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Oliveira M, Barros P, Rodrigues M, Ribeiro M, Afreixo V, Gregório T. Endovascular therapy for posterior cerebral artery occlusion: systematic review with meta-analysis. Intern Emerg Med 2024:10.1007/s11739-024-03581-z. [PMID: 38600317 DOI: 10.1007/s11739-024-03581-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 03/07/2024] [Indexed: 04/12/2024]
Abstract
Endovascular therapy (EVT) is a highly effective stroke treatment, but trials validating this intervention did not include patients with posterior cerebral artery (PCA) occlusion. The aim of this systematic review with meta-analysis was to assess the efficacy and safety of EVT for acute PCA occlusion. PubMed, Scopus, ISI, and CENTRAL were searched for studies assessing EVT in adult patients with PCA occlusion. Outcomes of interest were recanalization, symptomatic intracerebral haemorrhage (sICH), mortality, functional independence, and excellent functional outcome at 90 days. Frequencies and odds ratios (ORs) were pooled using random effect models and heterogeneity was measured using the I2 statistic and explored by means of meta-regression. Fifteen studies were included, all observational. Recanalization rates were high [81%, 95% CI (73-88%)] and sICH rates low [2%, 95% CI (1-4%)]. Heterogeneity was high for recanalization (I2 = 80%) but not for sICH, and not accounted for by any of the moderators tested. Compared to best medical treatment, EVT was associated with higher chances of sICH [OR = 2.04, 95% CI (1.12-3.71)] and no effect in functional independence [OR = 0.98, 95% CI (0.63-1.54)], with a tendency to higher chances of excellent functional outcome [OR = 1.29, 95% CI (0.90-1.86)] and mortality [OR = 1.56, 95% CI (0.84-2.90)]. EVT for acute PCA occlusion is technically feasible but associated with higher chance of sICH. There is no evidence to support this treatment to achieve higher rates of functional independence, but other gains that can impact patients' quality of life cannot be excluded. More studies are required with robust design, better patient selection, and comprehensive outcome evaluation.
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Affiliation(s)
- Marta Oliveira
- Department of Internal Medicine, Hospital CUF Porto, Estr. da Circunvalação 14341, 4100-180, Porto, Portugal.
| | - Pedro Barros
- Stroke Unit, Centro Hospitalar de Vila Nova de Gaia e Espinho EPE. Rua Conceição Fernandes, 4434-502, Vila Nova de Gaia, Portugal
| | - Marta Rodrigues
- Cerebrovascular Interventional Neuroradiology Unit, Centro Hospitalar de Vila Nova de Gaia e Espinho EPE. Rua Conceição Fernandes, 4434-502, Vila Nova de Gaia, Portugal
| | - Manuel Ribeiro
- Cerebrovascular Interventional Neuroradiology Unit, Centro Hospitalar de Vila Nova de Gaia e Espinho EPE. Rua Conceição Fernandes, 4434-502, Vila Nova de Gaia, Portugal
| | - Vera Afreixo
- Center for Research and Development in Mathematics and Applications, University of Aveiro. Campus Universitário de Santiago, 3810-193, Aveiro, Portugal
| | - Tiago Gregório
- Stroke Unit, Centro Hospitalar de Vila Nova de Gaia e Espinho EPE. Rua Conceição Fernandes, 4434-502, Vila Nova de Gaia, Portugal
- Department of Internal Medicine, Centro Hospitalar de Vila Nova de Gaia e Espinho EPE. Rua Conceição Fernandes, 4434-502, Vila Nova de Gaia, Portugal
- CINTESIS, University of Porto. R. Dr. Plácido Costa, 4200-450, Porto, Portugal
- MEDCIDS, University of Porto. R. Dr. Plácido Costa, 4200-450, Porto, Portugal
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Ribeiro M, Azevedo L, Santos AP, Pinto Leite P, Pereira MJ. Understanding spatiotemporal patterns of COVID-19 incidence in Portugal: A functional data analysis from August 2020 to March 2022. PLoS One 2024; 19:e0297772. [PMID: 38300912 PMCID: PMC10833534 DOI: 10.1371/journal.pone.0297772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 01/12/2024] [Indexed: 02/03/2024] Open
Abstract
During the SARS-CoV-2 pandemic, governments and public health authorities collected massive amounts of data on daily confirmed positive cases and incidence rates. These data sets provide relevant information to develop a scientific understanding of the pandemic's spatiotemporal dynamics. At the same time, there is a lack of comprehensive approaches to describe and classify patterns underlying the dynamics of COVID-19 incidence across regions over time. This seriously constrains the potential benefits for public health authorities to understand spatiotemporal patterns of disease incidence that would allow for better risk communication strategies and improved assessment of mitigation policies efficacy. Within this context, we propose an exploratory statistical tool that combines functional data analysis with unsupervised learning algorithms to extract meaningful information about the main spatiotemporal patterns underlying COVID-19 incidence on mainland Portugal. We focus on the timeframe spanning from August 2020 to March 2022, considering data at the municipality level. First, we describe the temporal evolution of confirmed daily COVID-19 cases by municipality as a function of time, and outline the main temporal patterns of variability using a functional principal component analysis. Then, municipalities are classified according to their spatiotemporal similarities through hierarchical clustering adapted to spatially correlated functional data. Our findings reveal disparities in disease dynamics between northern and coastal municipalities versus those in the southern and hinterland. We also distinguish effects occurring during the 2020-2021 period from those in the 2021-2022 autumn-winter seasons. The results provide proof-of-concept that the proposed approach can be used to detect the main spatiotemporal patterns of disease incidence. The novel approach expands and enhances existing exploratory tools for spatiotemporal analysis of public health data.
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Affiliation(s)
- Manuel Ribeiro
- CERENA, DER, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal
| | - Leonardo Azevedo
- CERENA, DER, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal
| | - André Peralta Santos
- Direção de Serviços de Informação e Análise, Direção-Geral da Saúde, Lisbon, Portugal
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Pedro Pinto Leite
- Direção de Serviços de Informação e Análise, Direção-Geral da Saúde, Lisbon, Portugal
| | - Maria João Pereira
- CERENA, DER, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal
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Pinto de Carvalho C, Ribeiro M, Godinho Simões D, Pita Ferreira P, Azevedo L, Gonçalves-Sá J, Mesquita S, Gonçalves L, Pinto Leite P, Peralta-Santos A. Spatial Analysis of Determinants of COVID-19 Vaccine Hesitancy in Portugal. Vaccines (Basel) 2024; 12:119. [PMID: 38400103 PMCID: PMC10892156 DOI: 10.3390/vaccines12020119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/18/2024] [Accepted: 01/22/2024] [Indexed: 02/25/2024] Open
Abstract
Vaccine hesitancy tends to exhibit geographical patterns and is often associated with social deprivation and migrant status. We aimed to estimate COVID-19 vaccination hesitancy in a high-vaccination-acceptance country, Portugal, and determine its association with sociodemographic risk factors. We used the Registry of National Health System Users to determine the eligible population and the Vaccination Registry to determine individuals without COVID-19 vaccine doses. Individuals older than five with no COVID-19 vaccine dose administered by 31 March 2022 were considered hesitant. We calculated hesitancy rates by municipality, gender, and age group for all municipalities in mainland Portugal. We used the spatial statistical scan method to identify spatial clusters and the Besag, Yorke, and Mollié (BYM) model to estimate the effect of age, gender, social deprivation, and migrant proportion across all mainland municipalities. The eligible population was 9,852,283, with 1,212,565 (12%) COVID-19 vaccine-hesitant individuals. We found high-hesitancy spatial clusters in the Lisbon metropolitan area and the country's southwest. Our model showed that municipalities with higher proportions of migrants are associated with an increased relative risk (RR) of vaccine hesitancy (RR = 8.0; CI 95% 4.6; 14.0). Social deprivation and gender were not associated with vaccine hesitancy rates. We found COVID-19 vaccine hesitancy has a heterogeneous distribution across Portugal and has a strong association with the proportion of migrants per municipality.
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Affiliation(s)
- Constança Pinto de Carvalho
- Direção de Serviços de Informação e Análise, Direção-Geral da Saúde, Alameda D. Afonso Henriques, 45, 1049-005 Lisbon, Portugal; (C.P.d.C.); (D.G.S.); (P.P.F.); (P.P.L.)
- Unidade de Saúde Pública Alentejo Litoral, Unidade Local de Saúde do Litoral Alentejano, Rua do Hospital Conde Bracial, 7540-166 Santiago do Cacém, Portugal
| | - Manuel Ribeiro
- Centro de Recursos Naturais e Ambiente, Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais 1, 1049-001 Lisbon, Portugal; (M.R.); (L.A.)
| | - Diogo Godinho Simões
- Direção de Serviços de Informação e Análise, Direção-Geral da Saúde, Alameda D. Afonso Henriques, 45, 1049-005 Lisbon, Portugal; (C.P.d.C.); (D.G.S.); (P.P.F.); (P.P.L.)
- Unidade de Saúde Pública Almada-Seixal, Agrupamento de Centros de Saúde de Almada-Seixal, Administração Regional de Saúde de Lisboa e Vale do Tejo, Av. Rainha D. Leonor, n° 2, 5°, 2809-010 Almada, Portugal
| | - Patrícia Pita Ferreira
- Direção de Serviços de Informação e Análise, Direção-Geral da Saúde, Alameda D. Afonso Henriques, 45, 1049-005 Lisbon, Portugal; (C.P.d.C.); (D.G.S.); (P.P.F.); (P.P.L.)
- Unidade de Saúde Pública Zé Povinho, Agrupamento de Centros de Saúde do Oeste Norte, Administração Regional de Saúde de Lisboa e Vale do Tejo, Rua Etelvino Santos, 2500-297 Caldas da Rainha, Portugal
| | - Leonardo Azevedo
- Centro de Recursos Naturais e Ambiente, Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais 1, 1049-001 Lisbon, Portugal; (M.R.); (L.A.)
| | - Joana Gonçalves-Sá
- Social Physics and Complexity Research Group, Laboratory of Instrumentation and Experimental Particle Physics, Av. Prof. Gama Pinto, n.2, Complexo Interdisciplinar, 1649-003 Lisbon, Portugal; (J.G.-S.); (S.M.)
| | - Sara Mesquita
- Social Physics and Complexity Research Group, Laboratory of Instrumentation and Experimental Particle Physics, Av. Prof. Gama Pinto, n.2, Complexo Interdisciplinar, 1649-003 Lisbon, Portugal; (J.G.-S.); (S.M.)
- Nova Medical School, Campo dos Mártires da Pátria 130, 1169-056 Lisbon, Portugal
| | - Licínio Gonçalves
- Serviços Partilhados do Ministério da Saúde, Av. Da República 61, 1050-099 Lisbon, Portugal;
| | - Pedro Pinto Leite
- Direção de Serviços de Informação e Análise, Direção-Geral da Saúde, Alameda D. Afonso Henriques, 45, 1049-005 Lisbon, Portugal; (C.P.d.C.); (D.G.S.); (P.P.F.); (P.P.L.)
| | - André Peralta-Santos
- Direção de Serviços de Informação e Análise, Direção-Geral da Saúde, Alameda D. Afonso Henriques, 45, 1049-005 Lisbon, Portugal; (C.P.d.C.); (D.G.S.); (P.P.F.); (P.P.L.)
- Public Health Research Centre, NOVA National School of Public Health, Universidade NOVA de Lisboa, Av. Padre Cruz, 1600-560 Lisbon, Portugal
- Comprehensive Health Research Centre (CHRC), Universidade NOVA de Lisboa, Rua do Instituto Bacteriológico, n°5, 1150-082 Lisbon, Portugal
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Oliveira M, Rocha A, Barbosa F, Barros P, Fonseca L, Ribeiro M, Afreixo V, Gregório T. Acute kidney injury after endovascular therapy in acute stroke patients: systematic review with meta-analysis. J Neurointerv Surg 2023; 15:e468-e474. [PMID: 36797049 DOI: 10.1136/jnis-2022-019955] [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: 12/02/2022] [Accepted: 02/09/2023] [Indexed: 02/18/2023]
Abstract
AIMS Endovascular therapy (EVT) is a highly effective stroke treatment, but it requires the administration of contrast media which puts patients at risk of acute kidney injury (AKI). AKI is associated with increased morbidity and mortality in cardiovascular patients. METHODS PubMed, Scopus, ISI and the Cochrane Library were systematically searched for observational and experimental studies assessing the occurrence of AKI in adult acute stroke patients submitted to EVT. Two independent reviewers collected study data regarding study setting, period, source of data, and AKI definition and predictors, the outcomes of interest being AKI incidence and 90-day death or dependency (modified Rankin Scale score ≥3). These outcomes were pooled using random effect models, and heterogeneity was measured using the I2 statistic. RESULTS 22 studies were identified and included in the analysis, involving 32 034 patients. Pooled incidence of AKI was 7% (95% CI 5% to 10%), but heterogeneity was high across studies (I2=98%), and not accounted for by the definition of AKI used. The most frequently reported AKI predictors were impaired baseline renal function (5 studies) and diabetes (3 studies); 3 studies (2103 patients) reported data on death and 4 studies (2424 patients) reported data on dependency. Overall, AKI was associated with both outcomes, with ORs of 6.21 (95% CI 3.52 to 10.96) and 2.86 (95% CI 1.88 to 4.37), respectively. Heterogeneity was low for both analyses (I2=0%). CONCLUSIONS AKI affects 7% of acute stroke patients submitted to EVT and identifies a subgroup of patients for which treatment outcomes are suboptimal, with an increased risk of death and dependency.
