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Faria N, Sucena M, Gomes J. Main bronchus fistula: An open window to the lung parenchyma. Pulmonology 2024; 30:317-318. [PMID: 37684106 DOI: 10.1016/j.pulmoe.2023.07.007] [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: 06/28/2023] [Revised: 07/19/2023] [Accepted: 07/21/2023] [Indexed: 09/10/2023] Open
Affiliation(s)
- N Faria
- Pulmonology Department, Centro Hospitalar Universitário de Santo António, Porto, Portugal.
| | - M Sucena
- Pulmonology Department, Centro Hospitalar Universitário de Santo António, Porto, Portugal
| | - J Gomes
- Pulmonology Department, Centro Hospitalar Universitário de Santo António, Porto, Portugal
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Pradilla G, Ratcliff JJ, Hall AJ, Saville BR, Allen JW, Paulon G, McGlothlin A, Lewis RJ, Fitzgerald M, Caveney AF, Li XT, Bain M, Gomes J, Jankowitz B, Zenonos G, Molyneaux BJ, Davies J, Siddiqui A, Chicoine MR, Keyrouz SG, Grossberg JA, Shah MV, Singh R, Bohnstedt BN, Frankel M, Wright DW, Barrow DL. Trial of Early Minimally Invasive Removal of Intracerebral Hemorrhage. N Engl J Med 2024; 390:1277-1289. [PMID: 38598795 DOI: 10.1056/nejmoa2308440] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
BACKGROUND Trials of surgical evacuation of supratentorial intracerebral hemorrhages have generally shown no functional benefit. Whether early minimally invasive surgical removal would result in better outcomes than medical management is not known. METHODS In this multicenter, randomized trial involving patients with an acute intracerebral hemorrhage, we assessed surgical removal of the hematoma as compared with medical management. Patients who had a lobar or anterior basal ganglia hemorrhage with a hematoma volume of 30 to 80 ml were assigned, in a 1:1 ratio, within 24 hours after the time that they were last known to be well, to minimally invasive surgical removal of the hematoma plus guideline-based medical management (surgery group) or to guideline-based medical management alone (control group). The primary efficacy end point was the mean score on the utility-weighted modified Rankin scale (range, 0 to 1, with higher scores indicating better outcomes, according to patients' assessment) at 180 days, with a prespecified threshold for posterior probability of superiority of 0.975 or higher. The trial included rules for adaptation of enrollment criteria on the basis of hemorrhage location. A primary safety end point was death within 30 days after enrollment. RESULTS A total of 300 patients were enrolled, of whom 30.7% had anterior basal ganglia hemorrhages and 69.3% had lobar hemorrhages. After 175 patients had been enrolled, an adaptation rule was triggered, and only persons with lobar hemorrhages were enrolled. The mean score on the utility-weighted modified Rankin scale at 180 days was 0.458 in the surgery group and 0.374 in the control group (difference, 0.084; 95% Bayesian credible interval, 0.005 to 0.163; posterior probability of superiority of surgery, 0.981). The mean between-group difference was 0.127 (95% Bayesian credible interval, 0.035 to 0.219) among patients with lobar hemorrhages and -0.013 (95% Bayesian credible interval, -0.147 to 0.116) among those with anterior basal ganglia hemorrhages. The percentage of patients who had died by 30 days was 9.3% in the surgery group and 18.0% in the control group. Five patients (3.3%) in the surgery group had postoperative rebleeding and neurologic deterioration. CONCLUSIONS Among patients in whom surgery could be performed within 24 hours after an acute intracerebral hemorrhage, minimally invasive hematoma evacuation resulted in better functional outcomes at 180 days than those with guideline-based medical management. The effect of surgery appeared to be attributable to intervention for lobar hemorrhages. (Funded by Nico; ENRICH ClinicalTrials.gov number, NCT02880878.).
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Affiliation(s)
- Gustavo Pradilla
- From the Departments of Neurosurgery (G. Pradilla, J.A.G., D.L.B.), Emergency Medicine (J.J.R., A.J.H., D.W.W.), Neurology (J.J.R., J.W.A., M. Frankel), and Radiology (J.W.A., X.T.L.), Emory University School of Medicine, and the Marcus Stroke and Neuroscience Center, Grady Memorial Hospital (G. Pradilla, J.J.R., A.J.H., J.A.G., M. Frankel, D.W.W.) - both in Atlanta; Berry Consultants, Austin, TX (B.R.S., G. Paulon, A.M., R.J.L., M. Fitzgerald); the Department of Biostatistics, Vanderbilt University School of Medicine, Nashville (B.R.S.); the Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, CA (R.J.L.); the Department of Psychiatry, University of Michigan, Ann Arbor (A.F.C.); the Cerebrovascular Center, Cleveland Clinic, Cleveland (M.B., J.G.); the Department of Neurosurgery, University of Pennsylvania, Philadelphia (B.J.); the Department of Neurological Surgery, University of Pittsburgh, Pittsburgh (G.Z.); the Department of Neurology, Brigham and Women's Hospital, Boston (B.J.M.); the Department of Neurosurgery, State University of New York at Buffalo, Buffalo (J.D., A.S.); the Department of Neurosurgery, University of Missouri, Columbia (M.R.C.), and the Department of Neurology, Washington University, St. Louis (S.G.K.); and the Departments of Neurosurgery (M.V.S., B.N.B.) and Pulmonary and Critical Care Medicine (R.S.), Indiana University, Indianapolis
| | - Jonathan J Ratcliff
- From the Departments of Neurosurgery (G. Pradilla, J.A.G., D.L.B.), Emergency Medicine (J.J.R., A.J.H., D.W.W.), Neurology (J.J.R., J.W.A., M. Frankel), and Radiology (J.W.A., X.T.L.), Emory University School of Medicine, and the Marcus Stroke and Neuroscience Center, Grady Memorial Hospital (G. Pradilla, J.J.R., A.J.H., J.A.G., M. Frankel, D.W.W.) - both in Atlanta; Berry Consultants, Austin, TX (B.R.S., G. Paulon, A.M., R.J.L., M. Fitzgerald); the Department of Biostatistics, Vanderbilt University School of Medicine, Nashville (B.R.S.); the Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, CA (R.J.L.); the Department of Psychiatry, University of Michigan, Ann Arbor (A.F.C.); the Cerebrovascular Center, Cleveland Clinic, Cleveland (M.B., J.G.); the Department of Neurosurgery, University of Pennsylvania, Philadelphia (B.J.); the Department of Neurological Surgery, University of Pittsburgh, Pittsburgh (G.Z.); the Department of Neurology, Brigham and Women's Hospital, Boston (B.J.M.); the Department of Neurosurgery, State University of New York at Buffalo, Buffalo (J.D., A.S.); the Department of Neurosurgery, University of Missouri, Columbia (M.R.C.), and the Department of Neurology, Washington University, St. Louis (S.G.K.); and the Departments of Neurosurgery (M.V.S., B.N.B.) and Pulmonary and Critical Care Medicine (R.S.), Indiana University, Indianapolis
| | - Alex J Hall
- From the Departments of Neurosurgery (G. Pradilla, J.A.G., D.L.B.), Emergency Medicine (J.J.R., A.J.H., D.W.W.), Neurology (J.J.R., J.W.A., M. Frankel), and Radiology (J.W.A., X.T.L.), Emory University School of Medicine, and the Marcus Stroke and Neuroscience Center, Grady Memorial Hospital (G. Pradilla, J.J.R., A.J.H., J.A.G., M. Frankel, D.W.W.) - both in Atlanta; Berry Consultants, Austin, TX (B.R.S., G. Paulon, A.M., R.J.L., M. Fitzgerald); the Department of Biostatistics, Vanderbilt University School of Medicine, Nashville (B.R.S.); the Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, CA (R.J.L.); the Department of Psychiatry, University of Michigan, Ann Arbor (A.F.C.); the Cerebrovascular Center, Cleveland Clinic, Cleveland (M.B., J.G.); the Department of Neurosurgery, University of Pennsylvania, Philadelphia (B.J.); the Department of Neurological Surgery, University of Pittsburgh, Pittsburgh (G.Z.); the Department of Neurology, Brigham and Women's Hospital, Boston (B.J.M.); the Department of Neurosurgery, State University of New York at Buffalo, Buffalo (J.D., A.S.); the Department of Neurosurgery, University of Missouri, Columbia (M.R.C.), and the Department of Neurology, Washington University, St. Louis (S.G.K.); and the Departments of Neurosurgery (M.V.S., B.N.B.) and Pulmonary and Critical Care Medicine (R.S.), Indiana University, Indianapolis
| | - Benjamin R Saville
- From the Departments of Neurosurgery (G. Pradilla, J.A.G., D.L.B.), Emergency Medicine (J.J.R., A.J.H., D.W.W.), Neurology (J.J.R., J.W.A., M. Frankel), and Radiology (J.W.A., X.T.L.), Emory University School of Medicine, and the Marcus Stroke and Neuroscience Center, Grady Memorial Hospital (G. Pradilla, J.J.R., A.J.H., J.A.G., M. Frankel, D.W.W.) - both in Atlanta; Berry Consultants, Austin, TX (B.R.S., G. Paulon, A.M., R.J.L., M. Fitzgerald); the Department of Biostatistics, Vanderbilt University School of Medicine, Nashville (B.R.S.); the Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, CA (R.J.L.); the Department of Psychiatry, University of Michigan, Ann Arbor (A.F.C.); the Cerebrovascular Center, Cleveland Clinic, Cleveland (M.B., J.G.); the Department of Neurosurgery, University of Pennsylvania, Philadelphia (B.J.); the Department of Neurological Surgery, University of Pittsburgh, Pittsburgh (G.Z.); the Department of Neurology, Brigham and Women's Hospital, Boston (B.J.M.); the Department of Neurosurgery, State University of New York at Buffalo, Buffalo (J.D., A.S.); the Department of Neurosurgery, University of Missouri, Columbia (M.R.C.), and the Department of Neurology, Washington University, St. Louis (S.G.K.); and the Departments of Neurosurgery (M.V.S., B.N.B.) and Pulmonary and Critical Care Medicine (R.S.), Indiana University, Indianapolis
| | - Jason W Allen
- From the Departments of Neurosurgery (G. Pradilla, J.A.G., D.L.B.), Emergency Medicine (J.J.R., A.J.H., D.W.W.), Neurology (J.J.R., J.W.A., M. Frankel), and Radiology (J.W.A., X.T.L.), Emory University School of Medicine, and the Marcus Stroke and Neuroscience Center, Grady Memorial Hospital (G. Pradilla, J.J.R., A.J.H., J.A.G., M. Frankel, D.W.W.) - both in Atlanta; Berry Consultants, Austin, TX (B.R.S., G. Paulon, A.M., R.J.L., M. Fitzgerald); the Department of Biostatistics, Vanderbilt University School of Medicine, Nashville (B.R.S.); the Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, CA (R.J.L.); the Department of Psychiatry, University of Michigan, Ann Arbor (A.F.C.); the Cerebrovascular Center, Cleveland Clinic, Cleveland (M.B., J.G.); the Department of Neurosurgery, University of Pennsylvania, Philadelphia (B.J.); the Department of Neurological Surgery, University of Pittsburgh, Pittsburgh (G.Z.); the Department of Neurology, Brigham and Women's Hospital, Boston (B.J.M.); the Department of Neurosurgery, State University of New York at Buffalo, Buffalo (J.D., A.S.); the Department of Neurosurgery, University of Missouri, Columbia (M.R.C.), and the Department of Neurology, Washington University, St. Louis (S.G.K.); and the Departments of Neurosurgery (M.V.S., B.N.B.) and Pulmonary and Critical Care Medicine (R.S.), Indiana University, Indianapolis
| | - Giorgio Paulon
- From the Departments of Neurosurgery (G. Pradilla, J.A.G., D.L.B.), Emergency Medicine (J.J.R., A.J.H., D.W.W.), Neurology (J.J.R., J.W.A., M. Frankel), and Radiology (J.W.A., X.T.L.), Emory University School of Medicine, and the Marcus Stroke and Neuroscience Center, Grady Memorial Hospital (G. Pradilla, J.J.R., A.J.H., J.A.G., M. Frankel, D.W.W.) - both in Atlanta; Berry Consultants, Austin, TX (B.R.S., G. Paulon, A.M., R.J.L., M. Fitzgerald); the Department of Biostatistics, Vanderbilt University School of Medicine, Nashville (B.R.S.); the Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, CA (R.J.L.); the Department of Psychiatry, University of Michigan, Ann Arbor (A.F.C.); the Cerebrovascular Center, Cleveland Clinic, Cleveland (M.B., J.G.); the Department of Neurosurgery, University of Pennsylvania, Philadelphia (B.J.); the Department of Neurological Surgery, University of Pittsburgh, Pittsburgh (G.Z.); the Department of Neurology, Brigham and Women's Hospital, Boston (B.J.M.); the Department of Neurosurgery, State University of New York at Buffalo, Buffalo (J.D., A.S.); the Department of Neurosurgery, University of Missouri, Columbia (M.R.C.), and the Department of Neurology, Washington University, St. Louis (S.G.K.); and the Departments of Neurosurgery (M.V.S., B.N.B.) and Pulmonary and Critical Care Medicine (R.S.), Indiana University, Indianapolis
| | - Anna McGlothlin
- From the Departments of Neurosurgery (G. Pradilla, J.A.G., D.L.B.), Emergency Medicine (J.J.R., A.J.H., D.W.W.), Neurology (J.J.R., J.W.A., M. Frankel), and Radiology (J.W.A., X.T.L.), Emory University School of Medicine, and the Marcus Stroke and Neuroscience Center, Grady Memorial Hospital (G. Pradilla, J.J.R., A.J.H., J.A.G., M. Frankel, D.W.W.) - both in Atlanta; Berry Consultants, Austin, TX (B.R.S., G. Paulon, A.M., R.J.L., M. Fitzgerald); the Department of Biostatistics, Vanderbilt University School of Medicine, Nashville (B.R.S.); the Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, CA (R.J.L.); the Department of Psychiatry, University of Michigan, Ann Arbor (A.F.C.); the Cerebrovascular Center, Cleveland Clinic, Cleveland (M.B., J.G.); the Department of Neurosurgery, University of Pennsylvania, Philadelphia (B.J.); the Department of Neurological Surgery, University of Pittsburgh, Pittsburgh (G.Z.); the Department of Neurology, Brigham and Women's Hospital, Boston (B.J.M.); the Department of Neurosurgery, State University of New York at Buffalo, Buffalo (J.D., A.S.); the Department of Neurosurgery, University of Missouri, Columbia (M.R.C.), and the Department of Neurology, Washington University, St. Louis (S.G.K.); and the Departments of Neurosurgery (M.V.S., B.N.B.) and Pulmonary and Critical Care Medicine (R.S.), Indiana University, Indianapolis
| | - Roger J Lewis
- From the Departments of Neurosurgery (G. Pradilla, J.A.G., D.L.B.), Emergency Medicine (J.J.R., A.J.H., D.W.W.), Neurology (J.J.R., J.W.A., M. Frankel), and Radiology (J.W.A., X.T.L.), Emory University School of Medicine, and the Marcus Stroke and Neuroscience Center, Grady Memorial Hospital (G. Pradilla, J.J.R., A.J.H., J.A.G., M. Frankel, D.W.W.) - both in Atlanta; Berry Consultants, Austin, TX (B.R.S., G. Paulon, A.M., R.J.L., M. Fitzgerald); the Department of Biostatistics, Vanderbilt University School of Medicine, Nashville (B.R.S.); the Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, CA (R.J.L.); the Department of Psychiatry, University of Michigan, Ann Arbor (A.F.C.); the Cerebrovascular Center, Cleveland Clinic, Cleveland (M.B., J.G.); the Department of Neurosurgery, University of Pennsylvania, Philadelphia (B.J.); the Department of Neurological Surgery, University of Pittsburgh, Pittsburgh (G.Z.); the Department of Neurology, Brigham and Women's Hospital, Boston (B.J.M.); the Department of Neurosurgery, State University of New York at Buffalo, Buffalo (J.D., A.S.); the Department of Neurosurgery, University of Missouri, Columbia (M.R.C.), and the Department of Neurology, Washington University, St. Louis (S.G.K.); and the Departments of Neurosurgery (M.V.S., B.N.B.) and Pulmonary and Critical Care Medicine (R.S.), Indiana University, Indianapolis
| | - Mark Fitzgerald
- From the Departments of Neurosurgery (G. Pradilla, J.A.G., D.L.B.), Emergency Medicine (J.J.R., A.J.H., D.W.W.), Neurology (J.J.R., J.W.A., M. Frankel), and Radiology (J.W.A., X.T.L.), Emory University School of Medicine, and the Marcus Stroke and Neuroscience Center, Grady Memorial Hospital (G. Pradilla, J.J.R., A.J.H., J.A.G., M. Frankel, D.W.W.) - both in Atlanta; Berry Consultants, Austin, TX (B.R.S., G. Paulon, A.M., R.J.L., M. Fitzgerald); the Department of Biostatistics, Vanderbilt University School of Medicine, Nashville (B.R.S.); the Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, CA (R.J.L.); the Department of Psychiatry, University of Michigan, Ann Arbor (A.F.C.); the Cerebrovascular Center, Cleveland Clinic, Cleveland (M.B., J.G.); the Department of Neurosurgery, University of Pennsylvania, Philadelphia (B.J.); the Department of Neurological Surgery, University of Pittsburgh, Pittsburgh (G.Z.); the Department of Neurology, Brigham and Women's Hospital, Boston (B.J.M.); the Department of Neurosurgery, State University of New York at Buffalo, Buffalo (J.D., A.S.); the Department of Neurosurgery, University of Missouri, Columbia (M.R.C.), and the Department of Neurology, Washington University, St. Louis (S.G.K.); and the Departments of Neurosurgery (M.V.S., B.N.B.) and Pulmonary and Critical Care Medicine (R.S.), Indiana University, Indianapolis
| | - Angela F Caveney
- From the Departments of Neurosurgery (G. Pradilla, J.A.G., D.L.B.), Emergency Medicine (J.J.R., A.J.H., D.W.W.), Neurology (J.J.R., J.W.A., M. Frankel), and Radiology (J.W.A., X.T.L.), Emory University School of Medicine, and the Marcus Stroke and Neuroscience Center, Grady Memorial Hospital (G. Pradilla, J.J.R., A.J.H., J.A.G., M. Frankel, D.W.W.) - both in Atlanta; Berry Consultants, Austin, TX (B.R.S., G. Paulon, A.M., R.J.L., M. Fitzgerald); the Department of Biostatistics, Vanderbilt University School of Medicine, Nashville (B.R.S.); the Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, CA (R.J.L.); the Department of Psychiatry, University of Michigan, Ann Arbor (A.F.C.); the Cerebrovascular Center, Cleveland Clinic, Cleveland (M.B., J.G.); the Department of Neurosurgery, University of Pennsylvania, Philadelphia (B.J.); the Department of Neurological Surgery, University of Pittsburgh, Pittsburgh (G.Z.); the Department of Neurology, Brigham and Women's Hospital, Boston (B.J.M.); the Department of Neurosurgery, State University of New York at Buffalo, Buffalo (J.D., A.S.); the Department of Neurosurgery, University of Missouri, Columbia (M.R.C.), and the Department of Neurology, Washington University, St. Louis (S.G.K.); and the Departments of Neurosurgery (M.V.S., B.N.B.) and Pulmonary and Critical Care Medicine (R.S.), Indiana University, Indianapolis
| | - Xiao T Li
