1
|
Silva-Cardoso J, Santos J, Araújo I, Andrade A, Morais Sarmento P, Santos P, Moura B, Marques I, Peres M, Ferreira JP, Agostinho J, Pimenta J. conTemporary reflectiOns regarding heart failure manaGEmenT - How to ovERcome the PorTuguese barriers (TOGETHER-PT). Rev Port Cardiol 2024; 43:225-235. [PMID: 37689388 DOI: 10.1016/j.repc.2023.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 04/11/2023] [Accepted: 05/02/2023] [Indexed: 09/11/2023] Open
Abstract
INTRODUCTION AND OBJECTIVES Heart failure (HF) is a complex clinical syndrome that is a significant burden in hospitalisations, morbidity, and mortality. Although a significant effort has been made to better understand its consequences and current barriers in its management, there are still several gaps to address. The present work aimed to identify the views of a multidisciplinary group of health care professionals on HF awareness and literacy, diagnosis, treatment and organization of care, identifying current challenges and providing insights into the future. METHODS A steering committee was established, including members of the Heart Failure Study Group of the Portuguese Society of Cardiology (GEIC-SPC), the Heart Failure Study Group of the Portuguese Society of Internal Medicine (NEIC-SPMI) and the Cardiovascular Study Group (GEsDCard) of the Portuguese Association of General and Family Medicine (APMGF). This steering committee produced a 16-statement questionnaire regarding different HF domains that was answered to by a diversified group of 152 cardiologists, internists, general practitioners, and nurses with an interest or dedicated to HF using a five-level Likert scale. Full agreement was defined as ≥80% of level 5 (fully agree) responses. RESULTS Globally, consensus was achieved in all but one of the 16 statements. Full agreement was registered in seven statements, namely 3 of 4 statements for patient education and HF awareness and 2 in 4 statements of both HF diagnosis and healthcare organization, with proportions of fully agree responses ranging from 82.9% to 96.7%. None of the HF treatment statements registered full agreement but 3 of 4 achieved ≥80% of level 4 (agree) responses. CONCLUSION This document aims to be a call-to-action to improve HF patients' quality of life and prognosis, by promoting a change in HF care in Portugal.
Collapse
Affiliation(s)
- José Silva-Cardoso
- Faculdade de Medicina da Universidade do Porto, Porto, Portugal; Serviço de Cardiologia, Centro Hospitalar Universitário de São João, Porto, Portugal; CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal; RISE - Health Research Network, Portugal.
| | - Jonathan Santos
- Faculdade de Medicina da Universidade do Porto, Porto, Portugal; CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal; ARS Norte, ACES Vale Sousa Norte, USF Torrão, Portugal
| | - Inês Araújo
- Clínica de Insuficiência Cardíaca, Serviço de Medicina III, Hospital S. Francisco Xavier, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal; NOVA Medical School, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Aurora Andrade
- Serviço de Cardiologia, Centro Hospitalar Tâmega e Sousa, Penafiel, Portugal
| | - Pedro Morais Sarmento
- Departamento de Medicina Interna e Hospital de Dia de Insuficiência Cardíaca do Hospital da Luz de Lisboa, Lisboa, Portugal
| | - Paulo Santos
- CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal; RISE - Health Research Network, Portugal; MEDCIDS, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Brenda Moura
- Serviço de Cardiologia, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Irene Marques
- Serviço de Medicina Interna, Centro Hospitalar Universitário do Porto (CHUPorto), Porto, Portugal; Unidade Multidisciplinar de Investigação Biomédica - Instituto de Ciências Biomédicas de Abel Salazar (ICBAS), Universidade do Porto, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Marisa Peres
- Serviço de Cardiologia, Hospital de Santarém, Santarém, Portugal
| | - João Pedro Ferreira
- Unic@RISE, Serviço de Cirurgia e Fisiologia, Faculdade de Medicina da Universidade do Porto, Porto, Portugal; Université de Lorraine, Inserm, Centre d'Investigations Cliniques-Plurithématique 14-33, and Inserm U1116, CHRU, F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Nancy, France
| | - Joao Agostinho
- Serviço de Cardiologia, Departamento de Coração e Vasos, Hospital de Santa Maria, Centro Hospitalar Universitário de Lisboa Norte, Lisboa, Portugal; CCUL, Centro Académico de Medicina de Lisboa, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Joana Pimenta
- Serviço de Medicina Interna, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal; UnIC@RISE, Departamento de Medicina, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| |
Collapse
|
2
|
Li S, Spitz N, Ghantous A, Abrishamcar S, Reimann B, Marques I, Silver MJ, Aguilar-Lacasaña S, Kitaba N, Rezwan FI, Röder S, Sirignano L, Tuhkanen J, Mancano G, Sharp GC, Metayer C, Morimoto L, Stein DJ, Zar HJ, Alfano R, Nawrot T, Wang C, Kajantie E, Keikkala E, Mustaniemi S, Ronkainen J, Sebert S, Silva W, Vääräsmäki M, Jaddoe VWV, Bernstein RM, Prentice AM, Cosin-Tomas M, Dwyer T, Håberg SE, Herceg Z, Magnus MC, Munthe-Kaas MC, Page CM, Völker M, Gilles M, Send T, Witt S, Zillich L, Gagliardi L, Richiardi L, Czamara D, Räikkönen K, Chatzi L, Vafeiadi M, Arshad SH, Ewart S, Plusquin M, Felix JF, Moore SE, Vrijheid M, Holloway JW, Karmaus W, Herberth G, Zenclussen A, Streit F, Lahti J, Hüls A, Hoang TT, London SJ, Wiemels JL. A Pregnancy and Childhood Epigenetics Consortium (PACE) meta-analysis highlights potential relationships between birth order and neonatal blood DNA methylation. Commun Biol 2024; 7:66. [PMID: 38195839 PMCID: PMC10776586 DOI: 10.1038/s42003-023-05698-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 12/12/2023] [Indexed: 01/11/2024] Open
Abstract
Higher birth order is associated with altered risk of many disease states. Changes in placentation and exposures to in utero growth factors with successive pregnancies may impact later life disease risk via persistent DNA methylation alterations. We investigated birth order with Illumina DNA methylation array data in each of 16 birth cohorts (8164 newborns) with European, African, and Latino ancestries from the Pregnancy and Childhood Epigenetics Consortium. Meta-analyzed data demonstrated systematic DNA methylation variation in 341 CpGs (FDR adjusted P < 0.05) and 1107 regions. Forty CpGs were located within known quantitative trait loci for gene expression traits in blood, and trait enrichment analysis suggested a strong association with immune-related, transcriptional control, and blood pressure regulation phenotypes. Decreasing fertility rates worldwide with the concomitant increased proportion of first-born children highlights a potential reflection of birth order-related epigenomic states on changing disease incidence trends.