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Affiliation(s)
- Marta Oliveira
- Department of Internal Medicine, Centro Hospitalar de Vila Nova de Gaia Espinho EPE, Vila Nova de Gaia, Portugal
| | - Ana Rocha
- Department of Medical Sciences, Universidade de Aveiro, Aveiro, Portugal
| | - Flávia Barbosa
- Department of Medical Sciences, Universidade de Aveiro, Aveiro, Portugal
| | - Pedro Barros
- Stroke Unit, Centro Hospitalar de Vila Nova de Gaia Espinho EPE, Vila Nova de Gaia, Porto, Portugal
- Neurology, Centro Hospitalar de Vila Nova de Gaia Espinho EPE, Vila Nova de Gaia, Porto, Portugal
| | - Luísa Fonseca
- Stroke Unit, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Manuel Ribeiro
- Cerebrovascular Interventional Neuroradiology Unit, Centro Hospitalar de Vila Nova de Gaia Espinho EPE, Vila Nova de Gaia, Porto, Portugal
| | - Vera Afreixo
- Center for Research and Development in Mathematics and Applications, University of Aveiro, Aveiro, Portugal
| | - Tiago Gregório
- Department of Internal Medicine, Centro Hospitalar de Vila Nova de Gaia Espinho EPE, Vila Nova de Gaia, Portugal
- Stroke Unit, Centro Hospitalar de Vila Nova de Gaia Espinho EPE, Vila Nova de Gaia, Porto, Portugal
- MEDCIDS, Universidade do Porto Faculdade de Medicina, Porto, Portugal
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Ribeiro M, Galli E, Guérin T, Silva JAL, Castanheira I, Leufroy A, Jitaru P. Simultaneous speciation analysis of Hg and Se in fish by high-performance liquid chromatography and inductively coupled plasma-mass spectrometry following microwave-assisted enzymatic hydrolysis. Anal Bioanal Chem 2023; 415:7175-7186. [PMID: 37819434 DOI: 10.1007/s00216-023-04984-1] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 09/13/2023] [Accepted: 09/25/2023] [Indexed: 10/13/2023]
Abstract
This study reports the development and validation of a new analytical method for simultaneous speciation analysis of Se and Hg in fish muscle. For this purpose, four Se species (selenite/Se(IV), selenate/Se(VI), selenomethionine/SeMet, and selenocysteine/SeCys) and two Hg species (inorganic mercury/iHg and methylmercury/MeHg) were extracted simultaneously by microwave-assisted enzymatic hydrolysis and then separated by HPLC in less than 15 min by using a column with both anion and cation exchange mechanisms and a mobile phase consisting of a mixture of methanol 5% (v/v), 45 mM HNO3, 0.015% 2-mercaptoethanol, and 1.5 mM sodium 3-mercapto-1-propanesulfonate. The separated species of Hg and Se were detected online by inductively coupled plasma-mass spectrometry (ICP-MS). The speciation analysis method was validated by means of the accuracy profile approach by carrying out three series of measurements in duplicate on three different days over a time-span of 3 weeks. The limits of quantification (LOQ) are in the range of 0.010-0.013 mg/kg wet weight (ww) for all selenium species, except for Se(IV) (0.15 mg/kg ww), while the coefficient of variation in terms of intermediate reproducibility (CVR) was < 7%. The LOQ for MeHg was 0.006 mg/kg ww, while the CVR was 3%. The method was successfully applied to the analysis of muscle samples from four different fish species: rainbow trout, tuna, swordfish, and dogfish.
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Affiliation(s)
- M Ribeiro
- Laboratory for Food Safety, ANSES, Univ Paris Est Creteil, 14 Rue Pierre Et Marie Curie, 94700, Maisons-Alfort, France
- Departamento de Alimentação E Nutrição, Instituto Nacional de Saúde Doutor Ricardo Jorge, INSA IP, Avenida Padre Cruz, 1649-016, Lisbon, Portugal
- Centro de Química Estrutural, Institute of Molecular Sciences, Departamento de Engenharia Química, Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais, 1049-001, Lisbon, Portugal
| | - E Galli
- Laboratory for Food Safety, ANSES, Univ Paris Est Creteil, 14 Rue Pierre Et Marie Curie, 94700, Maisons-Alfort, France
| | - T Guérin
- Strategy and Programmes Department, ANSES, 94701, Maisons-Alfort, France
| | - J A L Silva
- Centro de Química Estrutural, Institute of Molecular Sciences, Departamento de Engenharia Química, Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais, 1049-001, Lisbon, Portugal
| | - I Castanheira
- Departamento de Alimentação E Nutrição, Instituto Nacional de Saúde Doutor Ricardo Jorge, INSA IP, Avenida Padre Cruz, 1649-016, Lisbon, Portugal
| | - A Leufroy
- Laboratory for Food Safety, ANSES, Univ Paris Est Creteil, 14 Rue Pierre Et Marie Curie, 94700, Maisons-Alfort, France
| | - P Jitaru
- Laboratory for Food Safety, ANSES, Univ Paris Est Creteil, 14 Rue Pierre Et Marie Curie, 94700, Maisons-Alfort, France.
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Zaarour RF, Ribeiro M, Azzarone B, Kapoor S, Chouaib S. Tumor microenvironment-induced tumor cell plasticity: relationship with hypoxic stress and impact on tumor resistance. Front Oncol 2023; 13:1222575. [PMID: 37886168 PMCID: PMC10598765 DOI: 10.3389/fonc.2023.1222575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 09/27/2023] [Indexed: 10/28/2023] Open
Abstract
The role of tumor interaction with stromal components during carcinogenesis is crucial for the design of efficient cancer treatment approaches. It is widely admitted that tumor hypoxic stress is associated with tumor aggressiveness and thus impacts susceptibility and resistance to different types of treatments. Notable biological processes that hypoxia functions in include its regulation of tumor heterogeneity and plasticity. While hypoxia has been reported as a major player in tumor survival and dissemination regulation, the significance of hypoxia inducible factors in cancer stem cell development remains poorly understood. Several reports indicate that the emergence of cancer stem cells in addition to their phenotype and function within a hypoxic tumor microenvironment impacts cancer progression. In this respect, evidence showed that cancer stem cells are key elements of intratumoral heterogeneity and more importantly are responsible for tumor relapse and escape to treatments. This paper briefly reviews our current knowledge of the interaction between tumor hypoxic stress and its role in stemness acquisition and maintenance. Our review extensively covers the influence of hypoxia on the formation and maintenance of cancer stem cells and discusses the potential of targeting hypoxia-induced alterations in the expression and function of the so far known stem cell markers in cancer therapy approaches. We believe that a better and integrated understanding of the effect of hypoxia on stemness during carcinogenesis might lead to new strategies for exploiting hypoxia-associated pathways and their targeting in the clinical setting in order to overcome resistance mechanisms. More importantly, at the present time, efforts are oriented towards the design of innovative therapeutical approaches that specifically target cancer stem cells.
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Affiliation(s)
- RF. Zaarour
- Thumbay Research Institute for Precision Medicine, Gulf Medical University, Ajman, United Arab Emirates
| | - M. Ribeiro
- Thumbay Research Institute for Precision Medicine, Gulf Medical University, Ajman, United Arab Emirates
| | - B. Azzarone
- Tumor Immunology Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - S. Kapoor
- Thumbay Research Institute for Precision Medicine, Gulf Medical University, Ajman, United Arab Emirates
| | - S. Chouaib
- Thumbay Research Institute for Precision Medicine, Gulf Medical University, Ajman, United Arab Emirates
- INSERM UMR 1186, Integrative Tumor Immunology and Immunotherapy, Gustave Roussy, Faculty of Medicine, University Paris-Saclay, Villejuif, France
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Araújo A, Guimarães F, Miranda AM, Rodrigues M, Castro S, Ribeiro M. Endovascular Revascularization of an Unfavorable Type of Chronically Occluded Internal Carotid Artery Using a Balloon Guide Catheter. Clin Neuroradiol 2023; 33:565-568. [PMID: 36735019 DOI: 10.1007/s00062-022-01259-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 12/22/2022] [Indexed: 02/04/2023]
Affiliation(s)
- André Araújo
- Cerebrovascular Interventional Neuroradiology Unit, Imagiology Department, Centro Hospitalar Vila Nova de Gaia/Espinho, Rua Conceição Fernandes S/N., Vila Nova de Gaia, Portugal.
| | - Francisca Guimarães
- Cerebrovascular Interventional Neuroradiology Unit, Imagiology Department, Centro Hospitalar Vila Nova de Gaia/Espinho, Rua Conceição Fernandes S/N., Vila Nova de Gaia, Portugal
| | - André Miguel Miranda
- Cerebrovascular Interventional Neuroradiology Unit, Imagiology Department, Centro Hospitalar Vila Nova de Gaia/Espinho, Rua Conceição Fernandes S/N., Vila Nova de Gaia, Portugal
| | - Marta Rodrigues
- Cerebrovascular Interventional Neuroradiology Unit, Imagiology Department, Centro Hospitalar Vila Nova de Gaia/Espinho, Rua Conceição Fernandes S/N., Vila Nova de Gaia, Portugal
| | - Sérgio Castro
- Cerebrovascular Interventional Neuroradiology Unit, Imagiology Department, Centro Hospitalar Vila Nova de Gaia/Espinho, Rua Conceição Fernandes S/N., Vila Nova de Gaia, Portugal
| | - Manuel Ribeiro
- Cerebrovascular Interventional Neuroradiology Unit, Imagiology Department, Centro Hospitalar Vila Nova de Gaia/Espinho, Rua Conceição Fernandes S/N., Vila Nova de Gaia, Portugal
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Cuesta MJ, Sánchez-Torres AM, Moreno-Izco L, García de Jalón E, Gil-Berrozpe GJ, Zarzuela A, Peralta V, Ballesteros A, Fañanás L, Hernández R, Janda L, Lorente R, Papiol S, Peralta D, Ribeiro M, Rosero A, Zandio M. Neurocognitive correlates of the varied domains of outcomes at 20 year follow-up of first-episode psychosis. Psychiatry Res 2022; 318:114933. [PMID: 36334328 DOI: 10.1016/j.psychres.2022.114933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 10/18/2022] [Accepted: 10/26/2022] [Indexed: 11/06/2022]
Abstract
Little is known about long-term outcomes of the first episode of psychosis (FEP) other than in the symptomatic domain. We hypothesised that cognitive impairment is associated with poorer multi-domain outcomes at a long-term follow-up of FEP patients. We followed-up 172 FEP patients for a mean of 20.3 years. Ten outcome dimensions were assessed (symptomatic, functional and personal recovery, social disadvantage, physical health, suicide attempts, number of episodes, current drug use, chlorpromazine equivalent doses (CPZ), and schizophrenia/schizoaffective disorder final diagnosis). Cognition was assessed at follow-up. Processing speed and verbal memory deficits showed significant associations with poor outcomes on symptomatic, social functioning, social disadvantage, higher number of episodes, and higher CPZ. Significant associations were found between visual memory impairments were significantly associated with low symptomatic and functional recovery, between attentional deficits and a final diagnosis of schizophrenia/schizoaffective disorder, and between social cognition deficits and poor personal recovery.Lower cognitive global scores were significantly associated with all outcome dimensions except for drug abuse and physical status. Using multiple outcome dimensions allowed for the inclusion of the patients' perspective and other commonly neglected outcome measures. Taken together, cognitive impairment in FEP patients is strongly related to poor performance on several outcome dimensions beyond symptomatic remission.
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Affiliation(s)
- M J Cuesta
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.
| | - A M Sánchez-Torres
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - L Moreno-Izco
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - E García de Jalón
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain; Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain
| | - G J Gil-Berrozpe
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - A Zarzuela
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain; Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain
| | - V Peralta
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain; Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain
| | - A Ballesteros
- Red de Salud Mental de Álava, Vitoria-Gasteiz, Spain
| | - L Fañanás
- Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology, University of Barcelona, Biomedicine Institute of the University of Barcelona (IBUB), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Spain
| | - R Hernández
- CSMIJ Ciutat Vella. Consorci Parc de Salut Mar, Barcelona, Spain
| | - L Janda
- Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain
| | - R Lorente
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - S Papiol
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Spain; Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, 80336, Germany; Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, 80336, Germany
| | - D Peralta
- Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain
| | - M Ribeiro
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - A Rosero
- Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain
| | - M Zandio
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
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Hutt E, Vega Brizneda M, Aguilera J, Wang TKM, Taimeh Z, Culver D, Callahan T, Tang W, Jaber WA, Cremer P, Ribeiro M, Jellis C. Multimodality imaging predictors of appropriate ICD shock and mortality in adults with cardiac sarcoidosis. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Identifying patients with cardiac sarcoidosis (CS) who are at increased risk of sudden cardiac death (SCD) is imperative. Current guideline recommendations for implantable cardioverter-defibrillator (ICD) implantation in patients with CS are based on small observational studies and have not been validated in contemporary cohorts using multimodality cardiac imaging.
Purpose
The aim of this study was to characterize a cohort of patients with tissue-proven cardiac sarcoidosis who underwent multimodality cardiac imaging and identify predictors of appropriate ICD shock and mortality.
Methods
We retrospectively identified subjects with a diagnosis of CS established by clinical/imaging criteria, and tissue biopsy (N=273) seen at our tertiary care center between 2001 and 2021. Clinical characteristics and outcomes were collected from electronic medical records. The primary endpoint of interest was a composite of appropriate ICD shock and all-cause mortality. Secondary endpoints were individual rates of appropriate ICD shock and all-cause mortality. Cox proportional hazard regression analysis was used to identify independent predictors of the outcomes.
Results
Mean age was 59±11 years and 40% were female. Isolated CS was found in 49 subjects (17.9%). The prevalence of traditional cardiovascular risk factors was low. Atrial fibrillation prevalence was high (41%). After a median follow-up of 7.9 years, the rate of appropriate ICD shock and all-cause mortality was 29% (N=79). The 5-year overall survival rate of 97.5%. Age, left ventricular ejection fraction (LVEF), and delayed gadolinium enhancement (DGE) in cardiac magnetic resonance (CMR) were independent predictors of the primary composite endpoint; LVEF and DGE in CMR were independent predictors of appropriate ICD-shock; and LVEF and baseline serum NT proBNP were independent predictors of overall mortality. An LVEF of 47% was identified as the optimal cutoff in predicting the primary composite endpoint. Presence of scar, inflammation or mismatch pattern in positron emission tomography were not significant predictors of the outcomes.
