1
|
Amorim J, Ventura AC. Co-created decision-making: From co-production to value co-creation in health care. J Med Access 2023; 7:27550834231177503. [PMID: 37323851 PMCID: PMC10262615 DOI: 10.1177/27550834231177503] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 05/05/2023] [Indexed: 06/17/2023]
Abstract
Rare diseases are characterized by a wide diversity of signs and symptoms and vary not only from disease to disease but also from person to person, and living with a disease leads patients to peculiar experiences, without limits of time and space, as they extend to various environments and relationships of their lives. Therefore, the objective of this study is the theoretical interaction between value co-creation (VC) and the stakeholder theory (ST) with the shared decision-making (SDM) health care theory, to enable the analysis of the relationships between patients and their stakeholders in the co-creation of value for decision-making focused on the patient's quality of life. It is configured as a multi-paradigmatic proposal by enabling the analysis of multiple perspectives of different stakeholders in health care. Thus, co-created decision-making (CDM) emerges with emphasis on interactivity of the relationships. As previous studies have already highlighted the importance of holistic care, seeing the patient as a whole and not just the body, studies with CDM will be beneficial for analyses that go beyond the clinical office and doctor-patient relationships, extending to all environments and interactions that add value to the patient's treatment. It was concluded that the essence of this new theory proposed here is neither in patient-centered care nor in patient self-care, but in co-created relationships with and between stakeholders, including non-health care environments that are important to the patient, such as relationships with friends, family, other patients with the same disease, social media, public policies, and the practice of pleasurable activities.
Collapse
Affiliation(s)
- Jason Amorim
- Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | | |
Collapse
|
2
|
Fontes R, Rodrigues J, Oliveira C, Peixoto M, Couto E, Freitas D, Cunha J, Amorim J, Nabiço R, Marques A. P-207 FLOT in clinical practice: Retrospective analysis of an oncological center. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
3
|
Giannasi L, Meira e Cruz M, Rezende T, Dutra M, Nacif S, Oliveira E, Oliveira L, Oliveira W, Rode S, Nazário L, Silvestre P, Bacigalupo E, Amorim J, Salgado M, Gomes M. 0804 Sleep Bruxism, Awake Bruxism and Sleep Related Breathing Disorders in Adults With Down Syndrome. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.800] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
To our knowledge, no studies have accessed theawake bruxism (AB) and stage by stage sleep bruxism (SB) in adults with Down syndrome. Recent works have shown that portable PSG systems are accurate for SB assessment even in the absence of audio-video recording. We aimed to evaluate the prevalence of awake bruxism, stage-by-stage sleep bruxism and Sleep Related Breathing Disorders (SRBD) in adults with Down syndrome.
Methods
Twenty-three adults with Down Syndrome (DS) were enrolled in this study. General health, dental status, parafunctional habits and temporomandibular symptoms were assessed. The history of SB/AB was taken from a questionnaire to the caregivers. A portable PSG type II system (Embla Embletta MPR+PG ST+Proxy, Natus, California-USA) was used to perform a full-sleep study at patients’ home. RMMA activity was defined as low (>1 and <2 episodes/h of sleep), moderate (>2 and <4 episodes/h of sleep), or high (>4 episodes/h of sleep). PSG diagnose of SB was assumed if RMMA index was >2 episodes/h of sleep.
Results
According to caregiver’s report, AB was present in all patients whereas only 13.1% had SB. PSG records showed a SB prevalence of 91.3%, with a mean RMMA index 40.0±30.0/h. Only 2 (8,7%) showed RMMA index of 0.0/h. SB episodes were predominant in N3 and REM sleep stage in 14 and 9 patients, respectively. All but one (95,7%) patient (isolated snoring) presented with OSA (AHI=32.8±28.6). A unique TMD symptom (pain on palpation) was present in 8,7% of the global sample.
Conclusion
The high prevalence of “definitive SB” together with the high prevalence of OSA and snoring point in favor to the recommendation of routine PSG in adults with DS. Furthermore, the low sensitivity of parent-oriented questionnaires reinforces the need of more accurate assessment tools in order to get a better standard of care in this particular group of patients.