- From the Departments of Neurosurgery (G. Pradilla, J.A.G., D.L.B.), Emergency Medicine (J.J.R., A.J.H., D.W.W.), Neurology (J.J.R., J.W.A., M. Frankel), and Radiology (J.W.A., X.T.L.), Emory University School of Medicine, and the Marcus Stroke and Neuroscience Center, Grady Memorial Hospital (G. Pradilla, J.J.R., A.J.H., J.A.G., M. Frankel, D.W.W.) - both in Atlanta; Berry Consultants, Austin, TX (B.R.S., G. Paulon, A.M., R.J.L., M. Fitzgerald); the Department of Biostatistics, Vanderbilt University School of Medicine, Nashville (B.R.S.); the Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, CA (R.J.L.); the Department of Psychiatry, University of Michigan, Ann Arbor (A.F.C.); the Cerebrovascular Center, Cleveland Clinic, Cleveland (M.B., J.G.); the Department of Neurosurgery, University of Pennsylvania, Philadelphia (B.J.); the Department of Neurological Surgery, University of Pittsburgh, Pittsburgh (G.Z.); the Department of Neurology, Brigham and Women's Hospital, Boston (B.J.M.); the Department of Neurosurgery, State University of New York at Buffalo, Buffalo (J.D., A.S.); the Department of Neurosurgery, University of Missouri, Columbia (M.R.C.), and the Department of Neurology, Washington University, St. Louis (S.G.K.); and the Departments of Neurosurgery (M.V.S., B.N.B.) and Pulmonary and Critical Care Medicine (R.S.), Indiana University, Indianapolis
| | - Mark Bain
- From the Departments of Neurosurgery (G. Pradilla, J.A.G., D.L.B.), Emergency Medicine (J.J.R., A.J.H., D.W.W.), Neurology (J.J.R., J.W.A., M. Frankel), and Radiology (J.W.A., X.T.L.), Emory University School of Medicine, and the Marcus Stroke and Neuroscience Center, Grady Memorial Hospital (G. Pradilla, J.J.R., A.J.H., J.A.G., M. Frankel, D.W.W.) - both in Atlanta; Berry Consultants, Austin, TX (B.R.S., G. Paulon, A.M., R.J.L., M. Fitzgerald); the Department of Biostatistics, Vanderbilt University School of Medicine, Nashville (B.R.S.); the Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, CA (R.J.L.); the Department of Psychiatry, University of Michigan, Ann Arbor (A.F.C.); the Cerebrovascular Center, Cleveland Clinic, Cleveland (M.B., J.G.); the Department of Neurosurgery, University of Pennsylvania, Philadelphia (B.J.); the Department of Neurological Surgery, University of Pittsburgh, Pittsburgh (G.Z.); the Department of Neurology, Brigham and Women's Hospital, Boston (B.J.M.); the Department of Neurosurgery, State University of New York at Buffalo, Buffalo (J.D., A.S.); the Department of Neurosurgery, University of Missouri, Columbia (M.R.C.), and the Department of Neurology, Washington University, St. Louis (S.G.K.); and the Departments of Neurosurgery (M.V.S., B.N.B.) and Pulmonary and Critical Care Medicine (R.S.), Indiana University, Indianapolis
| | - Joao Gomes
- From the Departments of Neurosurgery (G. Pradilla, J.A.G., D.L.B.), Emergency Medicine (J.J.R., A.J.H., D.W.W.), Neurology (J.J.R., J.W.A., M. Frankel), and Radiology (J.W.A., X.T.L.), Emory University School of Medicine, and the Marcus Stroke and Neuroscience Center, Grady Memorial Hospital (G. Pradilla, J.J.R., A.J.H., J.A.G., M. Frankel, D.W.W.) - both in Atlanta; Berry Consultants, Austin, TX (B.R.S., G. Paulon, A.M., R.J.L., M. Fitzgerald); the Department of Biostatistics, Vanderbilt University School of Medicine, Nashville (B.R.S.); the Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, CA (R.J.L.); the Department of Psychiatry, University of Michigan, Ann Arbor (A.F.C.); the Cerebrovascular Center, Cleveland Clinic, Cleveland (M.B., J.G.); the Department of Neurosurgery, University of Pennsylvania, Philadelphia (B.J.); the Department of Neurological Surgery, University of Pittsburgh, Pittsburgh (G.Z.); the Department of Neurology, Brigham and Women's Hospital, Boston (B.J.M.); the Department of Neurosurgery, State University of New York at Buffalo, Buffalo (J.D., A.S.); the Department of Neurosurgery, University of Missouri, Columbia (M.R.C.), and the Department of Neurology, Washington University, St. Louis (S.G.K.); and the Departments of Neurosurgery (M.V.S., B.N.B.) and Pulmonary and Critical Care Medicine (R.S.), Indiana University, Indianapolis
| | - Brain Jankowitz
- From the Departments of Neurosurgery (G. Pradilla, J.A.G., D.L.B.), Emergency Medicine (J.J.R., A.J.H., D.W.W.), Neurology (J.J.R., J.W.A., M. Frankel), and Radiology (J.W.A., X.T.L.), Emory University School of Medicine, and the Marcus Stroke and Neuroscience Center, Grady Memorial Hospital (G. Pradilla, J.J.R., A.J.H., J.A.G., M. Frankel, D.W.W.) - both in Atlanta; Berry Consultants, Austin, TX (B.R.S., G. Paulon, A.M., R.J.L., M. Fitzgerald); the Department of Biostatistics, Vanderbilt University School of Medicine, Nashville (B.R.S.); the Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, CA (R.J.L.); the Department of Psychiatry, University of Michigan, Ann Arbor (A.F.C.); the Cerebrovascular Center, Cleveland Clinic, Cleveland (M.B., J.G.); the Department of Neurosurgery, University of Pennsylvania, Philadelphia (B.J.); the Department of Neurological Surgery, University of Pittsburgh, Pittsburgh (G.Z.); the Department of Neurology, Brigham and Women's Hospital, Boston (B.J.M.); the Department of Neurosurgery, State University of New York at Buffalo, Buffalo (J.D., A.S.); the Department of Neurosurgery, University of Missouri, Columbia (M.R.C.), and the Department of Neurology, Washington University, St. Louis (S.G.K.); and the Departments of Neurosurgery (M.V.S., B.N.B.) and Pulmonary and Critical Care Medicine (R.S.), Indiana University, Indianapolis
| | - Georgios Zenonos
- From the Departments of Neurosurgery (G. Pradilla, J.A.G., D.L.B.), Emergency Medicine (J.J.R., A.J.H., D.W.W.), Neurology (J.J.R., J.W.A., M. Frankel), and Radiology (J.W.A., X.T.L.), Emory University School of Medicine, and the Marcus Stroke and Neuroscience Center, Grady Memorial Hospital (G. Pradilla, J.J.R., A.J.H., J.A.G., M. Frankel, D.W.W.) - both in Atlanta; Berry Consultants, Austin, TX (B.R.S., G. Paulon, A.M., R.J.L., M. Fitzgerald); the Department of Biostatistics, Vanderbilt University School of Medicine, Nashville (B.R.S.); the Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, CA (R.J.L.); the Department of Psychiatry, University of Michigan, Ann Arbor (A.F.C.); the Cerebrovascular Center, Cleveland Clinic, Cleveland (M.B., J.G.); the Department of Neurosurgery, University of Pennsylvania, Philadelphia (B.J.); the Department of Neurological Surgery, University of Pittsburgh, Pittsburgh (G.Z.); the Department of Neurology, Brigham and Women's Hospital, Boston (B.J.M.); the Department of Neurosurgery, State University of New York at Buffalo, Buffalo (J.D., A.S.); the Department of Neurosurgery, University of Missouri, Columbia (M.R.C.), and the Department of Neurology, Washington University, St. Louis (S.G.K.); and the Departments of Neurosurgery (M.V.S., B.N.B.) and Pulmonary and Critical Care Medicine (R.S.), Indiana University, Indianapolis
| | - Bradley J Molyneaux
- From the Departments of Neurosurgery (G. Pradilla, J.A.G., D.L.B.), Emergency Medicine (J.J.R., A.J.H., D.W.W.), Neurology (J.J.R., J.W.A., M. Frankel), and Radiology (J.W.A., X.T.L.), Emory University School of Medicine, and the Marcus Stroke and Neuroscience Center, Grady Memorial Hospital (G. Pradilla, J.J.R., A.J.H., J.A.G., M. Frankel, D.W.W.) - both in Atlanta; Berry Consultants, Austin, TX (B.R.S., G. Paulon, A.M., R.J.L., M. Fitzgerald); the Department of Biostatistics, Vanderbilt University School of Medicine, Nashville (B.R.S.); the Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, CA (R.J.L.); the Department of Psychiatry, University of Michigan, Ann Arbor (A.F.C.); the Cerebrovascular Center, Cleveland Clinic, Cleveland (M.B., J.G.); the Department of Neurosurgery, University of Pennsylvania, Philadelphia (B.J.); the Department of Neurological Surgery, University of Pittsburgh, Pittsburgh (G.Z.); the Department of Neurology, Brigham and Women's Hospital, Boston (B.J.M.); the Department of Neurosurgery, State University of New York at Buffalo, Buffalo (J.D., A.S.); the Department of Neurosurgery, University of Missouri, Columbia (M.R.C.), and the Department of Neurology, Washington University, St. Louis (S.G.K.); and the Departments of Neurosurgery (M.V.S., B.N.B.) and Pulmonary and Critical Care Medicine (R.S.), Indiana University, Indianapolis
| | - Jason Davies
- From the Departments of Neurosurgery (G. Pradilla, J.A.G., D.L.B.), Emergency Medicine (J.J.R., A.J.H., D.W.W.), Neurology (J.J.R., J.W.A., M. Frankel), and Radiology (J.W.A., X.T.L.), Emory University School of Medicine, and the Marcus Stroke and Neuroscience Center, Grady Memorial Hospital (G. Pradilla, J.J.R., A.J.H., J.A.G., M. Frankel, D.W.W.) - both in Atlanta; Berry Consultants, Austin, TX (B.R.S., G. Paulon, A.M., R.J.L., M. Fitzgerald); the Department of Biostatistics, Vanderbilt University School of Medicine, Nashville (B.R.S.); the Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, CA (R.J.L.); the Department of Psychiatry, University of Michigan, Ann Arbor (A.F.C.); the Cerebrovascular Center, Cleveland Clinic, Cleveland (M.B., J.G.); the Department of Neurosurgery, University of Pennsylvania, Philadelphia (B.J.); the Department of Neurological Surgery, University of Pittsburgh, Pittsburgh (G.Z.); the Department of Neurology, Brigham and Women's Hospital, Boston (B.J.M.); the Department of Neurosurgery, State University of New York at Buffalo, Buffalo (J.D., A.S.); the Department of Neurosurgery, University of Missouri, Columbia (M.R.C.), and the Department of Neurology, Washington University, St. Louis (S.G.K.); and the Departments of Neurosurgery (M.V.S., B.N.B.) and Pulmonary and Critical Care Medicine (R.S.), Indiana University, Indianapolis
| | - Adnan Siddiqui
- From the Departments of Neurosurgery (G. Pradilla, J.A.G., D.L.B.), Emergency Medicine (J.J.R., A.J.H., D.W.W.), Neurology (J.J.R., J.W.A., M. Frankel), and Radiology (J.W.A., X.T.L.), Emory University School of Medicine, and the Marcus Stroke and Neuroscience Center, Grady Memorial Hospital (G. Pradilla, J.J.R., A.J.H., J.A.G., M. Frankel, D.W.W.) - both in Atlanta; Berry Consultants, Austin, TX (B.R.S., G. Paulon, A.M., R.J.L., M. Fitzgerald); the Department of Biostatistics, Vanderbilt University School of Medicine, Nashville (B.R.S.); the Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, CA (R.J.L.); the Department of Psychiatry, University of Michigan, Ann Arbor (A.F.C.); the Cerebrovascular Center, Cleveland Clinic, Cleveland (M.B., J.G.); the Department of Neurosurgery, University of Pennsylvania, Philadelphia (B.J.); the Department of Neurological Surgery, University of Pittsburgh, Pittsburgh (G.Z.); the Department of Neurology, Brigham and Women's Hospital, Boston (B.J.M.); the Department of Neurosurgery, State University of New York at Buffalo, Buffalo (J.D., A.S.); the Department of Neurosurgery, University of Missouri, Columbia (M.R.C.), and the Department of Neurology, Washington University, St. Louis (S.G.K.); and the Departments of Neurosurgery (M.V.S., B.N.B.) and Pulmonary and Critical Care Medicine (R.S.), Indiana University, Indianapolis
| | - Michael R Chicoine
- From the Departments of Neurosurgery (G. Pradilla, J.A.G., D.L.B.), Emergency Medicine (J.J.R., A.J.H., D.W.W.), Neurology (J.J.R., J.W.A., M. Frankel), and Radiology (J.W.A., X.T.L.), Emory University School of Medicine, and the Marcus Stroke and Neuroscience Center, Grady Memorial Hospital (G. Pradilla, J.J.R., A.J.H., J.A.G., M. Frankel, D.W.W.) - both in Atlanta; Berry Consultants, Austin, TX (B.R.S., G. Paulon, A.M., R.J.L., M. Fitzgerald); the Department of Biostatistics, Vanderbilt University School of Medicine, Nashville (B.R.S.); the Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, CA (R.J.L.); the Department of Psychiatry, University of Michigan, Ann Arbor (A.F.C.); the Cerebrovascular Center, Cleveland Clinic, Cleveland (M.B., J.G.); the Department of Neurosurgery, University of Pennsylvania, Philadelphia (B.J.); the Department of Neurological Surgery, University of Pittsburgh, Pittsburgh (G.Z.); the Department of Neurology, Brigham and Women's Hospital, Boston (B.J.M.); the Department of Neurosurgery, State University of New York at Buffalo, Buffalo (J.D., A.S.); the Department of Neurosurgery, University of Missouri, Columbia (M.R.C.), and the Department of Neurology, Washington University, St. Louis (S.G.K.); and the Departments of Neurosurgery (M.V.S., B.N.B.) and Pulmonary and Critical Care Medicine (R.S.), Indiana University, Indianapolis
| | - Salah G Keyrouz
- From the Departments of Neurosurgery (G. Pradilla, J.A.G., D.L.B.), Emergency Medicine (J.J.R., A.J.H., D.W.W.), Neurology (J.J.R., J.W.A., M. Frankel), and Radiology (J.W.A., X.T.L.), Emory University School of Medicine, and the Marcus Stroke and Neuroscience Center, Grady Memorial Hospital (G. Pradilla, J.J.R., A.J.H., J.A.G., M. Frankel, D.W.W.) - both in Atlanta; Berry Consultants, Austin, TX (B.R.S., G. Paulon, A.M., R.J.L., M. Fitzgerald); the Department of Biostatistics, Vanderbilt University School of Medicine, Nashville (B.R.S.); the Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, CA (R.J.L.); the Department of Psychiatry, University of Michigan, Ann Arbor (A.F.C.); the Cerebrovascular Center, Cleveland Clinic, Cleveland (M.B., J.G.); the Department of Neurosurgery, University of Pennsylvania, Philadelphia (B.J.); the Department of Neurological Surgery, University of Pittsburgh, Pittsburgh (G.Z.); the Department of Neurology, Brigham and Women's Hospital, Boston (B.J.M.); the Department of Neurosurgery, State University of New York at Buffalo, Buffalo (J.D., A.S.); the Department of Neurosurgery, University of Missouri, Columbia (M.R.C.), and the Department of Neurology, Washington University, St. Louis (S.G.K.); and the Departments of Neurosurgery (M.V.S., B.N.B.) and Pulmonary and Critical Care Medicine (R.S.), Indiana University, Indianapolis
| | - Jonathan A Grossberg
- From the Departments of Neurosurgery (G. Pradilla, J.A.G., D.L.B.), Emergency Medicine (J.J.R., A.J.H., D.W.W.), Neurology (J.J.R., J.W.A., M. Frankel), and Radiology (J.W.A., X.T.L.), Emory University School of Medicine, and the Marcus Stroke and Neuroscience Center, Grady Memorial Hospital (G. Pradilla, J.J.R., A.J.H., J.A.G., M. Frankel, D.W.W.) - both in Atlanta; Berry Consultants, Austin, TX (B.R.S., G. Paulon, A.M., R.J.L., M. Fitzgerald); the Department of Biostatistics, Vanderbilt University School of Medicine, Nashville (B.R.S.); the Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, CA (R.J.L.); the Department of Psychiatry, University of Michigan, Ann Arbor (A.F.C.); the Cerebrovascular Center, Cleveland Clinic, Cleveland (M.B., J.G.); the Department of Neurosurgery, University of Pennsylvania, Philadelphia (B.J.); the Department of Neurological Surgery, University of Pittsburgh, Pittsburgh (G.Z.); the Department of Neurology, Brigham and Women's Hospital, Boston (B.J.M.); the Department of Neurosurgery, State University of New York at Buffalo, Buffalo (J.D., A.S.); the Department of Neurosurgery, University of Missouri, Columbia (M.R.C.), and the Department of Neurology, Washington University, St. Louis (S.G.K.); and the Departments of Neurosurgery (M.V.S., B.N.B.) and Pulmonary and Critical Care Medicine (R.S.), Indiana University, Indianapolis
| | - Mitesh V Shah
- From the Departments of Neurosurgery (G. Pradilla, J.A.G., D.L.B.), Emergency Medicine (J.J.R., A.J.H., D.W.W.), Neurology (J.J.R., J.W.A., M. Frankel), and Radiology (J.W.A., X.T.L.), Emory University School of Medicine, and the Marcus Stroke and Neuroscience Center, Grady Memorial Hospital (G. Pradilla, J.J.R., A.J.H., J.A.G., M. Frankel, D.W.W.) - both in Atlanta; Berry Consultants, Austin, TX (B.R.S., G. Paulon, A.M., R.J.L., M. Fitzgerald); the Department of Biostatistics, Vanderbilt University School of Medicine, Nashville (B.R.S.); the Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, CA (R.J.L.); the Department of Psychiatry, University of Michigan, Ann Arbor (A.F.C.); the Cerebrovascular Center, Cleveland Clinic, Cleveland (M.B., J.G.); the Department of Neurosurgery, University of Pennsylvania, Philadelphia (B.J.); the Department of Neurological Surgery, University of Pittsburgh, Pittsburgh (G.Z.); the Department of Neurology, Brigham and Women's Hospital, Boston (B.J.M.); the Department of Neurosurgery, State University of New York at Buffalo, Buffalo (J.D., A.S.); the Department of Neurosurgery, University of Missouri, Columbia (M.R.C.), and the Department of Neurology, Washington University, St. Louis (S.G.K.); and the Departments of Neurosurgery (M.V.S., B.N.B.) and Pulmonary and Critical Care Medicine (R.S.), Indiana University, Indianapolis
| | - Ranjeet Singh
- From the Departments of Neurosurgery (G. Pradilla, J.A.G., D.L.B.), Emergency Medicine (J.J.R., A.J.H., D.W.W.), Neurology (J.J.R., J.W.A., M. Frankel), and Radiology (J.W.A., X.T.L.), Emory University School of Medicine, and the Marcus Stroke and Neuroscience Center, Grady Memorial Hospital (G. Pradilla, J.J.R., A.J.H., J.A.G., M. Frankel, D.W.W.) - both in Atlanta; Berry Consultants, Austin, TX (B.R.S., G. Paulon, A.M., R.J.L., M. Fitzgerald); the Department of Biostatistics, Vanderbilt University School of Medicine, Nashville (B.R.S.); the Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, CA (R.J.L.); the Department of Psychiatry, University of Michigan, Ann Arbor (A.F.C.); the Cerebrovascular Center, Cleveland Clinic, Cleveland (M.B., J.G.); the Department of Neurosurgery, University of Pennsylvania, Philadelphia (B.J.); the Department of Neurological Surgery, University of Pittsburgh, Pittsburgh (G.Z.); the Department of Neurology, Brigham and Women's Hospital, Boston (B.J.M.); the Department of Neurosurgery, State University of New York at Buffalo, Buffalo (J.D., A.S.); the Department of Neurosurgery, University of Missouri, Columbia (M.R.C.), and the Department of Neurology, Washington University, St. Louis (S.G.K.); and the Departments of Neurosurgery (M.V.S., B.N.B.) and Pulmonary and Critical Care Medicine (R.S.), Indiana University, Indianapolis
| | - Bradley N Bohnstedt
- From the Departments of Neurosurgery (G. Pradilla, J.A.G., D.L.B.), Emergency Medicine (J.J.R., A.J.H., D.W.W.), Neurology (J.J.R., J.W.A., M. Frankel), and Radiology (J.W.A., X.T.L.), Emory University School of Medicine, and the Marcus Stroke and Neuroscience Center, Grady Memorial Hospital (G. Pradilla, J.J.R., A.J.H., J.A.G., M. Frankel, D.W.W.) - both in Atlanta; Berry Consultants, Austin, TX (B.R.S., G. Paulon, A.M., R.J.L., M. Fitzgerald); the Department of Biostatistics, Vanderbilt University School of Medicine, Nashville (B.R.S.); the Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, CA (R.J.L.); the Department of Psychiatry, University of Michigan, Ann Arbor (A.F.C.); the Cerebrovascular Center, Cleveland Clinic, Cleveland (M.B., J.G.); the Department of Neurosurgery, University of Pennsylvania, Philadelphia (B.J.); the Department of Neurological Surgery, University of Pittsburgh, Pittsburgh (G.Z.); the Department of Neurology, Brigham and Women's Hospital, Boston (B.J.M.); the Department of Neurosurgery, State University of New York at Buffalo, Buffalo (J.D., A.S.); the Department of Neurosurgery, University of Missouri, Columbia (M.R.C.), and the Department of Neurology, Washington University, St. Louis (S.G.K.); and the Departments of Neurosurgery (M.V.S., B.N.B.) and Pulmonary and Critical Care Medicine (R.S.), Indiana University, Indianapolis