Conclusion
In this large cohort of subjects with CS, we found that the presence of DGE in CMR was the strongest independent predictor of the composite endpoint of appropriate ICD-shock and mortality and of appropriate ICD-shock individually; LVEF by echocardiogram was an independent predictor of the primary and secondary endpoints with an optimal LVEF cutoff for predicting the composite endpoint of 47%.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- E Hutt
- Cleveland Clinic , Cleveland , United States of America
| | | | - J Aguilera
- Cleveland Clinic , Cleveland , United States of America
| | - T K M Wang
- Cleveland Clinic , Cleveland , United States of America
| | - Z Taimeh
- Cleveland Clinic , Cleveland , United States of America
| | - D Culver
- Cleveland Clinic , Cleveland , United States of America
| | - T Callahan
- Cleveland Clinic , Cleveland , United States of America
| | - W Tang
- Cleveland Clinic , Cleveland , United States of America
| | - W A Jaber
- Cleveland Clinic , Cleveland , United States of America
| | - P Cremer
- Cleveland Clinic , Cleveland , United States of America
| | - M Ribeiro
- Cleveland Clinic , Cleveland , United States of America
| | - C Jellis
- Cleveland Clinic , Cleveland , United States of America
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Ignatenko E, Ribeiro M, Oliveira MD. Informing the Design of Data Visualization Tools to Monitor the COVID-19 Pandemic in Portugal: A Web-Delphi Participatory Approach. Int J Environ Res Public Health 2022; 19:11012. [PMID: 36078728 PMCID: PMC9517757 DOI: 10.3390/ijerph191711012] [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] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/07/2022] [Accepted: 08/10/2022] [Indexed: 06/15/2023]
Abstract
Due to the large amount of data generated by new technologies and information systems in the health arena, health dashboards have become increasingly popular as data visualization tools which stimulate visual perception capabilities. Although the importance of involving users is recognized in dashboard design, a limited number of studies have combined participatory methods with visualization options. This study proposes a novel approach to inform the design of data visualization tools in the COVID-19 context. With the objective of understanding which visualization formats should be incorporated within dashboards for the COVID-19 pandemic, a specifically designed Web-Delphi process was developed to understand the preferences and views of the public in general regarding distinct data visualization formats. The design of the Delphi process aimed at considering not only the theory-based evidence regarding input data and visualization formats but also the perception of final users. The developed approach was implemented to select appropriate data visualization formats to present information commonly used in public web-based COVID-19 dashboards. Forty-seven individuals completed a two-round Web-Delphi process that was launched through a snowball approach. Most respondents were young and highly educated and expressed to prefer distinct visualisation formats for different types of indicators. The preferred visualization formats from the participants were used to build a redesigned version of the official DGS COVID-19 dashboard used in Portugal. This study provides insights into data visualization selection literature, as well as shows how a Delphi process can be implemented to assist the design of public health dashboards.
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Affiliation(s)
- Ekaterina Ignatenko
- Centre for Management Studies of Instituto Superior Técnico (CEG-IST), Universidade de Lisboa, Av. Rovisco Pais, 1, 1049-001 Lisboa, Portugal
| | - Manuel Ribeiro
- Centro de Recursos Naturais e Ambiente (CERENA), Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais, 1, 1049-001 Lisboa, Portugal
| | - Mónica D. Oliveira
- Centre for Management Studies of Instituto Superior Técnico (CEG-IST), Universidade de Lisboa, Av. Rovisco Pais, 1, 1049-001 Lisboa, Portugal
- iBB—Institute for Bioengineering and Biosciences and i4HB—Associate Laboratory Institute for Health and Bioeconomy, Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais, 1, 1049-001 Lisboa, Portugal
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Ribeiro M, Gomes Da Broi M, Matos A, Scaranari C, Buttros D, Bragheto A, Faúndes D. P-010 Sperm selection by birefringence: a promising non-invasive tool to improve ICSI outcomes. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.009] [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
Study question
Could the sperm selection by birefringence improve ICSI outcomes in couples with different infertility factors?
Summary answer
Sperm selection by birefringence demonstrated a positive clinical impact on ICSI outcomes in couples with different infertility factors when compared to the conventional sperm selection.
What is known already
Higher sperm DNA fragmentation may affect ICSI outcomes. However, the utilized sperm selection protocols do not allow the evaluation of this parameter. In this sense, the analysis of sperm’s head birefringence has been suggested as an adjuvant of seminal processing in order to select viable sperm for couples with severe male factor. Nevertheless, considering men with normal seminal parameters may also curse with DNA fragmentation, the impact of birefringence on ICSI outcomes of couples with different infertility factors should be investigated.
Study design, size, duration
Retrospective case-control study. One hundred eighty-one couples who underwent ICSI from January 2018 to August 2020 [107 submitted to sperm selection by conventional analysis (Nonbirefringence group) and 74 whose sperm were selected by conventional analysis associated to sperm head birefringence evaluation (Birefringence group)] were included in the study.
Participants/materials, setting, methods
Medical records were assessed for eligibility evaluation and data collection. Clinical characteristics (female age, body mass index, infertility factor, seminal parameters) and ICSI outcomes (eg. fertilization rate, cleavage rate, blastulation rate, number of high quality embryos formed, implantation rate, biochemical pregnancy rate, clinical pregnancy rate per transfer and per initiated cycle) were compared between the groups using (p < 0.05). A multivariate logistic regression model was applied to verify the factors associated with clinical pregnancy.
Main results and the role of chance
Despite the Birefringence group showed higher female age (p = 0.01), lower seminal sperm concentration (p < 0.01) and higher sperm DNA fragmentation (p < 0.01), those patients cursed with higher cleavage rate (p = 0.04), higher clinical pregnancy rate per transfer (p = 0.03) and higher clinical pregnancy rate per initiated cycle (p = 0.02) than the Nonbirefringence group. The logistic regression showed a positive group (Birefrincence) effect on clinical pregnancy achievement.
Limitations, reasons for caution
The unequal inclusion of infertility factors between the groups might represent a bias. In logistic regression analysis, none of those factors interfered with clinical pregnancy, which reinforces the impact of the technique on the results. The endpoint analyzed was clinical pregnancy, while live birth would better reflect ICSI success.
Wider implications of the findings
Sperm selection by birefringence could positively impact ICSI outcomes. Because it is a cheap and easily reproducible technique, it could be combined with conventional ICSI treatments to improve the reproductive chances of those patients.
Trial registration number
not applicable
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Affiliation(s)
- M Ribeiro
- Fivmed - Human Reproduction Institute, Laboratory, Campinas, Brazil
| | - M Gomes Da Broi
- Fivmed - Human Reproduction Institute, Laboratory, Campinas, Brazil
| | - A Matos
- Fivmed - Human Reproduction Institute, Laboratory, Campinas, Brazil
| | - C Scaranari
- Fivmed - Human Reproduction Institute, Laboratory, Campinas, Brazil
| | - D Buttros
- Fivmed - Human Reproduction Institute, Laboratory, Campinas, Brazil
| | - A.M Bragheto
- Fivmed - Human Reproduction Institute, Laboratory, Campinas, Brazil
| | - D Faúndes
- Fivmed - Human Reproduction Institute, Laboratory, Campinas, Brazil
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Ribeiro M, Gomes IB, Saavedra MJ, Simões M. Photodynamic therapy and combinatory treatments for the control of biofilm-associated infections. Lett Appl Microbiol 2022; 75:548-564. [PMID: 35689422 DOI: 10.1111/lam.13762] [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] [Received: 09/21/2021] [Revised: 04/26/2022] [Accepted: 05/26/2022] [Indexed: 12/20/2022]
Abstract
The advent of antimicrobial resistance has added considerable impact to infectious diseases both in the number of infections and healthcare costs. Furthermore, the relentless emergence of multidrug-resistant bacteria, particularly in the biofilm state, has made mandatory the discovery of new alternative antimicrobial therapies that are capable to eradicate resistant bacteria and impair the development of new forms of resistance. Amongst the therapeutic strategies for treating biofilms, antimicrobial photodynamic therapy (aPDT) has shown great potential in inactivating several clinically relevant micro-organisms, including antibiotic-resistant 'priority bacteria' declared by the WHO as critical pathogens. Its antimicrobial effect is centred on the basis that harmless low-intensity light stimulates a non-toxic dye named photosensitizer, triggering the production of reactive oxygen species upon photostimulation. In addition, combination therapies of aPDT with other antimicrobial agents (e.g. antibiotics) have also drawn considerable attention, as it is a multi-target strategy. Therefore, the present review highlights the recent advances of aPDT against biofilms, also covering progress on combination therapy.
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Affiliation(s)
- M Ribeiro
- LEPABE - Laboratory for Process Engineering, Environment, Biotechnology and Energy, Faculty of Engineering, University of Porto, Porto, Portugal.,ALiCE - Associate Laboratory in Chemical Engineering, Faculty of Engineering, University of Porto, Porto, Portugal.,CIQUP/Department of Chemistry and Biochemistry, Faculty of Sciences, University of Porto, Porto, Portugal
| | - I B Gomes
- LEPABE - Laboratory for Process Engineering, Environment, Biotechnology and Energy, Faculty of Engineering, University of Porto, Porto, Portugal.,ALiCE - Associate Laboratory in Chemical Engineering, Faculty of Engineering, University of Porto, Porto, Portugal
| | - M J Saavedra
- Department of Veterinary Sciences, School of Agriculture and Veterinary Science, UTAD, Vila Real, Portugal.,Centre for the Research and Technology for Agro-Environment and Biological Sciences (CITAB), UTAD, Vila Real, Portugal
| | - M Simões
- LEPABE - Laboratory for Process Engineering, Environment, Biotechnology and Energy, Faculty of Engineering, University of Porto, Porto, Portugal.,ALiCE - Associate Laboratory in Chemical Engineering, Faculty of Engineering, University of Porto, Porto, Portugal
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Ribeiro M, Lourenço A, Lemos M, Bastos J, Pereira J. A review: Circadian Rhythm Dysfunction and Bipolar Disorder. Eur Psychiatry 2022. [PMCID: PMC9567115 DOI: 10.1192/j.eurpsy.2022.1035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Introduction Circadian rhythm (CR) dysfunction is a prominent feature in bipolar disorder (BD) and sleep disturbances are characteristic, although not essential to the diagnosis. Objectives To review the literature regarding the CR dysfunction and its impact on the onset and clinical course of BD. Methods We conducted a MEDLINE search using bipolar disorder, circadian rhythm and sleep as keywords, selecting studies written in English. Results CR dysfunction is a trait marker of BD. It’s known that during depressive episodes insomnia is present, with difficulty falling asleep/ maintaining sleep and early awakening. Regarding mania, decreased need for sleep is a critical marker. During the euthymic period significant alterations in sleep pattern have been described. It’s also known that changes in the sleep pattern occur prior to those in mood patterns, indicating that sleep dysregulation may trigger the onset of mood episodes or relapses. Therefore, CR disruption may be associated with the pathophysiology of BD and some factors have already been identified: irregularity of the sleep-wake rhythm, eveningness chronotype, abnormality of melatonin secretion, vulnerability of clock genes and the irregularity of social zeitgeber. Conclusions Disturbances of sleep are pervasive, and an essential feature of BD, worse during mood episodes, but still present during euthymic periods. It remains to determine whether circadian rhythm dysfunction is a trait marker or mood state dependent. Further studies are warranted to clarify this association. Disclosure No significant relationships.
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Lemos M, Lourenço A, Ribeiro M. Psychiatric manifestations of paraneoplastic syndromes. Eur Psychiatry 2022. [PMCID: PMC9567621 DOI: 10.1192/j.eurpsy.2022.1698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Introduction Paraneoplastic syndromes (PS) result from indirect effects of neoplasms. In 50% of the cases the symptoms precede the diagnosis and run independently. PS may involve the peripheral or central nervous system, resulting in symptoms from sensory neuropathies to several neuropsychiatric manifestations. Objectives To review the psychiatric manifestations of paraneoplastic syndromes affecting the nervous system. Methods Selective literature review via PubMed search, using the keywords “paraneoplastic syndromes”, “endrocrine paraneoplastic syndromes”, “neuropsychiatric manifestations”, “limbic encephalitis”. Results The prevalence of PS varies with the type of cancer (<1% for breast and ovarian cancers; 3-5% for small cell lung cancer; 20% for thymomas). The general mechanisms behind PS are related to the production of substances by the tumor that directly or indirectly cause distant symptoms, the depletion of substances or the host response to the tumor. Frequently there are autoimmune phenomena involved, with the production of antineuronal antibodies that recognise various antigens at the nervous system. Paraneoplastic neurological disorders include limbic encephalits that can present subacutely with symptoms of depression, irritability, hallucinations, cognitive impairment associated with sleep alterations, confusion and seizures. Others include psoclonus-myoclonus ataxia syndrome, neuromyotonia and cramp fasciculation syndrome. Metabolic and endocrine paraneoplastic syndromes (hypercortisolism, carcinoid tumors, pancreatic cancer) can result from the production of cytokines and hormones by the tumor and produce mood disorders, confusional states and psychosis. Conclusions PS can be related to various neuropsychiatric manifestations affecting consciousness, cognition, mood and perception. The recognition of this association can alert for the possibility of a cancer diagnosis specially when facing a patient with unusual clinical presentation. Disclosure No significant relationships.