Support
State of Sao Paulo Research Support Foundation - FAPESP grant number: 2017/06835-8
Collapse
Affiliation(s)
- L Giannasi
- COAT - Institute of Science and Technology, São José dos Campos, BRAZIL
| | - M Meira e Cruz
- Sleep Unit, Cardiovascular Center of University of Lisbon, Lisbon School of Medicine, Lisbon, PORTUGAL
| | - T Rezende
- COAT - Institute of Science and Technology, São José dos Campos, BRAZIL
| | - M Dutra
- CEBAPE - Institute of Science and Technology, CEBAPE - Institute of Science and Technology, BRAZIL
| | - S Nacif
- Hospital do Servidor Público Estadual de São Paulo, São Paulo, BRAZIL
| | - E Oliveira
- Hospital do Servidor Público Estadual de São Paulo, São Paulo, BRAZIL
| | - L Oliveira
- University Center of Anápolis-UniEnvagélica, Goiás, BRAZIL
| | - W Oliveira
- CEBAPE - Institute of Science and Technology, São José dos Campos, BRAZIL
| | - S Rode
- COAT - Institute of Science and Technology, São José dos Campos, BRAZIL
| | - L Nazário
- CEBAPE - Institute of Science and Technology, São José dos Campos, BRAZIL
| | - P Silvestre
- CEBAPE - Institute of Science and Technology, São José dos Campos, BRAZIL
| | - E Bacigalupo
- CEBAPE - Institute of Science and Technology, São José dos Campos, BRAZIL
| | - J Amorim
- CEBAPE - Institute of Science and Technology, São José dos Campos, BRAZIL
| | - M Salgado
- CEBAPE - Institute of Science and Technology, São José dos Campos, BRAZIL
| | - M Gomes
- CEBAPE - Institute of Science and Technology, São José dos Campos, BRAZIL
| |
Collapse
|
4
|
Giannasi L, Gomes M, Oliveira L, Nacif S, Oliveira E, Rezende T, Dutra M, Bacigalupo E, Soviero L, Nazário L, Oliveira W, Rode S, Amorim J, Salgado M, Meira e Cruz M. 0657 Impact of Treatment With Mandibular Advancement Oral Appliance on Respiratory Parameters, Sleep and Cardiometabolic Risk Factors of CPAP Non-Adherent Patients With Severe Obstructive Sleep Apnea. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Obstructive sleep apnea (OSA) may trigger systemic changes linked to important cardiometabolic risk factors such as hypertension, stroke and diabetes II. As a life-threatening, multifactorial disorder, OSA demands a multiprofessional approach. The most common worldwide treatments are Continuous Positive Airway Pressure (CPAP) and Mandibular Advancement Oral Appliance (OAm). The aim of this study was to evaluate the impact of OAm treatment on CPAP non-adherent patients with severe OSA, comparing objective and subjective data between baseline and follow up.
Methods
A prospective study was carried out including non-adherent severe OSA patients, which were referred to OAm therapy evaluation. Patients presenting with snoring, gasping/choking during sleep, fatigue and daily sleepiness were evaluated by a sleep medicine specialist and the diagnosis of severe OSA with a basal polysomnography (PSG). All the patients were treated with a standard OAm (PMPositioner®). Baseline and Follow up (6 months) sleep parameters (PSG and Epworth Sleepiness Scale - ESS) were compared to assess treatment efficacy.
Results
Seventeen patients (9 with hypertension and 8 with hypertension + diabetes) met the inclusion criteria and 13 finished the protocol. After treatment with OAm the following parameters improved significantly: OSA severity (44.5±13.5 to 9.0±4.3, p≤0.001), ODI (46.8±11.6 to 12.1±9.1(p<0.05)), REM (18.4± 4.8 to 21.5± 2.9 (p<0.05)) and SaO2nadir (75.7± 9.4 to 87.0±3.6, p<0.001), ESS (p<0.005). Ten patients (58%) reported a reduction either in systolic and diastolic blood pressure with 3 of them (30%) reduced the hypertensive drug dose.
Conclusion
Our findings show that OAm is a safe and effective treatment option to CPAP non-adherent severe OSA patients. Furthermore OAm therapy had also a positive impact on cardiometabolic risk factors which are particularly relevant outcomes in OSA patients.
Support
State of Sao Paulo Research Support Foundation (FAPESP).