| | - Michael Frankel
- From the Departments of Neurosurgery (G. Pradilla, J.A.G., D.L.B.), Emergency Medicine (J.J.R., A.J.H., D.W.W.), Neurology (J.J.R., J.W.A., M. Frankel), and Radiology (J.W.A., X.T.L.), Emory University School of Medicine, and the Marcus Stroke and Neuroscience Center, Grady Memorial Hospital (G. Pradilla, J.J.R., A.J.H., J.A.G., M. Frankel, D.W.W.) - both in Atlanta; Berry Consultants, Austin, TX (B.R.S., G. Paulon, A.M., R.J.L., M. Fitzgerald); the Department of Biostatistics, Vanderbilt University School of Medicine, Nashville (B.R.S.); the Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, CA (R.J.L.); the Department of Psychiatry, University of Michigan, Ann Arbor (A.F.C.); the Cerebrovascular Center, Cleveland Clinic, Cleveland (M.B., J.G.); the Department of Neurosurgery, University of Pennsylvania, Philadelphia (B.J.); the Department of Neurological Surgery, University of Pittsburgh, Pittsburgh (G.Z.); the Department of Neurology, Brigham and Women's Hospital, Boston (B.J.M.); the Department of Neurosurgery, State University of New York at Buffalo, Buffalo (J.D., A.S.); the Department of Neurosurgery, University of Missouri, Columbia (M.R.C.), and the Department of Neurology, Washington University, St. Louis (S.G.K.); and the Departments of Neurosurgery (M.V.S., B.N.B.) and Pulmonary and Critical Care Medicine (R.S.), Indiana University, Indianapolis
| | - David W Wright
- From the Departments of Neurosurgery (G. Pradilla, J.A.G., D.L.B.), Emergency Medicine (J.J.R., A.J.H., D.W.W.), Neurology (J.J.R., J.W.A., M. Frankel), and Radiology (J.W.A., X.T.L.), Emory University School of Medicine, and the Marcus Stroke and Neuroscience Center, Grady Memorial Hospital (G. Pradilla, J.J.R., A.J.H., J.A.G., M. Frankel, D.W.W.) - both in Atlanta; Berry Consultants, Austin, TX (B.R.S., G. Paulon, A.M., R.J.L., M. Fitzgerald); the Department of Biostatistics, Vanderbilt University School of Medicine, Nashville (B.R.S.); the Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, CA (R.J.L.); the Department of Psychiatry, University of Michigan, Ann Arbor (A.F.C.); the Cerebrovascular Center, Cleveland Clinic, Cleveland (M.B., J.G.); the Department of Neurosurgery, University of Pennsylvania, Philadelphia (B.J.); the Department of Neurological Surgery, University of Pittsburgh, Pittsburgh (G.Z.); the Department of Neurology, Brigham and Women's Hospital, Boston (B.J.M.); the Department of Neurosurgery, State University of New York at Buffalo, Buffalo (J.D., A.S.); the Department of Neurosurgery, University of Missouri, Columbia (M.R.C.), and the Department of Neurology, Washington University, St. Louis (S.G.K.); and the Departments of Neurosurgery (M.V.S., B.N.B.) and Pulmonary and Critical Care Medicine (R.S.), Indiana University, Indianapolis
| | - Daniel L Barrow
- From the Departments of Neurosurgery (G. Pradilla, J.A.G., D.L.B.), Emergency Medicine (J.J.R., A.J.H., D.W.W.), Neurology (J.J.R., J.W.A., M. Frankel), and Radiology (J.W.A., X.T.L.), Emory University School of Medicine, and the Marcus Stroke and Neuroscience Center, Grady Memorial Hospital (G. Pradilla, J.J.R., A.J.H., J.A.G., M. Frankel, D.W.W.) - both in Atlanta; Berry Consultants, Austin, TX (B.R.S., G. Paulon, A.M., R.J.L., M. Fitzgerald); the Department of Biostatistics, Vanderbilt University School of Medicine, Nashville (B.R.S.); the Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, CA (R.J.L.); the Department of Psychiatry, University of Michigan, Ann Arbor (A.F.C.); the Cerebrovascular Center, Cleveland Clinic, Cleveland (M.B., J.G.); the Department of Neurosurgery, University of Pennsylvania, Philadelphia (B.J.); the Department of Neurological Surgery, University of Pittsburgh, Pittsburgh (G.Z.); the Department of Neurology, Brigham and Women's Hospital, Boston (B.J.M.); the Department of Neurosurgery, State University of New York at Buffalo, Buffalo (J.D., A.S.); the Department of Neurosurgery, University of Missouri, Columbia (M.R.C.), and the Department of Neurology, Washington University, St. Louis (S.G.K.); and the Departments of Neurosurgery (M.V.S., B.N.B.) and Pulmonary and Critical Care Medicine (R.S.), Indiana University, Indianapolis
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Hosouli S, Gaikwad N, Qamar SH, Gomes J. Optimizing photovoltaic thermal (PVT) collector selection: A multi-criteria decision-making (MCDM) approach for renewable energy systems. Heliyon 2024; 10:e27605. [PMID: 38533027 PMCID: PMC10963225 DOI: 10.1016/j.heliyon.2024.e27605] [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: 11/27/2023] [Revised: 02/09/2024] [Accepted: 03/04/2024] [Indexed: 03/28/2024] Open
Abstract
In the realm of renewable energy systems, the effective selection of Photovoltaic Thermal (PVT) collectors is important. This study delves into the intricacies of choosing optimal PVT collectors available in the market, emphasizing the utility of Multiple Criteria Decision Making (MCDM) methodologies. PVT collectors are differentiated based on various aspects such as their transparent front cover presence and the medium-liquid or air-used for heat transfer. The study methodologically identifies commercially available PVT collectors and establishes key performance indicators for comparison. Using an 11-point fuzzy scale, a weight matrix is determined. Subsequently, advanced MCDM techniques, including PROMETHEE II, TOPSIS, EDAS, and VIKOR, are employed to rank the alternatives. This research not only provides a systematic approach to PVT collector selection but also extends to a MATLAB-based tool for facilitating the process. The results underscore the value of the proposed methodologies in refining the selection of PVT collectors and their potential adaptability to other applications, such as PVT collector design.
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Affiliation(s)
| | - Nachiket Gaikwad
- MG Sustainable Engineering AB, Sweden
- University of Oldenburg, Germany
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Gomes J, Begum M, Kumarathasan P. Polybrominated diphenyl ether (PBDE) exposure and adverse maternal and infant health outcomes: Systematic review. Chemosphere 2024; 347:140367. [PMID: 37890790 DOI: 10.1016/j.chemosphere.2023.140367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 10/03/2023] [Indexed: 10/29/2023]
Abstract
Polybrominated diphenyl ethers (PBDEs) are flame retardants found in ambient environment and are measured in humans. There are reports on general PBDE toxicity, including endocrine disrupting properties. Studies on adverse maternal and infant outcomes and underlying toxicity mechanisms needs to be understood. The objective of this study was to conduct a systematic review to examine the state of science on the relationship between PBDE and adverse maternal/infant health outcomes and related maternal biomarker changes. This literature review was conducted using PubMed, Scopus, Embase and Web of Science for published articles from January 2005-February 2022. Article quality was assessed using Newcastle-Ottawa Scale. Of the 1518 articles, only 54 human observational studies were screened in for this review. A second reviewer examined the validity of these articles. Reports on associations between PBDE and maternal health outcomes included gestational hypertension/preeclampsia (N = 2) and gestational diabetes mellitus/glycemic index (N = 6). Meanwhile, reports on PBDE and infant outcomes (N=32) included effects on infant birth weight, birth length and cephalic perimeter, preterm birth, fetal growth restriction and APGAR scores. Although findings on PBDE exposure and adverse infant outcomes showed inconsistencies across studies, in general, negative correlations between maternal PBDEs and infant birth weight, birth length and cephalic perimeter were seen, in few cases, after stratification by sex. Association between maternal PBDE and maternal biomarkers (N=18) suggested negative impact of PBDE exposure on markers relevant to neuro-endocrine system and inflammatory processes. The review findings identified potential associations between maternal PBDE and adverse maternal/infant health outcomes. Furthermore, PBDE-related biomarker changes suggest disturbances in maternal mechanisms relevant to endocrine disrupting properties of PBDEs. The observed study heterogeneity can be attributed to factors namely, sample size, study design and statistical analysis. Overall review findings imply the necessity for further research to validate PBDE exposure-related adverse maternal/infant health effects and to validate underlying toxicity mechanisms.
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Affiliation(s)
- J Gomes
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.
| | - M Begum
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - P Kumarathasan
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada; Environmental Health Science and Research Bureau, HECS, Health Canada, Ottawa, ON, Canada.
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Ladeira I, Oliveira P, Gomes J, Lima R, Guimarães M. Can static hyperinflation predict exercise capacity in COPD? Pulmonology 2023; 29 Suppl 4:S44-S53. [PMID: 34629326 DOI: 10.1016/j.pulmoe.2021.08.011] [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: 04/21/2021] [Revised: 07/29/2021] [Accepted: 08/02/2021] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION The diagnosis and severity assessment of COPD relies on spirometry, and in particular the FEV1. However, it has been proposed that hyperinflation and air-trapping are better predictors of exercise capacity and mortality than the FEV1. RESEARCH QUESTION: Does static hyperinflation predict exercise capacity? METHODS We conducted an observational prospective study. Patients with COPD referred to the lung function laboratory were consecutively recruited. Patients with hyperinflation (the experimental group) were compared to patients without hyperinflation (the control group). The sample sizes were determined assuming an effect size of 0.5 and a power of 0.80. RESULTS We recruited 124 participants, of whom 87% were male, the mean age was 66.1 ± 8.8 years. 67% were symptomatic (GOLD B or D). Airflow limitation was moderate to severe in the majority of patients (median FEV1 47%, IQR 38-65%) and 43% of patients had static hyperinflation. The median 6MWD was 479 meters (404-510) and peak workload in CPET was 64 watts (46-88) with peak VO2 1.12 L/min, 0.89-1.31 L/min. Patients with lower FEV1, DLCO and IC/TLC and higher RV/TLC had reduced exercise capacity in both 6MWT and CPET, measured as lower distance, greater desaturation and ∆Borg dyspnoea, and reduced workload, peak VO2 and peak VE and higher desaturation and ventilatory limitation (VE/MVV). An IC/TLC < 0.33 predicted reduced exercise performance (peak O2 <60%). Dyspnoea assessed by mMRC and QoL measured by CAT and CCQ were also worse in the hyperinflation in COPD patients. CONCLUSION In COPD patients, IC/TLC and RV/TLC are valuable predictors of exercise performance in both 6MWT and CPET and PRO.
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Affiliation(s)
- I Ladeira
- Department of Pulmonology; Centro Hospitalar de Vila Nova de Gaia e Espinho, EPE; Vila Nova de Gaia; Portugal; Medicine Department, Faculdade de Medicina da Universidade do Porto; Porto; Portugal.
| | - P Oliveira
- EPIUnit, Instituto de Saúde Pública, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto; Porto; Portugal
| | - J Gomes
- Department of Pulmonology; Centro Hospitalar de Vila Nova de Gaia e Espinho, EPE; Vila Nova de Gaia; Portugal
| | - R Lima
- Department of Pulmonology; Centro Hospitalar de Vila Nova de Gaia e Espinho, EPE; Vila Nova de Gaia; Portugal
| | - M Guimarães
- Department of Pulmonology; Centro Hospitalar de Vila Nova de Gaia e Espinho, EPE; Vila Nova de Gaia; Portugal
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Aveiro A, Graça B, Gomes J. Inflammatory linear verrucous epidermal nevus—A rare variant of epidermal nevus. Semergen 2023; 49:101954. [DOI: 10.1016/j.semerg.2023.101954] [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] [Received: 11/16/2022] [Accepted: 11/29/2022] [Indexed: 03/31/2023]
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Habboub G, Hassett C, Kondylis E, Gomes J. 332 Estimation of Intracranial Pressure Using Non-Invasive Monitor and Machine Learning. Neurosurgery 2023. [DOI: 10.1227/neu.0000000000002375_332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
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dos Santos FAA, Duarte MD, Carvalho CL, Monteiro M, Carvalho P, Mendonça P, Valente PCLG, Sheikhnejad H, Waap H, Gomes J. Author Correction: Genetic and morphological identification of filarial worm from Iberian hare in Portugal. Sci Rep 2022; 12:20311. [PMID: 36434020 PMCID: PMC9700828 DOI: 10.1038/s41598-022-24734-0] [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: 11/27/2022] Open
Affiliation(s)
- F. A. Abade dos Santos
- grid.9983.b0000 0001 2181 4263Centre for Interdisciplinary Research in Animal Health (CIISA), Faculdade de Medicina Veterinária, Universidade de Lisboa, Avenida da Universidade Técnica, 1300-477 Lisboa, Portugal ,grid.420943.80000 0001 0190 2100Instituto Nacional de Investigação Agrária E Veterinária (INIAV, I.P.), Quinta Do Marquês, Av. da República, 2780-157 Oeiras, Portugal ,Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), Vila Real, Portugal
| | - M. D. Duarte
- grid.9983.b0000 0001 2181 4263Centre for Interdisciplinary Research in Animal Health (CIISA), Faculdade de Medicina Veterinária, Universidade de Lisboa, Avenida da Universidade Técnica, 1300-477 Lisboa, Portugal ,grid.420943.80000 0001 0190 2100Instituto Nacional de Investigação Agrária E Veterinária (INIAV, I.P.), Quinta Do Marquês, Av. da República, 2780-157 Oeiras, Portugal ,Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), Vila Real, Portugal
| | - C. L. Carvalho
- grid.420943.80000 0001 0190 2100Instituto Nacional de Investigação Agrária E Veterinária (INIAV, I.P.), Quinta Do Marquês, Av. da República, 2780-157 Oeiras, Portugal
| | - M. Monteiro
- grid.420943.80000 0001 0190 2100Instituto Nacional de Investigação Agrária E Veterinária (INIAV, I.P.), Quinta Do Marquês, Av. da República, 2780-157 Oeiras, Portugal
| | - P. Carvalho
- grid.420943.80000 0001 0190 2100Instituto Nacional de Investigação Agrária E Veterinária (INIAV, I.P.), Quinta Do Marquês, Av. da República, 2780-157 Oeiras, Portugal
| | - P. Mendonça
- grid.420943.80000 0001 0190 2100Instituto Nacional de Investigação Agrária E Veterinária (INIAV, I.P.), Quinta Do Marquês, Av. da República, 2780-157 Oeiras, Portugal
| | - P. C. L. G. Valente
- grid.9983.b0000 0001 2181 4263Centre for Interdisciplinary Research in Animal Health (CIISA), Faculdade de Medicina Veterinária, Universidade de Lisboa, Avenida da Universidade Técnica, 1300-477 Lisboa, Portugal
| | - H. Sheikhnejad
- InnovPlantProtect Collaborative Laboratory, Department of Protection of Specific Crops, 7350-478 Elvas, Portugal
| | - H. Waap
- grid.9983.b0000 0001 2181 4263Centre for Interdisciplinary Research in Animal Health (CIISA), Faculdade de Medicina Veterinária, Universidade de Lisboa, Avenida da Universidade Técnica, 1300-477 Lisboa, Portugal ,grid.420943.80000 0001 0190 2100Instituto Nacional de Investigação Agrária E Veterinária (INIAV, I.P.), Quinta Do Marquês, Av. da República, 2780-157 Oeiras, Portugal
| | - J. Gomes
- grid.9983.b0000 0001 2181 4263Centre for Interdisciplinary Research in Animal Health (CIISA), Faculdade de Medicina Veterinária, Universidade de Lisboa, Avenida da Universidade Técnica, 1300-477 Lisboa, Portugal ,grid.420943.80000 0001 0190 2100Instituto Nacional de Investigação Agrária E Veterinária (INIAV, I.P.), Quinta Do Marquês, Av. da República, 2780-157 Oeiras, Portugal
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9
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Dos Santos FAA, Duarte MD, Carvalho CL, Monteiro M, Carvalho P, Mendonça P, Valente PCLG, Sheikhnejad H, Waap H, Gomes J. Genetic and morphological identification of filarial worm from Iberian hare in Portugal. Sci Rep 2022; 12:9310. [PMID: 35661130 PMCID: PMC9166702 DOI: 10.1038/s41598-022-13354-3] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 05/24/2022] [Indexed: 11/29/2022] Open
Abstract
The Iberian hare (Lepus granatensis) is an endemic species of the Iberian Peninsula and the only hare species found in Portugal, although also being present in some areas of Spain. The reduction of wild hare populations due to several ecological and sanitary factors, has been raising growing concerns in the recent years. Despite different helminth species were already described in Iberian hares in Portugal, to this date, no filarial worms have been identified in this species. Furthermore, only a few studies on lagomorphs' onchocercid worms are available, referring to other hosts species of hares and/or rabbits. In this study, we describe the presence of filarial worms in the blood vessels of two adult Iberian hares collected in 2019 in continental Portugal. Morphology and sequencing data from the 12S rRNA, coxI, 18S rRNA, myoHC, hsp70 and rbp1 genes, showed that the filaroid species were genetically related with Micipsella numidica. However, the extension of the genetic differences found with M. numidica suggests that the filaroids specimens under study belong to a new species, that we provisionally named Micipsella iberica n. sp.. The body location of this putative new parasite species and its physiological implications indicate that it may constitute a potential menace to the already fragile Iberian hare justifying, therefore, further investigation regarding the morphological characterization, prevalence and real clinical impact of this new parasite in hares.
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Affiliation(s)
- F A Abade Dos Santos
- Centre for Interdisciplinary Research in Animal Health (CIISA), Faculdade de Medicina Veterinária, Universidade de Lisboa, Avenida da Universidade Técnica, 1300-477, Lisboa, Portugal.
- Instituto Nacional de Investigação Agrária E Veterinária (INIAV, I.P.), Quinta Do Marquês, Av. da República, 2780-157, Oeiras, Portugal.