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Reynolds De Sousa T, Ribeiro M, Lourenço A, Novais F. Anhedonia. Depressive versus negative symptom. Eur Psychiatry 2022. [PMCID: PMC9562733 DOI: 10.1192/j.eurpsy.2022.570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction
Anhedonia is a symptom usually, and probably simplistically, defined as the inability to experience pleasure. It is considered one of the core symptoms of depression and a negative symptom of schizophrenia.
Objectives
We intend to explore whether previous studies found common or dissimilar experiences of anhedonia in depression and schizophrenia.
Methods
We performed a review of the published literature on the subject using PubMed. We conducted a search using ‘anhedonia’, ‘schizophrenia’, and ‘depression’ as keywords.
Results
There is different and diverging evidence on the matter. Historical reports associated schizophrenia with trait anhedonia, and depression with state anhedonia. More recently, some authors correlated appetitive anhedonia (lack of interest/desire) with schizophrenia, and consummatory anhedonia (lack of pleasure/enjoyment) with depression, but this was not corroborated by other studies. However, in line with it, there are findings of a normal physiological response to pleasurable stimuli among schizophrenics. Some authors propose that, in schizophrenia, this symptom might not represent an inability to feel pleasure but rather a deficient expression of its experience, as a part of blunted affect. Reward models highlight a deficit in reward learning in depression, but disorganization of reward processing and a focus on irrelevant clues in schizophrenia, which prevent patients from pursuing a pleasurable experience.
Conclusions
There are still limited studies comparing the experience of anhedonia in depression and schizophrenia. There seem to be significant differences between the two, but further studies are needed. In particular, this could be important in screening schizophrenic patients for depression.
Disclosure
No significant relationships.
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Lourenço A, Ribeiro M, Lemos M, Duarte A, Neves A. Global world, global hospitals. Ethnic differences and psychotic symptoms presentation – a review. Eur Psychiatry 2022. [PMCID: PMC9568105 DOI: 10.1192/j.eurpsy.2022.1622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction We live in a global world, where immigration is no longer just an escape, but also a demand and a desire. Globalization imposes the challenge of recognizing psychiatric illness in the most diverse of patients. Objectives To review the literature about the documentation of ethnic differences and the psychotic symptoms presentation. Methods We performed a MEDLINE search using the key words: ethnic differences and psychotic symptoms. We only included studies with full text published in English. Results
Since the 1970s, some studies have shown that there are differences in the manifestation of psychiatric illness in ethnic minorities. Most recent studies confirm this statement, mainly with an increase in immigration in the 20th century, with the receiving countries having an increase in the number of cases of psychosis (affective and non-affective). Belonging to an ethnic minority increases the risk of psychotic symptoms and experiences, witch is related to the patients perception of discrimination, social differences, family separation and the stress associated with immigration. On the other hand, these groups also have less access to health care. Conclusions Currently, professionals are more aware of the global world and what this implies in the manifestations of psychiatric illnesses. However, more studies will be needed to identify these natural differences. In this way, we will be able to help our patients anywhere and support their families. Disclosure No significant relationships.
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Romão J, Gonçalves M, Ribeiro M, André R, Saraiva R, Abreu M. Growing use of valproic acid in substance use disorders. Eur Psychiatry 2022. [PMCID: PMC9567128 DOI: 10.1192/j.eurpsy.2022.628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Valproic acid is an antiepileptic drug used in different fields of Psychiatry. It is known mostly for its use in managing patients with bipolar affective disorder. In psychiatry of addiction, there is still no approved indications for its usage, but it is widely prescribed in treating alcohol and cocaine abuse, due to the existence of studies in these addictions. Objectives This review aims to clarify the relation between valproic acid and dependences, particularly cocaine. Methods Non-systematic literature review using a PubMed search, using the following key words: “valproate”; “cocaine use”. Results Cocaine dependence can decrease GABA levels in humans. Valproic acid has multiple mechanisms that favour the synthesis of GABA, potentiating its release and postsynaptic GABAergic response. Because of this, valproic acid was found effective in promoting abstinence and in reducing the use of cocaine. There are studies that support the valproic acid’s use in alcohol and cocaine dependences. Valproic acid has been shown to be promising in relapse prevention. It has also showed efficacy in the management of impulsivity and irritability, what makes it useful in managing patients with borderline personality disorder – patients at higher risk for alcohol or substance use disorders. Conclusions Cocaine addiction involves different phenomena and may respond to distinct pharmacologic approaches. Although some studies need to be confirmed by larger clinical trials, valproic acid seems a promising agent as one of some potential treatments for cocaine dependence. Further studies are required in this field to come to more reliable conclusions. Disclosure No significant relationships.
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Ribeiro M, Lourenço A, Lemos M, Duarte A. Levothyroxine supplementation among individuals with Subclinical Hypothyroidism and Depression | a review. Eur Psychiatry 2022. [PMCID: PMC9568179 DOI: 10.1192/j.eurpsy.2022.1437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Depression is known to be associated with changes in the hypothalamic-pituitary-thyroid axis and the brain is a major target organ for thyroid hormone. Overt hypothyroidism can cause symptoms compatible with depression. However, its relationship with subclinical hypothyroidism (SCH) is not well established. Objectives To review the literature regarding the effect of levothyroxine therapy among patients with SCH and coexistent depression. Methods We conducted a MEDLINE search using depression, subclinical hypothyroidism and levothyroxine as keywords, selecting studies written in English. Results SCH is defined as an elevated thyroid stimulating hormone with normal peripheric hormone levels. The association between SCH and depression is controversial. Some studies indicate that SCH had the same propensity with overt hypothyroidism, while others report that major affective symptoms are not associated with SCH, but are likely due to independent psychiatric diagnoses, which are common in the general population and occur with similar frequency in patients with SCH. Individuals with SCH are recommended to initiate levothyroxine replacement therapy only when their TSH level is above 10 mIU/L or if symptoms are present. There is a lack of evidence supporting the use of levothyroxine therapy to improve mental health outcomes and the majority of meta-analysis do not show relief of affective symptoms after levothyroxine therapy, among individuals with SCH. Conclusions Routine screening for depressive symptoms among individuals with SCH is important to prevent morbidity. Nevertheless, there is no evidence enduring levothyroxine supplementation in these cases. Further studies, with larger sample sizes and longer follow-up periods are needed to enlighten the potential benefit of this therapy. Disclosure No significant relationships.
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Lourenço A, Ribeiro M, Lemos M. Hospital environment and patient recovery – a review. Eur Psychiatry 2022. [PMCID: PMC9568128 DOI: 10.1192/j.eurpsy.2022.1946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Since the second half of the 20th century, studies have been carried out that prove the benefits of the hospital environment in the improvement and recovery of patients. In this way, it would be important to understand what has already been done within the reality of Psychiatry Department. Objectives To review the literature about the documentation of hospital environment influence in patients’ recovery. Methods We performed a MEDLINE search using the key words: hospital environment influence and patients’ recovery or patients healing. We only included studies with full text published in English. Results In the selected articles, we only found studies developed in the Surgery department; in one of them, the authors tested the presence of plants in the patients’ rooms and assessed lower blood pressure values, less pain and less anxiety than the control group; in another, they tested the presence of music and landscape, although there was no difference in terms of pain assessment, there was an improvement in the assessment of the postoperative experience. A review pointed some other aspects that patients linked with their recovery, such as: audio and visual environment; specifically, in anxiety, pain and stress. On the other hand, other studies address the influence of the hospital environment on the satisfaction of health care providers. Conclusions Although hospital environment has already demonstrated an impact on the patient recovery, none (in our review) was developed directly in a Psychiatric Department; further studies are needed to understand the impact on this kind of service. Disclosure No significant relationships.
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Duarte A, Ribeiro M, Lopes J, Oliveira S, Martins P. Risk of suicide during pregnacy and postpartum period. Eur Psychiatry 2022. [PMCID: PMC9568081 DOI: 10.1192/j.eurpsy.2022.2214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Pregnancy and the postpartum are generally characterized by positive feelings and expectations but they may also disguise maternal stress and difficulties. These are typical periods for the onset or relapse of psychiatric symptoms and disorders. Even though suicide during pregnancy and postpartum is rare, it is among the leading causes of maternal perinatal mortality. Objectives To provide an overview on the risk of suicide during pregnancy and postpartum. Methods PubMed database was searched using combinations of the terms “suicide”, combined with “pregnancy” and “depression”. Results The major risk factors for suicidal ideation are previous suicide attempts, self-harm, current or past history of psychiatric disorder, young maternal age, being unmarried, an unplanned pregnancy, substance use disorders, lack effective psychosocial support and discontinuation of psychotropic drugs. Pregnant women with suicidality behavior have also an increased risk for various adverse obstetric outcomes, including miscarriage, preterm delivery, maternal hemorrhage, and stillbirth. Furthermore, the postpartum period is often associated with the onset of mood and psychotic disorders with an increased risk of both suicide and infanticide. Women who have suffered from serious psychiatric conditions either after childbirth or in other phases of life should be informed about the possibility of relapse after subsequent pregnancies, thus presenting a higher risk of suicide. Conclusions During pregnancy and postpartum, it is fundamental to investigate suicide risk, including suicidal ideation, thoughts, and intent, especially (but not only) in women affected by mental pathology. Moreover, maternal suicide behaviour affects the child’s neuropsychological development and can also increase the infant´s suicide risk. Disclosure No significant relationships.
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Mafra D, Borges NA, Alvarenga L, Ribeiro M, Fonseca L, Leal VO, Shiels PG, Stenvinkel P. Fermented food: Should patients with cardiometabolic diseases go back to an early neolithic diet? Crit Rev Food Sci Nutr 2022; 63:10173-10196. [PMID: 35593230 DOI: 10.1080/10408398.2022.2077300] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Fermentation has been used since the Early Neolithic period to preserve foods. It has inherent organoleptic and nutritive properties that bestow health benefits, including reducing inflammation and oxidative stress, supporting the growth of salutogenic microbiota, enhancing intestinal mucosal protection and promoting beneficial immunometabolic health effects. The fermentation of food with specific microbiota increases the production salutogenic bioactive compounds that can activate Nrf2 mediated cytoprotective responses and mitigate the effects of the 'diseasome of aging' and its associated inflammageing, which presents as a prominent feature of obesity, type-2 diabetes, cardiovascular and chronic kidney disease. This review discusses the importance of fermented food in improving health span, with special reference to cardiometabolic diseases.
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Affiliation(s)
- D Mafra
- Post Graduation Program in Medical Sciences, Federal Fluminense University, Niterói-Rio de Janeiro, Brazil
- Graduate Program in Biological Sciences, Physiology, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - N A Borges
- Institute of Nutrition, University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
| | - L Alvarenga
- Post Graduation Program in Medical Sciences, Federal Fluminense University, Niterói-Rio de Janeiro, Brazil
| | - M Ribeiro
- Graduate Program in Biological Sciences, Physiology, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - L Fonseca
- Post Graduation Program in Medical Sciences, Federal Fluminense University, Niterói-Rio de Janeiro, Brazil
| | - V O Leal
- Division of Nutrition, Pedro Ernesto University Hospital, University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
| | - P G Shiels
- Wolfson Wohl Translational Research Centre, University of Glasgow, Bearsden, Glasgow, UK
| | - P Stenvinkel
- Division of Renal Medicine, Department of Clinical Science, Technology and Intervention, Karolinska Instituted, Stockholm, Sweden
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Baumann A, Vázquez A, Macchione A, Lima A, Coelho A, Juras M, Ribeiro M, Kohlsdorf M, Carothers B. Translation and validation of the evidence-based practice attitude scale (EBPAS-15) to Brazilian Portuguese: Examining providers' perspective about evidence-based parent intervention. Child Youth Serv Rev 2022; 136:106421. [PMID: 35431379 PMCID: PMC9012479 DOI: 10.1016/j.childyouth.2022.106421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Few existing evidence-based parent interventions (EBPIs) for prevention and treatment of child and youth mental health disorders are implemented in low-middle-income countries. This study aimed to translate and confirm the factor structure of the Evidence-Based Practice Attitude Scale (EBPAS-15) survey in Brazilian Portuguese with the goal of examining providers' perspective about EBPIs. METHODS We translated and back translated the EBPAS-15 from English to Brazilian Portuguese. Participants were recruited via snowball sampling and data were collected using an online survey from July of 2018 through January of 2020. A confirmatory factor analysis was conducted to determine if the scale retained its original structure. Open-ended questions about providers' perspectives of their own clinical practice were coded using the Theoretical Domains Framework (TDF). Analyses included data from 362 clinicians (318 women, 41 men) from 20 of the 27 states of Brazil. Participants on average were 26.7 years old, held specialist degrees in the field of psychology, actively worked as therapists, and practiced in private clinics. RESULTS The translation of the EBPAS to Brazilian Portuguese retained the same four-factor structure as the English version except for dropping one item from the Divergence domain. When asked about the challenges in their practices, providers generally referred to parents as clients with little skills to discipline their children and lacking knowledge about child development. DISCUSSION The Brazilian version of the EBPAS-15 is promising, but future research should consider using quantitative data alongside qualitative information to better understand providers' attitudes about evidence-based interventions to inform implementation efforts. TRIAL REGISTRATION N/A.