Collapse
Affiliation(s)
- Shaobo Li
- Center for Genetic Epidemiology, Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
| | - Natalia Spitz
- Epigenomics and Mechanisms Branch, International Agency for Research on Cancer, Lyon, France
| | - Akram Ghantous
- Epigenomics and Mechanisms Branch, International Agency for Research on Cancer, Lyon, France
| | - Sarina Abrishamcar
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Brigitte Reimann
- Centre for Environmental Sciences, UHasselt, Agoralaan, Building D, 3590, Diepenbeek, Belgium
| | - Irene Marques
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Matt J Silver
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, London, UK
| | - Sofía Aguilar-Lacasaña
- ISGlobal, Institute for Global Health, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública, Madrid, Spain
| | - Negusse Kitaba
- Human Development and Health, Faculty of Medicine, Southampton General Hospital, University of Southampton, Southampton, UK
| | - Faisal I Rezwan
- Human Development and Health, Faculty of Medicine, Southampton General Hospital, University of Southampton, Southampton, UK
- Department of Computer Science, Aberystwyth University, Aberystwyth, Ceredigion, SY23 3DB, UK
| | - Stefan Röder
- Department of Environmental Immunology, Helmholtz Centre for Environmental Research -UFZ, Leipzig, Germany
| | - Lea Sirignano
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Johanna Tuhkanen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Giulia Mancano
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Gemma C Sharp
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- School of Psychology, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Catherine Metayer
- School of Public Health, University of California Berkeley, Berkeley, California, USA
| | - Libby Morimoto
- School of Public Health, University of California Berkeley, Berkeley, California, USA
| | - Dan J Stein
- SAMRC Unit on Risk & Resilience in Mental Disorders, Dept of Psychiatry & Neuroscience Institute, University of Cape Town, Rondebosch, South Africa
| | - Heather J Zar
- SAMRC Unit on Risk & Resilience in Mental Disorders, Dept of Psychiatry & Neuroscience Institute, University of Cape Town, Rondebosch, South Africa
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Rondebosch, South Africa
| | - Rossella Alfano
- Centre for Environmental Sciences, UHasselt, Agoralaan, Building D, 3590, Diepenbeek, Belgium
| | - Tim Nawrot
- Centre for Environmental Sciences, UHasselt, Agoralaan, Building D, 3590, Diepenbeek, Belgium
| | - Congrong Wang
- Centre for Environmental Sciences, UHasselt, Agoralaan, Building D, 3590, Diepenbeek, Belgium
| | - Eero Kajantie
- Clinical Medicine Research Unit, Medical Research Center Oulu, Oulu University, Hospital and University of Oulu, Oulu, Finland
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Pediatric Research Centre, Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Elina Keikkala
- Clinical Medicine Research Unit, Medical Research Center Oulu, Oulu University, Hospital and University of Oulu, Oulu, Finland
- Population Health Unit, Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Oulu, Finland
| | - Sanna Mustaniemi
- Clinical Medicine Research Unit, Medical Research Center Oulu, Oulu University, Hospital and University of Oulu, Oulu, Finland
- Population Health Unit, Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Oulu, Finland
| | - Justiina Ronkainen
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Sylvain Sebert
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Wnurinham Silva
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Marja Vääräsmäki
- Clinical Medicine Research Unit, Medical Research Center Oulu, Oulu University, Hospital and University of Oulu, Oulu, Finland
- Population Health Unit, Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Oulu, Finland
| | - Vincent W V Jaddoe
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Robin M Bernstein
- Department of Anthropology and Institute of Behavioral Science, University of Colorado Boulder, Boulder, CO, USA
| | - Andrew M Prentice
- MRC Unit The Gambia at the London School of Hygiene & Tropical Medicine, Fajara, The Gambia
| | - Marta Cosin-Tomas
- ISGlobal, Institute for Global Health, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública, Madrid, Spain
| | - Terence Dwyer
- Nuffield Department of Women's & Reproductive Health, University of Oxford, John Radcliffe Hospital, Oxford, OX3 9DU, UK
| | - Siri Eldevik Håberg
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Zdenko Herceg
- Epigenomics and Mechanisms Branch, International Agency for Research on Cancer, Lyon, France
| | - Maria C Magnus
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Monica Cheng Munthe-Kaas
- Department of Pediatric Oncology and Hematology, Oslo University Hospital, Norwegian Institute of Public Health, Oslo, Norway
| | - Christian M Page
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
- Department of Physical Health and Aging, Division for Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Maja Völker
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Maria Gilles
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Tabea Send
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Stephanie Witt
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Lea Zillich
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Luigi Gagliardi
- Woman and Child Health Department, Ospedale Versilia, AUSL Toscana Nord Ovest, Pisa, Italy
| | - Lorenzo Richiardi
- Department of Medical Sciences, University of Turin, CPO Piemonte, Turin, Italy
| | - Darina Czamara
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Katri Räikkönen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Lida Chatzi
- Department of Population and Public Health Sciences, Keck School of Medicine of USC. University of Southern California, Los Angeles, CA, USA
| | - Marina Vafeiadi
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
| | - S Hasan Arshad
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
- David Hide Asthma and Allergy Research Centre, Isle of Wight, UK
| | - Susan Ewart
- College of Veterinary Medicine, Michigan State University, East Lansing, MI, USA
| | - Michelle Plusquin
- Centre for Environmental Sciences, UHasselt, Agoralaan, Building D, 3590, Diepenbeek, Belgium
| | - Janine F Felix
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Sophie E Moore
- Department of Women & Children's Health, King's College London, London, UK
| | - Martine Vrijheid
- ISGlobal, Institute for Global Health, Barcelona, Spain
- CIBER Epidemiología y Salud Pública, Madrid, Spain
| | - John W Holloway
- Human Development and Health, Faculty of Medicine, Southampton General Hospital, University of Southampton, Southampton, UK
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Wilfried Karmaus
- Division of Epidemiology, Biostatistics, and Environmental Health, University of Memphis, Memphis, TN, USA
| | - Gunda Herberth
- Department of Environmental Immunology, Helmholtz Centre for Environmental Research -UFZ, Leipzig, Germany
| | - Ana Zenclussen
- Department of Environmental Immunology, Helmholtz Centre for Environmental Research -UFZ, Leipzig, Germany
- Perinatal Immunology, Medical Faculty, Saxonian Incubator for Clinical Translation (SIKT), University of Leipzig, Leipzig, Germany
| | - Fabian Streit
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Jari Lahti
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Anke Hüls
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Thanh T Hoang
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
| | - Stephanie J London
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
| | - Joseph L Wiemels
- Center for Genetic Epidemiology, Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA.
| |
Collapse
|
3
|
Marques I, Santos S, Monasso GS, Fossati S, Vrijheid M, Nieuwenhuijsen M, Jaddoe VWV, Felix JF. Associations of green and blue space exposure in pregnancy with epigenetic gestational age acceleration. Epigenetics 2023; 18:2165321. [PMID: 36628941 PMCID: PMC9980449 DOI: 10.1080/15592294.2023.2165321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Early life is seen as a particularly sensitive period for environmental exposures. Natural space exposure during pregnancy has been associated with offspring health. Epigenetic gestational age acceleration, a discrepancy between clinical and DNA methylation-based gestational age, may underlie these associations. In 1359 mother-newborn pairs from the population-based Generation R Study, we examined the associations of natural space exposure, defined as surrounding greenness, distance to major green and blue (water) space, and size of the blue space during pregnancy with offspring epigenetic gestational age acceleration. Natural space exposure was based on participants' geocoded addresses, and epigenetic gestational age acceleration was calculated from cord blood DNA methylation using Bohlin's and Knight's epigenetic clocks. Sensitivity analyses were conducted in a subgroup of newborns with optimal pregnancy dating, based on last menstrual period. Surrounding greenness, measured in normalized difference vegetation index values, was intermediate (median 0.4, IQR 0.2), and 84% and 56% of the participants had a major green or blue space near their home address, respectively. We did not observe associations of natural space availability during pregnancy with offspring epigenetic gestational age acceleration. This could imply that epigenetic gestational age acceleration in cord blood does not underlie the effects of residential natural space availability in pregnancy on offspring health. Future studies could investigate whether residential natural space availability during pregnancy is associated with offspring differential DNA methylation at other CpGs than those included in the epigenetic gestational clocks.
Collapse
Affiliation(s)
- Irene Marques
- Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.,Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Susana Santos
- Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.,Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.,EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Porto, Portugal
| | - Giulietta S Monasso
- Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.,Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Serena Fossati
- ISGlobal, Institute for Global Health, Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,Spanish Consortium for Research on Epidemiology and Public Health (CIBER), Madrid, Spain
| | - Martine Vrijheid
- ISGlobal, Institute for Global Health, Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,Spanish Consortium for Research on Epidemiology and Public Health (CIBER), Madrid, Spain
| | - Mark Nieuwenhuijsen
- ISGlobal, Institute for Global Health, Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,Spanish Consortium for Research on Epidemiology and Public Health (CIBER), Madrid, Spain
| | - Vincent W V Jaddoe
- Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.,Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Janine F Felix
- Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.,Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| |
Collapse
|
4
|
Rego R, Pereira N, Pinto A, Pereira S, Marques I. Impact of a heart failure multidisciplinary clinic on the reduction of healthcare-related events and costs: the GEstIC study. Front Cardiovasc Med 2023; 10:1232291. [PMID: 37840965 PMCID: PMC10576556 DOI: 10.3389/fcvm.2023.1232291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 09/12/2023] [Indexed: 10/17/2023] Open
Abstract
Introduction Heart failure (HF) is the leading cause of hospitalization in the elderly in developed countries and significantly impacts public health expenditures. Patients with HF usually have associated comorbidities that require multidisciplinary management. This study aims to demonstrate the benefits of a multidisciplinary clinic in reducing all-cause hospitalizations and HF events (HF hospitalizations and urgent HF visits) in a real-world setting. Finally, the study evaluates the associated costs of HF events. Methods This observational study included patients admitted to GEstIC, a multidisciplinary Portuguese HF clinic, from January 2013 to February 2019, who had one-year follow-up. Hospitalizations and HF events, total days spent in the hospital during HF hospitalizations, and HF events-related costs, in the year before and the year after GEstIC admission, were compared. Results Of the 487 patients admitted to the GEstIC, 287 were eligible for the study sample. After one year of HF patients' multidisciplinary management at GEstIC, there was a 53.7% reduction in all-cause hospitalizations (462 vs. 214), a 71.7% reduction in HF hospitalizations (392 vs. 111), and a 39.1% reduction in urgent HF visits (87 vs. 53). As a result, there was a significant decrease of 12.6 days in the length of hospital stay due to HF per patient (15.6 vs. 3.0, p < 0.001). This translated into the release of 9.9 hospital beds in the year following admission to GEstIC. The average total savings associated with the reduction of HF events was €5,439.77 per patient (6,774.15 vs. 1,334.38, p < 0.001), representing a total cost reduction of €1,561,213. Furthermore, the significant reduction in the number of all events was independent of the patient's left ventricular ejection fraction (LVEF). Discussion Significant reductions in all-cause and HF hospitalizations and urgent HF visits were observed with the implementation of this multidisciplinary clinic for HF patients' management. This was particularly important for patients with LVEF >40%. Before GEstIC, there was no medical intervention to improve the prognosis of these patients. The reduction of over one million euros in health-related costs after only one year of person-centered multidisciplinary management highlights the need to replicate this approach in other national healthcare institutions.