Collapse
Affiliation(s)
- L Giannasi
- COAT - Institute of Science and Technology, São José dos Campos, BRAZIL
| | - M Gomes
- CEBAPE - Institute of Science and Technology, São José dos Campos, BRAZIL
| | - L Oliveira
- University Center of Anápolis-UniEnvangélica, Goiás, BRAZIL
| | - S Nacif
- Hospital do Servidor Público Estadual de São Paulo - IAMSPE, São Paulo, BRAZIL
| | - E Oliveira
- Hospital do Servidor Público Estadual de São Paulo - IAMSPE, São Paulo, BRAZIL
| | - T Rezende
- COAT - Institute of Science and Technology, São José dos Campos, BRAZIL
| | - M Dutra
- CEBAPE - Institute of Science and Technology, São José dos Campos, BRAZIL
| | - E Bacigalupo
- CEBAPE - Institute of Science and Technology, São José dos Campos, BRAZIL
| | - L Soviero
- CEBAPE - Institute of Science and Technology, São José dos Campos, BRAZIL
| | - L Nazário
- CEBAPE - Institute of Science and Technology, São José dos Campos, BRAZIL
| | - W Oliveira
- COAT - Institute of Science and Technology, São José dos Campos, BRAZIL
| | - S Rode
- COAT - Institute of Science and Technology, São José dos Campos, BRAZIL
| | - J Amorim
- CEBAPE - Institute of Science and Technology, São José dos Campos, BRAZIL
| | - M Salgado
- CEBAPE - Institute of Science and Technology, São José dos Campos, BRAZIL
| | - M Meira e Cruz
- Sleep Unit, Cardiovascular Center of University of Lisbon, Lisbon School of Medicine, Lisbon, PORTUGAL
| |
Collapse
|
5
|
Vieira J, Amorim J, Martí-Bonmatí L, Alberich-Bayarri Á, França M. Quantifying steatosis in the liver and pancreas with MRI in patient with chronic liver disease. Radiología (English Edition) 2020. [DOI: 10.1016/j.rxeng.2019.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
|
6
|
Vieira J, Amorim J, Martí-Bonmatí L, Alberich-Bayarri Á, França M. Quantifying steatosis in the liver and pancreas with MRI in patient with chronic liver disease. Radiologia (Engl Ed) 2020; 62:222-228. [PMID: 31932016 DOI: 10.1016/j.rx.2019.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 09/08/2019] [Accepted: 11/04/2019] [Indexed: 12/13/2022]
Abstract
AIM To compare pancreatic and hepatic steatosis quantified by proton density fat fraction (PDFF) on magnetic resonance imaging (MRI) in patients with chronic liver disease. MATERIAL AND METHODS This cross-sectional study included 46 adult patients who underwent liver biopsy for chronic viral hepatitis (n=19) or other chronic non-alcoholic liver diseases (NALD) (n=27). Liver biopsy was used as the gold standard for diagnosing and grading hepatic steatosis. All patients underwent clinical evaluation and MRI with a multi-echo chemical shift-encoded (MECSE) gradient-echo sequence for liver and pancreas PDFF quantification. We used Spearman's correlation coefficient to determine the degree of association between hepatic PDFF and steatosis grade, and between pancreatic PDFF and steatosis grade and hepatic PDFF. To compare the chronic viral hepatitis group and the NALD group, we used t-tests for continuous or ordinal variables and chi-square tests for categorical variables. RESULTS Hepatic PDFF measurements correlated with steatosis grades (RS=0.875, p<0.001). Pancreatic PDFF correlated with hepatic steatosis grades (RS=0.573, p<0.001) and hepatic PDFF measurements (RS=0.536, p<0.001). In the subgroup of patients with chronic NALD, the correlations remained significant between pancreatic PDFF and hepatic PDFF (RS=0.632, p<0.001) and between pancreatic PDFF and liver steatosis (RS=0.608, p<0.001); however, in the subgroup of patients with viral hepatitis these correlations were no longer significant. CONCLUSION Pancreatic fat deposition correlates with hepatic steatosis in patients with chronic NALD, but not in those with chronic viral hepatitis.
Collapse
Affiliation(s)
- J Vieira
- Instituto de Ciências Biomédicas de Abel Salazar (ICBAS), Universidad de Oporto, Oporto, Portugal.
| | - J Amorim
- Departamento de Diagnóstico por la Imagen, Centro Hospitalar do Porto, Oporto, Portugal; Escola de Medicina, Universidade do Minho, Braga, Portugal; ICVS/3B's, Instituto de Investigación de Ciencias de la Vida y la Salud, Universidade do Minho, Braga, Portugal
| | - L Martí-Bonmatí
- Departamento de Radiología y Grupo de Investigación Biomédica en Imagen GIBI2(30). Hospital Universitario y Politécnico La Fe e Instituto de Investigación Sanitaria La Fe, Valencia, España
| | - Á Alberich-Bayarri
- Departamento de Radiología y Grupo de Investigación Biomédica en Imagen GIBI2(30). Hospital Universitario y Politécnico La Fe e Instituto de Investigación Sanitaria La Fe, Valencia, España; Quantitative Imaging Biomarkers in Medicine (QUIBIM), Valencia, España
| | - M França
- Instituto de Ciências Biomédicas de Abel Salazar (ICBAS), Universidad de Oporto, Oporto, Portugal; Departamento de Diagnóstico por la Imagen, Centro Hospitalar do Porto, Oporto, Portugal; i3S, Instituto de Investigacão e Inovação em Saúde, IBMC, Instituto de Biología Molecular y Celular, Oporto, Portugal