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Affiliation(s)
- A.A. Baumann
- Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis, MO, USA
| | | | - A.C. Macchione
- Centro Paradigma de Ciências do Comportamento, São Paulo, Brazil
| | - A. Lima
- Sam Houston State University, TX, USA
| | - A.F. Coelho
- Universidade de Brasilia, Brasília-DF, Brazil
| | - M. Juras
- Florida Gulf Coast University, USA
| | - M. Ribeiro
- Aiutare Instituto de Psicologia, Brasília-DF, Brazil
| | - M. Kohlsdorf
- Centro Universitario UniCEUB, Brasília-DF, Brazil
| | - B.J. Carothers
- Brown School, Washington University in St. Louis, Missouri, United States
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23
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Mallereau CH, Ribeiro M, Ardellier FD, Dannhoff G, Cebula H, Proust F, Chibbaro S, Todeschi J. Delayed cerebral ischemia after meningioma resection: Literature review and illustrative case. Neurochirurgie 2022; 68:e27-e33. [DOI: 10.1016/j.neuchi.2022.02.009] [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: 01/24/2022] [Revised: 02/18/2022] [Accepted: 02/23/2022] [Indexed: 10/18/2022]
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24
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Jacob J, Feuvret L, Simon JM, Ribeiro M, Nichelli L, Jenny C, Ricard D, Psimaras D, Hoang-Xuan K, Maingon P. Neurological side effects of radiation therapy. Neurol Sci 2022; 43:2363-2374. [DOI: 10.1007/s10072-022-05944-w] [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: 08/27/2021] [Accepted: 02/05/2022] [Indexed: 10/19/2022]
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25
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Dias MC, Dos Reis RS, Santos JV, Nunes AP, Ferreira P, Maia B, Fragata I, Reis J, Lopes JR, Cruz L, Santo G, Machado E, Gabriel D, Felgueiras R, Dória HM, Carneiro A, Correia M, Veloso LM, Barros P, Gregorio T, Carvalho A, Ribeiro M, Teotonio P, Neto L, E Melo TP, Canhao P, Filipe JP, Moreira G, Azevedo E, Silva ML, Costa EC, Oliveira G, Pereira L, Neves L, Rodrigues M, Marto JP, Calado S, Grenho F, Branco G, Baptista T, Rocha J, Ferreira C, Pinho J, Amorim JM, Araujo JM, Neiva RM, Viana J, Lobo M, Freitas A, Cruz VT, Sargento-Freitas J, Lopes JC. Nationwide Access to Endovascular Treatment for Acute Ischemic Stroke in Portugal. ACTA MEDICA PORT 2022; 35:127-134. [PMID: 34499849 DOI: 10.20344/amp.15031] [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: 10/11/2020] [Revised: 01/23/2021] [Accepted: 02/10/2021] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Since the publication of endovascular treatment trials and European Stroke Guidelines, Portugal has re-organized stroke healthcare. The nine centers performing endovascular treatment are not equally distributed within the country, which may lead to differential access to endovascular treatment. Our main aim was to perform a descriptive analysis of the main treatment metrics regarding endovascular treatment in mainland Portugal and its administrative districts. MATERIAL AND METHODS A retrospective national multicentric cohort study was conducted, including all ischemic stroke patients treated with endovascular treatment in mainland Portugal over two years (July 2015 to June 2017). All endovascular treatment centers contributed to an anonymized database. Demographic, stroke-related and procedure-related variables were collected. Crude endovascular treatment rates were calculated per 100 000 inhabitants for mainland Portugal, and each district and endovascular treatment standardized ratios (indirect age-sex standardization) were also calculated. Patient time metrics were computed as the median time between stroke onset, first-door, and puncture. RESULTS A total of 1625 endovascular treatment procedures were registered. The endovascular treatment rate was 8.27/100 000 inhabitants/year. We found regional heterogeneity in endovascular treatment rates (1.58 to 16.53/100 000/year), with higher rates in districts closer to endovascular treatment centers. When analyzed by district, the median time from stroke onset to puncture ranged from 212 to 432 minutes, reflecting regional heterogeneity. DISCUSSION Overall endovascular treatment rates and procedural times in Portugal are comparable to other international registries. We found geographic heterogeneity, with lower endovascular treatment rates and longer onset-to-puncture time in southern and inner regions. CONCLUSION The overall national rate of EVT in the first two years after the organization of EVT-capable centers is one of the highest among European countries, however, significant regional disparities were documented. Moreover, stroke-onset-to-first-door times and in-hospital procedural times in the EVT centers were comparable to those reported in the randomized controlled trials performed in high-volume tertiary hospitals.
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Ribeiro M, Zephyr N, Silva JAL, Danion M, Guérin T, Castanheira I, Leufroy A, Jitaru P. Assessment of the mercury-selenium antagonism in rainbow trout fish. Chemosphere 2022; 286:131749. [PMID: 34426140 DOI: 10.1016/j.chemosphere.2021.131749] [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: 04/30/2021] [Revised: 07/02/2021] [Accepted: 07/30/2021] [Indexed: 06/13/2023]
Abstract
This study aims at the assessment of mercury (Hg)-selenium (Se) antagonism in fish. For this purpose, rainbow trout fish (Oncorhynchus mykiss) were exposed to methylmercury (MeHg) under controlled conditions, in the presence or absence of selenomethionine (SeMet) using an in-house prepared diet (enriched with MeHg and SeMet at 0.2 μg/g and 5.0 μg/g, respectively). The total duration of the exposure study was 3 months. Fish was sampled and analysed for total Se (SeT) and total mercury (HgT) content after 1, 2 and 3 months of exposure. Six feeding protocols were compared, depending on the exposure type: (i) no MeHg nor SeMet exposure (control group); (ii) exposure to SeMet solely; (iii) exposure to MeHg solely; (iv) exposure to both MeHg and SeMet; (v) exposure first to MeHg during 1 month and then to SeMet during 2 months and (vi), exposure to SeMet during 1 month and then to MeHg for 2 months. The levels of SeT and HgT in the fish (control and supplemented with MeHg/SeMet) were measured by inductively coupled plasma-mass spectrometry (ICPMS). Steadily (linear) bioaccumulation of MeHg in the fish muscle occurred when the fish were exposed individually to this species during the period. The bioaccumulation of MeHg is diminished when the fish are firstly exposed to SeMet and then to MeHg, hence indicating the MeHg detoxification due to SeMet supplementation.
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Affiliation(s)
- M Ribeiro
- ANSES, Laboratory for Food Safety, F-94700, Maisons-Alfort, France; Departamento de Alimentação e Nutrição, Instituto Nacional de Saúde Doutor Ricardo Jorge, INSA IP, Avenida Padre Cruz, 1649-016, Lisboa, Portugal; Centro de Química Estrutural, Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais, 1049-001, Lisboa, Portugal
| | - N Zephyr
- ANSES, Laboratory for Food Safety, F-94700, Maisons-Alfort, France
| | - J A L Silva
- Centro de Química Estrutural, Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais, 1049-001, Lisboa, Portugal
| | - M Danion
- ANSES, Ploufragan-Plouzané-Niort Laboratory, Fish Virology, Immunology and Ecotoxicology Unit, Technopôle Brest-Iroise, 29280, Plouzané, France
| | - T Guérin
- ANSES, Directorate of Strategy and Programs, F-94700, Maisons-Alfort, France
| | - I Castanheira
- Departamento de Alimentação e Nutrição, Instituto Nacional de Saúde Doutor Ricardo Jorge, INSA IP, Avenida Padre Cruz, 1649-016, Lisboa, Portugal
| | - A Leufroy
- ANSES, Laboratory for Food Safety, F-94700, Maisons-Alfort, France
| | - P Jitaru
- ANSES, Laboratory for Food Safety, F-94700, Maisons-Alfort, France.
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Rabbani N, Calvet L, Espinel Y, Le Roy B, Ribeiro M, Buc E, Bartoli A. A methodology and clinical dataset with ground-truth to evaluate registration accuracy quantitatively in computer-assisted Laparoscopic Liver Resection. Computer Methods in Biomechanics and Biomedical Engineering: Imaging & Visualization 2021. [DOI: 10.1080/21681163.2021.1997642] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- N. Rabbani
- EnCoV, Institut Pascal, Clermont-Ferrand, France
| | - L. Calvet
- EnCoV, Institut Pascal, Clermont-Ferrand, France
- CHU, Clermont-Ferrand, France
- IRIT, University of Toulouse
| | - Y. Espinel
- EnCoV, Institut Pascal, Clermont-Ferrand, France
| | - B. Le Roy
- EnCoV, Institut Pascal, Clermont-Ferrand, France
- CHU, Saint-Etienne, France
| | - M. Ribeiro
- EnCoV, Institut Pascal, Clermont-Ferrand, France
- CHU, Clermont-Ferrand, France
| | - E. Buc
- EnCoV, Institut Pascal, Clermont-Ferrand, France
- CHU, Clermont-Ferrand, France
| | - A. Bartoli
- EnCoV, Institut Pascal, Clermont-Ferrand, France
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Gassó P, Rodríguez N, Martínez-Pinteño A, Mezquida G, Ribeiro M, González-Peñas J, Zorrilla I, Martínez-Sadurni L, Rodriguez-Jimenez R, Corripio I, Sarró S, Ibáñez A, Usall J, Lobo A, Moren C, Cuesta MJ, Parellada M, González-Pinto A, Berrocoso E, Bernardo M, Mas S. A longitudinal study of gene expression in first-episode schizophrenia; exploring relapse mechanisms by co-expression analysis in peripheral blood. Transl Psychiatry 2021; 11:539. [PMID: 34667144 PMCID: PMC8526619 DOI: 10.1038/s41398-021-01645-8] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 09/22/2021] [Accepted: 09/30/2021] [Indexed: 12/20/2022] Open
Abstract
Little is known about the pathophysiological mechanisms of relapse in first-episode schizophrenia, which limits the study of potential biomarkers. To explore relapse mechanisms and identify potential biomarkers for relapse prediction, we analyzed gene expression in peripheral blood in a cohort of first-episode schizophrenia patients with less than 5 years of evolution who had been evaluated over a 3-year follow-up period. A total of 91 participants of the 2EPs project formed the sample for baseline gene expression analysis. Of these, 67 provided biological samples at follow-up (36 after 3 years and 31 at relapse). Gene expression was assessed using the Clariom S Human Array. Weighted gene co-expression network analysis was applied to identify modules of co-expressed genes and to analyze their preservation after 3 years of follow-up or at relapse. Among the 25 modules identified, one module was semi-conserved at relapse (DarkTurquoise) and was enriched with risk genes for schizophrenia, showing a dysregulation of the TCF4 gene network in the module. Two modules were semi-conserved both at relapse and after 3 years of follow-up (DarkRed and DarkGrey) and were found to be biologically associated with protein modification and protein location processes. Higher expression of DarkRed genes was associated with higher risk of suffering a relapse and early appearance of relapse (p = 0.045). Our findings suggest that a dysregulation of the TCF4 network could be an important step in the biological process that leads to relapse and suggest that genes related to the ubiquitin proteosome system could be potential biomarkers of relapse.
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Affiliation(s)
- P. Gassó
- grid.5841.80000 0004 1937 0247Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain ,grid.10403.36Institut d’investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain
| | - N. Rodríguez
- grid.5841.80000 0004 1937 0247Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain ,grid.10403.36Institut d’investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain
| | - A. Martínez-Pinteño
- grid.5841.80000 0004 1937 0247Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain ,grid.10403.36Institut d’investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain
| | - G. Mezquida
- grid.5841.80000 0004 1937 0247Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain ,grid.10403.36Institut d’investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain ,grid.410458.c0000 0000 9635 9413Barcelona Clínic Schizophrenia Unit (BCSU), Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain ,grid.469673.90000 0004 5901 7501Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Madrid, Spain
| | - M. Ribeiro
- grid.497559.3Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain ,grid.508840.10000 0004 7662 6114IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - J. González-Peñas
- grid.469673.90000 0004 5901 7501Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Madrid, Spain ,grid.4795.f0000 0001 2157 7667Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - I. Zorrilla
- grid.469673.90000 0004 5901 7501Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Madrid, Spain ,Department of Psychiatry, Hospital Universitario de Alava, Vitoria, Spain ,BIOARABA Health Research Institute, Vitoria, Spain ,grid.11480.3c0000000121671098University of the Basque Country, Vitoria, Spain
| | - L. Martínez-Sadurni
- grid.411142.30000 0004 1767 8811Hospital del Mar Medicar Research Institute (IMIM), Barcelona, Spain
| | - R. Rodriguez-Jimenez
- grid.469673.90000 0004 5901 7501Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Madrid, Spain ,grid.144756.50000 0001 1945 5329Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain ,grid.4795.f0000 0001 2157 7667CogPsy Group, Universidad Complutense de Madrid (UCM), Madrid, Spain
| | - I. Corripio
- grid.469673.90000 0004 5901 7501Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Madrid, Spain ,grid.413396.a0000 0004 1768 8905Psychiatry Department, Institut d’Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain ,grid.7080.f0000 0001 2296 0625Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - S. Sarró
- grid.469673.90000 0004 5901 7501Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Madrid, Spain ,grid.466668.cFIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain ,grid.410675.10000 0001 2325 3084School of Medicine, Universitat Internacional de Catalunya, Barcelona, Spain
| | - A. Ibáñez
- grid.469673.90000 0004 5901 7501Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Madrid, Spain ,grid.411347.40000 0000 9248 5770Department of Psychiatry, Hospital Universitario Ramón y Cajal, IRYCIS, Universidad de Alcalá, Madrid, Spain
| | - J. Usall
- grid.466982.70000 0004 1771 0789Etiopatogènia i tractament dels trastorns mentals greus (MERITT) Institut de Recerca Sant Joan de Déu Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | - A. Lobo
- grid.469673.90000 0004 5901 7501Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Madrid, Spain ,grid.11205.370000 0001 2152 8769Department of Medicine and Psychiatry, Universidad de Zaragoza, Zaragoza, Spain ,grid.488737.70000000463436020Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - C. Moren
- grid.10403.36Cellex, IDIBAPS, University of Barcelona-Hospital Clínic of Barcelona, Barcelona, 08036 Spain ,grid.512890.7Centro de Investigación Biomédica en Red (CIBER) de Enfermedades Raras (CIBERER), Madrid, 28029 Spain
| | - M. J. Cuesta
- grid.497559.3Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain ,grid.508840.10000 0004 7662 6114IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - M. Parellada
- grid.469673.90000 0004 5901 7501Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Madrid, Spain ,grid.4795.f0000 0001 2157 7667Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - A. González-Pinto
- grid.469673.90000 0004 5901 7501Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Madrid, Spain ,Department of Psychiatry, Hospital Universitario de Alava, Vitoria, Spain ,BIOARABA Health Research Institute, Vitoria, Spain ,grid.11480.3c0000000121671098University of the Basque Country, Vitoria, Spain
| | - E. Berrocoso
- grid.7759.c0000000103580096Neuropsychopharmacology and Psychobiology Research Group, Department of Psychology, University of Cádiz, Cádiz, Spain ,grid.411342.10000 0004 1771 1175Instituto de Investigación e Innovación Biomédica de Cádiz, INiBICA, Hospital Universitario Puerta del Mar, Cádiz, Spain
| | - M. Bernardo
- grid.10403.36Institut d’investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain ,grid.410458.c0000 0000 9635 9413Barcelona Clínic Schizophrenia Unit (BCSU), Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain ,grid.469673.90000 0004 5901 7501Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Madrid, Spain ,grid.5841.80000 0004 1937 0247Department of Medicine, University of Barcelona, Barcelona, Spain
| | - S. Mas
- grid.5841.80000 0004 1937 0247Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain ,grid.10403.36Institut d’investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain ,grid.469673.90000 0004 5901 7501Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Madrid, Spain
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Bachtiger P, Scott F, Park S, Petri C, Padam PS, Sahemey H, Dumea B, Ribeiro M, Alquero R, Bual N, Cheung WS, Rana B, Keene D, Plymen CM, Peters NS. Multicentre validation of point-of-care screening tool for heart failure: single-lead ECG recorded by smart stethoscope predicts low ejection fraction using artificial intelligence. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.3071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background/Introduction
Artificial intelligence (AI) applied to 12-lead ECG can identify left ventricular ejection fraction (EF) ≤35% with a sensitivity and specificity of 86.3% and 85.7%, respectively. Whether AI algorithms trained on 12-lead can accurately predict EF from single-lead ECGs (recorded by a smart stethoscope) remains unknown. This could facilitate point-of-care screening for low EF during routine clinical examination.