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), Vila Real, Portugal.
| | - M D Duarte
- Centre for Interdisciplinary Research in Animal Health (CIISA), Faculdade de Medicina Veterinária, Universidade de Lisboa, Avenida da Universidade Técnica, 1300-477, Lisboa, Portugal
- Instituto Nacional de Investigação Agrária E Veterinária (INIAV, I.P.), Quinta Do Marquês, Av. da República, 2780-157, Oeiras, Portugal
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), Vila Real, Portugal
| | - C L Carvalho
- Instituto Nacional de Investigação Agrária E Veterinária (INIAV, I.P.), Quinta Do Marquês, Av. da República, 2780-157, Oeiras, Portugal
| | - M Monteiro
- Instituto Nacional de Investigação Agrária E Veterinária (INIAV, I.P.), Quinta Do Marquês, Av. da República, 2780-157, Oeiras, Portugal
| | - P Carvalho
- Instituto Nacional de Investigação Agrária E Veterinária (INIAV, I.P.), Quinta Do Marquês, Av. da República, 2780-157, Oeiras, Portugal
| | - P Mendonça
- Instituto Nacional de Investigação Agrária E Veterinária (INIAV, I.P.), Quinta Do Marquês, Av. da República, 2780-157, Oeiras, Portugal
| | - P C L G Valente
- Centre for Interdisciplinary Research in Animal Health (CIISA), Faculdade de Medicina Veterinária, Universidade de Lisboa, Avenida da Universidade Técnica, 1300-477, Lisboa, Portugal
| | - H Sheikhnejad
- InnovPlantProtect Collaborative Laboratory, Department of Protection of Specific Crops, 7350-478, Elvas, Portugal
| | - H Waap
- Centre for Interdisciplinary Research in Animal Health (CIISA), Faculdade de Medicina Veterinária, Universidade de Lisboa, Avenida da Universidade Técnica, 1300-477, Lisboa, Portugal
- Instituto Nacional de Investigação Agrária E Veterinária (INIAV, I.P.), Quinta Do Marquês, Av. da República, 2780-157, Oeiras, Portugal
| | - J Gomes
- Centre for Interdisciplinary Research in Animal Health (CIISA), Faculdade de Medicina Veterinária, Universidade de Lisboa, Avenida da Universidade Técnica, 1300-477, Lisboa, Portugal
- Instituto Nacional de Investigação Agrária E Veterinária (INIAV, I.P.), Quinta Do Marquês, Av. da República, 2780-157, Oeiras, Portugal
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10
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Torres T, Paiva-Lopes MJ, Gonçalo M, Claro C, Oliveira M, Gomes J, Vieira AP, Amoedo P, Alpalhão M, Nogueira M, Santiago F, Henrique M, Amaro C, Esteves T, Alves J, Cerejeira D, Mendes-Bastos P, Pestana M, Ramos L, Rocha J, Carvalho R, Teixeira L, Selores M, Mota A, Filipe P. Dupilumab for atopic dermatitis: a real-world portuguese multicenter retrospective study. J DERMATOL TREAT 2022; 33:2554-2559. [PMID: 35083945 DOI: 10.1080/09546634.2022.2035309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Introduction: Atopic dermatitis (AD) is a difficult-to-treat inflammatory skin disease with a high impact on patients' quality of life. Dupilumab, an IL-4 and IL-13 inhibitor, was the first monoclonal antibody approved for the treatment of moderate-to-severe AD and is currently approved in patients aged 6 or older.Methods: This is a nationwide, multicenter, retrospective, 48-week study designed by the Portuguese Group of AD to assess real-world efficacy and safety of dupilumab for the treatment of AD.Results: A total of 169 patients were enrolled, with a mean disease duration of 22.75 (±11.98) years. The percentage of patients achieving an improvement of at least 75% in Eczema Area and Severity Index (EASI) compared to baseline (EASI75 response) at weeks 12 and 48 was 67.6% and 74.1%, respectively. In the same timepoints, 25.0% and 44.1% achieved an EASI90 response. Patient-reported outcome measures also improved throughout the study period. Regarding safety, 32.0% of the patients developed adverse events, with conjunctivitis (26.6%), persistent facial erythema (4.7%), and arthritis/arthralgia (3.6%) as the more frequently reported.Conclusion: Data from real-world populations are crucial to guide clinicians in their daily decisions. This study provides data demonstrating that dupilumab is an effective and safe therapeutic option for AD.
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Affiliation(s)
- T Torres
- Department of Dermatology, Centro Hospitalar Universitário do Porto, Porto, Portugal.,Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, Portugal
| | - M J Paiva-Lopes
- Department of Dermatology, Centro Hospitalar Universitário Lisboa Central, Lisboa, Portugal.,CEDOC, Nova Medical School, Universidade Nova de Lisboa, Lisboa, Portugal
| | - M Gonçalo
- Department of Dermatology, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal.,Clinic of Dermatology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - C Claro
- Department of Dermatology, Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisboa, Portugal
| | - M Oliveira
- Department of Dermatology, Centro Hospitalar Tondela Viseu, Viseu, Portugal
| | - J Gomes
- Department of Dermatology, Hospital de Braga, Braga, Portugal
| | - A P Vieira
- Department of Dermatology, Hospital de Braga, Braga, Portugal
| | - P Amoedo
- Department of Dermatology, Centro Hospitalar Universitário de São João EPE, Porto, Portugal
| | - M Alpalhão
- Department of Dermatology, Centro Hospitalar Universitário Lisboa Norte EPE, Lisbon, Portugal.,Dermatology University Clinic, Faculty of Medicine, University of Lisbon, Lisbon, Portugal.,Dermatology Research Unit, IMM João Lobo Antunes, University of Lisbon, Lisbon, Portugal
| | - M Nogueira
- Department of Dermatology, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - F Santiago
- Department of Dermatology, Centro Hospitalar Leiria-Pombal, Leiria, Portugal
| | - M Henrique
- Department of Dermatology, Centro Hospitalar Leiria-Pombal, Leiria, Portugal
| | - C Amaro
- Department of Dermatology, Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisboa, Portugal
| | - T Esteves
- Department of Dermatology, Hospital Central do Funchal, Madeira, Portugal
| | - J Alves
- Department of Dermatology, Hospital Garcia de Orta, Almada, Portugal
| | - D Cerejeira
- Department of Dermatology, Hospital Garcia de Orta, Almada, Portugal
| | - P Mendes-Bastos
- Dermatology Center, Hospital CUF Descobertas, Lisboa, Portugal
| | - M Pestana
- Department of Dermatology, Centro Hospitalar Universitário Lisboa Central, Lisboa, Portugal
| | - L Ramos
- Department of Dermatology, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal
| | - J Rocha
- Department of Dermatology, Hospital de Pedro Hispano, Matosinhos, Portugal
| | - R Carvalho
- Department of Dermatology, Centro Hospitalar Universitário Lisboa Central, Lisboa, Portugal.,Nova Medical School, Universidade Nova de Lisboa, Lisboa, Portugal
| | - L Teixeira
- Center for Health Technology and Services Research (CINTESIS), Institute of Biomedical Sciences Abel Salazar, University of Porto (ICBAS.UP), Porto, Portugal
| | - M Selores
- Department of Dermatology, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - A Mota
- Department of Dermatology, Centro Hospitalar Universitário de São João EPE, Porto, Portugal.,Faculty of Medicine, University of Porto, CINTESIS, Porto, Portugal
| | - P Filipe
- Department of Dermatology, Centro Hospitalar Universitário Lisboa Norte EPE, Lisbon, Portugal.,Dermatology University Clinic, Faculty of Medicine, University of Lisbon, Lisbon, Portugal.,Dermatology Research Unit, IMM João Lobo Antunes, University of Lisbon, Lisbon, Portugal
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11
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Dayo GK, Houaga I, Somda MB, Linguelegue A, Ira M, Konkobo M, Djassi B, Gomes J, Sangare M, Cassama B, Yapi-Gnaore CV. Morphological and microsatellite DNA diversity of Djallonké sheep in Guinea-Bissau. BMC Genom Data 2022; 23:3. [PMID: 34991442 PMCID: PMC8740422 DOI: 10.1186/s12863-021-01009-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 11/01/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The present study aimed at characterizing the Djallonké Sheep (DS), the only local sheep breed raised in Guinea-Bissau. A total of 200 animals were sampled from four regions (Bafatá, Gabú, Oio and Cacheu) and described using 7 visual criteria and 8 measurements. These parameters have been studied by principal components analysis. The genetic diversity and population structure of 92 unrelated animals were studied using 12 microsatellite markers. RESULTS The values of quantitative characters in the Bafatá region were significantly higher than those obtained in the other three regions. A phenotypic diversity of the DS population was observed and three genetic types distinguished: animals with "large traits" in the region of Bafatá, animals with "intermediate traits" in the regions of Gabú and Oio and animals with "small traits" in the Cacheu region. The hair coat colors are dominated by the white color, the shape of the facial head profile is mainly convex and the ears "erected horizontally". Most of the morphobiometric characteristics were significantly influenced by the "region" and "sex of animals". The average Polymorphism Information Content (PIC) of 0.65 ± 0.11 supports the use of markers in genetic characterization. Gabú subpopulation had the highest genetic diversity measures (He = 0.716 ± 0.089) while Cacheu DS subpopulation presented the smallest (He = 0.651 ± 0.157). Only Gabú and Bafatá subpopulations presented significant heterozygote deficiency across all loci indicating possible significant inbreeding. Mean values for FIT, FST, FIS and GST statistics across all loci were 0.09, 0.029, 0.063 and 0.043 respectively. The overall genetic differentiation observed between the four DS subpopulations studied was low. Bafatá and Gabú are the most closely related subpopulations (DS = 0.04, genetic identity = 0.96) while Bafatá and Cacheu were the most genetically distant subpopulations (DS = 0.14, genetic identity = 0.87). Using Bayesian approach, the number of K groups that best fit the data is detected between 2 and 3, which is consistent with the morphological analysis and the factorial analysis of correspondence. CONCLUSIONS The molecular results on DS population of Guinea-Bissau confirmed the ones obtained with morphological analysis. The three genetic types observed phenotypically might be due to a combination of the agro-ecological differences and the management of breeding rather than genetic factors.
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Affiliation(s)
- Guiguigbaza-Kossigan Dayo
- Centre International de Recherche-Développement sur l'Elevage en zone Subhumide (CIRDES), Bobo-Dioulasso, 01 BP 454, Burkina Faso. .,Institut du Sahel (INSAH/CILSS), BP 1530, Bamako, Mali.
| | - Isidore Houaga
- Centre International de Recherche-Développement sur l'Elevage en zone Subhumide (CIRDES), Bobo-Dioulasso, 01 BP 454, Burkina Faso.,Current address: Centre for Tropical Livestock Genetics and Health (CTLGH), Roslin Institute, University of Edinburgh, Edinburgh, UK
| | - Martin Bienvenu Somda
- Centre International de Recherche-Développement sur l'Elevage en zone Subhumide (CIRDES), Bobo-Dioulasso, 01 BP 454, Burkina Faso.,Université Nazi BONI (UNB), Bobo-Dioulasso, 01 BP 1091, Burkina Faso
| | - Awa Linguelegue
- Centre International de Recherche-Développement sur l'Elevage en zone Subhumide (CIRDES), Bobo-Dioulasso, 01 BP 454, Burkina Faso
| | - Mamadou Ira
- Centre International de Recherche-Développement sur l'Elevage en zone Subhumide (CIRDES), Bobo-Dioulasso, 01 BP 454, Burkina Faso
| | - Maurice Konkobo
- Centre International de Recherche-Développement sur l'Elevage en zone Subhumide (CIRDES), Bobo-Dioulasso, 01 BP 454, Burkina Faso
| | - Bacar Djassi
- Direction Générale de l'Elevage (DGE), BP 26, Bissau, Guinea-Bissau
| | - Joao Gomes
- Direction Générale de l'Elevage (DGE), BP 26, Bissau, Guinea-Bissau
| | - Mamadou Sangare
- Centre International de Recherche-Développement sur l'Elevage en zone Subhumide (CIRDES), Bobo-Dioulasso, 01 BP 454, Burkina Faso
| | - Bernardo Cassama
- Direction Générale de l'Elevage (DGE), BP 26, Bissau, Guinea-Bissau
| | - Chia Valentine Yapi-Gnaore
- Centre International de Recherche-Développement sur l'Elevage en zone Subhumide (CIRDES), Bobo-Dioulasso, 01 BP 454, Burkina Faso
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12
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Farag E, Liang C, Mascha EJ, Toth G, Argalious M, Manlapaz M, Gomes J, Ebrahim Z, Hussain MS. Oxygen Saturation and Postoperative Mortality in Patients With Acute Ischemic Stroke Treated by Endovascular Thrombectomy. Anesth Analg 2021; 134:369-379. [PMID: 34609988 DOI: 10.1213/ane.0000000000005763] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Monitored anesthesia care (MAC) and general anesthesia (GA) with endotracheal intubation are the 2 most used techniques for patients with acute ischemic stroke (AIS) undergoing endovascular thrombectomy. We aimed to test the hypothesis that increased arterial oxygen concentration during reperfusion period is a mechanism underlying the association between use of GA (versus MAC) and increased risk of in-hospital mortality. METHODS In this retrospective cohort study, data were collected at the Cleveland Clinic between 2013 and 2018. To assess the potential mediation effect of time-weighted average oxygen saturation (Spo2) in first postoperative 48 hours between the association between GA versus MAC and in-hospital mortality, we assessed the association between anesthesia type and post-operative Spo2 tertiles (exposure-mediator relationship) through a cumulative logistic regression model and assessed the association between Spo2 and in-hospital mortality (mediator-outcome relationship) using logistic regression models. Confounding factors were adjusted for using propensity score methods. Both significant exposure-mediator and significant mediator-outcome relationships are needed to suggest potential mediation effect. RESULTS Among 358 patients included in the study, 104 (29%) patients received GA and 254 (71%) received MAC, with respective hospital mortality rate of 19% and 5% (unadjusted P value <.001). GA patients were 1.6 (1.2, 2.1) (P < .001) times more likely to have a higher Spo2 tertile as compared to MAC patients. Patients with higher Spo2 tertile had 3.8 (2.1, 6.9) times higher odds of mortality than patients with middle Spo2 tertile, while patients in the lower Spo2 tertile did not have significant higher odds compared to the middle tertile odds ratio (OR) (1.8 [0.9, 3.4]; overall P < .001). The significant exposure-mediator and mediator-outcome relationships suggest that Spo2 may be a mediator of the relationship between anesthetic method and mortality. However, the estimated direct effect of GA versus MAC on mortality (ie, after adjusting for Spo2; OR [95% confidence interval {CI}] of 2.1 [0.9-4.9]) was close to the estimated association ignoring Spo2 (OR [95% CI] of 2.2 [1.0-5.1]), neither statistically significant, suggesting that Spo2 had at most a modest mediator role. CONCLUSIONS GA was associated with a higher Spo2 compared to MAC among those treated by endovascular thrombectomy for AIS. Spo2 values that were higher than the middle tertile were associated with higher odds of mortality. However, GA was not significantly associated with higher odds of death. Spo2 at most constituted a modest mediator role in explaining the relationship between GA versus MAC and mortality.
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Affiliation(s)
- Ehab Farag
- From the Department of General Anesthesia.,Department of Outcomes Research, Anesthesiology & Pain Management Institute
| | - Chen Liang
- Department of Outcomes Research, Anesthesiology & Pain Management Institute.,Department of Quantitative Health Sciences, Lerner Research Institute
| | - Edward J Mascha
- Department of Outcomes Research, Anesthesiology & Pain Management Institute.,Department of Quantitative Health Sciences, Lerner Research Institute
| | - Gabor Toth
- Department of Neurointerventional Radiology
| | | | | | - Joao Gomes
- Department of Neurology, Neurological Institute, The Cleveland Clinic, Cleveland, Ohio
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13
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Marques MS, Fonseca A, Lima R, Ladeira I, Gomes J, Guimarães M. Effect of a viral filter on cardiopulmonary exercise testing. Pulmonology 2021; 28:140-141. [PMID: 34446380 PMCID: PMC8879983 DOI: 10.1016/j.pulmoe.2021.07.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/20/2021] [Accepted: 07/22/2021] [Indexed: 11/29/2022] Open
Affiliation(s)
- M Sá Marques
- Pulmonology Department, Centro Hospitalar Vila Nova de Gaia e Espinho, Portugal.
| | - A Fonseca
- Pulmonology Department, Centro Hospitalar Vila Nova de Gaia e Espinho, Portugal
| | - R Lima
- Pulmonology Department, Centro Hospitalar Vila Nova de Gaia e Espinho, Portugal; Pulmonary Function Laboratory, Centro Hospitalar Vila Nova de Gaia e Espinho, Portugal
| | - I Ladeira
- Pulmonology Department, Centro Hospitalar Vila Nova de Gaia e Espinho, Portugal; Pulmonary Function Laboratory, Centro Hospitalar Vila Nova de Gaia e Espinho, Portugal; Medicine Department, Faculty of Medicine of the University of Porto, Portugal
| | - J Gomes
- Pulmonary Function Laboratory, Centro Hospitalar Vila Nova de Gaia e Espinho, Portugal
| | - M Guimarães
- Pulmonology Department, Centro Hospitalar Vila Nova de Gaia e Espinho, Portugal; Pulmonary Function Laboratory, Centro Hospitalar Vila Nova de Gaia e Espinho, Portugal
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14
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Fan TH, Kharal GA, Biedny J, Ahrens C, Gomes J. Callosal Diffusion-Restriction in Patients with Intracranial Hemorrhage. J Stroke Cerebrovasc Dis 2021; 30:105951. [PMID: 34298426 DOI: 10.1016/j.jstrokecerebrovasdis.2021.105951] [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: 04/13/2021] [Revised: 06/08/2021] [Accepted: 06/13/2021] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE We aim to report the incidence and clinical characteristics of patients who were found to have diffusion restricting lesions of the corpus callosum (CC) on Diffusion-weighted imaging (DWI) on magnetic resonance imaging (MRI) following intracranial hemorrhage (ICH). DESIGN/METHODS A retrospective cross-sectional analysis was performed of medical records of all adult patients admitted to a single tertiary center with a primary diagnosis of ICH and received nicardipine infusion over a 2-year period. Patients without MRI brain available or patients who underwent digital subtraction angiography (DSA) prior to MRI were excluded. ICH and intraventricular hemorrhage (IVH) volumes and scores were calculated. MRI brain scans were evaluated for presence and locations of DWI lesions. RESULTS Among 162 patients who met inclusion criteria, 6 patients (4%, median age 53, range 37-71, 100% male, 33% white) were found to have DWI lesions in the CC with a median ICH volume of 17ml (range 1-105ml). The ICH locations were lobar (n=3), deep (n=2) and cerebellum (n=1). All patients (100%) had intraventricular hemorrhage (IVH) with median IVH volume of 25ml (range 2.7-55ml). Four patients were on levetiracetam. No identifiable infections or metabolic abnormalities were found among these patients. All but one patient had normal DSA. Follow up MRI was only available in one patient and showed no reversibility at 14 days. CONCLUSION Although rare, diffusion restricting corpus callosum lesions can be seen in patients with ICH, especially in patients with IVH. The etiology and clinical significance of these lesions remains unknown and warrant further research.
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Affiliation(s)
- Tracey H Fan
- Department of Neurology, Neurological Institute, Cleveland Clinic, Cleveland, OH, United States
| | - G Abbas Kharal
- Department of Neurology, Cerebrovascular Center, Neurological Institute, Cleveland, OH, United States
| | - Jessica Biedny
- Department of Pharmacy, Neurological Institute, Cleveland Clinic, Cleveland, OH, United States
| | - Christine Ahrens
- Department of Pharmacy, Neurological Institute, Cleveland Clinic, Cleveland, OH, United States
| | - Joao Gomes
- Department of Neurology, Cerebrovascular Center, Neurological Institute, Cleveland, OH, United States.
