intra-arterial targeted cisplatin, and concomitant radiotherapy were analyzed for response rates, survival, pattern of failure, and function of the preserved organs. Our protocol consisted of weekly intra-arterial infusions of cisplatin at 150 mg/m(2) x 4 and concurrent radiation therapy at 1.8 Gy or 2.0 Gy/fraction to a planned total of 68-74 Gy to the primary site/overt nodal disease. RESULTS Nineteen (76%) of the 25 patients were diagnosed with stage IV disease, 17 of whom were first seen with bulky lymphadenopathy (ie, N2-N3 disease) while 10 had T4 lesions. Twenty-four of 25 patients were evaluable for response assessment. Complete response rates of 92% and 76% were achieved at the primary site and in lymph nodes, respectively. Hence, the overall complete response rate in the neck was 76% (16/21). At a median follow up interval of 42 months (range = 30-58 months), the projected 5-year overall and disease-specific survival using the Kaplan-Meier method are 23% and 50% respectively. No patient has developed recurrence at the primary site and only one patient relapsed regionally, which was surgically salvaged for an "above clavicle" disease control rate of 88% and an organ preservation rate of 88%. Almost 90% of the patients have achieved a satisfactory voice and 70% are able to swallow at 12 months postcompletion of therapy. CONCLUSION Our chemoradiation protocol is as effective as other treatment modalities for patients with advanced pyriform sinus carcinoma while maintaining organ preservation and function in the majority of the patients.
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Affiliation(s)
- S Samant
- Department of Otolaryngology-Head and Neck Surgery, University of Tennessee-Memphis, 956 Court Avenue, Memphis, TN 38163, USA
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Robbins KT, Wong FS, Kumar P, Hartsell WF, Vieira F, Mullins B, Niell HB. Efficacy of targeted chemoradiation and planned selective neck dissection to control bulky nodal disease in advanced head and neck cancer. Arch Otolaryngol Head Neck Surg 1999; 125:670-5. [PMID: 10367925 DOI: 10.1001/archotol.125.6.670] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
PURPOSE To determine the efficacy of targeted chemoradiation with the radiation plus platinum (RADPLAT) protocol and planned selective neck dissection in patients with N2 to N3 nodal disease associated with upper aerodigestive tract carcinoma. METHODS Analysis of 52 patients with N2a, N2b, or N3 disease involving 60 heminecks treated with intraarterial cisplatin, 150 mg/m2, and intravenous sodium thiosulfate, 9 g/m2, on days 1, 8, 15, and 22; radiation therapy, 180 to 200 cGy per fraction for 35 fractions (total dose, 68-74 Gy); and planned neck dissection (33 of 35 procedures were selective). RESULTS Of the 56 evaluable heminecks, a clinical complete response was achieved in 33 (59%). Within this group, 16 neck dissections were performed, none of which yielded disease on pathological examination. A clinical partial response was obtained in 21 heminecks, of which 18 subsequently had a neck dissection, yielding disease on pathological examination in 14. In all cases, it was possible to completely excise all adenopathy with clear margins on pathological examination. The rate of regional disease control among the 56 evaluable heminecks was 91% (51/56) (median follow-up, 36 months). Four failures were associated with uncontrolled disease at other sites, and 1 was an isolated neck recurrence. CONCLUSION Selective neck dissection appears to be an effective adjunct to targeted chemoradiation in controlling N2 to N3 neck disease.
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Affiliation(s)
- K T Robbins
- Department of Otolaryngology-Head and Neck Surgery, University of Tennessee, Memphis, College of Medicine 38163, USA.
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Newman LA, Vieira F, Schwiezer V, Samant S, Murry T, Woodson G, Kumar P, Robbins KT. Eating and weight changes following chemoradiation therapy for advanced head and neck cancer. Arch Otolaryngol Head Neck Surg 1998; 124:589-92. [PMID: 9604988 DOI: 10.1001/archotol.124.5.589] [Citation(s) in RCA: 117] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To describe the functional outcomes of weight loss and eating following a targeted chemoradiation protocol consisting of a selective supradose of intra-arterial cisplatin (150 mg/m2 per week for 4 weeks) with parenteral sodium thiosulfate and external-beam irradiation (1.8-2.0 Gy per fraction per day for 35 days). SUBJECTS AND DESIGN Forty-seven patients with advanced head and neck cancer treated with a targeted chemoradiation protocol were monitored for weight and eating status before treatment and as long as 18 months after treatment. RESULTS A statistically significant weight loss (P<.001) occurred during the targeted chemoradiation protocol, with a mean weight ratio of 90% of the starting weight. The ability to eat also declined, with an increase in reported swallowing difficulties and a need for percutaneous endoscopic gastrostomy tubes from 4 (9%) to 12 (26%). There were no significant changes in weight after the initial weight loss. Tumor stage and nodal involvement had no effect on weight loss. At the start of treatment, 18 patients (38%) reported normal eating and 4 (8%) required a feeding tube. By 18 months after treatment, 41 (87%) were eating normally, 34 (72%) reported normal eating, and 6 (13%) required a percutaneous endoscopic gastrostomy tube. CONCLUSIONS Patients undergoing a targeted chemoradiation protocol for head and neck cancer lost about 10% of their pretreatment weight and had a decline in eating ability. Difficulty swallowing during the treatment may be due to adverse effects such as mucositis and nausea. By 18 months after therapy, most were able to eat normally and maintain their weight.
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Affiliation(s)
- L A Newman
- Department of Otolaryngology-Head and Neck Surgery, University of Tennessee, College of Medicine, Memphis 38163, USA.
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Abstract
In this study a morphologic and anthropometric characterisation of Dutch korfball players (N = 36) is performed. Data, compared with those of other sports populations, showed that (1) korfball athletes are smaller and lighter than basketball and volleyball players but heavier and taller than other team-sport players; (2) korfball players have less relative body fat, more lean body mass, more limb fat, and less or similar trunk fat than the other athletes. (3) Male korfball players presented a somatotype (1.9-4.4-3.4) similar to endurance athletes and an endomorphic value lower than or similar to the other athletes. (4) The only apparent similarity between female korfball somatotype (3.2-4.0-2.8) and other athletes' somatotypes is the dominance of mesomorphy.
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Affiliation(s)
- M Godinho
- Faculdade de Motricidade Humana, Universidade Técnica de Lisboa, Portugal
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