Purpose
First independent multicentre real-world UK National Health Service (NHS) prospective validation of 12-lead-ECG-trained AI algorithm applied to single-lead ECG recorded by a smart stethoscope, with AI algorithm tuned to detect EF ≤40%.
Methods
Prospective recruitment of unselected patients attending for echocardiography across six urban NHS hospital sites (UK). In addition to transthoracic echocardiogram (routine care), all participants had 15 seconds of supine, single-lead ECG recorded at six different positions (figure), encompassing standard anatomical positions for cardiac auscultation. A convolutional neural network (CNN) previously trained on 35,970 independent pairings of 12-lead-ECG and echocardiograms was retrained to use the single-lead ECG as input. Accuracy of CNN detection of low EF (binary ≤40%) is reported at a threshold of 0.5 against gold-standard; echo-determined percentage EF.
Results
Among 353 patients recruited (mean age 63±17; 58% male, 43.1% non-white), 309 (87.5%) had an EF >40%, and 44 (12.5%) had EF ≤40%. The best single recording position in isolation was position 3 (sensitivity 57.9% [42.2–73.6], specificity 86.3% [82.2–90.3]). Taking any of the six positions performed during the examination as predicting EF ≤40%, this achieved a sensitivity of 81.2% and specificity of 61.5%.
Conclusion(s)
In this first prospective multicentre validation study the retrained AI algorithm reliably detected low EF from single-lead ECGs acquired using a novel ECG-enabled stethoscope in standard auscultation positions. The ability to identify patients with possible low EF during routine physical examination addresses a significant unmet clinical need in point-of-care ruling in/out of heart failure, and has potential to provide broader population-level screening for asymptomatic cardiovascular disease.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Institute of Health Research, Accelerated Access Collaborative & NHSX: Artificial Intelligence in Health & Social Care Award
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Affiliation(s)
- P Bachtiger
- National Heart and Lung Institute Imperial College, London, United Kingdom
| | - F Scott
- National Heart and Lung Institute Imperial College, London, United Kingdom
| | - S Park
- National Heart and Lung Institute Imperial College, London, United Kingdom
| | - C Petri
- National Heart and Lung Institute Imperial College, London, United Kingdom
| | - P S Padam
- National Heart and Lung Institute Imperial College, London, United Kingdom
| | - H Sahemey
- Imperial College Healthcare NHS Trust, London, United Kingdom
| | - B Dumea
- Imperial College Healthcare NHS Trust, London, United Kingdom
| | - M Ribeiro
- Imperial College Healthcare NHS Trust, London, United Kingdom
| | - R Alquero
- Imperial College Healthcare NHS Trust, London, United Kingdom
| | - N Bual
- Imperial College Healthcare NHS Trust, London, United Kingdom
| | - W S Cheung
- Imperial College Healthcare NHS Trust, London, United Kingdom
| | - B Rana
- Imperial College Healthcare NHS Trust, London, United Kingdom
| | - D Keene
- National Heart and Lung Institute Imperial College, London, United Kingdom
| | - C M Plymen
- Imperial College Healthcare NHS Trust, London, United Kingdom
| | - N S Peters
- National Heart and Lung Institute Imperial College, London, United Kingdom
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Belhadef A, Ribeiro M, Mazevet M, Laudette M, Crozatier B, Lezoualc’h F, Benitah J, Gomez A, Morel E, Lemaire C. EPAC1 inhibition as a new therapeutic target in anthracyclines induced cardiotoxicity. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2021.04.167] [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: 11/16/2022]
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Brizneda MV, Hutt E, Aguilera J, Wang TKM, Taimeh Z, Culver D, Hussein A, Callahan T, Wazni O, Jaber W, Cremer P, Ribeiro M, Jellis C. CARDIAC INVOLVEMENT IN SARCOIDOSIS: A POOR PROGNOSTIC MARKER. J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)02103-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Martinez-Zayas G, Almeida FA, Yarmus L, Steinfort D, Lazarus DR, Simoff MJ, Saettele T, Murgu S, Dammad T, Duong DK, Mudambi L, Filner JJ, Molina S, Aravena C, Thiboutot J, Bonney A, Rueda AM, Debiane LG, Hogarth DK, Bedi H, Deffebach M, Sagar AES, Cicenia J, Yu DH, Cohen A, Frye L, Grosu HB, Gildea T, Feller-Kopman D, Casal RF, Machuzak M, Arain MH, Sethi S, Eapen GA, Lam L, Jimenez CA, Ribeiro M, Noor LZ, Mehta A, Song J, Choi H, Ma J, Li L, Ost DE. Predicting Lymph Node Metastasis in Non-small Cell Lung Cancer: Prospective External and Temporal Validation of the HAL and HOMER Models. Chest 2021; 160:1108-1120. [PMID: 33932466 DOI: 10.1016/j.chest.2021.04.048] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 04/02/2021] [Accepted: 04/08/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Two models, the Help with the Assessment of Adenopathy in Lung cancer (HAL) and Help with Oncologic Mediastinal Evaluation for Radiation (HOMER), were recently developed to estimate the probability of nodal disease in patients with non-small cell lung cancer (NSCLC) as determined by endobronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA). The objective of this study was to prospectively externally validate both models at multiple centers. RESEARCH QUESTION Are the HAL and HOMER models valid across multiple centers? STUDY DESIGN AND METHODS This multicenter prospective observational cohort study enrolled consecutive patients with PET-CT clinical-radiographic stages T1-3, N0-3, M0 NSCLC undergoing EBUS-TBNA staging. HOMER was used to predict the probability of N0 vs N1 vs N2 or N3 (N2|3) disease, and HAL was used to predict the probability of N2|3 (vs N0 or N1) disease. Model discrimination was assessed using the area under the receiver operating characteristics curve (ROC-AUC), and calibration was assessed using the Brier score, calibration plots, and the Hosmer-Lemeshow test. RESULTS Thirteen centers enrolled 1,799 patients. HAL and HOMER demonstrated good discrimination: HAL ROC-AUC = 0.873 (95%CI, 0.856-0.891) and HOMER ROC-AUC = 0.837 (95%CI, 0.814-0.859) for predicting N1 disease or higher (N1|2|3) and 0.876 (95%CI, 0.855-0.897) for predicting N2|3 disease. Brier scores were 0.117 and 0.349, respectively. Calibration plots demonstrated good calibration for both models. For HAL, the difference between forecast and observed probability of N2|3 disease was +0.012; for HOMER, the difference for N1|2|3 was -0.018 and for N2|3 was +0.002. The Hosmer-Lemeshow test was significant for both models (P = .034 and .002), indicating a small but statistically significant calibration error. INTERPRETATION HAL and HOMER demonstrated good discrimination and calibration in multiple centers. Although calibration error was present, the magnitude of the error is small, such that the models are informative.
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Affiliation(s)
- Gabriela Martinez-Zayas
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Lonny Yarmus
- Division of Pulmonary and Critical Care, Johns Hopkins University, Baltimore, MD
| | - Daniel Steinfort
- Department of Respiratory Medicine, Royal Melbourne Hospital, Melbourne, Australia; Department of Medicine, University of Melbourne, Melbourne, Australia
| | - Donald R Lazarus
- Department of Pulmonary, Critical Care, and Sleep Medicine, Baylor College of Medicine, Houston, TX
| | - Michael J Simoff
- Department of Pulmonary and Critical Care Medicine, Henry Ford Hospital, Detroit, MI
| | - Timothy Saettele
- Department of Pulmonary Disease and Critical Care Medicine, Saint Luke's Hospital of Kansas City, Kansas City, MO
| | - Septimiu Murgu
- Division of Pulmonary and Critical Care Medicine, University of Chicago, Chicago, IL
| | - Tarek Dammad
- Department of Pulmonary Medicine, University of New Mexico, Albuquerque, NM; Department of Pulmonary and Critical Care Medicine, CHRISTUS St. Vincent Medical Center, Santa Fe, NM
| | - D Kevin Duong
- Department of Pulmonary, Allergy and Critical Care Medicine, Stanford University Medical Center and School of Medicine, Stanford, CA
| | - Lakshmi Mudambi
- Division of Pulmonary and Critical Care, VA Portland Health Care System, Oregon Health and Science University, Portland, OR
| | - Joshua J Filner
- Department of Pulmonary Medicine, Northwest Permanente and The Center for Health Research, Kaiser Permanente Northwest, Portland, OR
| | - Sofia Molina
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Carlos Aravena
- Department of Respiratory Diseases, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Jeffrey Thiboutot
- Division of Pulmonary and Critical Care, Johns Hopkins University, Baltimore, MD
| | - Asha Bonney
- Department of Respiratory Medicine, Royal Melbourne Hospital, Melbourne, Australia
| | - Adriana M Rueda
- Department of Pulmonary, Critical Care, and Sleep Medicine, Baylor College of Medicine, Houston, TX
| | - Labib G Debiane
- Department of Pulmonary and Critical Care Medicine, Henry Ford Hospital, Detroit, MI
| | - D Kyle Hogarth
- Division of Pulmonary and Critical Care Medicine, University of Chicago, Chicago, IL
| | - Harmeet Bedi
- Department of Pulmonary, Allergy and Critical Care Medicine, Stanford University Medical Center and School of Medicine, Stanford, CA
| | - Mark Deffebach
- Division of Pulmonary and Critical Care, VA Portland Health Care System, Oregon Health and Science University, Portland, OR
| | - Ala-Eddin S Sagar
- Department of Pulmonary Medicine, Banner MD Anderson Cancer Center, Gilbert, AZ
| | - Joseph Cicenia
- Department of Pulmonary Medicine, Cleveland Clinic, Cleveland, OH
| | - Diana H Yu
- Division of Pulmonary, Critical Care and Sleep Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Avi Cohen
- Department of Pulmonary and Critical Care Medicine, Henry Ford Hospital, Detroit, MI
| | - Laura Frye
- Division of Allergy, Pulmonary and Critical Care Medicine, University of Wisconsin, Madison, WI
| | - Horiana B Grosu
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Thomas Gildea
- Department of Pulmonary Medicine, Cleveland Clinic, Cleveland, OH
| | - David Feller-Kopman
- Division of Pulmonary and Critical Care, Johns Hopkins University, Baltimore, MD
| | - Roberto F Casal
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Michael Machuzak
- Department of Pulmonary Medicine, Cleveland Clinic, Cleveland, OH
| | - Muhammad H Arain
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Sonali Sethi
- Department of Pulmonary Medicine, Cleveland Clinic, Cleveland, OH
| | - George A Eapen
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Louis Lam
- Department of Pulmonary Medicine, Cleveland Clinic, Cleveland, OH
| | - Carlos A Jimenez
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Manuel Ribeiro
- Department of Pulmonary Medicine, Cleveland Clinic, Cleveland, OH
| | - Laila Z Noor
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Atul Mehta
- Department of Pulmonary Medicine, Cleveland Clinic, Cleveland, OH
| | - Juhee Song
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Humberto Choi
- Department of Pulmonary Medicine, Cleveland Clinic, Cleveland, OH
| | - Junsheng Ma
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Liang Li
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - David E Ost
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX.