Collapse
Affiliation(s)
- Rita Rego
- Serviço de Medicina Interna, Centro Hospitalar Universitário de Santo António, Porto, Portugal
| | - Nuno Pereira
- Serviço de Medicina Interna, Centro Hospitalar Universitário de Santo António, Porto, Portugal
| | - António Pinto
- Unidade Multidisciplinar de Investigação Biomédica—Instituto de Ciências Biomédicas de Abel Salazar (ICBAS), Universidade do Porto, Porto, Portugal
| | - Sofia Pereira
- Serviço de Medicina Interna, Centro Hospitalar de Tondela Viseu, Viseu, Portugal
| | - Irene Marques
- Serviço de Medicina Interna, Centro Hospitalar Universitário de Santo António, Porto, Portugal
- Unidade Multidisciplinar de Investigação Biomédica—Instituto de Ciências Biomédicas de Abel Salazar (ICBAS), Universidade do Porto, Porto, Portugal
- ITR-Laboratory for Integrative and Translational Research in Population Health, Porto, Portugal
| |
Collapse
|
5
|
Marques I, Ramos RL, Mendonça D, Teixeira L. One-year mortality after hospitalization for acute heart failure: Predicting factors (PRECIC study subanalysis). Rev Port Cardiol 2023:S0870-2551(23)00121-X. [PMID: 36893846 DOI: 10.1016/j.repc.2022.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 04/07/2022] [Accepted: 07/14/2022] [Indexed: 03/09/2023] Open
Abstract
INTRODUCTION AND OBJECTIVES One-year mortality after hospitalization for heart failure (HF) is high. This study aims to identify predictive factors of one-year mortality. METHODS This is a retrospective, single-center and observational study. All patients hospitalized for acute HF for one-year were enrolled. RESULTS A total of 429 patients were enrolled, mean age of 79 years. The in-hospital and one-year all-cause mortality rates were 7.9% and 34.3%, respectively. In the univariable analysis, the factors significantly associated with higher one-year mortality risk were: age ≥80 years (odds ratio (OR)=2.05, 95% confidence interval (CI) 1.35-3.11, p=0.001); active cancer (OR=2.93, 95% CI 1.36-6.32, p=0.008); dementia (OR=2.84, 95% CI 1.81-4.47, p<0.001); functional dependency (OR=2.63, 95% CI 1.65-4.19, p<0.001); atrial fibrillation (OR=1.86, 95% CI 1.24-2.80, p=0.004); higher creatinine (OR=2.03, 95% CI 1.29-3.21, p=0.002), urea (OR=2.92, 95% CI 1.95-4.36, p<0.001) and red cell distribution width (RDW; 4thQ OR=5.59, 95% CI 3.03-10.32, p=0.001); and lower hematocrit (OR=0.94, 95% CI 0.91-0.97, p<0.001), hemoglobin (OR=0.83, 95% CI 0.75-0.92, p<0.001) and platelet distribution width (PDW; OR=0.89, 95% CI 0.82-0.97, p=0.005). In the multivariable analysis, the independent predictors of higher one-year mortality risk were: age ≥80 years (OR=2.05, 95% CI 1.21-3.48); active cancer (OR=2.70, 95% CI 1.03-7.01); dementia (OR=2.69, 95% CI 1.53-4.74); higher urea (OR=2.97, 95% CI 1.84-4.80) and RDW (4thQ OR=5.24, 95% CI 2.55-10.76); and lower PDW (OR=0.88, 95% CI 0.80-0.97). CONCLUSIONS Active cancer, dementia, and high values for urea and RDW at admission are predictors of one-year mortality in patients hospitalized for HF. These variables are readily available at admission and can support the clinical management of HF patients.
Collapse
Affiliation(s)
- Irene Marques
- Department of Internal Medicine, Centro Hospitalar Universitário do Porto (CHUPorto), Porto, Portugal; Unidade Multidisciplinar de Investigação Biomédica, ICBAS - Instituto de Ciências Biomédicas de Abel Salazar, Universidade do Porto, Porto, Portugal; ITR-Laboratory for Integrative and Translational Research in Population Health, Porto, Portugal.
| | - Raquel Lopes Ramos
- Department of Internal Medicine, Centro Hospitalar Universitário do Porto (CHUPorto), Porto, Portugal
| | - Denisa Mendonça
- ITR-Laboratory for Integrative and Translational Research in Population Health, Porto, Portugal; Department of Population Studies, Instituto de Ciências Biomédicas de Abel Salazar, Universidade do Porto, Porto, Portugal; EPIUnit, Institute of Public Health, University of Porto, Porto, Portugal
| | - Laetitia Teixeira
- Department of Population Studies, Instituto de Ciências Biomédicas de Abel Salazar, Universidade do Porto, Porto, Portugal; Centro de Investigação em Tecnologias e Serviços de Saúde (CINTESIS), Instituto de Ciências Biomédicas de Abel Salazar, Universidade do Porto, Porto, Portugal
| |
Collapse
|
6
|
Marques I, Mendonça D, Teixeira L. One-year rehospitalisation and mortality after acute heart failure hospitalisation: a competing risk analysis. Open Heart 2023; 10:openhrt-2022-002167. [PMID: 36941025 PMCID: PMC10030761 DOI: 10.1136/openhrt-2022-002167] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 01/04/2023] [Indexed: 03/23/2023] Open
Abstract
OBJECTIVE To identify factors that independently predict the risk of rehospitalisation and death after acute heart failure (AHF) hospital discharge in a real-world setting, considering death without rehospitalisation as a competing event. METHODS Single-centre, retrospective, observational study enrolling 394 patients discharged from an index AHF hospitalisation. Overall survival was evaluated using Kaplan-Meier and Cox regression models. For the risk of rehospitalisation, survival analysis considering competing risks was performed: rehospitalisation was the event of interest, and death without rehospitalisation was the competing event. RESULTS During the first year after discharge, 131 (33.3%) patients were rehospitalised for AHF and 67 (17.0%) died without being readmitted; the remaining 196 patients (49.7%) lived without further hospitalisations. The 1-year overall survival estimate was 0.71 (SE=0.02). After adjusting for gender, age and left ventricle ejection fraction, the results showed that the risk of death was higher in patients with dementia, higher levels of plasma creatinine (PCr), lower levels of platelet distribution width (PDW) and at Q4 of red cell distribution width (RDW). Multivariable models showed that the risk of rehospitalisation was increased in patients with atrial fibrillation, higher PCr or taking beta-blockers at discharge. Furthermore, the risk of death without AHF rehospitalisation was higher in males, those aged ≥80 years, patients with dementia or RDW at Q4 on admission (compared with Q1). Taking beta-blockers at discharge and having a higher PDW on admission reduced the risk of death without rehospitalisation. CONCLUSION When assessing rehospitalisation as a study endpoint, death without rehospitalisation should be considered a competing event in the analyses. Data from this study reveal that patients with atrial fibrillation, renal dysfunction or taking beta-blockers are more likely to be rehospitalised for AHF, while older men with dementia or high RDW are more prone to die without hospital readmission.