| |
Collapse
|
7
|
Ross JM, Coppotelli G, Amorim J, Hillstedt E, Potts E, Sinclair D. DISRUPTING THE EPIGENOME IN NOVEL NICE MICE TO STUDY AGE-RELATED COGNITIVE DECLINE. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2333] [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: 11/13/2022] Open
Affiliation(s)
- J M Ross
- Paul F. Glenn Labs for the Biology of Aging, Harvard Medical School, Boston, Massachusetts, United States
| | - G Coppotelli
- Paul F. Glenn Labs for the Biology of Aging, Harvard Medical School, United States
| | - J Amorim
- Institute of Interdisciplinary Research, University of Coimbra, United States
| | - E Hillstedt
- Department of Neuroscience, Karolinska Institutet, Sweden
| | - E Potts
- Paul F. Glenn Center Labs for the Biology of Aging, Harvard Medical School, United States
| | - D Sinclair
- Paul F. Glenn Labs for the Biology of Aging, Harvard Medical School, United States
| |
Collapse
|
8
|
Jaffey JA, Amorim J, DeClue AE. Effect of calcitriol on in vitro whole blood cytokine production in critically ill dogs. Vet J 2018; 236:31-36. [PMID: 29871746 DOI: 10.1016/j.tvjl.2018.04.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 04/14/2018] [Accepted: 04/17/2018] [Indexed: 12/20/2022]
Abstract
Hypovitaminosis D has been identified as a predictor of mortality in human beings, dogs, cats and foals. However, the immunomodulatory effects of vitamin D in critically ill dogs has not been evaluated. The aim of this study was to evaluate the effect of calcitriol on cytokine production from whole blood collected from critically ill dogs in vitro. Twelve critically ill dogs admitted to a veterinary intensive care unit (ICU) were enrolled in a prospective cohort study. Whole blood from these dogs was incubated with calcitriol (2×10-7M) or ethanol (control) for 24h. Subsequent to this incubation, lipopolysaccharide (LPS)-stimulated whole blood production of tumor necrosis factor (TNF)-α, interleukin (IL)-6 and IL-10 were measured using a canine-specific multiplex assay. Calcitriol significantly increased LPS-stimulated whole blood production of IL-10 and decreased TNF-α production without significantly altering IL-6 production. There was no significant difference in whole blood cytokine production capacity between survivors and non-survivors at the time of discharge from the ICU or 30days after discharge. These data suggests that calcitriol induces an anti-inflammatory phenotype in vitro in whole blood from critically ill dogs.
Collapse
Affiliation(s)
- J A Jaffey
- Comparative Internal Medicine Laboratory, Veterinary Health Center, University of Missouri, 900 East Campus Drive, Columbia, MO 65211, USA
| | - J Amorim
- Comparative Internal Medicine Laboratory, Veterinary Health Center, University of Missouri, 900 East Campus Drive, Columbia, MO 65211, USA
| | - A E DeClue
- Comparative Internal Medicine Laboratory, Veterinary Health Center, University of Missouri, 900 East Campus Drive, Columbia, MO 65211, USA.
| |
Collapse
|
9
|
Abstract
Background People with critical illness (CI) commonly develop various forms of immune dysfunction, however, there is limited information concerning immune dysfunction in dogs with CI. Hypothesis The immune response in CI dogs differs from that of healthy dogs. Animals Immunologic variables were compared between 14 dogs with CI, defined as APPLEfast score of >20 points, admitted to the University of Missouri Veterinary Health Center Small Animal Clinic Intensive Care Unit and healthy controls (n = 15). Methods Cohort study evaluating constitutive and lipopolysaccharide (LPS)‐stimulated TNF‐α, IL‐6, and IL‐10 production, phagocytosis of opsonized E. coli and respiratory burst capacity after opsonized E. coli or phorbol 12‐myristate 13‐acetate (PMA) stimulation, peripheral blood lymphocyte phenotype, and monocyte expressions of HLA‐DR and TLR‐4. Results Lipopolysaccharide‐stimulated leukocyte TNF‐α (median, Q1, Q3; CI, 49, 49, 120; control, 655, 446, 1174 pg/mL; P = < 0.001), IL‐6 (median, Q1, Q3; CI, 49, 49, 64; control, 100, 49, 166 pg/mL; P = 0.029), and IL‐10 (CI, 49, 49, 56; control, 96, 49, 203 pg/mL; P = 0.014) production and both E. coli (median, Q1, Q3; CI, 60.5, 43, 88.5; control, 86.6, 81, 89.2%; P = 0.047) and PMA (CI, 40, 11.7, 70; control, 93, 83, 97.6%; P = < 0.001)‐stimulated respiratory burst capacity significantly decreased in CI dogs. Percentage of monocytes expressing TLR‐4 greater in the CI dogs (median, Q1, Q3; CI, 46.9, 24.3, 64.2; control, 16.4, 9.4, 26.2%; P = 0.005). Conclusion These findings suggest dogs with CI develop immune system alterations that result in reduced respiratory burst function and cytokine production despite upregulation of TLR‐4.