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Sánchez-Torres A, Gil-Berrozpe G, Lorente-Omeñaca R, Zandio M, Moreno-Izco L, De Jalón EG, Ribeiro M, Peralta V, Cuesta M. A polydiagnostic approach to cognitive deficits in schizophrenia. Eur Psychiatry 2021. [PMCID: PMC9471716 DOI: 10.1192/j.eurpsy.2021.432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Cognitive deficits are common, clinically relevant and closely linked to poor functional outcomes in everyday functioning in patients with schizophrenia and other psychoses. Objectives To ascertain to which extent a polydiagnostic assessment of schizophrenia is associated with clinically-derived criteria of cognitive impairment and gold-standard neuropsychological assessment. Methods We assessed 98 patients with a psychotic disorder. We tested if patients met criteria for schizophrenia according to five diagnostic classifications: Krapelin, Bleuler, Schneider, ICD-10 and DSM-IV. Also, we applied a set of clinically-derived criteria to assess cognitive impairment associated with psychosis (CIAPs). Gold-standard neuropsychological assessment was administered, covering the cognitive domains included in the MATRICS Cognitive Battery: attention, processing speed, verbal memory, visual memory, working memory, executive function and social cognition. MANOVAs were performed to test the association between polydiagnostic and clinically-derived criteria and neuropsychological assessment. Results ![]()
MANOVA profile analyses revealed that patients who met CIAPs criteria showed cognitive impairment in all the cognitive domains except for social cognition. Patients diagnosed with Kraepelin’s criteria showed significant differences in processing speed, visual memory, working memory and GCI. Patients fulfilling Bleuler and DSM-IV criteria showed significant deficits in processing speed and verbal memory, respectively. Schneider and ICD-10 diagnostic criteria did not reveal differences in cognition between patients who fulfilled these criteria. Conclusions CIAPs criteria were the most accurate classifying patients with cognitive impairment, followed by Kraepelin’s criteria, which were the ones among diagnostic criteria which better differentiated patients regarding cognitive impairment. These criteria take into consideration the outcome in addition to symptoms. Disclosure This work was supported by the Government of Navarra (grants 17/31, 18/41, 87/2014) and the Carlos III Health Institute (FEDER Funds) from the Spanish Ministry of Economy and Competitivity (14/01621 and 16/02148). Both had no further role in the study des
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Ribeiro M, Hueb W, Rezende P, Rochitte C, Nomura C, Morais T, Lima E, Boros G, Ribas F, Carvalho F, Carvalho G, Mocha M, Serrano C, Ramires J, Kalil Filho R. T1 mapping for myocardial tissue evaluation in patients with ischemia and stable coronary artery disease: MASS V-Trial Study Group. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
T1 mapping is a magnetic resonance imaging (MRI) technique that enables the identification of myocardial structural changes during acute ischemic injury. However, it is not known whether these structural changes are present in patients with chronic effort induced ischemia.Thus, we sought to document the possible T1 mapping changes in chronic coronary artery disease (CAD) patients with documented myocardial ischemia.
Methods
Multivessel CAD patients from MASS V Trial with indication of myocardial revascularization, were evaluated for the presence of ischemia by myocardial scintigraphy. MRI with T1 mapping was performed in all patients. Based on the results of the scintigraphy, the myocardial segments were identified as ischemic and non-ischemic segments. The corresponding segments of scintigraphy and MRI were compared in relation to native T1 map (NT1), post-contrast T1 (CAT1) and extracellular volume (ECV).
Results
Of the 720 myocardial segments analyzed, there were 161 ischemic and 559 non-ischemic segments. Comparing ischemic vs non-ischemic segments, respectively, NT1 was 1022.7 (980.0–1052.0) versus 1029.3 (985.0–1066.3), p=0.57, ECV results were 25.4 (24.0–28.1) versus 26.4 (25.3–29.9), p=0.75 and CAT1 results were 492 (461.9–515.4) versus 488 (469.2–521.7), p=0.09. Myocardial segments supplied by obstructive coronary arteries were compared to those supplied by non-obstructive coronary arteries in relation to NT1 and ECV. NT1 values in obstructive and non-obstructive territories were, respectively, 1024.7 (998.5–1043.5) versus 1036.8 (1008.6–1046.9), p=0.30 and ECV results were 26.8 (24.4–29.9) versus 26.8 (24.4–30.0), p=0.90.
Conclusion
In this study, MRI identified structural similarities between chronic ischemic myocardium compared to the non-ischemic myocardium. This finding supports myocardial tissue stability in the presence of stress induced ischemia.
Funding Acknowledgement
Type of funding source: Foundation. Main funding source(s): Zerbini Foundation and also by the FAPESP (2011/ 20876-2)
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Affiliation(s)
- M Ribeiro
- Heart Institute of the University of Sao Paulo (InCor), Sao Paulo, Brazil
| | - W Hueb
- Heart Institute of the University of Sao Paulo (InCor), Sao Paulo, Brazil
| | - P.C Rezende
- Heart Institute of the University of Sao Paulo (InCor), Sao Paulo, Brazil
| | - C.E Rochitte
- Heart Institute of the University of Sao Paulo (InCor), Sao Paulo, Brazil
| | - C.H Nomura
- Heart Institute of the University of Sao Paulo (InCor), Sao Paulo, Brazil
| | - T Morais
- Heart Institute of the University of Sao Paulo (InCor), Sao Paulo, Brazil
| | - E.G Lima
- Heart Institute of the University of Sao Paulo (InCor), Sao Paulo, Brazil
| | - G.A.B Boros
- Heart Institute of the University of Sao Paulo (InCor), Sao Paulo, Brazil
| | - F.F Ribas
- Heart Institute of the University of Sao Paulo (InCor), Sao Paulo, Brazil
| | - F.P.C Carvalho
- Heart Institute of the University of Sao Paulo (InCor), Sao Paulo, Brazil
| | - G.F Carvalho
- Heart Institute of the University of Sao Paulo (InCor), Sao Paulo, Brazil
| | - M.R Mocha
- Heart Institute of the University of Sao Paulo (InCor), Sao Paulo, Brazil
| | - C.V Serrano
- Heart Institute of the University of Sao Paulo (InCor), Sao Paulo, Brazil
| | - J.A.F Ramires
- Heart Institute of the University of Sao Paulo (InCor), Sao Paulo, Brazil
| | - R Kalil Filho
- Heart Institute of the University of Sao Paulo (InCor), Sao Paulo, Brazil
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Jacob J, Ribeiro M, Benadjaoud M, Jenny C, Feuvret L, Simon J, Bernier M, Antoni D, Hoang-Xuan K, Psimaras D, Carpentier A, Ricard D, Maingon P. OC-0696: Development of dose constraints to the brain areas implied in cognition: a prospective study. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00718-0] [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: 10/22/2022]
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Loap P, Goudjil F, Baron B, Ribeiro M, Fourquet A, Kirova Y. Deep Inspiration Breath-Hold (DIBH) for Locoregional Breast Irradiation using Volumetric Modulated Arc Therapy (VMAT) and Intensity Modulated Proton Therapy (IMPT): A Dosimetric Comparison to Cardiac Substructure. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Aguiar J, Ribeiro M, Pedro AR, Martins AP, da Costa FA. Awareness about barriers to medication adherence in cardiovascular patients and strategies used in clinical practice by Portuguese clinicians: a nationwide study. Int J Clin Pharm 2020; 43:629-636. [PMID: 33104948 DOI: 10.1007/s11096-020-01174-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 10/06/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Although much is known about cardiovascular patients' medication adherence, the extent to which clinicians perceive non-adherence as a barrier in clinical practice is little explored. Objective To evaluate knowledge and awareness about potential barriers to medication adherence, and to evaluate strategies used in clinical practice by Portuguese clinicians on how to foster medication adherence of patients undergoing secondary cardiovascular prevention. Setting Nominal Group Technique (NGT) at the University of Lisbon; online survey addressed to physicians working in primary and secondary care in Portugal. Method A narrative literature review was conducted in Pubmed to identify studies describing interventions targeted at physicians to manage medication adherence. The NGT included 12 allied healthcare professionals with recognized expertise in medication adherence and was organised in four phases, resulting in survey development. The survey was used in a cross-sectional national study where clinicians reported their knowledge and perceptions about patients' medication adherence and their daily practice. Main outcome measures Knowledge and awareness about barriers to medication adherence; and practice patterns. Results A total of 296 papers were identified, 26 of which were included. Four main topics were selected to be used in the NGT: adherence determinants, detecting non-adherence, fostering adherence, and educating physicians. NGT resulted in a survey, reaching 451 physicians, mostly practicing in primary care. Most had specific education on medication adherence and considered patient interviews and prescription records the most useful assessment methods. Nonetheless, many recognised often using clinical judgement to evaluate adherence in practice. Barriers to medication adherence were perceived to occur often during implementation. Most perceived reasons for uncontrolled hypertension were non-adherence to lifestyle recommendations and to medication. Less than half the physicians asked their patients if medication was taken. More useful enabling strategies included reducing daily doses, reviewing therapeutic options and motivational interventions. Conclusions Clinicians seem well informed about the importance of medication adherence and aware of problems encountered in practice. Limited time during medical appointment may be a barrier for better patient support.
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Affiliation(s)
- João Aguiar
- Research Institute for Medicines (iMED.ULisboa), Faculty of Pharmacy, University of Lisbon, Lisbon, Portugal
| | - Manuel Ribeiro
- Environmental and Natural Resources Center (CERENA), University of Lisbon, Higher Technical Institute, Lisbon, Portugal
| | - Ana Rita Pedro
- National School of Public Health, Nova University of Lisbon, Research Group in Health Policy and Administration, Lisbon, Portugal
| | | | - Filipa Alves da Costa
- Research Institute for Medicines (iMED.ULisboa), Faculty of Pharmacy, University of Lisbon, Lisbon, Portugal. .,Interdisciplinary Research Center Egas Moniz (CiiEM), University Institute Egas Moniz (IUEM), Campus Universitário, Quinta da Granja, Monte da Caparica, 2829-511, Caparica, Portugal.
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Belhadef A, Ribeiro M, Mazevet M, Lezoualc’h F, Crozatier B, Benitah J, Gomez A, Lemaire C, Morel E. EPAC1 inhibition prevents adverse cardiotoxicity induced by anticancer treatment. Archives of Cardiovascular Diseases Supplements 2020. [DOI: 10.1016/j.acvdsp.2020.03.106] [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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Loap P, Goudjil F, Baron B, Ribeiro M, Fourquet A, Kirova Y. Comparaison de l’exposition des sous-structures cardiaques lors de l’irradiation mammaire locorégionale par protons et par arcthérapie volumétrique modulée, avec ou sans blocage inspiratoire. Cancer Radiother 2020. [DOI: 10.1016/j.canrad.2020.08.012] [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: 11/16/2022]
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Carvalho Sousa S, Fernandes S, Novais L, Verne M, Areias R, Dourado F, Ribeiro M. Acute gastroenteritis outbreak: epidemiology at the core of investigation. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.1329] [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: 11/14/2022] Open
Abstract
Abstract
Background
At 28th February 2020, local public health authorities were notified that an occupational activity center headed to adult individuals with disabilities, in Guimarães (Portugal), had several cases of users vomiting or with diarrhea during that week, requesting control measures.
Methods
An outbreak investigation was carried out, with case definition being someone with nausea, vomiting and/or diarrhea. An epidemic curve was made with the number of cases per date of symptoms onset. Attack rate was calculated as the number of cases in the occupational activity center divided by the number of people in the same center.
Results
Mild, self-limited acute symptoms of nausea, vomiting and/or diarrhea were identified in 18 individuals that attended the occupational activity center. The first case developed symptoms on 24th February (day 0); the second case appeared about 24 hours after; the peak occurred at day 4 with seven cases. Attack rate was 27% among users and 15% among monitors. The mean age was 40 years. Two cases went to the emergency department and were clinically diagnosed with acute viral gastroenteritis, no further care needed. Meals were served at a neighbor building, shared with another rehabilitation institution. The rehabilitation institution reported zero cases. Additionally, Hazard Analysis and Critical Control Point process was fully accomplished.
Conclusions
Clinical and epidemiological findings suggest a probable viral outbreak with person-to-person transmission. The incubation period is consistent with norovirus, the most common agent of viral gastroenteritis. No biological samples were collected, because symptoms were mild and there was no chance to do it. Environmental samples were not collected. Preventive hygiene measures were immediatly enhanced, namely hand washing, appropriate disinfection of contaminated surfaces and isolation if symptomatic. These measures are highly efficient breaking the chain of infection and that was obtained.
Key messages
Epidemiological findings are at the core of an outbreak investigation and support immediate implemention of effective control measures. Although laboratory results are important, they are not always available for outbreak investigation.
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Affiliation(s)
- S Carvalho Sousa
- Public Health Unit Alto Ave, Northern Regional Health Administration, Guimarães, Portugal
- Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
| | - S Fernandes
- Public Health Unit Alto Ave, Northern Regional Health Administration, Guimarães, Portugal
| | - L Novais
- Public Health Unit Alto Ave, Northern Regional Health Administration, Guimarães, Portugal
| | - M Verne
- Public Health Unit Alto Ave, Northern Regional Health Administration, Guimarães, Portugal
| | - R Areias
- Public Health Unit Alto Ave, Northern Regional Health Administration, Guimarães, Portugal
| | - F Dourado
- Public Health Unit Alto Ave, Northern Regional Health Administration, Guimarães, Portugal
| | - M Ribeiro
- Public Health Unit Alto Ave, Northern Regional Health Administration, Guimarães, Portugal
- Medical School, University of Minho, Braga, Portugal
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Ciciliotti da Silva M, Ferreira BH, Santos DF, Fernandes F, Magalhães B, de Brito Martins G, Pacheco J, Barbosa M, Ribeiro M, Riquieri L, da Cordeiro SMV, Duarte Lima RC, Carvalho Andrade MA. The experiences of maternity in front of hospitalization in high risk pregnances. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.960] [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
The pregnancy-puerperal cycle is defined as a moment that involves physical, psychological and social changes. There are pregnancies that require specialized care and attention due to the presence of risk factors that may be prior to pregnancy and / or that may be associated with the pregnancy condition itself, which characterize them as high-risk pregnancies. Currently, prenatal care with risk stratification is the main care strategy for pregnant women, once the risk classification is identified, it is possible to promote interventions according to the health needs of each pregnant woman. For this, the risk assessment is carried out at each prenatal consultation, so that, depending on the course of pregnancy, hospitalization becomes necessary. The diagnosis of high-risk pregnancies accompanied by hospitalization has impacts on the woman's life, such as loss of autonomy, a sense of failure and the incidence of greater care and interventions by the health team and the family that can configure practices to control their bodies.