Collapse
Affiliation(s)
- Irene Marques
- Serviço de Medicina Interna, Centro Hospitalar Universitário de Santo António, Porto, Portugal
- Unidade Multidisciplinar de Investigação Biomédica (UMIB), Instituto de Ciências Biomédicas de Abel Salazar (ICBAS), Universidade do Porto, Porto, Portugal
- ITR - Laboratory for Integrative and Translational Research in Population Health, Porto, Portugal
| | - Denisa Mendonça
- ITR - Laboratory for Integrative and Translational Research in Population Health, Porto, Portugal
- Departamento de Estudos de Populações, Instituto de Ciências Biomédicas de Abel Salazar (ICBAS), Universidade do Porto, Porto, Portugal
- Unidade de Investigação em Epidemiologia (EPIUnit), Instituto de Saúde Pública da Universidade do Porto (ISPUP), Porto, Portugal
| | - Laetitia Teixeira
- Departamento de Estudos de Populações, Instituto de Ciências Biomédicas de Abel Salazar (ICBAS), Universidade do Porto, Porto, Portugal
- Centro de Investigação em Tecnologias e Serviços de Saúde (CINTESIS), Instituto de Ciências Biomédicas de Abel Salazar (ICBAS), Universidade do Porto, Porto, Portugal
| |
Collapse
|
7
|
Almeida F, Pires L, Bettencourt C, Marques I, Gomes A. Social Media at night and Sleep Quality : the relevance of FOMO, Cognitive Pre-sleep Arousal and Maladaptive cognitive emotion regulation. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
8
|
Marques I, Pires L, Bettencourt C, Gomes F, Almeida R, Ruivo Marques D, Allen Gomes A. Evening screen time, sleep and diurnal type in preschool and primary school children. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
9
|
Balmant B, Fonseca D, Torrinhas R, Marques I, Callado L, Kadouaki D, Pinelli D, Santos W, Prudêncio A, Formiga F, Fernandes G, Bonfá E, Borba E, Waitzberg D. Reduction of beneficial gut bacteria can increase intestinal permeability in inactive systemic lupus erythematosus. Clin Nutr ESPEN 2021. [DOI: 10.1016/j.clnesp.2021.09.333] [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]
|
10
|
Quaresma V, Marconi L, Lopes M, Marques I, Andrade D, Donato P, Figueiredo A. Diagnostic performance of contrast-enhanced ultrasonography for the evaluation of malignancy in complex cystic masses. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)02746-4] [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: 11/15/2022] Open
|
11
|
Salah K, Stienen S, Moons AHM, Bakx ALM, van Pol PE, Kortz RAM, Ferreira JP, Marques I, Schroeder-Tanka JM, Keijer JT, Bayes-Genis A, Pinto YM, Tijssen JG, Kok WE. External Validation of the ELAN-HF Score, Predicting 6-Month All-Cause Mortality in Patients Hospitalized for Acute Decompensated Heart Failure. J Am Heart Assoc 2019; 8:e010309. [PMID: 31296084 PMCID: PMC6662127 DOI: 10.1161/jaha.118.010309] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Background Our aim was to calibrate and externally revalidate the ELAN‐HF (European Collaboration on Acute Decompensated Heart Failure) score, to confirm and improve on a previous external validation of the risk score. Methods and Results The ELAN‐HF score predicts 6‐month all‐cause mortality in patients hospitalized for acute decompensated heart failure using absolute and percentage change of NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide) levels in addition to clinical variables. For the external validation, we used the PRIMA II (Can NT‐proBNP–Guided Therapy During Hospital Admission for Acute Decompensated Heart Failure Reduce Mortality and Readmissions?) trial. For both data sets, observed versus predicted mortality was compared for the 4 risk categories; and the mean predicted mortality was plotted against the observed mortality with calculation of a correlation coefficient and SEE. The model discriminant ability was determined by comparing the C‐statistics for both data sets. The predicted versus actual 6‐month mortality values in the derivation cohort were 3.7% versus 3.6% for the low‐risk category, 9.4% versus 9.2% for the intermediate‐risk category, 24.2% versus 23.5% for the high‐risk category, and 54.2% versus 51.1% for the very‐high‐risk category. The correlation between predicted and observed mortality by deciles was 0.92, with an SEE of ±4%. In the validation cohort, predicted versus actual 6‐month mortality values were 3.0% versus 2.2% for the low‐risk category, 9.4% versus 8.2% for the intermediate‐risk category, 25.0% versus 22.9% for the high‐risk category, and 56.8% versus 53.6% for the very‐high‐risk category. The correlation between predicted and actual mortality by quintiles was 0.99, with an SEE of ±2%. There was no significant difference in C‐statistic between the derivation cohort (0.78; 95% CI, 0.74–0.82) and the validation cohort (0.77; 95% CI, 0.69–0.84; P=0.693). Conclusions Our study confirms that the ELAN‐HF score predicts accurately 6‐month mortality in patients hospitalized for acute decompensated heart failure with the use of easily obtained characteristics.
Collapse
Affiliation(s)
- Khibar Salah
- 1 Heart Center Department of Clinical and Experimental Cardiology Amsterdam Cardiovascular Sciences Amsterdam University Medical Center University of Amsterdam Amsterdam the Netherlands.,2 Department of Radiology and Nuclear Medicine Radboud University Medical Center Nijmegen the Netherlands
| | - Susan Stienen
- 1 Heart Center Department of Clinical and Experimental Cardiology Amsterdam Cardiovascular Sciences Amsterdam University Medical Center University of Amsterdam Amsterdam the Netherlands.,3 INSERM Centre d'Investigations Cliniques Plurithématique Université de Lorraine CHRU de Nancy Nancy France
| | - Andreas H M Moons
- 4 Department of Cardiology Onze Lieve Vrouwe Gasthuis (OLVG) Amsterdam the Netherlands
| | - Adrianus L M Bakx
- 5 Department of Cardiology BovenIJ ziekenhuis Amsterdam the Netherlands
| | - Petra E van Pol
- 6 Department of Cardiology Alrijne ziekenhuis Leiderdorp the Netherlands
| | - R A Mikael Kortz
- 7 Department of Cardiology Flevoziekenhuis Almere the Netherlands
| | - João Pedro Ferreira
- 8 Cardiovascular Research and Development Unit Department of Physiology and Cardiothoracic Surgery Faculty of Medicine University of Porto Porto Portugal.,9 INSERM Centre d'Investigations Cliniques Plurithématique 1433 INSERM U1116 Université de Lorraine CHRU de Nancy F-CRIN INI-CRCT Nancy France
| | - Irene Marques
- 10 Department of Internal Medicine Centro Hospitalar do Porto Instituto de Ciências Biomédicas de Abel Salazar University of Porto Porto Portugal
| | | | - Jan T Keijer
- 12 Department of Cardiology Tergooiziekenhuizen Blaricum the Netherlands
| | - Antoni Bayes-Genis
- 13 Department of Cardiology Hospital Universitari Germans Trias i Pujol Barcelona Spain
| | - Yigal M Pinto
- 1 Heart Center Department of Clinical and Experimental Cardiology Amsterdam Cardiovascular Sciences Amsterdam University Medical Center University of Amsterdam Amsterdam the Netherlands
| | - Jan G Tijssen
- 1 Heart Center Department of Clinical and Experimental Cardiology Amsterdam Cardiovascular Sciences Amsterdam University Medical Center University of Amsterdam Amsterdam the Netherlands
| | - Wouter E Kok
- 1 Heart Center Department of Clinical and Experimental Cardiology Amsterdam Cardiovascular Sciences Amsterdam University Medical Center University of Amsterdam Amsterdam the Netherlands
| |
Collapse
|
12
|
Miguel I, Monteiro A, Oliveira I, Marques T, Rosa I, Limbert M, Fernandez G, Barroca R, Marques I, Fonseca R, Mirones L, Ferreira T, Venâncio J, Moreira A, Freire J. Chemoradiation with capecitabine and mitomycin-C for locally advanced anal squamous cell carcinoma: experience of a single Portuguese institution. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.312] [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
|
13
|
Balteiro G, Marques I, Abrantes M, Neves A, Meireles I, Pires A, Costa G, Tavares-Silva E, Figueiredo A, Botelho M. Radium-223 therapy in Metastatic Castration-Resistant Prostate Cancer: effects on tumor and normal cell lines. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz034.090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- G Balteiro
- Biophysics Institute - Institute for Clinical and Biomedical Research (iCBR) area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine of University of Coimbra, Portugal
| | - I Marques
- Biophysics Institute - Institute for Clinical and Biomedical Research (iCBR) area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine of University of Coimbra, Portugal
- Faculty of Sciences and Technology of University of Coimbra, Portugal
| | - M Abrantes
- Biophysics Institute - Institute for Clinical and Biomedical Research (iCBR) area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine of University of Coimbra, Portugal
- ESTeSC - Coimbra Health School, Instituto Politécnico de Coimbra, Portugal
- CNC.IBILI, University of Coimbra, Portugal
| | - A Neves
- Biophysics Institute - Institute for Clinical and Biomedical Research (iCBR) area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine of University of Coimbra, Portugal
| | - I Meireles
- Biophysics Institute - Institute for Clinical and Biomedical Research (iCBR) area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine of University of Coimbra, Portugal
- Faculty of Sciences and Technology of University of Coimbra, Portugal
| | - A Pires
- Biophysics Institute - Institute for Clinical and Biomedical Research (iCBR) area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine of University of Coimbra, Portugal
- CNC.IBILI, University of Coimbra, Portugal
| | - G Costa
- Department of Nuclear Medicine, Centro Hospitalar e Universitário de Coimbra, Portugal
| | - E Tavares-Silva
- Department of Urology and Transplantation, Centro Hospitalar e Universitário de Coimbra, Portugal
| | - A Figueiredo
- Department of Urology and Transplantation, Centro Hospitalar e Universitário de Coimbra, Portugal
| | - M Botelho
- Biophysics Institute - Institute for Clinical and Biomedical Research (iCBR) area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine of University of Coimbra, Portugal
- CNC.IBILI, University of Coimbra, Portugal
| |
Collapse
|
14
|
Cuevas E, Espino J, Marques I. Reproductive isolation between Salvia elegans and S. fulgens, two hummingbird-pollinated sympatric sages. Plant Biol (Stuttg) 2018; 20:1075-1082. [PMID: 30004608 DOI: 10.1111/plb.12874] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 07/09/2018] [Indexed: 06/08/2023]
Abstract
The integrity of species in sympatric contact sites is dependent on the existence of reproductive isolating mechanisms, which restrict gene flow between them. However, we know little about the mechanisms that enable the coexistence of species with similar floral morphologies. Here, we evaluated several reproductive isolation barriers between Salvia elegans and S. fulgens, two sympatric sages with a similar ornithophilous floral syndrome, offering nectar as the main reward. Over 3 years, we evaluated broad-scale geographic isolation, floral phenologies and floral visitors as pre-pollination barriers, and fruit set, seed number and seed germination as post-pollination barriers. We found considerable geographic isolation and significant altitudinal differences between the two sages. The flowering period of both sages always overlapped extensively during the 3 years of this study, but hummingbirds were highly specific, visiting one or the other Salvia species and showing aggressive territorial behaviour. Interspecific experimental crosses revealed that hybrid seeds might be formed although strong asymmetric barriers were found depending on the species acting as the maternal donor. Despite the low level of flowering asynchrony, reproductive isolation was remarkably high in the two sages. Geographic isolation and pollinator fidelity were the main factors responsible for maintaining species integrity. Despite an extensive review, we found very few studies quantifying the efficiency of isolation barriers in Neotropical plants or even the importance of hummingbirds as pollinators.