Collapse
Affiliation(s)
- D Hoffman
- The Comparative Internal Medicine Laboratory, University of Missouri College of Veterinary Medicine, Columbia, MO
| | - J Amorim
- The Comparative Internal Medicine Laboratory, University of Missouri College of Veterinary Medicine, Columbia, MO
| | - A DeClue
- The Comparative Internal Medicine Laboratory, University of Missouri College of Veterinary Medicine, Columbia, MO
| |
Collapse
|
10
|
|
11
|
Zhang Y, Axiak-Bechtel S, Friedman Cowan C, Amorim J, Tsuruta K, DeClue AE. Evaluation of immunomodulatory effect of recombinant human granulocyte-macrophage colony-stimulating factor on polymorphonuclear cell from dogs with cancerin vitro. Vet Comp Oncol 2016; 15:968-979. [DOI: 10.1111/vco.12236] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 03/22/2016] [Accepted: 03/22/2016] [Indexed: 12/14/2022]
Affiliation(s)
- Y. Zhang
- Comparative Internal Medicine Laboratory, Department of Veterinary Medicine and Surgery, College of Veterinary Medicine; University of Missouri; Columbia MO 65211 USA
| | - S. Axiak-Bechtel
- Comparative Oncology Laboratory, Department of Veterinary Medicine and Surgery, College of Veterinary Medicine; University of Missouri; Columbia MO 65211 USA
| | - C. Friedman Cowan
- Comparative Internal Medicine Laboratory, Department of Veterinary Medicine and Surgery, College of Veterinary Medicine; University of Missouri; Columbia MO 65211 USA
| | - J. Amorim
- Comparative Internal Medicine Laboratory, Department of Veterinary Medicine and Surgery, College of Veterinary Medicine; University of Missouri; Columbia MO 65211 USA
| | - K. Tsuruta
- Comparative Internal Medicine Laboratory, Department of Veterinary Medicine and Surgery, College of Veterinary Medicine; University of Missouri; Columbia MO 65211 USA
| | - A. E. DeClue
- Comparative Internal Medicine Laboratory, Department of Veterinary Medicine and Surgery, College of Veterinary Medicine; University of Missouri; Columbia MO 65211 USA
| |
Collapse
|
12
|
|
13
|
Affiliation(s)
- J Amorim
- Paediatric Haematology Department, Centro Hospitalar do Porto, Porto, Portugal.
| | | | | | | | | | | |
Collapse
|
14
|
Souza-Corrêa JA, Ridenti MA, Oliveira C, Araújo SR, Amorim J. Decomposition of Lignin from Sugar Cane Bagasse during Ozonation Process Monitored by Optical and Mass Spectrometries. J Phys Chem B 2013; 117:3110-9. [DOI: 10.1021/jp3121879] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- J. A. Souza-Corrêa
- Laboratório
Nacional
de Ciência e Tecnologia do Bioetanol − CTBE/CNPEM, 13083-970, Campinas, São Paulo,
Brazil
| | - M. A. Ridenti
- Laboratório
Nacional
de Ciência e Tecnologia do Bioetanol − CTBE/CNPEM, 13083-970, Campinas, São Paulo,
Brazil
- Instituto de Física
Gleb
Wataghin, Universidade Estadual de Campinas − UNICAMP, 13083-859, Campinas, São Paulo, Brazil
| | - C. Oliveira
- Laboratório
Nacional
de Ciência e Tecnologia do Bioetanol − CTBE/CNPEM, 13083-970, Campinas, São Paulo,
Brazil
| | - S. R. Araújo
- Laboratório Nacional de
Nanotecnologia − LNNANO/LME/CNPEM, Rua Giuseppe Máximo Scolfaro, 10.000, Polo II de Alta Tecnologia,
13083-100, Campinas, São Paulo, Brazil
| | - J. Amorim
- Laboratório
Nacional
de Ciência e Tecnologia do Bioetanol − CTBE/CNPEM, 13083-970, Campinas, São Paulo,
Brazil
- Instituto de Física
Gleb
Wataghin, Universidade Estadual de Campinas − UNICAMP, 13083-859, Campinas, São Paulo, Brazil
| |
Collapse
|
15
|
Diogo M, Faustino C, Pimentel T, Amorim J, Tavares I. Nephrotic syndrome in plasma cell leukaemia--a rare presentation. Indian J Cancer 2011; 48:131-2. [PMID: 21330765 DOI: 10.4103/0019-509x.76644] [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: 11/04/2022]
|
16
|
Loureiro J, Amorim J. Possibility of nonexistence of hot and superhot hydrogen atoms in electrical discharges. Phys Rev E 2011; 82:035401. [PMID: 21230132 DOI: 10.1103/physreve.82.035401] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2010] [Revised: 08/04/2010] [Indexed: 11/07/2022]
Abstract
Recently, the existence of extremely energetic hydrogen atoms in electrical discharges has been proposed in the literature with large controversy, from the analysis of the anomalous broadening of hydrogen Balmer lines. In this paper, the velocity distribution of H atoms and the profiles of the emitting atom lines created by the exothermic reaction H2++H{2}→H{3}{+}+H+ΔE are calculated, as a function of the internal energy defect ΔE . The shapes found for the non-Maxwell-Boltzmann distributions resulting in non-Gaussian line profiles raise serious arguments against the existence of hot and superhot H atoms as it has been proposed, at least with those temperatures.