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15
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Gomes J, Saeed Y, Kawada S, Benson L, Downar E, Nair K. Outcome of catheter ablation of arrhythmias in adult congenital heart disease with high density multi-electrode mapping with automatic annotation algorithm. Europace 2021. [DOI: 10.1093/europace/euab116.499] [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
Funding Acknowledgements
Type of funding sources: None.
Introduction
Arrhythmias are frequently encountered in adult congenital heart disease (ACHD) and respond poorly to pharmacological therapies. Catheter ablation is challenging due to anatomical variation and complexity of the arrhythmia substrate. High density multi electrode mapping (MEM) with automatic annotation of activation time may aid mapping of arrhythmia, decrease procedure time and improve the accuracy of targeting of ablation therapy.
Purpose
To compare the acute and long term outcomes and procedural characteristics of catheter ablation in ACHD patients with and without automatic annotation of activation with MEM.
Methods
Retrospective analysis of the acute and long term outcomes of ACHD patients in a single centre undergoing ablation procedures from 1 Jan 2014 to 18 August 2017 was undertaken. 2 groups were identified.
Group 1 included patients who had arrhythmia mapping performed with the CARTO 3D electroanatomic mapping system without the use of automatic signal annotation. Most patients in this group had sequential mapping performed with the ablation catheter (78%), the rest had multi-electrode mapping with the PentaRay 20 pole catheter.
Group 2 included patients who had arrhythmia mapping performed with the CARTO 3D electroanatomic mapping system using the automated CONFIDENSE mapping algorithm.
Results
Group 1: n = 27, mean age 44.6 +/-3 years. Male 46.6%. Group 2: n = 38, mean age 44.0 +/- 1.9 years. Male 56.7%. All patients had CHD of at least moderate complexity. 25% of patients in group 1 and 45% in group 2 were repeat ablations. 45 arrhythmias were induced in group 1 of which 29 were targeted and 74 arrhythmias were induced in group 2 of which 46 were targeted. Acute success rates (after attempts at reinduction) were 96.3% in group 1 and 94.7% in group 2. Recurrences of arrhythmia occurred significantly less in patients in group 2 compared to group 1 (44.7% and 70.4% respectively, p < 0.05) after a follow up duration of 17.3+/-0.43 months in group 2 and 45.3 +/-1.19 months in group 1. Fluoroscopy time, procedure time and ablation time were not significantly different between groups.
Conclusions
The use of multi-electrode mapping with an automatic annotation algorithm was associated with a significantly lower risk of recurrence during the follow up period of this study.
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Affiliation(s)
- J Gomes
- Peter Munk Cardiac Centre, Department of Cardiac Electrophysiology, Toronto, Canada
| | - Y Saeed
- Peter Munk Cardiac Centre, Department of Cardiac Electrophysiology, Toronto, Canada
| | - S Kawada
- Peter Munk Cardiac Centre, Department of Cardiac Electrophysiology, Toronto, Canada
| | - L Benson
- Peter Munk Cardiac Centre, Department of Cardiac Electrophysiology, Toronto, Canada
| | - E Downar
- Peter Munk Cardiac Centre, Department of Cardiac Electrophysiology, Toronto, Canada
| | - K Nair
- Peter Munk Cardiac Centre, Department of Cardiac Electrophysiology, Toronto, Canada
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Abstract
BACKGROUND Radon is a predominant indoor air pollutant and second leading cause of lung cancer in radon-prone areas. Despite the gravity of the health risk, residents in Canada have inadequate perception and taken minimal protective actions. Better perception of a risk motivates people to take preventive measures. Scholarship about radon health risk perception is lacking in Canada. We applied a mixed methods population health approach to explore the determinants shaping perception and actions of a resident population in Canada. METHODS We conducted mixed surveys (n = 557) and qualitative bilingual interviews (n = 35) with both homeowners and tenants of Ottawa-Gatineau areas. The study explored residents' risk perception and adaptations factors. Descriptive, correlational and regression analyses described and established associations between quantitative variables. Thematic, inductive analyses identified themes in the qualitative data. A mixed methods analysis triangulated both results to draw a holistic perception of the health risk. RESULTS Residents' quantitative perceptions of radon health risk, smoking at home, synergistic risk perception, social influence and care for family were associated significantly with their intention to test for radon levels in their home, actual testing and mitigation. These results were explained further with the qualitative findings. Residents who had dual cognitive and emotional awareness of the risk were motivated enough to take preventive actions. Caring for family, knowing others who contracted lung cancer and financial capability were enablers, whereas lack of awareness and homeownership, cost of mitigation and stigma were obstacles to preventive actions. We also explored the dual subjective and objective aspects of risk perception that are influenced by micro- and macro-level determinants. CONCLUSIONS Inducing protective action to reduce risk requires comprehensive population-level interventions considering dual perceptions of the risk that can modify the risk determinants. Future research can explore the dual aspects of risk perception and unequal distribution of the risk factors.
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Affiliation(s)
- S. M. Khan
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - J. Gomes
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - S. Chreim
- Telfer School of Management, University of Ottawa, Ottawa, ON, Canada
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17
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Abd E, Gomes J, Sales CC, Yousef S, Forouz F, Telaprolu KC, Roberts MS, Grice JE, Lopes PS, Leite-Silva VR, Andréo-Filho N. Deformable liposomes as enhancer of caffeine penetration through human skin in a Franz diffusion cell test. Int J Cosmet Sci 2020; 43:1-10. [PMID: 32866296 DOI: 10.1111/ics.12659] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [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: 07/17/2020] [Revised: 08/17/2020] [Accepted: 08/24/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The permeation of hydrophilic molecules through the skin is still a challenge due to the barrier posed by stratum corneum, the outermost layer of the skin. Liposomes have frequently been used as carriers for different types of drugs and may also function as permeation enhancers. Propylene glycol has also been used as an edge activator in liposomes to increase the permeation. The aim of this work was to prepare liposomes containing an edge activator and loaded with caffeine to evaluate the potential of caffeine reaching the deeper layers in the skin. METHODS The formulations were prepared by a top-down process using high-pressure homogenization at 200 00 psi for 10 min. They were characterized by size, polydispersity index (PI), zeta potential (ZP), pH, caffeine content and encapsulation efficiency (EE%) on preparation (time zero) and after 30 days. Cytotoxicity of blank and loaded liposomes was assessed by MTT proliferation assay with a normal keratinocyte cell line (HaCaT). In vitro permeation tests were performed with human skin in Franz cells over 24 h, and caffeine concentration was determined in the skin surface, stratum corneum, dermo-epidermal fraction and receptor medium by HPLC. RESULTS The caffeine liposomes with (DL-Caf) or without propylene glycol (CL-Caf) showed, respectively, mean size 94.5 and 95.4 nm, PI 0.48 and 0.42, ZP + 1.3 and + 18.1 mV and caffeine content of 78.57 and 80.13%. IC50 values of caffeine in DL-Caf (3.59 v/v %) and CL-Caf (3.65 v/v %) were not significantly different from conventional blank liposome (3.27 v/v %). The DL-Caf formulation presented the best capability to enhance the caffeine permeation through the skin, resulting 1.94-folds higher than caffeine solution. Furthermore, the caffeine flux from DL-Caf was 1.56- and 3.05-folds higher than caffeine solution and CL-Caf, respectively. On the other hand, CL-Caf showed the lowest caffeine penetration revealing the importance of edge activator to aid hydrophilic drug penetration to all skin layers. CONCLUSION The DL-Caf formulation tested was able to improve the permeation of caffeine through the stratum corneum and dermo-epidermal layers, suggesting that this delivery system may be effective for deep skin delivery of hydrophilic drugs.
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Affiliation(s)
- E Abd
- Therapeutics Research Centre, Translational Research Institute, Diamantina Institute, University of Queensland, 37 Kent Street, Woolloongabba, Qld., 4072, Australia
| | - J Gomes
- Departamento de Ciências Farmacêuticas, Instituto de Ciências Ambientais, Químicas e Farmacêuticas, Universidade Federal de São Paulo, Rua São Nicolau, 210, prédio de vidro, Diadema, SP, CEP 09913-030, Brazil
| | - C C Sales
- Departamento de Ciências Farmacêuticas, Instituto de Ciências Ambientais, Químicas e Farmacêuticas, Universidade Federal de São Paulo, Rua São Nicolau, 210, prédio de vidro, Diadema, SP, CEP 09913-030, Brazil
| | - S Yousef
- Therapeutics Research Centre, Translational Research Institute, Diamantina Institute, University of Queensland, 37 Kent Street, Woolloongabba, Qld., 4072, Australia.,Faculty of Pharmacy, Helwan University, Helwan, Cairo, 11795, Egypt
| | - F Forouz
- Therapeutics Research Centre, Translational Research Institute, Diamantina Institute, University of Queensland, 37 Kent Street, Woolloongabba, Qld., 4072, Australia
| | - K C Telaprolu
- Therapeutics Research Centre, Translational Research Institute, Diamantina Institute, University of Queensland, 37 Kent Street, Woolloongabba, Qld., 4072, Australia
| | - M S Roberts
- Therapeutics Research Centre, Translational Research Institute, Diamantina Institute, University of Queensland, 37 Kent Street, Woolloongabba, Qld., 4072, Australia.,Clinical and Health Sciences, City West Campus, Level 6 Cancer Research Institute (UniSA CRI), University of South Australia, North Terrace, Adelaide, S.A., 5000, Australia
| | - J E Grice
- Therapeutics Research Centre, Translational Research Institute, Diamantina Institute, University of Queensland, 37 Kent Street, Woolloongabba, Qld., 4072, Australia
| | - P S Lopes
- Departamento de Ciências Farmacêuticas, Instituto de Ciências Ambientais, Químicas e Farmacêuticas, Universidade Federal de São Paulo, Rua São Nicolau, 210, prédio de vidro, Diadema, SP, CEP 09913-030, Brazil
| | - V R Leite-Silva
- Therapeutics Research Centre, Translational Research Institute, Diamantina Institute, University of Queensland, 37 Kent Street, Woolloongabba, Qld., 4072, Australia.,Departamento de Ciências Farmacêuticas, Instituto de Ciências Ambientais, Químicas e Farmacêuticas, Universidade Federal de São Paulo, Rua São Nicolau, 210, prédio de vidro, Diadema, SP, CEP 09913-030, Brazil
| | - N Andréo-Filho
- Departamento de Ciências Farmacêuticas, Instituto de Ciências Ambientais, Químicas e Farmacêuticas, Universidade Federal de São Paulo, Rua São Nicolau, 210, prédio de vidro, Diadema, SP, CEP 09913-030, Brazil
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Pirkle C, Peltzer N, Câmara S, Gomes J, Ylli A. Burden of food insecurity in older adults from diverse global settings: policy recommendations. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.311] [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: 11/12/2022] Open
Abstract
Abstract
Food insecurity prevalence is highest in low and middle-income countries, yet there is a dearth of research on the burden in older adults in these settings. Food insecurity has long-term consequences for the health of older persons. We examined cross-sectional food security data from 1,482 participants in the 2016 wave of the longitudinal International Mobility in Aging Study (IMIAS) conducted in Canada, Albania, Colombia, and Brazil. These are community samples between 68 and 79 years. Food security was assessed with the Latin American and Caribbean Household Food Security Scale and recoded to yes/no. Covariates of interest included sex, site, income, living arrangement, and education. Descriptive statistics, with tests of statistical significance, were used. Responses to scale items varied from 10% of participants reporting worry about running out of food and being unable to eat healthy foods to 2% reporting not eating for a whole day or having to beg for food. Food insecurity in the sample was 17%. Few Canadian respondents (<5%) were food insecure, compared to 30% in Tirana, 28% in Manizales, and 18% in Natal. Better educated and income sufficient respondents were significantly more food secure than lesser educated, lower income ones. Respondents living with spouses were significantly less likely to be food insecure than those living alone or in other arrangements (e.g. with children). The exception was Tirana; 25% of those in other arrangements were food insecure compared to 32% living with a spouse and 44% alone. Food insecurity did not differ significantly by age or sex. Site, income, living arrangement, and education were all associated with food insecurity status. Study findings contribute to a significant gap in literature about food security in older adults. Because food insecurity in older adults leads to negative health outcomes, results suggest specific interventions to improve health and reduce burden on healthcare systems is needed for elderly.
Key messages
Food insecurity has severe health consequences for elderly and location, income, education, and living arrangement contributes to health inequalities in this population across diverse settings. Little to no research has been done on food insecurity in elderly outside of North America and study findings contribute to significant gap in research in this population across global settings.
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Affiliation(s)
- C Pirkle
- Office of Public Health Studies, University of Hawaʻi at Mānoa, Honolulu, USA
| | - N Peltzer
- Office of Public Health Studies, University of Hawaʻi at Mānoa, Honolulu, USA
| | - S Câmara
- Health Sciences of Trairi, Federal University of Rio Grande do Norte, Santa Cruz, Brazil
| | - J Gomes
- Facultad de Ciencias para la Salud, Universidad de Caldas, Manizales, Colombia
| | - A Ylli
- Department of Public Health, Faculty of Medicine, Tirana, Albania
- Sector of Research on Non-Communicable Disease Policies, Institute of Public Health, Tirana, Albania
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19
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Pirkle C, Peltzer N, Câmara S, Gomes J, Ylli A. Older men from global settings more vulnerable to clinical changes associated with food insecurity. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Studies of the food security status of older adults are rare outside of the United States, especially in low- and middle-income settings. Food insecurity may contribute to disease and disability. Using a diverse sample of older adults, we examine the association of food insecurity with clinical and self-reported measures that are related to disease and impairment.
Methods
Cross sectional analysis of 1482 older adults from Kingston and St. Hyacinthe (Canada), Tirana (Albania), Manizales (Colombia), and Natal (Brazil). Outcome measures were Body Mass Index (BMI), waist circumference, and self-reported unintentional weight loss. Food insecurity was assessed with the 9-item Latin American and Caribbean Household Food Security Scale. Covariates were age, sex, study site, and education. Statistical analyses included Student's T-test, Chi-square test, and linear regression.
Results
83% of participants were food secure; 12% experienced mild food insecurity and 5%, moderate/severe food insecurity. Among men, BMI and waist circumference varied significantly by food security status (p < 0.05). Mean BMI among men with moderate/severe food insecurity was 25.5 compared to 27.0 for mild and 27.5 for no food insecurity. The pattern for waist circumference was similar (93.9cm for moderate/severe, 96.7cm for mild, and 98.9cm for no food insecurity). More food insecure men reported unintentional weight loss (13%) than food secure men (10%). This pattern was not observed among women. Statistical adjustment for study site, education, and age did not change the findings.
Conclusions
Significant differences in clinical indicators of disease were observed by food security status in men. At the extreme, low BMI and waist circumference are linked to increased risk of malnutrition, compromised immune function, and respiratory and digestive diseases. Differences in these measures by food security status emphasize the need for gender and age specific food security interventions.
Key messages
Food insecure men experience clinical indicators of disease significantly more than food insecure women. Successful food security interventions may require sex specific focus across global settings. Little research has been done on food insecurity in elderly outside of North America and study findings contribute to significant gap in sex specific research in this population across global settings.