Collapse
Affiliation(s)
- E Cuevas
- Facultad de Biología, Universidad Michoacana de San Nicolás de Hidalgo, Morelia, Mexico
| | - J Espino
- Facultad de Biología, Universidad Michoacana de San Nicolás de Hidalgo, Morelia, Mexico
| | - I Marques
- UBC Botanical Garden & Centre for Plant Research and Department of Botany, University of British Columbia, Vancouver, BC, Canada
- CE3C - Centre for Ecology, Evolution and Environmental Changes, Campo Grande, Portugal
| |
Collapse
|
15
|
Pite H, Pimenta L, Henriques AC, Marques I, Camarinha C, Lourenco AV, Almeida I, Borrego LM, Morais-Almeida M. Lower airway flow influences peak nasal inspiratory flow in school-aged children. Rhinology 2018; 56:288-296. [PMID: 29509828 DOI: 10.4193/rhin17.229] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Rhinitis and asthma frequently coexist. Peak nasal inspiratory flow (PNIF) objectively evaluates nasal obstruction. Lower airway flow's impact on PNIF has seldom been analysed in children. We aimed to study the associations between PNIF and: 1)forced expiratory volume in one second (FEV1) and peak expiratory flow (PEF) in children with allergic rhinitis and asthma and healthy controls; 2)allergic rhinitis and asthma control subjective evaluation. METHODS Sequential assessments of PNIF before and after nasal decongestion and spirometry with bronchodilation test were performed in 65 children (6-12 years) with allergic rhinitis and asthma, and 24 gender, age-matched healthy controls. The Control of Allergic Rhinitis and Asthma Test in children (CARATkids) was used for control assessment. Associations were investigated by multiple linear regression models. RESULTS Baseline and decongested PNIF correlated with baseline and post-bronchodilation FEV1 and PEF, observed independently of rhinitis and asthma diagnosis. The best model for PNIF included PEF, age and gender. No association was found between PNIF and CARATkids scores, except for nasal obstruction self-report. CONCLUSION In school-aged children, besides age and gender, PEF values should ideally be known to interpret PNIF values. PNIF can be complementary to subjective control assessment in children with allergic rhinitis and asthma.
Collapse
Affiliation(s)
- H Pite
- Allergy Center, CUF Descobertas Hospital and CUF Infante Santo Hospital, Lisbon, Portugal
| | - L Pimenta
- Allergy Center, CUF Descobertas Hospital and CUF Infante Santo Hospital, Lisbon, Portugal
| | - A C Henriques
- Allergy Center, CUF Descobertas Hospital and CUF Infante Santo Hospital, Lisbon, Portugal
| | - I Marques
- Allergy Center, CUF Descobertas Hospital and CUF Infante Santo Hospital, Lisbon, Portugal
| | - C Camarinha
- Allergy Center, CUF Descobertas Hospital and CUF Infante Santo Hospital, Lisbon, Portugal
| | - A V Lourenco
- Allergy Center, CUF Descobertas Hospital and CUF Infante Santo Hospital, Lisbon, Portugal
| | - I Almeida
- Allergy Center, CUF Descobertas Hospital and CUF Infante Santo Hospital, Lisbon, Portugal
| | - L M Borrego
- Allergy Center, CUF Descobertas Hospital and CUF Infante Santo Hospital, Lisbon, Portugal
| | - M Morais-Almeida
- Allergy Center, CUF Descobertas Hospital and CUF Infante Santo Hospital, Lisbon, Portugal
| |
Collapse
|
16
|
Marques I, Loureiro J, Draper D, Castro M, Castro S. How much do we know about the frequency of hybridisation and polyploidy in the Mediterranean region? Plant Biol (Stuttg) 2018; 20 Suppl 1:21-37. [PMID: 28963818 DOI: 10.1111/plb.12639] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [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: 03/22/2017] [Accepted: 09/25/2017] [Indexed: 06/07/2023]
Abstract
Natural hybridisation and polyploidy are currently recognised as drivers of biodiversity, despite early scepticism about their importance. The Mediterranean region is a biodiversity hotspot where geological and climatic events have created numerous opportunities for speciation through hybridisation and polyploidy. Still, our knowledge on the frequency of these mechanisms in the region is largely limited, despite both phenomena are frequently cited in studies of Mediterranean plants. We reviewed information available from biodiversity and cytogenetic databases to provide the first estimates of hybridisation and polyploidy frequency in the Mediterranean region. We also inspected the most comprehensive modern Mediterranean Flora (Flora iberica) to survey the frequency and taxonomic distribution of hybrids and polyploids in Iberian Peninsula. We found that <6% of Mediterranean plants were hybrids, although a higher frequency was estimated for the Iberian Peninsula (13%). Hybrids were concentrated in few families and in even fewer genera. The overall frequency of polyploidy (36.5%) was comparable with previous estimates in other regions; however our estimates increased when analysing the Iberian Peninsula (48.8%). A surprisingly high incidence of species harbouring two or more ploidy levels was also observed (21.7%). A review of the available literature also showed that the ecological factors driving emergence and establishment of new entities are still poorly studied in the Mediterranean flora, although geographic barriers seem to play a major role in polyploid complexes. Finally, this study reveals several gaps and limitations in our current knowledge about the frequency of hybridisation and polyploidy in the Mediterranean region. The obtained estimates might change in the future with the increasing number of studies; still, rather than setting the complete reality, we hope that this work triggers future studies on hybridisation and polyploidy in the Mediterranean region.
Collapse
Affiliation(s)
- I Marques
- Department of Agricultural and Environmental Sciences, High Polytechnic School of Huesca, University of Zaragoza, Huesca, Spain
| | - J Loureiro
- Centre for Functional Ecology, Department of Life Sciences, University of Coimbra, Coimbra, Portugal
| | - D Draper
- Centro de Ecologia, Evolução e Alterações Ambientais (cE3c), Universidade de Lisboa, Lisbon, Portugal
- UBC Botanical Garden & Centre for Plant Research, and Department of Botany, University of British Columbia, Vancouver, Canada
| | - M Castro
- Centre for Functional Ecology, Department of Life Sciences, University of Coimbra, Coimbra, Portugal
| | - S Castro
- Centre for Functional Ecology, Department of Life Sciences, University of Coimbra, Coimbra, Portugal
- Botanic Garden of the University of Coimbra, Coimbra, Portugal
| |
Collapse
|
17
|
Marques I, Draper D, López-Herranz ML, Garnatje T, Segarra-Moragues JG, Catalán P. Past climate changes facilitated homoploid speciation in three mountain spiny fescues (Festuca, Poaceae). Sci Rep 2016; 6:36283. [PMID: 27808118 PMCID: PMC5093761 DOI: 10.1038/srep36283] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 10/03/2016] [Indexed: 11/25/2022] Open
Abstract
Apart from the overwhelming cases of allopolyploidization, the impact of speciation through homoploid hybridization is becoming more relevant than previously thought. Much less is known, however, about the impact of climate changes as a driven factor of speciation. To investigate these issues, we selected Festuca picoeuropeana, an hypothetical natural hybrid between the diploid species F. eskia and F. gautieri that occurs in two different mountain ranges (Cantabrian Mountains and Pyrenees) separated by more than 400 km. To unravel the outcomes of this mode of speciation and the impact of climate during speciation we used a multidisciplinary approach combining genome size and chromosome counts, data from an extensive nuclear genotypic analysis, plastid sequences and ecological niche models (ENM). Our results show that the same homoploid hybrid was originated independently in the two mountain ranges, being currently isolated from both parents and producing viable seeds. Parental species had the opportunity to contact as early as 21000 years ago although niche divergence occurs nowadays as result of a climate-driven shift. A high degree of niche divergence was observed between the hybrid and its parents and no recent introgression or backcrossed hybrids were detected, supporting the current presence of reproductive isolation barriers between these species.