Collapse
Affiliation(s)
- J Loureiro
- Instituto de Plasmas e Fusão Nuclear-Laboratório Associado, Instituto Superior Técnico, Universidade Técnica de Lisboa, 1049-001 Lisboa, Portugal.
| | | |
Collapse
|
17
|
Reis JL, Amorim J, Dal Pino A. Occupancy of rotational population in molecular spectra based on nonextensive statistics. Phys Rev E Stat Nonlin Soft Matter Phys 2011; 83:017401. [PMID: 21405796 DOI: 10.1103/physreve.83.017401] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2010] [Revised: 11/26/2010] [Indexed: 05/30/2023]
Abstract
The procedure to obtain gas temperature in plasmas is to fit the experimental rotational spectrum to a theoretical one based on the Boltzmann distribution. For many systems a single distribution fails to account for the occupation of the levels. Researchers have improved the fitting by coupling two distributions and obtaining two distinct temperatures. They assigned the lowest temperature to the gas. Here, we show that these systems should be described by Tsallis nonextensive statistics and its unique associated temperature. Experimental and simulated spectra are tested and excellent agreement is obtained.
Collapse
Affiliation(s)
- J L Reis
- Departamento de Física, Instituto Tecnológico de Aeronáutica, 12228-900 São José dos Campos, São Paulo, Brazil
| | | | | |
Collapse
|
18
|
Costa B, Viana-Pereira M, Costa S, Lima J, Soares P, Amorim J, Linhares P, Pinheiro C, Oliveira P, Reis R. 95 Associations between functional EGFR polymorphisms and glioma risk. EJC Suppl 2010. [DOI: 10.1016/s1359-6349(10)70903-4] [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] Open
|
19
|
Amorim J, Pitarresi G. Investigation on the indentation behavior of sandwich beams using crushable and hyperelastic foam cores. EPJ Web of Conferences 2010. [DOI: 10.1051/epjconf/20100624002] [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: 11/14/2022] Open
|
20
|
Martinho O, Longatto-Filho A, Lambros MBK, Martins A, Pinheiro C, Silva A, Pardal F, Amorim J, Mackay A, Milanezi F, Tamber N, Fenwick K, Ashworth A, Reis-Filho JS, Lopes JM, Reis RM. Expression, mutation and copy number analysis of platelet-derived growth factor receptor A (PDGFRA) and its ligand PDGFA in gliomas. Br J Cancer 2009; 101:973-82. [PMID: 19707201 PMCID: PMC2743351 DOI: 10.1038/sj.bjc.6605225] [Citation(s) in RCA: 91] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 05/21/2009] [Accepted: 07/08/2009] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Malignant gliomas are the most prevalent type of primary brain tumours but the therapeutic armamentarium for these tumours is limited. Platelet-derived growth factor (PDGF) signalling has been shown to be a key regulator of glioma development. Clinical trials evaluating the efficacy of anti-PDGFRA therapies on gliomas are ongoing. In this study, we intended to analyse the expression of PDGFA and its receptor PDGFRA, as well as the underlying genetic (mutations and amplification) mechanisms driving their expression in a large series of human gliomas. METHODS PDGFA and PDGFRA expression was evaluated by immunohistochemistry in a series of 160 gliomas of distinct World Health Organization (WHO) malignancy grade. PDGFRA-activating gene mutations (exons 12, 18 and 23) were assessed in a subset of 86 cases by PCR-single-strand conformational polymorphism (PCR-SSCP), followed by direct sequencing. PDGFRA gene amplification analysis was performed in 57 cases by quantitative real-time PCR (QPCR) and further validated in a subset of cases by chromogenic in situ hybridisation (CISH) and microarray-based comparative genomic hybridisation (aCGH). RESULTS PDGFA and PDGFRA expression was found in 81.2% (130 out of 160) and 29.6% (48 out of 160) of gliomas, respectively. Its expression was significantly correlated with histological type of the tumours; however, no significant association between the expression of the ligand and its receptor was observed. The absence of PDGFA expression was significantly associated with the age of patients and with poor prognosis. Although PDGFRA gene-activating mutations were not found, PDGFRA gene amplification was observed in 21.1% (12 out of 57) of gliomas. No association was found between the presence of PDGFRA gene amplification and expression, excepting for grade II diffuse astrocytomas. CONCLUSION The concurrent expression of PDGFA and PDGFRA in different subtypes of gliomas, reinforce the recognised significance of this signalling pathway in gliomas. PDGFRA gene amplification rather than gene mutation may be the underlying genetic mechanism driving PDGFRA overexpression in a portion of gliomas. Taken together, our results could provide in the future a molecular basis for PDGFRA-targeted therapies in gliomas.