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Affiliation(s)
- C Pirkle
- Office of Public Health Studies, University of Hawaʻi at Mānoa, Honolulu, USA
| | - N Peltzer
- Office of Public Health Studies, University of Hawaʻi at Mānoa, Honolulu, USA
| | - S Câmara
- Health Sciences of Trairi, Federal University of Rio Grande do Norte, Santa Cruz, Brazil
| | - J Gomes
- Facultad de Ciencias para la Salud, Universidad de Caldas, Manizales, Colombia
| | - A Ylli
- Department of Public Health, Faculty of Medicine, Tirana, Albania
- Sector of Research on Non-Communicable Disease Policies, Institute of Public Health, Tirana, Albania
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20
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Jácome C, Pereira R, Almeida R, Amaral R, Correia MA, Mendes S, Vieira-Marques P, Ferreira JA, Lopes I, Gomes J, Vidal C, López Freire S, Méndez Brea P, Arrobas A, Valério M, Chaves Loureiro C, Santos LM, Couto M, Araujo L, Todo Bom A, Azevedo JP, Cardoso J, Emiliano M, Gerardo R, Lozoya C, Pinto PL, Castro Neves A, Pinto N, Palhinha A, Teixeira F, Ferreira-Magalhães M, Alves C, Coelho D, Santos N, Menezes F, Gomes R, Cidrais Rodrigues JC, Oliveira G, Carvalho J, Rodrigues Alves R, Moreira AS, Costa A, Abreu C, Silva R, Morête A, Falcão H, Marques ML, Câmara R, Cálix MJ, Bordalo D, Silva D, Vasconcelos MJ, Fernandes RM, Ferreira R, Freitas P, Lopes F, Almeida Fonseca J. Validation of App and Phone Versions of the Control of Allergic Rhinitis and Asthma Test (CARAT). J Investig Allergol Clin Immunol 2020; 31:270-273. [PMID: 32856596 DOI: 10.18176/jiaci.0640] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- C Jácome
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, Portugal.,Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
| | - R Pereira
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal.,Allergy Unit, Instituto and Hospital CUF, Porto, Portugal
| | - R Almeida
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, Portugal.,Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
| | - R Amaral
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, Portugal.,Dept. of Cardiovascular and Respiratory Sciences, Porto Health School, Polytechnic Institute of Porto, Porto, Portugal
| | - M A Correia
- Allergy Unit, Instituto and Hospital CUF, Porto, Portugal
| | - S Mendes
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, Portugal
| | - P Vieira-Marques
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, Portugal
| | - J A Ferreira
- Serviço de Imunoalergologia, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - I Lopes
- Serviço de Imunoalergologia, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - J Gomes
- Serviço de Imunoalergologia, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - C Vidal
- Servicio de Alergia, Complejo Hospitalario Universitario de Santiago, Santiago De Compostela, Spain
| | - S López Freire
- Servicio de Alergia, Complejo Hospitalario Universitario de Santiago, Santiago De Compostela, Spain
| | - P Méndez Brea
- Servicio de Alergia, Complejo Hospitalario Universitario de Santiago, Santiago De Compostela, Spain
| | - A Arrobas
- Serviço de Pneumologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - M Valério
- Serviço de Pneumologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - C Chaves Loureiro
- Serviço de Pneumologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - L M Santos
- Serviço de Pneumologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - M Couto
- Allergy Unit, Instituto and Hospital CUF, Porto, Portugal
| | - L Araujo
- Allergy Unit, Instituto and Hospital CUF, Porto, Portugal
| | - A Todo Bom
- Serviço de Imunoalergologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - J P Azevedo
- Imunoalergologia, Centro Hospitalar de Leiria, Leiria, Portugal
| | - J Cardoso
- Serviço de Pneumologia, Hospital Santa Marta, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
| | - M Emiliano
- Serviço de Pneumologia, Hospital Santa Marta, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
| | - R Gerardo
- Serviço de Pneumologia, Hospital Santa Marta, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
| | - C Lozoya
- Serviço de Imunoalergologia, Hospital Amato Lusitano, Unidade Local de Saúde de Castelo Branco, Castelo Branco, Portugal
| | - P L Pinto
- Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
| | - A Castro Neves
- Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
| | - N Pinto
- Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
| | - A Palhinha
- Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
| | - F Teixeira
- Serviço de Pediatria, Centro Materno Infantil do Norte, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - M Ferreira-Magalhães
- Serviço de Pediatria, Centro Materno Infantil do Norte, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - C Alves
- Serviço de Pneumologia, Hospital Nossa Senhora do Rosário, Centro Hospitalar Barreiro Montijo, Barreiro, Portugal
| | - D Coelho
- Serviço de Pneumologia, Hospital Nossa Senhora do Rosário, Centro Hospitalar Barreiro Montijo, Barreiro, Portugal
| | - N Santos
- Serviço de Imunoalergologia, Centro Hospitalar Universitário do Algarve, Portimão, Portugal
| | - F Menezes
- Serviço de Pneumologia, Hospital Garcia de Orta, Almada, Portugal
| | - R Gomes
- Serviço de Pneumologia, Hospital Garcia de Orta, Almada, Portugal
| | - J C Cidrais Rodrigues
- Serviço de Pediatria, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal
| | - G Oliveira
- Serviço de Pediatria, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal
| | - J Carvalho
- Serviço de Pediatria, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal
| | - R Rodrigues Alves
- Serviço de Imunoalergologia, Hospital do Divino Espirito Santo, Ponta Delgada, Portugal
| | - A S Moreira
- Serviço de Imunoalergologia, Hospital do Divino Espirito Santo, Ponta Delgada, Portugal
| | - A Costa
- Serviço de Pediatria, Hospital da Senhora da Oliveira, Guimarães, Portugal
| | - C Abreu
- Serviço de Imunoalergologia, Hospital São Pedro de Vila Real, Centro Hospitalar De Trás-Os-Montes E Alto Douro, Vila Real, Portugal
| | - R Silva
- Serviço de Imunoalergologia, Hospital São Pedro de Vila Real, Centro Hospitalar De Trás-Os-Montes E Alto Douro, Vila Real, Portugal
| | - A Morête
- Serviço de Imunoalergologia, Hospital Infante D. Pedro, Centro Hospitalar Baixo Vouga, Aveiro, Portugal
| | - H Falcão
- Serviço de Imunoalergologia, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - M L Marques
- Serviço de Imunoalergologia, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - R Câmara
- Serviço de Imunoalergologia, Serviço de Saúde da Região Autónoma da Madeira, Funchal, Portugal
| | - M J Cálix
- Serviço de Pediatria, Hospital de São Teotónio, Centro Hospitalar Tondela-Viseu, Viseu, Portugal
| | - D Bordalo
- Serviço de Pediatria, Unidade Hospitalar de Famalicão, Centro Hospitalar do Médio Ave, Vila Nova de Famalicão, Portugal
| | - D Silva
- Serviço de Imunoalergologia, Centro Hospitalar Universitário de São João, E.P.E., Porto, Portugal
| | - M J Vasconcelos
- Serviço de Imunoalergologia, Centro Hospitalar Universitário de São João, E.P.E., Porto, Portugal
| | - R M Fernandes
- Departamento de Pediatria, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal.,Farmacologia Clínica e Terapêutica, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - R Ferreira
- Departamento de Pediatria, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal.,Clínica Universitária de Pediatria, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - P Freitas
- Bloco operatório, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - F Lopes
- MEDIDA - Medicina, Educação, Investigação, Desenvolvimento e Avaliação, Porto, Portugal
| | - J Almeida Fonseca
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, Portugal.,Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal.,Allergy Unit, Instituto and Hospital CUF, Porto, Portugal.,MEDIDA - Medicina, Educação, Investigação, Desenvolvimento e Avaliação, Porto, Portugal
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China N, Vaz D, Martins C, Gomes J, Ladeira I, Lima R, Guimarães M. Obtaining spirometric reference values when height is not available – comparison of alternative anthropometric measures. Pulmonology 2020; 26:198-203. [DOI: 10.1016/j.pulmoe.2019.09.002] [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] [Received: 07/07/2019] [Revised: 08/18/2019] [Accepted: 09/05/2019] [Indexed: 10/25/2022] Open
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Sucena M, Gomes J, Guimarães C, Miravitlles M. Implementation of European Alpha-1 Research Collaboration (EARCO) in Portugal: the future starts now. Pulmonology 2020; 26:181-183. [DOI: 10.1016/j.pulmoe.2020.01.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Accepted: 01/10/2020] [Indexed: 12/14/2022] Open
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Newey CR, Thompson NR, George P, Punia V, Hantus S, Lapin B, Gomes J, Katzan I. Patient-Reported Outcomes (PROs) in Acute Symptomatic Seizure (ASyS) Versus Patients With Established Epilepsy. Neurohospitalist 2020; 10:193-200. [PMID: 32549943 DOI: 10.1177/1941874419900709] [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] [Indexed: 11/15/2022] Open
Abstract
Purpose Acute symptomatic seizures (ASyS) are common in critically ill patients. It is unknown how ASyS affect posthospitalization self-reported health compared to patients with established epilepsy. Methods This is a retrospective cohort study from 2010 to 2018. Patients were identified by an institutional epilepsy database (Ebase). Patient-reported outcome measures (PROMs) were completed as part of standard of care and included the number of seizures in the prior 4 weeks, Liverpool Seizure Severity Scale (LSSS) ictal score, quality of life in epilepsy (QOLIE)-10, Patient Health Questionnaire-9 scales, and the PROM Information System Global Health (PROMIS-GH) scale. Mixed-effects models were created to adjust for age, sex, and race and to examine score trajectory over the 1 year after baseline. Results A total of 15 311 established epilepsy patients and 317 patients with ASyS were identified. When compared to patients with epilepsy, patients with ASyS were older, mostly male, more often black, and had worse baseline scores on the QOLIE-10 (P < .001), PROMIS-GH Physical Health (P = .037), and LSSS Ictal (P = .006) scales. Patient-Reported Outcomes Measurement Information System Mental and Physical Health T-scores were worse than the general population (T-score = 50) for patients with both ASyS (44 and 42.5, respectively) and epilepsy (44.2 and 44.6, respectively). After adjusting for age, sex, and race, patients with ASyS reported 38% fewer seizures (P = .006) yet worse QOLIE-10 score (P = .034). We found that scores improved over time for all PROMs except for PROMIS-GH Mental Health. Conclusion Compared to patients with epilepsy, patients with ASyS had fewer seizures but worse epilepsy-specific quality of life. Independent of group status, scores generally improved over time.
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Affiliation(s)
- Christopher R Newey
- Epilepsy Center, Cleveland Clinic, Cleveland, OH, USA.,Cerebrovascular Centers, Cleveland Clinic, Cleveland, OH, USA.,Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA.,Clinical Neurophysiology Fellowship with ICU-EEG emphasis, Cleveland Clinic, Cleveland, OH, USA
| | - Nicolas R Thompson
- Neurological Institute Center for Outcome Research & Evaluation, Cleveland, OH, USA.,Section of Biostatistics, Quantitative Health Science, Cleveland Clinic, Cleveland, OH, USA
| | - Pravin George
- Cerebrovascular Centers, Cleveland Clinic, Cleveland, OH, USA.,Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA.,Neurointensive Care Fellowship, Cleveland Clinic, Cleveland, OH, USA
| | - Vineet Punia
- Epilepsy Center, Cleveland Clinic, Cleveland, OH, USA
| | - Stephen Hantus
- Epilepsy Center, Cleveland Clinic, Cleveland, OH, USA.,Cerebrovascular Centers, Cleveland Clinic, Cleveland, OH, USA
| | - Brittany Lapin
- Neurological Institute Center for Outcome Research & Evaluation, Cleveland, OH, USA.,Section of Biostatistics, Quantitative Health Science, Cleveland Clinic, Cleveland, OH, USA
| | - Joao Gomes
- Cerebrovascular Centers, Cleveland Clinic, Cleveland, OH, USA
| | - Irene Katzan
- Cerebrovascular Centers, Cleveland Clinic, Cleveland, OH, USA.,Neurological Institute Center for Outcome Research & Evaluation, Cleveland, OH, USA
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Alves F, Prata S, Nunes T, Gomes J, Aguiar S, Aires da Silva F, Tavares L, Almeida V, Gil S. Canine parvovirus: a predicting canine model for sepsis. BMC Vet Res 2020; 16:199. [PMID: 32539830 PMCID: PMC7294767 DOI: 10.1186/s12917-020-02417-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [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] [Received: 12/09/2019] [Accepted: 06/08/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Sepsis is a severe condition associated with high prevalence and mortality rates. Parvovirus enteritis is a predisposing factor for sepsis, as it promotes intestinal bacterial translocation and severe immunosuppression. This makes dogs infected by parvovirus a suitable study population as far as sepsis is concerned. The main objective of the present study was to evaluate the differences between two sets of SIRS (Systemic Inflammatory Response Syndrome) criteria in outcome prediction: SIRS 1991 and SIRS 2001. The possibility of stratifying and classifying septic dogs was assessed using a proposed animal adapted PIRO (Predisposition, Infection, Response and Organ dysfunction) scoring system. RESULTS The 72 dogs enrolled in this study were scored for each of the PIRO elements, except for Infection, as all were considered to have the same infection score, and subjected to two sets of SIRS criteria, in order to measure their correlation with the outcome. Concerning SIRS criteria, it was found that the proposed alterations on SIRS 2001 (capillary refill time or mucous membrane colour alteration) were significantly associated with the outcome (OR = 4.09, p < 0.05), contrasting with the 1991 SIRS criteria (p = 0.352) that did not correlate with the outcome. No significant statistical association was found between Predisposition (p = 1), Response (p = 0.1135), Organ dysfunction (p = 0.1135), total PIRO score (p = 0.093) and outcome. To explore the possibility of using the SIRS criteria as a fast decision-making tool, a Fast-and-Frugal tree (FFT) was created with a sensitivity of 92% and a specificity of 29%. CONCLUSION These results suggest that increasing the SIRS criteria specificity may improve their prognostic value and their clinical usefulness. In order to improve the proposed PIRO scoring system outcome prediction ability, more specific criteria should be added, mainly inflammatory and organ dysfunction biomarkers.
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Affiliation(s)
- F. Alves
- Faculty of Veterinary Medicine, ULisboa, Av. Universidade Técnica, 1300-477 Lisboa, Portugal
| | - S. Prata
- Faculty of Veterinary Medicine, ULisboa, Av. Universidade Técnica, 1300-477 Lisboa, Portugal
- Veterinary Teaching Hospital, Faculty of Veterinary Medicine, ULisboa, Av. Universidade Técnica, 1300-477 Lisboa, Portugal
| | - T. Nunes
- Faculty of Veterinary Medicine, ULisboa, Av. Universidade Técnica, 1300-477 Lisboa, Portugal
- CIISA - Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Av. Universidade Técnica, 1300-477 Lisboa, Portugal
| | - J. Gomes
- Veterinary Teaching Hospital, Faculty of Veterinary Medicine, ULisboa, Av. Universidade Técnica, 1300-477 Lisboa, Portugal
| | - S. Aguiar
- Faculty of Veterinary Medicine, ULisboa, Av. Universidade Técnica, 1300-477 Lisboa, Portugal
- CIISA - Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Av. Universidade Técnica, 1300-477 Lisboa, Portugal
| | - F. Aires da Silva
- Faculty of Veterinary Medicine, ULisboa, Av. Universidade Técnica, 1300-477 Lisboa, Portugal
- CIISA - Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Av. Universidade Técnica, 1300-477 Lisboa, Portugal
| | - L. Tavares
- Faculty of Veterinary Medicine, ULisboa, Av. Universidade Técnica, 1300-477 Lisboa, Portugal
- CIISA - Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Av. Universidade Técnica, 1300-477 Lisboa, Portugal
| | - V. Almeida
- Faculty of Veterinary Medicine, ULisboa, Av. Universidade Técnica, 1300-477 Lisboa, Portugal
- CIISA - Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Av. Universidade Técnica, 1300-477 Lisboa, Portugal
| | - S. Gil
- Faculty of Veterinary Medicine, ULisboa, Av. Universidade Técnica, 1300-477 Lisboa, Portugal
- Veterinary Teaching Hospital, Faculty of Veterinary Medicine, ULisboa, Av. Universidade Técnica, 1300-477 Lisboa, Portugal
- CIISA - Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Av. Universidade Técnica, 1300-477 Lisboa, Portugal
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Chaves P, Ribeiro D, Gomes J, Monteiro M, Marote S, Frutuoso S, Araújo FA, Paço M. Cross-cultural adaptation and validation of the VISA-P questionnaire for Portuguese-speaking (Portugal) patients with patellar tendinopathy. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa040.008] [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 Patellar tendinopathy is a condition frequently verified in individuals who practice regular physical activity, therefore functional evaluation is crucial to monitor symptoms. The VISA-P was developed for English-speaking population to evaluate patients with this condition, and there is a need to adapt this tool to Portuguese (Portugal).
Objectives To cross-cultural adapt and validate the VISA-P questionnaire for Portuguese-speaking (Portugal) patellar tendinopathy patients
Methodology The VISA-P questionnaire was translated and cross-culturally adapted into Portuguese (VISA-P-Por) according to specific guidelines, using six steps: Translation, synthesis, back translation, expert committee review, pretesting (n = 10), and appraisal of the adaptation process. The resulting VISA-P-Por was then subjected to an analysis of the psychometric properties (construct validity, reproducibility [agreement and reliability], internal consistency and floor and ceiling effects) in 73 patellar tendinopathy patients and 73 asymptomatic people. Participants completed the questionnaire at baseline and after a minimum interval of 48 hours.
Results The Visa-P-Por questionnaire revealed a high level of agreement, presenting semantic and content validity. Construct validity showed differences between both groups (p < 0,001) and the questionnaire exhibited very good internal consistency, with an excellent α Cronbach (0,91). Concerning reproducibility, agreement levels were considered optimal which can be proven by the Bland Altman graph, the standard error of measurement (5,74) and the minimally important change (15,91 points), as well as the excellent ICC value (0,92). There were no ceiling and floor effects detected.
Conclusion The VISA-P-Por questionnaire is a valid and reliable tool, with psychometric properties comparable with the original version. Thus, it can be recommended as a robust tool for measuring clinical severity and functional impact of patellar tendinopathy in Portuguese-speaking (Portugal) patients.
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Affiliation(s)
- P Chaves
- CESPU, Instituto de Investigacão e Formação Avançada em Ciências e Tecnologias da Saúde, Gandra - Paredes, Portugal
| | - D Ribeiro
- CESPU, Instituto de Investigacão e Formação Avançada em Ciências e Tecnologias da Saúde, Gandra - Paredes, Portugal
| | - J Gomes
- CESPU, Instituto de Investigacão e Formação Avançada em Ciências e Tecnologias da Saúde, Gandra - Paredes, Portugal
| | - M Monteiro
- CESPU, Instituto de Investigacão e Formação Avançada em Ciências e Tecnologias da Saúde, Gandra - Paredes, Portugal
| | - S Marote
- CESPU, Instituto de Investigacão e Formação Avançada em Ciências e Tecnologias da Saúde, Gandra - Paredes, Portugal
| | - S Frutuoso
- CESPU, Instituto de Investigacão e Formação Avançada em Ciências e Tecnologias da Saúde, Gandra - Paredes, Portugal
| | - FA Araújo
- ISPUP-EPIUnit, University of Porto, Porto
| | - M Paço
- CESPU, Instituto de Investigacão e Formação Avançada em Ciências e Tecnologias da Saúde, Gandra - Paredes, Portugal
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Felicio J, Pé-Leve P, Castro A, Gomes J, Martins N, Lopes T, Martins F. P-02-28 A Minimally Invasive Procedure in the Surgical Treatment of Peyronie's Disease: Short- and Mid-Term Results. J Sex Med 2020. [DOI: 10.1016/j.jsxm.2020.04.182] [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: 10/24/2022]
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Newey CR, George P, Honomichl R, Gomes J, Maraj A, Kinzy T, Conley S, Douglas B, Stoltz M, Hang D, Omer T, Abubakr S, Lynch G, Dani D, Katzan I. Satisfaction with Care and Satisfaction with Decision Making are Similar Regardless of Staffing Model in a Neurocritical Care Unit. Neurocrit Care 2020; 34:13-20. [PMID: 32323147 PMCID: PMC7222902 DOI: 10.1007/s12028-020-00967-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Introduction Patient-centered care, particularly shared medical decision making, is difficult to measure in critically ill patients where decisions are often made by a designated surrogate, often receiving information from multiple providers with varying degrees of training. The purpose of this study was to compare short-term satisfaction with care and decision making in patients or surrogates between two neurocritical care units [one staffed by a neurocritical care attending and advanced practice providers (APPs) and one staffed by a neurocritical care attending and resident/fellow trainees] using the Family Satisfaction in the ICU (FS-ICU) survey. Methods Over a 6-month period, the FS-ICU was administered on a tablet device to patients or surrogates at least 24 h after admission and stored on REDCap database. Results One hundred and thirty-four patients or surrogates completed the FS-ICU. The response rates were 59.97% and 46.58% in the APP and trainee units, respectively. There were no differences in patient age, sex, ventilator days or ICU length of stay. Overall, there were no differences in satisfaction with care or perceived shared medical making between the units. Respondents who identified their relationship with the patient as “other” (not a spouse, parent, nor a sibling) were less satisfied with care. Additionally, surrogates who identified as parents of the patient were more satisfied with degree of shared medical decision making. Conclusion This study showed that: (1) collecting FS-ICU in a neurocritical care unit is feasible, (2) overall there is no difference in short-term satisfaction with care or shared decision making between a NICU staffed with trainees compared to one staffed with APPs, and (3) parents of patients have a higher short-term satisfaction with degree of shared medical decision making.
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Affiliation(s)
- Christopher R Newey
- Neurological Institute, Cerebrovascular Center, Cleveland Clinic, 9500 Euclid Avenue, Mailcode 80, Cleveland, OH, 44195, USA.
- Neurological Institute, Epilepsy Center, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
- Neurological Institute, Patient Centered Outcome Center, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
| | - Pravin George
- Neurological Institute, Cerebrovascular Center, Cleveland Clinic, 9500 Euclid Avenue, Mailcode 80, Cleveland, OH, 44195, USA
- Neurological Institute, Patient Centered Outcome Center, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA
- Case Western Reserve University, Cleveland, OH, 44195, USA
| | - Ryan Honomichl
- Neurological Institute, Patient Centered Outcome Center, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA
| | - Joao Gomes
- Neurological Institute, Cerebrovascular Center, Cleveland Clinic, 9500 Euclid Avenue, Mailcode 80, Cleveland, OH, 44195, USA
| | - Anita Maraj
- Neurological Institute, Cerebrovascular Center, Cleveland Clinic, 9500 Euclid Avenue, Mailcode 80, Cleveland, OH, 44195, USA
| | - Tyler Kinzy
- Neurological Institute, Patient Centered Outcome Center, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA
- Case Western Reserve University, Cleveland, OH, 44195, USA
| | - Sarah Conley
- Neurological Institute, Cerebrovascular Center, Cleveland Clinic, 9500 Euclid Avenue, Mailcode 80, Cleveland, OH, 44195, USA
| | - Bradley Douglas
- Neurological Institute, Cerebrovascular Center, Cleveland Clinic, 9500 Euclid Avenue, Mailcode 80, Cleveland, OH, 44195, USA
| | - Michael Stoltz
- Neurological Institute, Cerebrovascular Center, Cleveland Clinic, 9500 Euclid Avenue, Mailcode 80, Cleveland, OH, 44195, USA
| | - David Hang
- Neurological Institute, Cerebrovascular Center, Cleveland Clinic, 9500 Euclid Avenue, Mailcode 80, Cleveland, OH, 44195, USA
| | - Tarig Omer
- Anesthesiology Institute, Cardiothoracic Anesthesia Center, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA
| | - Samer Abubakr
- Neurological Institute, Cerebrovascular Center, Cleveland Clinic, 9500 Euclid Avenue, Mailcode 80, Cleveland, OH, 44195, USA
| | - Gwen Lynch
- Neurological Institute, Cerebrovascular Center, Cleveland Clinic, 9500 Euclid Avenue, Mailcode 80, Cleveland, OH, 44195, USA
| | - Dhimant Dani
- Neurological Institute, Cerebrovascular Center, Cleveland Clinic, 9500 Euclid Avenue, Mailcode 80, Cleveland, OH, 44195, USA
| | - Irene Katzan
- Neurological Institute, Cerebrovascular Center, Cleveland Clinic, 9500 Euclid Avenue, Mailcode 80, Cleveland, OH, 44195, USA
- Neurological Institute, Patient Centered Outcome Center, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA
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Blanco-Alegre C, Calvo AI, Alves C, Fialho P, Nunes T, Gomes J, Castro A, Oduber F, Coz E, Fraile R. Aethalometer measurements in a road tunnel: A step forward in the characterization of black carbon emissions from traffic. Sci Total Environ 2020; 703:135483. [PMID: 31761363 DOI: 10.1016/j.scitotenv.2019.135483] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 10/20/2019] [Accepted: 11/10/2019] [Indexed: 06/10/2023]
Abstract
A sampling campaign was conducted in the Liberdade Avenue tunnel (Braga, Portugal) during a week (with 56,000 vehicles) to monitor black carbon (eBC-equivalent black carbon) by means of an Aethalometer AE-31, and gaseous pollutants (CO2, CO, NOx). Inside the tunnel, the mean eBC mass concentration was 21 ± 10 μg m-3, reaching a maximum hourly value of 49.0 μg m-3. An hourly and weekday-weekend study was carried out. Regarding the Absorption Ångström exponent (AAE), a mean value of 0.97 ± 0.10 was obtained, for a source of practically pure traffic. There was a positive significant correlation between eBC and the number of light vehicles (r = 0.47; p < 0.001) and between eBC and the gaseous emissions: CO (r = 0.67; p < 0.001), CO2 (r = 0.71; p < 0.001), NO (r = 0.63; p < 0.001) and NO2 (r = 0.70; p < 0.001). The mean black carbon emission factors (EFBC) inside the tunnel were 0.31 ± 0.08 g (kg fuel)-1 and 0.11 ± 0.08 mg veh-1 km-1, similar to those found in other studies for gasoline and diesel vehicles in road tunnels.