Collapse
Affiliation(s)
- I Marques
- Departamento de Ciencias Agrarias y del Medio Natural, Escuela Politécnica Superior de Huesca, Universidad de Zaragoza, C/Carretera de Cuarte Km 1, E22071 Huesca, Spain
| | - D Draper
- Centro de Ecologia, Evolução e Alterações Ambientais (CE3C - Centre for Ecology, Evolution and Environmental Changes), C2, Universidade de Lisboa, Campo Grande, 1749-016 Lisbon, Portugal
| | - M L López-Herranz
- Departamento de Ciencias Agrarias y del Medio Natural, Escuela Politécnica Superior de Huesca, Universidad de Zaragoza, C/Carretera de Cuarte Km 1, E22071 Huesca, Spain
| | - T Garnatje
- Institut Botànic de Barcelona (IBB-CSIC-ICUB), Passeig del Migdia s/n, 08038 Barcelona, Spain
| | - J G Segarra-Moragues
- Departamento de Biología Vegetal, Facultad de Ciencias Biológicas, Universitat de València, Avda. Dr. Moliner, 50, E-46100, Burjassot, Spain
| | - P Catalán
- Departamento de Ciencias Agrarias y del Medio Natural, Escuela Politécnica Superior de Huesca, Universidad de Zaragoza, C/Carretera de Cuarte Km 1, E22071 Huesca, Spain.,Department of Botany, Institute of Biology, Tomsk State University, Lenin Av. 36, 634050 Tomsk, Russia
| |
Collapse
|
18
|
Ferreira JP, Santos M, Oliveira JC, Marques I, Bettencourt P, Carvalho H. Influence of spironolactone on matrix metalloproteinase-2 in acute decompensated heart failure. Arq Bras Cardiol 2015; 104:308-14. [PMID: 25993594 PMCID: PMC4415867 DOI: 10.5935/abc.20140205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 09/30/2014] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Matrix metalloproteinases (MMPs) are a family of enzymes important for the resorption of extracellular matrices, control of vascular remodeling and repair. Increased activity of MMP2 has been demonstrated in heart failure, and in acutely decompensated heart failure (ADHF) a decrease in circulating MMPs has been demonstrated along with successful treatment. OBJECTIVE Our aim was to test the influence of spironolactone in MMP2 levels. METHODS Secondary analysis of a prospective, interventional study including 100 patients with ADHF. Fifty patients were non-randomly assigned to spironolactone (100 mg/day) plus standard ADHF therapy (spironolactone group) or standard ADHF therapy alone (control group). RESULTS Spironolactone group patients were younger and had lower creatinine and urea levels (all p < 0.05). Baseline MMP2, NT-pro BNP and weight did not differ between spironolactone and control groups. A trend towards a more pronounced decrease in MMP2 from baseline to day 3 was observed in the spironolactone group (-21 [-50 to 19] vs 1.5 [-26 to 38] ng/mL, p = 0.06). NT-pro BNP and weight also had a greater decrease in the spironolactone group. The proportion of patients with a decrease in MMP2 levels from baseline to day 3 was also likely to be greater in the spironolactone group (50% vs 66.7%), but without statistical significance. Correlations between MMP2, NT-pro BNP and weight variation were not statistically significant. CONCLUSION MMP2 levels are increased in ADHF. Patients treated with spironolactone may have a greater reduction in MMP2 levels.
Collapse
|
19
|
Nunes S, Maia J, Ferreira JP, Neves J, Marques I. Oxygen therapy: a clinical audit in an Internal Medicine Department. Rev Port Pneumol (2006) 2015; 21:101-103. [PMID: 25926375 DOI: 10.1016/j.rppnen.2014.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 11/09/2014] [Accepted: 11/10/2014] [Indexed: 06/04/2023] Open
Affiliation(s)
- S Nunes
- Department of Internal Medicine, Hospital Santo António, Centro Hospitalar do Porto, Porto, Portugal.
| | - J Maia
- Department of Internal Medicine, Hospital Santo António, Centro Hospitalar do Porto, Porto, Portugal
| | - J P Ferreira
- Department of Internal Medicine, Hospital Santo António, Centro Hospitalar do Porto, Porto, Portugal
| | - J Neves
- Department of Internal Medicine, Hospital Santo António, Centro Hospitalar do Porto, Porto, Portugal
| | - I Marques
- Department of Internal Medicine, Hospital Santo António, Centro Hospitalar do Porto, Porto, Portugal
| |
Collapse
|
20
|
Ferreira JP, Santos M, Almeida S, Marques I, Bettencourt P, Carvalho H. High-dose spironolactone changes renin and aldosterone levels in acutely decompensated heart failure. Cor Vasa 2014. [DOI: 10.1016/j.crvasa.2014.06.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
21
|
Ferreira JP, Santos M, Almeida S, Marques I, Bettencourt P, Carvalho H. The role of albuminuria as a non-invasive marker for congestive acutely decompensated chronic heart failure and the spironolactone effect in elderly Portuguese: a non-randomized trial. Nephrology (Carlton) 2014; 19:149-56. [PMID: 24533733 DOI: 10.1111/nep.12188] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2013] [Indexed: 01/09/2023]
Abstract
BACKGROUND/OBJECTIVES Albuminuria is a robust, validated cardiovascular risk factor. It is a simple and widely available test that was shown to be a powerful and independent predictor of prognosis in chronic heart failure. Mineralocorticoid receptor antagonists may reduce the acute and chronic harmful effects of mineralocorticoid receptor activation on the kidney. The objectives of the trial were to compare the effect of spironolactone versus standard acutely decompensated heart failure (ADHF) therapy on albuminuria and to investigate the role of albuminuria as a prognostic marker in patients with ADHF. METHODS Secondary analysis of a prospective, interventional study including 100 patients with ADHF. Fifty patients were non-randomly assigned to spironolactone 100 mg/day plus standard ADHF therapy (intervention group) or standard ADHF therapy alone (control group). RESULTS Patients in control group were older, had higher creatinine and urea levels, and had higher proportion of microalbuminuria (all, P < 0.05). Paired comparison of baseline and day 3 log albuminuria within each group, showed a more pronounced decrease in the intervention group (1.79 ± 0.75 to 1.59 ± 0.67, P = 0.003 vs 1.89 ± 0.70 to 1.79 ± 0.74, P = 0.096). In addition, the proportion of patients with normoalbuminuria increased from baseline to day 3 in spironolactone group (20 (40%) to 27 (54%), P < 001), accordingly the number of patients in the micro and macroalbuminuria groups was reduced. Day 1 albuminuria was positively correlated with day 1 N-terminal pro-brain natriuretic peptide (0.260 [0.105-0.758], P = 0.009). CONCLUSIONS High-dose spironolactone added to standard ADHF therapy is likely to induce a more pronounced albuminuria decrease and a significant reduction in the proportion of micro and macroalbuminuria.