Collapse
Affiliation(s)
- O Martinho
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, 4710 Braga, Portugal
| | - A Longatto-Filho
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, 4710 Braga, Portugal
- Instituto Adolfo Lutz, 355-01246-902 São Paulo, Brazil
| | - M B K Lambros
- The Breakthrough Breast Cancer Research Centre, Institute of Cancer Research, London SW3 6JB, UK
| | - A Martins
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, 4710 Braga, Portugal
| | - C Pinheiro
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, 4710 Braga, Portugal
| | - A Silva
- Department of Pathology, S. Marcos Hospital, 4710 Braga, Portugal
| | - F Pardal
- Department of Pathology, S. Marcos Hospital, 4710 Braga, Portugal
| | - J Amorim
- Department of Oncology, S. Marcos Hospital, 4710 Braga, Portugal
| | - A Mackay
- The Breakthrough Breast Cancer Research Centre, Institute of Cancer Research, London SW3 6JB, UK
| | - F Milanezi
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, 4710 Braga, Portugal
- IPATIMUP, 4200 Porto, Portugal
| | - N Tamber
- The Breakthrough Breast Cancer Research Centre, Institute of Cancer Research, London SW3 6JB, UK
| | - K Fenwick
- The Breakthrough Breast Cancer Research Centre, Institute of Cancer Research, London SW3 6JB, UK
| | - A Ashworth
- The Breakthrough Breast Cancer Research Centre, Institute of Cancer Research, London SW3 6JB, UK
| | - J S Reis-Filho
- The Breakthrough Breast Cancer Research Centre, Institute of Cancer Research, London SW3 6JB, UK
| | - J M Lopes
- IPATIMUP, 4200 Porto, Portugal
- Medical Faculties of Porto University, 4200 Porto, Portugal
| | - R M Reis
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, 4710 Braga, Portugal
| |
Collapse
|
21
|
Abstract
Introduction:Drug-induced increased libido has been reported mainly with dopaminergic agents. Although benzodiazepines may cause behavioural dishinibition, they were rarely related to sexual undesired urges.Case:A 62-year-old woman was seen for breast mucinous carcinoma. Besides mild hypertension and initial insomnia she was otherwise previously healthy. She was chronically medicated with ramipril and diazepam 5mg id. Tumour ressection was carried out and chemotherapy with FEC-T was began. One week after, in a follow-up visit, she complained having difficulties on sleep onset. Lorazepam 1mg at the bedtime was prescribed. After the first dose she felt an overwhelming sexual desire, the urge making her to repeatedly open and close her legs, feeling even the physical intercourse. This sensation fade gradually over the next few hours. On the following day she decided to take another lorazepam pill to be sure it was the cause of that strange feelings. The symptoms of the previous night were completely reproduced. She has now completed the chemotherapy and proposed to adjuvant radiotherapy. She never felt those symptoms again and did not take another lorazepam.Conclusion:It is believed that dopaminomimetic drugs can heighten sexual desire by increasing dopamine concentration on the mesolimbic pathway. In this way, benzodiazepines, as GABA enhancers, would inhibit dopamine release leading to reduced libido. On the other hand, GABA also inhibits serotoninergic-mediated vigilance and impulse control, leading to dishinibition and impulsivity. In our patient, lorazepam has caused a “virtual intercourse” as previously found in electric and mechanic stimulation of septal region and amygdala.
Collapse
|
22
|
Livermore DM, Struelens M, Amorim J, Baquero F, Bille J, Canton R, Henning S, Gatermann S, Marchese A, Mittermayer H, Nonhoff C, Oakton KJ, Praplan F, Ramos H, Schito GC, Van Eldere J, Verhaegen J, Verhoef J, Visser MR. Multicentre evaluation of the VITEK 2 Advanced Expert System for interpretive reading of antimicrobial resistance tests. J Antimicrob Chemother 2002; 49:289-300. [PMID: 11815570 DOI: 10.1093/jac/49.2.289] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.2] [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: 11/12/2022] Open
Abstract
Interpretive reading analyses the complete resistance profiles of bacteria to multiple antibiotics and infers the resistance mechanisms present; it aids therapeutic choice and enhances surveillance data. We evaluated the Advanced Expert System (AES), which interprets MICs generated by the VITEK 2. Ten European laboratories tested 42 reference strains and 76-106 of their own strains, representing important resistance genotypes. Interpretive reading by the VITEK 2 AES achieved full agreement with genotype data for 88-89% of strains, with the correct mechanism identified as one of two possibilities for a further 5-6%. Mechanisms inferred with 90% agreement with reference data included methicillin resistance in staphylococci, glycopeptide resistance in enterococci, quinolone resistance in staphylococci and Enterobacteriaceae, AAC(6')-APH(2")-mediated aminoglycoside resistance in Gram-positive cocci, erm-mediated macrolide resistance in pneumococci, extended-spectrum beta-lactamases (ESBLs) in Enterobacteriaceae and Pseudomonas aeruginosa, and acquired penicillinases in Enterobacteriaceae. VanA, VanB and VanC phenotypes of enterococci were distinguished reliably, and ESBL production was accurately inferred in AmpC-inducible species as well as Escherichia coli and Klebsiella spp. Mechanisms identified, but only as possibilities among several, included IRT-type beta-lactamases and individual aminoglycoside-modifying enzymes in Enterobacteriaceae. Most disagreements with reference data concerned pneumococci found to have high-level penicillin resistance by the VITEK 2 AES but previously determined, phenotypically, to have intermediate resistance. When ESBL production was inferred in E. coli and klebsiellae, the VITEK 2 AES edited susceptible results for cephalosporins (except cefoxitin) to resistant; when an acquired penicillinase was inferred in Enterobacteriaceae, piperacillin results were edited to resistant; and when staphylococci were found methicillin resistant, resistance was reported for all beta-lactams. Further editing may be desirable (e.g. of cephalosporin results for salmonellas inferred to have ESBLs).