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Affiliation(s)
- C Blanco-Alegre
- Department of Physics, IMARENAB University of León, 24071 León, Spain
| | - A I Calvo
- Department of Physics, IMARENAB University of León, 24071 León, Spain
| | - C Alves
- Centre for Environment and Marine Studies, Department of Physics, University of Aveiro, 3810-193 Aveiro, Portugal
| | - P Fialho
- Research Institute of Volcanology and Evaluation - IVAR, Rua da Mãe de Deus, 9500-321 Ponta Delgada, Portugal
| | - T Nunes
- Centre for Environment and Marine Studies, Department of Physics, University of Aveiro, 3810-193 Aveiro, Portugal
| | - J Gomes
- Centre for Environment and Marine Studies, Department of Physics, University of Aveiro, 3810-193 Aveiro, Portugal
| | - A Castro
- Department of Physics, IMARENAB University of León, 24071 León, Spain
| | - F Oduber
- Department of Physics, IMARENAB University of León, 24071 León, Spain
| | - E Coz
- Centre for Energy, Environment and Technology Research (CIEMAT), Department of the Environment, Madrid, Spain
| | - R Fraile
- Department of Physics, IMARENAB University of León, 24071 León, Spain.
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Gomes J, Au F, Basak A, Cakmak S, Vincent R, Kumarathasan P. Maternal blood biomarkers and adverse pregnancy outcomes: a systematic review and meta-analysis. Crit Rev Toxicol 2019; 49:461-478. [PMID: 31509042 DOI: 10.1080/10408444.2019.1629873] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: Pregnancy is a vulnerable period for the mother and the infant and exposures to environmental chemicals in utero can influence neonatal morbidity and mortality. There is a momentum toward understanding and exploring the current maternal biological mechanisms specific to in utero effects, to improve birth outcomes. This study aims to examine the current understanding of the role of biomarkers that may be associated with term of pregnancy, infant birth weights and infant development in utero.Methods: Electronic searches were conducted in PubMed, Embase, OvidMD, and Scopus databases; and all relevant research articles in English were retrieved. Studies were selected if they evaluated maternal blood plasma/serum biomarkers proposed to influence adverse birth outcomes in the neonate. Data were extracted on characteristics, quality, and odds ratios from each study and meta-analysis was conducted.Results: A total of 54 studies (35 for meta-analysis), including 43,702 women, 50 plasma markers and six descriptors of birth outcomes were included in the present study. The random effect point estimates for risk of adverse birth outcomes were 1.61(95%CI: 1.39-1.85, p < 0.0001) for inflammation-related biomarkers and 1.65(95%CI: 1.22-2.25, p = 0.0013) for growth factor/hormone-related biomarkers. All subgroups of plasma markers showed significant associations with adverse birth outcomes with no apparent study bias.Conclusions: The two subsets of plasma markers identified in this study (inflammation-related and growth factor/hormone-related) may serve as potentially valuable tools in the investigation of maternal molecular mechanisms, especially select pathways underlying inflammatory and immunological mediation in terms of modulating adverse infant outcomes. Future large, prospective cohort studies are needed to validate the promising plasma biomarkers, and to examine other maternal biological matrices such as cervicovaginal fluid and urine.
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Affiliation(s)
- J Gomes
- Faculty of Health Science, Interdisciplinary School of Health Sciences, Ottawa, Canada
| | - F Au
- Faculty of Health Science, Interdisciplinary School of Health Sciences, Ottawa, Canada.,Environmental Health Science and Research Bureau, Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, Canada
| | - A Basak
- Faculty of Health Science, Interdisciplinary School of Health Sciences, Ottawa, Canada
| | - S Cakmak
- Environmental Health Science and Research Bureau, Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, Canada
| | - R Vincent
- Environmental Health Science and Research Bureau, Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, Canada.,Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - P Kumarathasan
- Faculty of Health Science, Interdisciplinary School of Health Sciences, Ottawa, Canada.,Environmental Health Science and Research Bureau, Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, Canada.,Analytical Biochemistry and Proteomics Laboratory, Mechanistic Studies Division, Environmental Health Science and Research Bureau, Healthy Environments and Consumer Safety Branch, Ottawa, Canada
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Lopes AP, Mineiro MA, Costa F, Gomes J, Santos C, Antunes C, Maia D, Melo R, Canotilho M, Magalhães E, Vicente I, Valente C, Gonçalves BG, Conde B, Guimarães C, Sousa C, Amado J, Brandão ME, Sucena M, Oliveira MJ, Seixas S, Teixeira V, Telo L. Portuguese consensus document for the management of alpha-1-antitrypsin deficiency. Pulmonology 2019; 24 Suppl 1:1-21. [PMID: 30473034 DOI: 10.1016/j.pulmoe.2018.09.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 09/12/2018] [Accepted: 09/14/2018] [Indexed: 01/08/2023] Open
Abstract
Alpha-1-antitrypsin deficiency (AATD) is a genetic autosomal codominant disorder caused by mutations in SERPINA1 gene. It is one of the most prevalent genetic disorders, although it remains underdiagnosed. Whereas at international level there are several areas of consensus on this disorder, in Portugal, inter-hospital heterogeneity in clinical practice and resources available have been adding difficulties in reaching a diagnosis and in making therapeutic decisions in this group of patients. This raised a need to draft a document expressing a national consensus for AATD. To this end, a group of experts in this field was created within the Portuguese Pulmonology Society - Study group on AATD, in order to elaborate the current manuscript. The authors reviewed the existing literature and provide here general guidance and extensive recommendations for the diagnosis and management of AATD that can be adopted by Portuguese clinicians from different areas of Medicine. This article is part of a supplement entitled "Portuguese consensus document for the management of alpha-1-antitrypsin deficiency" which is sponsored by Sociedade Portuguesa de Pneumologia.
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Affiliation(s)
- A P Lopes
- Centro Hospitalar e Universitário de Coimbra (HUC); Alpha-1-antitrypsin deficiency study group coordinator.
| | | | - F Costa
- Centro Hospitalar e Universitário de Coimbra (HG)
| | | | | | | | - D Maia
- Centro Hospital Lisboa Central
| | - R Melo
- Hospital Prof. Doutor Fernando da Fonseca
| | | | | | | | | | | | - B Conde
- Centro Hospitalar de Trás os Montes e Alto Douro
| | | | - C Sousa
- Centro Hospitalar de São João
| | - J Amado
- Unidade Local de Saúde de Matosinhos
| | - M E Brandão
- Centro Hospitalar de Trás os Montes e Alto Douro
| | | | | | - S Seixas
- Instituto de Investigação e Inovação em Saúde, Universidade do Porto (I3S); Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP)
| | - V Teixeira
- Serviço de Saúde da Região Autónoma da Madeira (SESARAM)
| | - L Telo
- Centro Hospitalar Lisboa Norte
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Koffman L, Rincon F, Gomes J, Singh S, He Y, Ritzl E, Bleck TP, Kaplan PW, Nyquist P. Continuous Electroencephalographic Monitoring in the Intensive Care Unit: A Cross-Sectional Study. J Intensive Care Med 2019; 35:1235-1240. [DOI: 10.1177/0885066619849889] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: Research on continuous electro-encephalographic monitoring (cEEG) in the intensive care unit (ICU) has previously focused on neuroscience ICUs. This study determines cEEG utilization within a sample of specialty ICUs world-wide. Methods: A cross-sectional electronic survey of attending level physicians across various intensive care settings. Twenty-five questions developed from consensus statements on the use of cEEG in the critically ill sent as an electronic survey. Results: Of all, 9344 were queried and 417 (4.5%) responses were analyzed with 309 (74%) from the United States and 74 (18%) internationally. Intensive care units were: medical (10%), surgical (6%), neurologic/neurosurgical (12%), cardiac (4%), trauma (3%), pediatrics (29%), burn (<1%), multidisciplinary (30%), and other (5%). Intensive care units were: academic (65%), community (18%), public (3%), military (1%), and other (13%). Specialized cEEG teams were available in 71% of ICUs. Rapid 24/7 access and cEEG interpretation was available in 32% of ICUs. Interpretation changed clinical management frequently (28%) and sometimes (45%). Conclusions: Despite guideline recommendations for cEEG use, there is a discordance between availability, night coverage, and immediate interpretation. Only 27% have institutional protocols for indications and duration of cEEG monitoring. Furthermore, cEEG may be underutilized in nonneurologic ICUs as well as ICUs in smaller nonacademic affiliated hospitals and those outside of the United States.
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Affiliation(s)
- Lauren Koffman
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Fred Rincon
- Cerebrovascular Disease and Neurocritical Care, Thomas Jefferson University, Philadelphia, PA, USA
| | - Joao Gomes
- Cerebrovascular Center, Cleveland Clinic, Cleveland, OH, USA
| | - Sarabdeep Singh
- Department of Core Clinical Research and Biostatistics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Yitian He
- University of Wisconsin-Madison, Madison, WI, USA
| | - Eva Ritzl
- Department of Neurology and Epilepsy, The Johns Hopkins Hospital, Baltimore, MD, USA
| | - Thomas P. Bleck
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Peter W. Kaplan
- Department of Neurology and Epilepsy, Johns Hopkins Bayview Medical Center, Baltimore, MD, USA
| | - Paul Nyquist
- Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins Hospital, Baltimore, MD, USA
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Braúna M, Gomes J, Paúl C, Azevedo M. Care in dementia: Informal caregiver motivations. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz034.072] [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)
- M Braúna
- Escola Superior de Saúde do Instituto Politécnico de Leiria, Portugal
- Center for Innovative Care and Health Technology - CiTheCare, Politécnico de Leiria, Portugal
| | - J Gomes
- Escola Superior de Saúde do Instituto Politécnico de Leiria, Portugal
- Center for Innovative Care and Health Technology - CiTheCare, Politécnico de Leiria, Portugal
| | - C Paúl
- Abel Salazar Biomedical Sciences Institute, Portugal
- Research and Education Unit on Ageing – UNIFAI, Portugal
| | - M Azevedo
- Abel Salazar Biomedical Sciences Institute, Portugal
- Research and Education Unit on Ageing – UNIFAI, Portugal
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Gomes J, Shriver L, Bain M, Milne G, Kallianpur A. Abstract WMP30: F
2
-Isoprostanes and Isofurans as Markers of Oxidative Stress and Delayed Cerebral Ischemia Following Aneurysmal Subarachnoid Hemorrhage. Stroke 2019. [DOI: 10.1161/str.50.suppl_1.wmp30] [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: 11/16/2022]
Abstract
Background:
F
2
-Isoprostanes (F
2
-IsoP) and Isofurans (IsoF), specific markers of lipid peroxidation in vivo, have been reported to be elevated and have prognostic implications in aneurysmal subarachnoid hemorrhage (aSAH). We examined associations between these biomarkers and the risk of delayed cerebral ischemia (DCI) following aSAH.
Methods:
Eighteen patients with aSAH and 7 controls with normal neuroimaging and CSF analysis results underwent CSF sampling and abstraction of clinical, demographic, and laboratory data. Samples (two) of CSF were collected on day 1 and once on days 5-8 post-bleed. F
2
-IsoP and IsoF assays were performed at Vanderbilt Eicosanoid Core Lab by gas chromatography/mass spectroscopy. Levels are expressed in median (IQR) for non-parametric data. Repeated sample measurement were compared using the Wilcoxon signed-rank test, whereas the Mann Whitney test was used for other non-parametric data.
Results:
Mean age was 62
+
15 (aSAH cases) vs. 52
+
14 (controls) years,
p
=0.07, and 80% were female. Median Hunt-Hess score was 3 (2-4) and modified Fisher scale 3 (3-4). Thirty five percent of patients developed DCI. F
2
-IsoP were significantly higher in cases than controls 47.5 (30.2-53.5) vs. 26.0 (21.2-34.5) pg/mL,
p
0.01. No significant differences were observed in patients with or without DCI (41 (33.5-52) vs. 44 (28.5-55.5) pg/mL). IsoF were elevated in the second CSF sample (41.5 (34-72) pg/mL) in 9 patients, but undetectable in the remainder cases and all controls. Cases who developed DCI had significantly higher IsoF than cases who did not (57 (34-72) vs. 0 (0-34) pg/mL,
p=
0.001). Median PaO2 in both groups was similar (130.5 (89.2-189.7) vs. 115 (77.5-176) mmHg).
Conclusions:
F
2
-IsoP and IsoF serve as overall indicators of oxidative injury following aSAH, but IsoF may also be related to the development of DCI and cerebral vasospasm. Whether IsoF serve as mediators of vasospasm/ischemia or are merely favored byproducts of oxidative damage warrants further investigation. In the absence of higher oxygen tensions, we hypothesize the possibility of neuronal mitochondrial dysfunction in patients with elevated IsoF.
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Neto T, Freitas S, Andrade R, Gomes J, Mendes B, Mendes T, Nordez A, Oliveira R. Sciatic nerve stiffness is not changed immediately after a slump neurodynamics technique. Muscles Ligaments Tendons J 2019. [DOI: 10.32098/mltj.03.2017.24] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- T. Neto
- Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
- Lunex University, Faculty of Health Sciences, Differdange, Luxembourg
| | - S.R. Freitas
- Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
- Benfica LAB, Sport Lisboa e Benfica, Lisboa, Portugal
| | - R.J. Andrade
- Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
- University of Nantes, Laboratory “Movement, Interactions, Performance” (EA 4334), Faculty of Sport Sciences, Nantes, France
| | - J. Gomes
- Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
| | - B. Mendes
- Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
- Benfica LAB, Sport Lisboa e Benfica, Lisboa, Portugal
| | - T. Mendes
- Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
- Benfica LAB, Sport Lisboa e Benfica, Lisboa, Portugal
| | - A. Nordez
- University of Nantes, Laboratory “Movement, Interactions, Performance” (EA 4334), Faculty of Sport Sciences, Nantes, France
| | - R. Oliveira
- Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
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Margarido C, Ferns J, Chin V, Ribeiro T, Nascimento B, Barrett J, Herer E, Halpern S, Andrews L, Ballatyne G, Chapmam M, Gomes J, Callum J. Massive hemorrhage protocol activation in obstetrics: a 5-year quality performance review. Int J Obstet Anesth 2018; 38:37-45. [PMID: 30509680 DOI: 10.1016/j.ijoa.2018.10.004] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 09/24/2018] [Accepted: 10/13/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND A structured approach to hemorrhagic emergencies in obstetrics has gained popularity with the implementation of massive hemorrhage protocols. The trauma literature suggests that routine quality reviews should be in place to improve patient outcomes. The aim of this study was to develop quality indicators and assess compliance by the clinical team. METHODS A multidisciplinary team set the institutional quality indicators for the massive hemorrhage protocol review. A retrospective review of all obstetrical massive hemorrhage protocol activation events from September 2010 to January 2015 was performed. All protocol events occurred before the creation of the quality indicators. Data were retrieved from patient records. RESULTS There were 17 (0.09%) protocol activations for 19 790 deliveries during the study period. All 17 (100%) patients received at least one unit of red blood cells. Overactivation, defined as the transfusion of <2 units of red blood cells, occurred in two cases (12%). Common causes of non-compliance were: 24% (4/17) temperature monitoring, 18% (3/17) lactate measurement, 41% (7/17) arterial blood gas sampling, and 18% (3/17) hemoglobin maintenance within the target range of 55-95 g/L. Admission to intensive care and peripartum hysterectomy occurred in 12 and 5 cases (71% and 29%), respectively. CONCLUSIONS Suboptimal compliance was found in multiple areas, which may be attributable to the low frequency of activation of our massive haemorrhage protocol in obstetrics. The quality targets identified in this report can act as a basis for other institutions developing quality indicators to evaluate performance.