Collapse
|
22
|
Ferreira JP, Santos M, Almeida S, Marques I, Bettencourt P, Carvalho H. Mineralocorticoid receptor antagonism in acutely decompensated chronic heart failure. Eur J Intern Med 2014; 25:67-72. [PMID: 24070521 DOI: 10.1016/j.ejim.2013.08.711] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Revised: 08/14/2013] [Accepted: 08/14/2013] [Indexed: 12/13/2022]
Abstract
BACKGROUND/OBJECTIVES Mineralocorticoid receptor antagonist (MRA) use in acutely decompensated chronic heart failure (ADCHF) may improve congestion through diuretic effect and prevent neurohormonal activation. We aimed to evaluate the clinical effect and safety of spironolactone in ADCHF. METHODS Prospective, experimental, single-center, and single-blinded trial. Patients were treated with: standard ADCHF therapy or oral spironolactone 50-100mg/d plus standard ADCHF therapy. RESULTS During a 1year period, 100 patients were enrolled, 50 included in the treatment group. Mean (SD) spironolactone dose (mg) at day 1 was 94.5±23.3 and at day 3 was 62.7±24.3. Worsening renal function (increase in pCr≥0.3mg/dL from day 1 to day 3) was more likely to occur in control group (20% vs. 4%; p=0.038), serum potassium did not differ between groups, and plasma NTproBNP had a significant decrease in spironolactone group at day 3 (median [IQR], 2488 [4579] vs. 1555 [1832]; p=0.05). Furthermore, a greater proportion of patients in the treatment group were free of congestion at day 3: less edema, rales, jugular venous pressure (JVP) and orthopnea (all, p<0.05). In addition, a significantly higher proportion of patients were on oral furosemide at day 3 (44% vs. 82%; p<0.001). CONCLUSIONS Our study supports the safety of high dose spironolactone in ADCHF and suggests a positive impact in the resolution of congestion. The important findings of our pilot study need to be confirmed in larger trials.
Collapse
Affiliation(s)
| | | | - Sofia Almeida
- Climate Change Impacts, Adaptation and Mitigation Research Group (CC-IAM), Faculdade de Ciências, Universidade de Lisboa, Portugal
| | | | | | | |
Collapse
|
23
|
Ferreira JP, Santos M, Almeida S, Marques I, Bettencourt P, Carvalho H. Tailoring diuretic therapy in acute heart failure: insight into early diuretic response predictors. Clin Res Cardiol 2013; 102:745-53. [DOI: 10.1007/s00392-013-0588-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Accepted: 05/31/2013] [Indexed: 11/30/2022]
|
24
|
Abstract
Primary cardiac sarcomas are rare tumours carrying poor prognosis. Postradiation sarcoma has been reported in patients with breast, cervical and head and neck cancers. We report a case of a 56-year-old woman with stage IIA breast cancer diagnosed in 1997, submitted to mastectomy, adjuvant chemotherapy, radiotherapy and hormonotherapy. Pulmonary metastasis were detected in 2008 and treated with chemotherapy and hormonotherapy, being in complete remission since August 2009. She was admitted in December 2009 with a 3-week history of fever, dyspnoea, polyarthralgias and leg oedema. An echocardiography showed a mass in the left atrium. She was submitted to a surgical tumour resection and the histology revealed a sarcoma of intermediate degree of differentiation. Chemoradiation therapy was started and she remains alive after 3 years, without tumour regrowth or metastasis. This case is a therapeutic challenge, because the previous therapies for breast cancer hampered the options for extra chemoradiation therapy.
Collapse
Affiliation(s)
- Joana Ramalho
- Department of Medicine, Centro Hospitalar do Porto, Porto, Portugal.
| | | | | | | |
Collapse
|
25
|
Marques I, Júlio F, Januário C. J17 Apathy prevalence and clinical correlations in Huntington's disease. J Neurol Neurosurg Psychiatry 2012. [DOI: 10.1136/jnnp-2012-303524.127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
26
|
Teixeira A, Silva J, Ferreira M, Marques I, Gomes M, Mauricio J, Lobo F, Medeiros R. 891 Circulating MicroRNA-222 in Plasma – a Potential Biomarker for Renal Cell Carcinoma. Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)71523-x] [Citation(s) in RCA: 3] [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: 10/28/2022]
|
27
|
Assis J, Gomes M, Marques D, Marques I, Catarino R, Pereira D, Medeiros R. 1152 POSTER CYP3A4*1B Polymorphism – a Prognostic Value in Ovarian Cancer? Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)70795-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
28
|
Teixeira A, Marques I, Ferreira M, Gomes M, Lobo F, Medeiros R. 7155 POSTER Is Epidermal Growth Factor Receptor R497K Polymorphism in Renal Cell Carcinoma a Molecular Marker of Advanced Disease? Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)72070-6] [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: 10/17/2022]
|
29
|
Marques I, Teixeira A, Ferreira M, Lobo F, Assis J, Medeiros R. 7116 POSTER Influence of BIRC5 -31G/C Polymorphism in Renal Cell Carcinoma (RCC) Development and Metastization. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)72031-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
30
|
Nery FG, Marques I, Magalhaes M, Miranda HP. Wilson's Disease and Ulcerative Colitis in the Same Patient: Just A Coincidence? A Case Report and Literature Review. Gastroenterology Res 2010; 3:287-289. [PMID: 27942310 PMCID: PMC5139858 DOI: 10.4021/gr271w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/16/2010] [Indexed: 11/23/2022] Open
Abstract
Ulcerative Colitis (UC) is a chronic relapsing inflammatory bowel disease (IBD). Wilson’s disease (WD) is a disorder of copper (Cu) metabolism due to inherited mutations in a gene encoding a putative Cu-transporting P-type ATPase, with a heterogeneous clinical presentation that includes hepatic, neurological, or psychiatric symptoms. The case of a 17-year-old female that presented with severe liver failure, three years after UC onset, and in which diagnosis of WD was established is reported. We review the literature and discuss the possible association between the two rare diseases. Although evidence of a common genetic background between UC and WD has not been described, high Cu serum level is present in both diseases. Cu is one of the trace elements necessary for antioxidant defenses during inflammatory processes, affecting the production of free radicals of oxygen and the levels of cellular antioxidants. The presence of both entities in the same patient may suggest abnormal metabolism of Cu or be just a coincidence.
Collapse
Affiliation(s)
- Filipe G Nery
- Medicine Service, CHP - Hospital Sto Antonio, Porto, Portugal
| | - Irene Marques
- Medicine Service, CHP - Hospital Sto Antonio, Porto, Portugal
| | | | | |
Collapse
|
31
|
Carnide C, Almeida J, Rodrigues C, Aguas F, Marques I. CHROMOSOMAL ABNORMALITIES AS A CAUSE OF PREMATURE OVARIAN FAILURE. Maturitas 2009. [DOI: 10.1016/s0378-5122(09)70501-8] [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]
|
32
|
Almeida J, Carnide C, Ferreira S, Geraldes F, Águas F, Marques I. PREMATURE OVARIAN FAILURE AND FRAGILE X PREMUTATION. Maturitas 2009. [DOI: 10.1016/s0378-5122(09)70494-3] [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]
|
33
|
Cortes HCE, Reis Y, Waap H, Vidal R, Soares H, Marques I, Pereira da Fonseca I, Fazendeiro I, Ferreira ML, Caeiro V, Shkap V, Hemphill A, Leitão A. Isolation of Besnoitia besnoiti from infected cattle in Portugal. Vet Parasitol 2006; 141:226-33. [PMID: 16822614 DOI: 10.1016/j.vetpar.2006.05.022] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2005] [Revised: 04/28/2006] [Accepted: 05/11/2006] [Indexed: 10/24/2022]
Abstract
Besnoitia besnoiti, an obligate intracellular protozoan parasite belonging to the phylum apicomplexa, is the causative agent of bovine besnoitiosis. Besnoitiosis is responsible for significant losses in the cattle industry of Africa and Mediterranean countries due to the high morbidity rate, abortion and infertility in males. The acute stage of disease is associated with the proliferative forms (tachyzoites) and is characterized by fever, whimpery, general weakness and swelling of the superficial lymph nodes. During the following chronic stage, a huge number of cysts are formed mainly in the subcutaneous tissues. This process is non-reversible, and chronic besnoitiosis is characterized by hyper-sclerodermia, hyperkeratosis, alopecia and, in bulls, atrophy, sclerosis and focal necrosis that cause irreversible lesions in the testis. In this paper we report on the identification of large cysts in the skin of a cow and a bull in Portugal, which presented loss of hair and enlargement and pachydermis all over the body. The observation of a two-layered cyst wall within the host cell, the encapsulation of the host cell by a large outer cyst wall, and the subcutaneous localization of the cysts within the host, were characteristic for B. besnoiti. The parasites were isolated from the infected animals and successfully propagated in Vero cells without prior passages in laboratory animals. Morphological characterization of B. besnoiti tachyzoites and the amplification of the 149 bp segment from the internal transcribed spacer 1 (ITS1), aided with specific primers, confirmed the identification of B. besnoiti.