Collapse
Affiliation(s)
- D M Livermore
- Antibiotic Resistance Monitoring & Reference Laboratory, Central Public Health Laboratory, 61 Colindale Avenue, London NW9 5HT, UK.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
23
|
Amorim J, Loureiro J, Schram D. Formation of H− ions via vibrational excited molecules produced from recombinative wall desorption of H atoms in a low-pressure H2 positive column. Chem Phys Lett 2001. [DOI: 10.1016/s0009-2614(01)00977-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
24
|
Amorim J, Lino J, Loureiro J, Lima M, da Paixão F. Superelastic collisions of electrons with the c metastable state in hydrogen dc positive column. Chem Phys 1999. [DOI: 10.1016/s0301-0104(99)00166-4] [Citation(s) in RCA: 7] [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: 10/17/2022]
|
25
|
Loureiro J, Amorim J. Dependence of volume-produced H− ions on the wall recombination probability of H atoms in a low pressure H2 positive column. Chem Phys 1998. [DOI: 10.1016/s0301-0104(98)00088-3] [Citation(s) in RCA: 8] [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: 10/18/2022]
|
26
|
Broeiro P, Ramos V, Tavares I, Cunha E, Amorim J. [The assessment of functional status in the elderly. The application of a Portuguese version of the COOP/WONCA charts]. ACTA MEDICA PORT 1995; 8:279-88. [PMID: 7625227] [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: 01/26/2023]
Abstract
INTRODUCTION The outcomes of medical care can be measured in terms of health or functional status. Several outcomes measures have been developed in the last years but, there are several difficulties with cross-cultural adaptations. This study is mainly an application exercise to a group of old people of a Portuguese version of the COOP/WONCA charts. METHODS A descriptive cross-sectional study with a component of qualitative analysis was done. Population basis was the elderly registered in the lists of five family doctors in two Portuguese health centres (Lumiar and Costa da Caparica) in the Lisbon region. A random sample of 189 patients (aged 65 and over) was interviewed. The studied variables were: gender, age, civil status, literacy, co-morbidity and dimensions of the COOP/WONCA charts. Univariate and bivariate analysis was done. A qualitative analysis was also performed to approach relevancy and acceptability of the charts to the elderly. RESULTS 23% of the elderly had important limitations (values 4 and 5 of the charts) in physical fitness, 25% had unfavourable repercussions in feelings (values 4 and 5), 12% had important difficulties (value 4 and 5) in every-day life activities and 7% had important limitations in social life. 66% had no changes in their health in the last two weeks, 18% got better and 16% got worse. 21% valued their overall health as fair or poor, 47% as good and 24% as very good or excellent. Moderate to severe pain in the last two weeks was reported by 55% of the patients. Female reported in general worse scores than males. Statistical significance was found in the association between the number of the co-existent health problems in the same person (co-morbidity) and the values of some dimensions of the COOP/WONCA charts. In the half of the cases where the Katz index was measured there were non-concordance with the measures of the daily life of the COOP/WONCA charts. The charts had good acceptability and applicability but also some difficulties for illiterate elderly. DISCUSSION Although the use of COOP/WONCA charts could be difficult with elderly patients the present study showed its applicability and utility in the everyday clinical practice. The charts open new possibilities for international comparisons on functional status assessment.
Collapse
|
27
|
Amorim J, Pinotti JA, Schapiro M, Casanova R. [Fecaloma in acquired megacolon as a factor in dystocia in labor. Report of a case]. Matern Infanc (Sao Paulo) 1968; 26:353-5. [PMID: 5754144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
|