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Affiliation(s)
- C Margarido
- Department of Obstetrics Anaesthesia, Division of Obstetrical Anaesthesia, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
| | - J Ferns
- Department of Obstetrics Anaesthesia, Division of Obstetrical Anaesthesia, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - V Chin
- Department of Transfusion Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - T Ribeiro
- Department of Obstetrics Anaesthesia, Division of Obstetrical Anaesthesia, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - B Nascimento
- Department of General Surgery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - J Barrett
- Department of Obstetrics and Gynecology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - E Herer
- Department of Obstetrics and Gynecology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - S Halpern
- Department of Obstetrics Anaesthesia, Division of Obstetrical Anaesthesia, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - L Andrews
- Department of Women and Babies, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - G Ballatyne
- Department of Women and Babies, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - M Chapmam
- Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - J Gomes
- Department of Evaluative Clinical Sciences, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - J Callum
- Department of Transfusion Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
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Duarte H, Balmaña M, Mereiter S, Osório H, Polónia A, Santos L, Gomes J, Reis C. PO-174 ErbB2 glycosylation landscape in gastric cancer cells – a novel functional target? ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Gomes J, Duarte H, Meriter S, Gomes C, Freitas D, Campos D, Balmana M, Magalhaes A, Reis C. PO-248 Novel insights on the role of glycosylation in cancer: molecular functions and clinical applications. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Balmaña M, Mereiter S, Diniz F, Feijão T, Gomes J, Barrias C, Magalhães A, Reis C. PO-475 Unravelling the role of sialylation in targeted therapy resistance using 3D cancer models. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.494] [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] Open
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Leung L, Evranos B, Gonna H, Gomes J, Harding I, Raju H, Angelozzi A, Domenichini G, Zuberi Z, Norman M, Gallagher M. 220Simultaneous multi-catheter cryotherapy for the treatment of accessory pathways refractory to radiofrequency catheter ablation. Europace 2018. [DOI: 10.1093/europace/euy015.069] [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: 11/15/2022] Open
Affiliation(s)
- L Leung
- St George's University of London, Cardiology Clinical Academic Group, London, United Kingdom
| | - B Evranos
- St George's University of London, Cardiology Clinical Academic Group, London, United Kingdom
| | - H Gonna
- St George's University of London, Cardiology Clinical Academic Group, London, United Kingdom
| | - J Gomes
- St George's University of London, Cardiology Clinical Academic Group, London, United Kingdom
| | - I Harding
- St George's University of London, Cardiology Clinical Academic Group, London, United Kingdom
| | - H Raju
- St George's University of London, Cardiology Clinical Academic Group, London, United Kingdom
| | - A Angelozzi
- St George's University of London, Cardiology Clinical Academic Group, London, United Kingdom
| | - G Domenichini
- St George's University of London, Cardiology Clinical Academic Group, London, United Kingdom
| | - Z Zuberi
- Royal Surrey County Hospital, Cardiology Department, Guildford, United Kingdom
| | - M Norman
- St George's University of London, Cardiology Clinical Academic Group, London, United Kingdom
| | - M Gallagher
- St George's University of London, Cardiology Clinical Academic Group, London, United Kingdom
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Rodrigues AM, Canhão H, Marques A, Ambrósio C, Borges J, Coelho P, Costa L, Fernandes S, Gonçalves I, Gonçalves M, Guerra M, Marques ML, Pimenta S, Pinto P, Sequeira G, Simões E, Teixeira L, Vaz C, Vieira-Sousa E, Vieira R, Alvarenga F, Araújo F, Barcelos A, Barcelos F, Barros R, Bernardes M, Canas da Silva J, Cordeiro A, Costa M, Cunha-Miranda L, Cruz M, Duarte AC, Duarte C, Faustino A, Figueiredo G, Fonseca JE, Furtado C, Gomes J, Lopes C, Mourão AF, Oliveira M, Pimentel-Santos FM, Ribeiro A, Sampaio da Nóvoa T, Santiago M, Silva C, Silva-Dinis A, Sousa S, Tavares-Costa J, Terroso G, Vilar A, Branco JC, Tavares V, Romeu JC, da Silva J. Portuguese recommendations for the prevention, diagnosis and management of primary osteoporosis - 2018 update. Acta Reumatol Port 2018; 43:10-31. [PMID: 29602163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND Advances in osteoporosis (OP)case definition, treatment options, optimal therapy duration and pharmacoeconomic evidence in the national context motivated the Portuguese Society of Rheumatology (SPR) to update the Portuguese recommendations for the diagnosis and management of osteoporosis published in 2007. METHODS SPR bone diseases' working group organized meetings involving 55 participants (rheumatologists, rheumatology fellows and one OP specialist nurse) to debate and develop the document. First, the working group selected 11 pertinent clinical questions for the diagnosis and management of osteoporosis in standard clinical practice. Then, each question was investigated through literature review and draft recommendations were built through consensus. When insufficient evidence was available, recommendations were based on experts' opinion and on good clinical practice. At two national meetings, the recommendations were discussed and updated. A draft of the recommendations full text was submitted to critical review among the working group and suggestions were incorporated. A final version was circulated among all Portuguese rheumatologists before publication and the level of agreement was anonymously assessed using an online survey. RESULTS The 2018 SPR recommendations provide comprehensive guidance on osteoporosis prevention, diagnosis, fracture risk assessment, pharmacological treatment initiation, therapy options and duration of treatment, based on the best available evidence. They attained desirable agreement among Portuguese rheumatologists. As more evidence becomes available, periodic revisions will be performed. Target audience and patient population: The target audience for these guidelines includes all clinicians. The target patient population includes adult Portuguese people. Intended use: These recommendations provide general guidance for typical cases. They may not be appropriate in all situations - clinicians are encouraged to consider this information together with updated evidence and their best clinical judgment in individual cases.
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Gomes J, Lopes A, Bednarczyk K, Gmurek M, Stelmachowski M, Zaleska-Medynska A, Quinta-Ferreira M, Costa R, Quinta-Ferreira R, Martins R. Environmental preservation of emerging parabens contamination: effect of Ag and Pt loading over the catalytic efficiency of TiO 2 during photocatalytic ozonation. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.egypro.2017.10.282] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Rahman A, Kumarathasan P, Gomes J. Infant and mother related outcomes from exposure to metals with endocrine disrupting properties during pregnancy. Sci Total Environ 2016; 569-570:1022-1031. [PMID: 27378155 DOI: 10.1016/j.scitotenv.2016.06.134] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [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: 04/19/2016] [Revised: 06/16/2016] [Accepted: 06/17/2016] [Indexed: 05/27/2023]
Abstract
BACKGROUND Endocrine-related adverse health effects from exposure to heavy metals such as lead, arsenic, cadmium, and mercury are yet to be adequately described. The purpose of this review was to gain insight into maternal exposure to heavy metals, and to identify potential endocrine-related adverse health effects in the mother and the infant. METHODS Relevant databases were searched for original research reports and a total of 46 articles were retained for scrutiny. Required data was extracted from these studies and their methodology was assessed. RESULTS Impaired fetal growth was observed from exposure to all endocrine disrupting metals, while exposure to lead and arsenic were associated with spontaneous abortion, stillbirth and neonatal deaths. Maternal exposure to arsenic was associated with impaired glucose tolerance in these mothers. CONCLUSION Impaired fetal growth, fetal loss, and neonatal deaths were significantly associated with heavy metals exposure during pregnancy; however, hypertension and gestational diabetes require further investigation.
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Affiliation(s)
- A Rahman
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Canada
| | - P Kumarathasan
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, Canada
| | - J Gomes
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Canada; McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, Ottawa, Canada.
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Assoni A, Coatti G, Beccari M, Gomes J, Cardozo K, Neto M, Carvalho V, Zatz M. Controversial preclinical results in neuromuscular animal models: Are they related to differences in mesenchymal stromal cells (MSCs) secretome? Neuromuscul Disord 2016. [DOI: 10.1016/j.nmd.2016.06.156] [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: 10/21/2022]
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Champney F, Maddock L, Welford J, Kemp J, Allan V, Persidskikh Y, Orini M, Ang R, Workman A, Wong L, Honarbakhsh S, Leong K, Silberbauer J, O'Nunain S, Gomes J, McCready J, Bostock J, Shaw K, McKenna C, Bailey J, Honarbakhsh S, Casas J, Wallace J, Hunter R, Schilling R, Perel P, Morley K, Banerjee A, Hemingway H, Mrochak A, Ilyina T, Goncharik D, Chasnoits A, Plashinskaya L, Taggart P, Hayward M, Lambiase P, Hosford P, Kasparov S, Lambiase P, Tinker A, Gourine A, Kettlewell S, Dempster J, Colman M, Rankin A, Myles R, Smith G, Tester D, Jaye A, FitzPatrick D, Evans M, Fleming P, Jeffrey I, Cohen M, Simpson M, Ackerman M, Behr E, Srinivasan N, Kirkby C, Firman E, Tobin L, Murphy C, Lowe M, Hunter RJ, Finlay M, Schilling RJ, Lambiase PD, Ng F, Tomlinson L, Nuthoo S, Cajilog E, Lefroy D, Qureshi N, Koa-Wing M, Whinnett Z, Linton N, Davies D, Lim P, Peters N, Kanagaratnam P, Varnava A. ORAL ABSTRACTS (1)Allied Professionals7CRYOABLATION FOR PAROXYSMAL ATRIAL FIBRILLATION - IS AN EP LAB REQUIRED?8A PATHWAY TO SAFETY - ANTICOAGULATION COMPLIANCE IN CIED PATIENTS WITH AF9UNDERSTANDING THE WAYS IN WHICH OCCUPATION IS AFFECTED BY POSTURAL TACHYCARDIA SYNDROME: A UK OCCUPATIONAL THERAPY PERSPECTIVE10DEVELOPMENT OF AN INTERGRATED SUPPORT PATHWAY FOR PATIENTS FULFILLING NICE CRITERIA FOR AN INTERNAL CARDIOVASCULAR DEBRIBRILLATOR (ICD) IN A DISTRICT GENERAL HOSPITAL11ARE CARDIOVASCULAR RISK FACTORS ALSO ASSOCIATED WITH THE INCIDENCE OF ATRIAL FIBRILLATION? A SYSTEMATIC REVIEW AND FIELD SYNOPSIS OF 23 FACTORS IN 32 INITIALLY HEALTHY COHORTS OF 20 MILLION PARTICIPANTS12BRAIN MRI FINDINGS IN PATIENTS WITH ATRIAL FIBRILLATION UNDERGOING CARDIOVERSIONBasic Science/Sudden Cardiac Death13PRELIMINARY ASSESSMENT OF THE “RE-ENTRY VULNERABILITY INDEX” AS A MARKER OF CARDIAC INSTABILITY IN THE HUMAN HEART USING WHOLE-HEART CONTACT EPICARDIAL MAPPING14OPTOGENETIC STIMULATION OF BRAINSTEM'S VAGAL PREGANGLIONIC NEURONES IS ASSOCIATED WITH NEURONAL NITRIC OXIDE SYNTHASE-DEPENDENT PROLONGATION OF VENTRICULAR EFFECTIVE REFRACTORY PERIOD15A DYNAMIC-CLAMP STUDY OF L-TYPE Ca2+ CURRENT IN RABBIT AND HUMAN ATRIAL MYOCYTES: THE CONTRIBUTION OF WINDOW ICaL TO EARLY AFTERDEPOLARISATIONS16WHOLE EXOME SEQUENCING IN SUDDEN INFANT DEATH SYNDROME17MEDIUM TERM SURVIVAL AND FAMILY SCREENING OUTCOMES IN AN IDIOPATHIC VENTRICULAR FIBRILLATION COHORT - A MULTICENTRE EXPERIENCE18CLINICAL CHARACTERISTICS OF SCD SURVIVORS WITH BRUGADA SYNDROME:- ARE SPONSANEOUS TYPE I ECG AND PREVIOUS SYNCOPE REALLY ASSOCIATED WITH HIGH RISK? Europace 2016. [DOI: 10.1093/europace/euw270] [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
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Evans J, Silberbauer J, Glover B, Kontogeorgis A, McLellan A, Panikker S, Sieniewicz B, Martin C, Burg M, Providencia R, Behar J, Burke M, Withers K, White J, Lencioni M, Carolan-Rees G, Wood K, Patrick H, Griffith M, Gomes J, Kirubakaran S, O'Nunain S, Bencat M, McCready J, Michael K, Hashemi J, Gupta D, Akl S, Redfearn D, Lim E, Panikker S, Butcher C, Khan H, Mantziari L, Jarman J, Hussain W, Jones D, Clague J, Ernst S, Markides V, Wong T, Ezzat V, Schilling R, Lowe M, Whitaker J, Virmani R, Kutys R, Jarman J, Fastl T, Haldar S, Butcher C, Khan H, Mantziari L, O'Neill M, Corado C, Nicol E, Foran J, Markides V, Niederer S, Wong T, Behar J, Sohal M, Jais P, Derval N, Spragg D, Van Gelder B, Bracke F, Steendijk P, Rinaldi C, Chooneea B, Gajendragadkar P, Ahsan S, Begley D, Dhinoja M, Earley M, Ezzat V, Finlay M, Grace A, Heck P, Hunter R, Lambiase P, Lowe M, Rowland E, Schilling R, Segal O, Sporton S, Virdee M, Chow A, Apap Bologna R, Camilleri W, Sammut M, Aquilina O, Barra S, Papageorgiou N, Falconer D, Duehmke R, Rehal O, Ahsan S, Ezzat V, Dhinoja M, Ioannou A, Segal O, Sporton S, Rowland E, Lowe M, Lambiase P, Agarwal S, Chow A, Toth D, Mountney P, Reiml S, Panayioutu M, Brost A, Fahn B, Sohal M, Patel N, Claridge S, Jackson T, Adhya S, Sieniwicz B, O'Neill M, Razavi R, Rhode K, Rinaldi C, Tjong F, Brouwer T, Koop B, Soltis B, Shuros A, Knops R. ORAL ABSTRACTS (2)EP & Ablation19CARDIAC ABLATION PATIENT REPORTED OUTCOMES MEASURES (PROMS): ANALYSIS OF POST-ABLATION AND 1 YEAR FOLLOW-UP DATA20INTENTIONAL CORONARY VEIN EXIT AND CARBON DIOXIDE INSUFFLATION TO ALLOW SAFE SUBXIPHOID EPICARDIAL ACCESS FOR VENTRICULAR MAPPING AND ABLATION - FIRST EXPERIENCE21PACED FRACTIONATION DETECTION AS A TOOL FOR MAPPING SCARS IN VT22DOES USE OF CONTACT-FORCE SENSING CATHETERS IMPROVE THE OUTCOME OF ABLATION OF VENTRICULAR TACHYCARDIA?23RETROGRADE AORTIC ACCESS OF THE PULMONARY VENOUS ATRIUM PROVIDES EQUIVALENT OUTCOMES TO RIGHT ATRIAL OR TRANSEPTAL ACCESS OF THE LEFT ATRIUM IN PATIENTS WITH CONGENITAL HEART DISEASE24COMPUTATIONAL THREE-DIMENSION LEFT ATRIAL APPENDAGE WALL THICKNESS MAPS AND HISTOLOGICAL ANALYSIS TO GUIDE LEFT ATRIAL APPENDAGE ELECTRICAL ISOLATIONPacing & Devices25IDENTIFYING THE OPTIMAL LOCATION FOR LV ENDOCARIDAL PACING:RESULTS FROM A MULTICENTRE INTERNATIONAL REGISTRY OF LV ENDOCARDIAL PACING26UK MULTI-CENTRE REGISTRY OF TRANSVENOUS LEAD EXTRACTION: CLINICAL OUTCOME USING TRACTION, CUTTING SHEATHS AND LASER TECHNIQUES27SKIN FISTULA FORMATION - A NEW EXPERIENCE WITH THE NEW TYRX ABSORBABLE ANTIMICROVIAL ENVELOPE28BIFOCAL RIGHT VENTRICULAR PACING IN PATIENTS WITH FAILED CORONARY-SINUS LEAD IMPLANTS: LONG-TERM RESULTS FROM MULTICENTRE REGISTRY29REAL TIME X-MRI GUIDED LEFT VENTRICULAR LEAD IMPLANTATION FOR TARGETED DELIVERY OF CARDIAC RESYNCHRONIZATION THERAPY30ACUTE AND CHRONIC PERFORMANCE OF COMMUNICATING LEADLESS ANTI-TACHYCARDIA PACEMAKER AND SUBCUTANEOUS IMPLANTABLE DEFIBRILLATOR. Europace 2016. [DOI: 10.1093/europace/euw271] [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: 11/12/2022] Open
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Abstract
Neurological conditions are among the leading causes of disability in the Canadian population and are associated with a large public health burden. An increase in life expectancy and a declining birth rate has resulted in an aging Canadian population, and the proportion of age-adjusted mortality due to non-communicable diseases has been steadily increasing. These conditions are frequently associated with chronic disability and an increasing burden of care for patients, their families and caregivers. The National Population Health Study of Neurological Conditions (NPHSNC) aims to improve knowledge about neurological conditions and their impacts on individuals, their families, caregivers and health care system. The Systematic Review of Determinants of Neurological Conditions, a specific objective within the NPHSNC, is a compendium of systematic reviews on risk factors affecting onset and progression of the following 14 priority neurological conditions: Alzheimer's disease (AD), amyotrophic lateral sclerosis (ALS), brain tumours (BT), cerebral palsy (CP), dystonia, epilepsy, Huntington's disease (HD), hydrocephalus, multiple sclerosis (MS), muscular dystrophies (MD), neurotrauma, Parkinson's disease (PD), spina bifida (SB), and Tourette's syndrome (TS). The burden of neurological disease is expected to increase as the population ages, and this trend is presented in greater detail for Alzheimer's and Parkinson's disease because the incidence of these two common neurological diseases increases significantly with age over 65 years. This article provides an overview of burden of neurological diseases in Canada to set the stage for the in-depth systematic reviews of the 14 priority neurological conditions presented in subsequent articles in this issue.
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Affiliation(s)
- J Gaskin
- McLaughlin Center for Population Health Risk Assessment, University of Ottawa, Ottawa, ON, Canada; Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, ON, Canada.
| | - J Gomes
- McLaughlin Center for Population Health Risk Assessment, University of Ottawa, Ottawa, ON, Canada; Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, ON, Canada; Environmental Health Research Unit, University of Ottawa, ON, Canada
| | - S Darshan
- McLaughlin Center for Population Health Risk Assessment, University of Ottawa, Ottawa, ON, Canada
| | - D Krewski
- McLaughlin Center for Population Health Risk Assessment, University of Ottawa, Ottawa, ON, Canada; Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, ON, Canada; Risk Sciences International, Ottawa, ON, Canada
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Sousa A, Solana C, Gomes J, Barata P, Serrano R, Lages M, Oliveira C, Chainho J. Cycloid psychosis: From Kleist until our days. Eur Psychiatry 2016. [DOI: 10.1016/j.eurpsy.2016.01.1312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
IntroductionAfter Emil Kraepelin's division of psychoses into a group of dementia praecox and manic-depressive insanity, the classification of psychoses with atypical symptoms, which could not be assigned in this dichotomy created a debate, that lasts until our days. These “atypical psychoses” had been described under many terms and concepts in different countries.In 1926, Kleist coined the term “cycloid psychosis” to describe cases which did not meet the typical presentation shown in Kraepelian's dichotomy. Three decades later, Karl Leonhard established the concept of cycloid psychosis as a nosologically independent group of endogenous psychosis.Objectives/AimsMake an historical review of the concept of cycloid psychosis. Discuss the clinical features and debate the classification of this clinical entity.MethodsA bibliographical review is made of the cycloid psychosis, based on the data published in Pubmed.ResultsAccording to Leonhard, cycloid psychosis generally present with bipolar, polymorphous clinical symptomatology, and run a phasic course with complete remissions after each episode. Furthermore, Leonhard delineated three subtypes: anxiety-happiness psychosis, confusion psychosis and motility psychosis presenting with different symptoms. In 1981, Perris and Brockington formulated the first set of operational criteria for cycloid psychoses. In recent years, new data about this entity have been acknowledged due to information displayed by different clinical studies and imaging techniques.ConclusionThe phenomenology and classification of cycloid psychosis still needs more evidence for a greater use in clinical practice. However, this clinical entity can solve the void for the diagnosis of many of the so-called “atypical psychoses”.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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John S, Somal J, Thebo U, Hussain MS, Farag E, Dupler S, Gomes J. Safety and Hemodynamic Profile of Propofol and Dexmedetomidine Anesthesia during Intra-arterial Acute Stroke Therapy. J Stroke Cerebrovasc Dis 2015; 24:2397-403. [DOI: 10.1016/j.jstrokecerebrovasdis.2015.06.041] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2015] [Revised: 06/04/2015] [Accepted: 06/27/2015] [Indexed: 10/23/2022] Open
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Ferrolho J, Maia C, Gomes J, Alves-Pires C, Cristóvão J, Campino L, Afonso M. Rotation of the external genitalia in male Phlebotomine sand flies (Diptera, Psychodidae) in laboratory conditions and in captured specimens in Algarve, Portugal. Acta Trop 2015; 150:1-3. [PMID: 26099682 DOI: 10.1016/j.actatropica.2015.06.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Accepted: 06/16/2015] [Indexed: 10/23/2022]
Abstract
Protozoal parasites are the causative agents of many insect-borne infectious diseases worldwide with impact on human and animal health. Leishmaniasis is caused by Leishmania spp. and transmitted by female Phlebotomine sand flies. In Portugal, two species of Phlebotomus (Larroussius), namely Phlebotomus perniciosus and Phlebotomus ariasi are the proven vectors of Leishmania infantum. Phlebotomine females and males rest and breed in the same sites; and these locations can be predicted according to the male external genitalia maturation. Therefore, this study aimed to determine the timing of complete rotation of the male external genitalia in laboratory conditions and to characterize the external genitalia rotation in field captured males to predict the male and female sand fly breeding and resting sites. This knowledge can be applied in the design and implementation of integrated sand fly control strategies targeting these sites.
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Zatz M, Gomes J, Pelatti M, Secco M, Vieira N, Zucconi E, Vainzof M, Landini V, Andrade T. Long term follow-up of GRMD dogs transplanted with human adipose derived stem cells. Neuromuscul Disord 2015. [DOI: 10.1016/j.nmd.2015.06.371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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