Collapse
Affiliation(s)
- H C E Cortes
- Laboratório de Parasitologia, ICAM, Núcleo da Mitra, Universidade de Evora, Ap 94, Evora 7002-554, Portugal.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
34
|
|
35
|
Saraiva JM, Anionwu E, Belo M, Jenkins T, Kristoffersson U, Marques I, Santos HG, Sequeiros J, Simpson SA, Wertz D, Monteiro C. Issues in human GenEthics. Genet Med 2001; 3:218-9. [PMID: 11388765 DOI: 10.1097/00125817-200105000-00013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- J M Saraiva
- Servico de Genetica Medica, Centro Hospitalar de Coimbra, Portugal.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
36
|
Saraiva JM, Matoso E, Marques I. Absence of a del(22q11) in a patient with the 3C (craniocerebellocardiac) syndrome. J Med Genet 1998; 35:347-8. [PMID: 9598739 PMCID: PMC1051298 DOI: 10.1136/jmg.35.4.347-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
37
|
Jordan MA, Marques I, Rosendorff J, de Ravel TJ. Trisomy 8 mosaicism: a further five cases illustrating marked clinical and cytogenetic variability. Genet Couns 1998; 9:139-146. [PMID: 9664211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Trisomy 8 mosaicism is extremely variable in its phenotypic and cytogenic expression. We present five patients clearly demonstrating the lack of correlation between clinical and laboratory findings, and show that the aneuploid cell lines decreases with time in relation to the normal. This poses a counseling dilemma.
Collapse
Affiliation(s)
- M A Jordan
- Department of Human Genetics, School of Pathology, South African, Institute for Medical Research, Johannesburg, South Africa
| | | | | | | |
Collapse
|
38
|
Shankman S, Spurdle AB, Morris D, Rosendorff J, Marques I, Bernstein R, Ramsay M. Presence of Y chromosome sequences and their effect on the phenotype of six patients with Y chromosome anomalies. Am J Med Genet 1995; 55:269-75. [PMID: 7726221 DOI: 10.1002/ajmg.1320550305] [Citation(s) in RCA: 7] [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] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The extent of Y chromosome material was determined in 6 southern African subjects with sex chromosome anomalies. Four of the subjects were phenotypically female, and 2 were phenotypically male. Molecular and cytogenetic findings were correlated with phenotypic expression. An X;Y translocation was found in both male subjects, and in one female subject. The remaining female subjects were characterized by an isodicentric Y, an isochromosome Yq, and a micromarker of undetermined origin, respectively. The individuals were tested for the presence of a number of Y-specific DNA sequences. Molecular findings were generally compatible with the cytogenetic findings, and also with the phenotypic sex of the patients. All the female subjects had Y material and all but one were negative for the sex determining region of the Y (SRY). The somatic Ullrich-Turner-like findings present in 3 of the females were attributed to either the presence of a 45,X cell line and/or a single copy of Xp. The males both showed X;Y translocations without any detectable loss of Y DNA. Although molecularly very similar, the disparate clinical findings in these 2 subjects could have been accounted for by different X inactivation patterns.
Collapse
Affiliation(s)
- S Shankman
- MRC Human Ecogenetics Research Unit, School of Pathology, University of Witwatersrand, Johannesburg, South Africa
| | | | | | | | | | | | | |
Collapse
|
39
|
Verga V, Dos Santos M, Marques I, Povey S, Ramsay M, Jenkins T. Detection of a 3 allele AvaII RFLP by a single copy anonymous DNA sequence VC75 [D7S404] localized to chromosome 7. Nucleic Acids Res 1989; 17:5421. [PMID: 2569716 PMCID: PMC318160 DOI: 10.1093/nar/17.13.5421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Affiliation(s)
- V Verga
- Department of Human Genetics, School of Pathology, South African Institute for Medical Research, Johannesburg
| | | | | | | | | | | |
Collapse
|
40
|
Verga V, Dos Santos M, Marques I, Povey S, Ramsay M, Jenkins T. An arbitrary single copy human DNA sequence VC63 [D4S129] detects a TaqI RFLP on chromosome 4. Nucleic Acids Res 1989; 17:5423. [PMID: 2569718 PMCID: PMC318162 DOI: 10.1093/nar/17.13.5423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Affiliation(s)
- V Verga
- Department of Human Genetics, School of Pathology, South African Institute for Medical Research, Johannesburg
| | | | | | | | | | | |
Collapse
|
41
|
Verga V, Dos Santos M, Marques I, Povey S, Ramsay M, Jenkins T. An arbitrary single copy DNA sequence VC85 [D1S85] detects a 500 bp insertion/deletion polymorphism on chromosome 1. Nucleic Acids Res 1989; 17:5420. [PMID: 2569715 PMCID: PMC318159 DOI: 10.1093/nar/17.13.5420] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [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: 01/01/2023] Open
Affiliation(s)
- V Verga
- Department of Human Genetics, School of Pathology, South African Institute for Medical Research, Johannesburg
| | | | | | | | | | | |
Collapse
|
42
|
Verga V, Dos Santos M, Marques I, Povey S, Ramsay M, Jenkins T. A high frequency two allele TaqI RFLP detected by an anonymous sequence VC61 [D2S65] on chromosome 2. Nucleic Acids Res 1989; 17:5424. [PMID: 2569719 PMCID: PMC318163 DOI: 10.1093/nar/17.13.5424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Affiliation(s)
- V Verga
- Department of Human Genetics, School of Pathology, South African Institute for Medical Research, Johannesburg
| | | | | | | | | | | |
Collapse
|
43
|
Verga V, Dos Santos M, Marques I, Povey S, Ramsay M, Jenkins T. An arbitrary single copy sequence VC64 [D1S86] detects a moderate frequency TaqI RFLP on chromosome 1. Nucleic Acids Res 1989; 17:5422. [PMID: 2569717 PMCID: PMC318161 DOI: 10.1093/nar/17.13.5422] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [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: 01/01/2023] Open
Affiliation(s)
- V Verga
- Department of Human Genetics, School of Pathology, South African Institute for Medical Research, Johannesburg
| | | | | | | | | | | |
Collapse
|
44
|
Verga V, Dos Santos M, Marques I, Povey S, Ramsay M, Jenkins T. An arbitrary single copy sequence VC64 [D1S86] detects a moderate frequency TaqI RFLP on chromosome 1]. Nucleic Acids Res 1989; 17:4009. [PMID: 2567509 PMCID: PMC317907 DOI: 10.1093/nar/17.10.4009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Affiliation(s)
- V Verga
- Department of Human Genetics, School of Pathology, South African Institute for Medical Research, Johannesburg
| | | | | | | | | | | |
Collapse
|
45
|
Verga V, Dos Santos M, Marques I, Povey S, Ramsay M, Jenkins T. A high frequency two allele TaqI RFLP detected by an anonymous sequence VC61 [D2S65] on chromosome 2. Nucleic Acids Res 1989; 17:4011. [PMID: 2567511 PMCID: PMC317909 DOI: 10.1093/nar/17.10.4011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Affiliation(s)
- V Verga
- Department of Human Genetics, School of Pathology, South African Institute for Medical Research, Johannesburg
| | | | | | | | | | | |
Collapse
|
46
|
Verga V, Dos Santos M, Marques I, Povey S, Ramsay M, Jenkins T. An arbitrary single copy DNA sequence VC85 [D1S85] detects a 500 bp insertion/deletion polymorphism on chromosome 1. Nucleic Acids Res 1989; 17:4007. [PMID: 2567507 PMCID: PMC317905 DOI: 10.1093/nar/17.10.4007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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: 01/01/2023] Open
Affiliation(s)
- V Verga
- Department of Human Genetics, School of Pathology, South African Institute for Medical Research, Johannesburg
| | | | | | | | | | | |
Collapse
|
47
|
Verga V, Dos Santos M, Marques I, Povey S, Ramsay M, Jenkins T. Detection of a 3 allele AvaII RFLP by a single copy anonymous DNA sequence VC75 [D7S404] localized to chromosome 7. Nucleic Acids Res 1989; 17:4008. [PMID: 2567508 PMCID: PMC317906 DOI: 10.1093/nar/17.10.4008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Affiliation(s)
- V Verga
- Department of Human Genetics, School of Pathology, South African Institute for Medical Research, Johannesburg
| | | | | | | | | | | |
Collapse
|
48
|
Verga V, Dos Santos M, Marques I, Povey S, Ramsay M, Jenkins T. An arbitrary single copy human DNA sequence VC63 [D4S129] detects a TaqI RFLP on chromosome 4]. Nucleic Acids Res 1989; 17:4010. [PMID: 2567510 PMCID: PMC317908 DOI: 10.1093/nar/17.10.4010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Affiliation(s)
- V Verga
- Department of Human Genetics, School of Pathology, South African Institute for Medical Research, Johannesburg
| | | | | | | | | | | |
Collapse
|
49
|
Proença R, De Sousa M, Vakil K, Sequeira M, Sykes A, Marques I, Malhado J. A case of Kawasaki disease in Portugal. ACTA MEDICA PORT 1983; 4:97-9. [PMID: 6846060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
|