Objective
This work aims to identify the hospitalization process during high-risk pregnancy as a space for the production of projects, resistance and protagonism through the protocols and regulations that configure the hospital context.
Methodology
This is an exploratory analysis of a qualitative approach in public health. A reference maternity hospital in high-risk pregnancy located in a teaching hospital in Greater Vitória was chosen. It will be used to define sampling for convenience. The data will be collected through semi-structured interviews and on-site observations by the researcher. The data analysis methodology used will be content analysis.
Expected Results
It is expected to understand the various practices of protagonism and resistance that permeate the care of hospitalized pregnant women.
Key messages
This work has an impact on the improvement of the maternal and child care network of the public health system in Brazil. This work allows to evaluate the quality of the assistance provided in the public maternity.
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Affiliation(s)
- M Ciciliotti da Silva
- Centro de Ciencias da Saúde, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - B Heintze Ferreira
- Centro de Ciencias da Saúde, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - D Fraga Santos
- Centro de Ciencias da Saúde, Universidade Federal do Espírito Santo, Vitória, Brazil
| | | | - Bersot Magalhães
- Centro de Ciencias da Saúde, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - G de Brito Martins
- Centro de Ciencias da Saúde, Universidade Federal do Espírito Santo, Vitória, Brazil
| | | | - Moreira Barbosa
- Centro de Ciencias da Saúde, Universidade Federal do Espírito Santo, Vitória, Brazil
| | | | - Lira Riquieri
- Centro de Ciencias da Saúde, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - Silva M V da Cordeiro
- Centro de Ciencias da Saúde, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - R C Duarte Lima
- Centro de Ciencias da Saúde, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - M A Carvalho Andrade
- Centro de Ciencias da Saúde, Universidade Federal do Espírito Santo, Vitória, Brazil
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Almeida C, Silva A, Marques S, Ribeiro M. Ocular Syphilis mimicking Acute Zonal Occult Outer Retinopathy (AZOOR). ACTA ACUST UNITED AC 2020; 95:284-288. [PMID: 32376127 DOI: 10.1016/j.oftal.2020.02.018] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 02/19/2020] [Accepted: 02/21/2020] [Indexed: 11/28/2022]
Abstract
Ocular syphilis can simulate various ophthalmic pathologies with multiple possible ophthalmic findings. Timely treatment of these patients can minimize visual damage, but its diagnosis is often a challenge for the ophthalmologist. We review a case report of a 45-year-old man with a rare and atypical clinical presentation of ocular syphilis, its clinical and imaging characteristics, its diagnosis, treatment and evolution. The patient presented with bilateral painless loss of vision, photopsia and peripheral scotomas with about 1 week evolution. There were no signs of ocular inflammation. The complementary ophthalmic study revealed an acute zonal occult outer retinopathy-like ("AZOOR-like") presentation. Ocular syphilis does not always present with ocular inflammation and its presentation as "AZOOR-like" is very rare. So, we should always maintain a high index of suspicion for this condition, as early diagnosis and treatment are essential for a better prognosis.
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Affiliation(s)
- C Almeida
- Ophthalmology Department, Centro Hospitalar Tondela-Viseu, Viseu, Portugal.
| | - A Silva
- Ophthalmology Department, Centro Hospitalar Tondela-Viseu, Viseu, Portugal
| | - S Marques
- Ophthalmology Department, Centro Hospitalar Tondela-Viseu, Viseu, Portugal
| | - M Ribeiro
- Ophthalmology Department, Centro Hospitalar Tondela-Viseu, Viseu, Portugal
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Jacob J, Clausse E, Benadjaoud M, Jenny C, Ribeiro M, Feuvret L, Mazeron JJ, Antoni D, Bernier MO, Hoang-Xuan K, Psimaras D, Carpentier A, Ricard D, Maingon P. Dose distribution of the brain tissue associated with cognitive functions in high-grade glioma patients. Cancer Radiother 2020; 24:1-10. [DOI: 10.1016/j.canrad.2019.08.009] [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: 07/12/2019] [Revised: 08/19/2019] [Accepted: 08/20/2019] [Indexed: 12/22/2022]
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Ribeiro M, Dupuy Q, Bartolucci L. 3 Combining complexity metrics to better predict VMAT deliverability. Phys Med 2019. [DOI: 10.1016/j.ejmp.2019.09.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Ribeiro M, Gongora A, Oliveira L, Alessi J, Saccardo K, Zucchetti B, Barbosa F, Muniz D, Shimada A, De Souza C, Feher O, Katz A. P2.14-67 Metastatic RET-Rearranged Lung Adenocarcinomas Treated with Alectinib: Retrospective Analysis of a Single Institution. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1852] [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: 10/25/2022]
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Belhadef A, Ribeiro M, Mazevet M, Laudette M, Crozatier B, Lezoualc'h F, Benitah JP, Gomez AM, Lemaire C, Morel E. P3116New role of EPAC1 in Anthracycline-induced cardiotoxicity and anticancer therapy. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Doxorubicin (Dox) is an anthracycline commonly used to treat many types of cancer; unfortunately this chemotherapeutic agent induces many side effects such as cardiotoxicity leading to dilated cardiomyopathy (DCM). The cardiotoxicity of Dox has been related to reactive oxygen species generation, DNA intercalation, topoisomerase II inhibition and bioenergetics alterations leading to cardiomyocyte death.
Objective
Nowadays the challenge is to find new treatment options aiming at reducing Dox cardiotoxicity. Epac (exchange protein directly activated by cAMP) signaling could be worth investigating as Epac activates small G proteins which are known to be involved in Dox-induced cardiotoxicity.
Methods
We investigated the time/dose-dependent Dox effect on Epac signaling in both in vivo mice model (C57Bl63/ Knock-out Epac1 mice, iv injections, 12mg/kg cumulative dose) and in vitro (primary culture of neonatal rat cardiomyocytes (NRVM, 24h, Dox 1μM).
Results
In vivo, Dox-treated mice developed a DCM associated with Ca2+ homeostasis dysfunction (increase of Ca2+ waves and Ca2+ leaks). In vitro, as measured by flow cytometry and western blot, Dox (1μM) induced DNA damages and cell death in NRVM. This cell death is associated with apoptotic features including mitochondrial membrane permeabilization, caspase activation and cell size reduction. The inhibition of Epac1 (ESI09, CE3F4) decreased Dox-induced DNA damage, loss of mitochondrial membrane potential, apoptosis and finally cardiomyocyte death. Moreover, in vivo, Epac1 KO mice were protected against Dox-induced cardiotoxicity by unaltered cardiac function (no DCM) and calcium homeostasis at 15 weeks post-treatment.
Conclusion
Inhibition of Epac1 could be a valuable therapeutic strategy to limit Dox-induced cardiomyopathy during cancer chemotherapy. Indeed, preliminary data show also that preventing Dox-induced cardiotoxicity, the inhibition of Epac1 can also potentiate cancerous cells death.
Acknowledgement/Funding
Labex Lermit (ANR 0033), Torino and Inserm
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Affiliation(s)
- A Belhadef
- University of Paris-Sud 11, UMR-S 1180, Chatenay-Malabry, France
| | - M Ribeiro
- University of Paris-Sud 11, UMR-S 1180, Chatenay-Malabry, France
| | - M Mazevet
- University of Paris-Sud 11, UMR-S 1180, Chatenay-Malabry, France
| | - M Laudette
- Institute of Cardiovascular and Metabolic Diseases, INSERM U1048, Toulouse, France
| | - B Crozatier
- University of Paris-Sud 11, UMR-S 1180, Chatenay-Malabry, France
| | - F Lezoualc'h
- Institute of Cardiovascular and Metabolic Diseases, INSERM U1048, Toulouse, France
| | - J.-P Benitah
- University of Paris-Sud 11, UMR-S 1180, Chatenay-Malabry, France
| | - A.-M Gomez
- University of Paris-Sud 11, UMR-S 1180, Chatenay-Malabry, France
| | - C Lemaire
- University of Paris-Sud 11, UMR-S 1180, Chatenay-Malabry, France
| | - E Morel
- University of Paris-Sud 11, UMR-S 1180, Chatenay-Malabry, France
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González-deSantos LM, Martínez-Sánchez J, González-Jorge H, Ribeiro M, de Sousa JB, Arias P. Payload for Contact Inspection Tasks with UAV Systems. Sensors (Basel) 2019; 19:s19173752. [PMID: 31480300 PMCID: PMC6749228 DOI: 10.3390/s19173752] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 08/23/2019] [Accepted: 08/27/2019] [Indexed: 11/16/2022]
Abstract
This paper presents a payload designed to perform semi-autonomous contact inspection tasks without any type of positioning system external to the UAV, such as a global navigation satellite system (GNSS) or motion capture system, making possible inspection in challenging GNSS- denied sites. This payload includes two LiDAR sensors which measure the distance between the UAV and the target structure and their inner orientation angle. The system uses this information to control the approaching of the UAV to the structure and the contact between both, actuating over the pitch and yaw signals. This control is performed using a hybrid automaton with different states that represent all the possible UAV status during the inspection tasks. It uses different control strategies in each state. An ultrasonic gauge has been used as the inspection sensor of the payload to measure the thickness of a metallic sheet. The sensor requires a stable contact in order to collect reliable measurements. Several tests have been performed on the system, reaching accurate results which show it is able to maintain a stable contact with the target structure.
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Affiliation(s)
- L M González-deSantos
- Applied Geotechnologies Group, Dept. Natural Resources and Environmental Engineering, University of Vigo, Campus Lagoas-Marcosende, CP 36310 Vigo, Spain.
| | - J Martínez-Sánchez
- Applied Geotechnologies Group, Dept. Natural Resources and Environmental Engineering, University of Vigo, Campus Lagoas-Marcosende, CP 36310 Vigo, Spain
| | - H González-Jorge
- Applied Geotechnologies Group, Dept. Natural Resources and Environmental Engineering, School of Aerospace Engineering, University of Vigo, Campus Lagoas, CP 32004 Ourense, Spain
| | - M Ribeiro
- Underwater Systems and Technology Laboratory, Dept. of Electrical and Computer Engineering, School of Engineering (FEUP), University of Porto, 4200-465 Porto, Portugal
| | - J B de Sousa
- Underwater Systems and Technology Laboratory, Dept. of Electrical and Computer Engineering, School of Engineering (FEUP), University of Porto, 4200-465 Porto, Portugal
| | - P Arias
- Applied Geotechnologies Group, Dept. Natural Resources and Environmental Engineering, University of Vigo, Campus Lagoas-Marcosende, CP 36310 Vigo, Spain
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Rabbers A, Rabelo R, Oliveira L, Ribeiro M, Martins V, Plepis A, Vulcani V. Additive effect of pulp pequi oil (Caryocar brasiliense Camb.) on the biocompatibility of collagen and gelatin membranes in subcutaneous implants. ARQ BRAS MED VET ZOO 2019. [DOI: 10.1590/1678-4162-10412] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Trauma or disease inflicted by tissue injuries may cause tissue degeneration. The use of biomaterials for direct or indirect repair has emerged as a promising alternative, and has become an important research topic. The pequi fruit (Caryocar brasiliense Camb.) has shown antifungal, antibacterial, anti-inflammatory, healing, antitumor, and antioxidant properties. The objective of this study was to develop a new biomaterial using a combination of collagen, gelatin, and pulp pequi oil, and to evaluate its biocompatibility in comparison with that of biomaterials produced without pulp pequi oil. Membranes were prepared from a mixture of bovine tendon collagen, commercial gelatin, and pulp pequi oil. The inflammatory and cicatricial processes were assessed via histopathology of the tissue interface/implants in the subcutaneous tissues and quantitative evaluation of leukocyte and collagen production in Wistar rats. It was observed that the presence of pequi oil reduced the amount of foreign-body giant cells and favored the recruitment of fibroblasts (P< 0.01), thereby promoting greater production of collagen membrane than that in the membranes of control samples. Therefore, it can be concluded that the addition of pequi oil improved the biocompatibility of collagen and accelerated the healing process.
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Magalhaes C, Vardasca R, Rebelo M, Valenca-Filipe R, Ribeiro M, Mendes J. Distinguishing melanocytic nevi from melanomas using static and dynamic infrared thermal imaging. J Eur Acad Dermatol Venereol 2019; 33:1700-1705. [PMID: 30974494 DOI: 10.1111/jdv.15611] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 03/15/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND The incidence rates of melanoma have risen to worrying levels over the last decade. Delayed diagnosis, due to faults on the detection stage, indicates the necessity of new aiding diagnosis techniques. Since metabolic activity is highly connected to neoplasia formation, a detection technique that focuses its results on vascular responses, as Infrared thermal (IRT), seems to be a viable option. MATERIALS AND METHODS Static and dynamic (cooling) thermal images of melanoma and melanocytic nevi lesions were collected and analysed to retrieve thermal parameters characteristic of this skin lesion types. The steady-state and dynamic variables were tested separately with different machine learning classifiers to verify whether the distinction of melanoma and nevi lesions was achievable. RESULTS The differentiation of both types of skin tumours was doable, achieving an accuracy of 84.2% and a sensitivity of 91.3% with the implementation of a learner based on support vector machines and an input vector composed by static variables. CONCLUSION The use of IRT for skin tumour classification is achievable, but some improvement is needed to raise the metrics of sensitivity and specificity. For future work, it is recommended the study of dynamic parameters for the classification of other types of skin neoplasia.
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Affiliation(s)
- C Magalhaes
- LABIOMEP, INEGI-LAETA, Faculdade de Engenharia, Universidade do Porto, Porto, Portugal
| | - R Vardasca
- LABIOMEP, INEGI-LAETA, Faculdade de Engenharia, Universidade do Porto, Porto, Portugal
| | - M Rebelo
- Serviço de Cirurgia Plástica e Reconstrutiva, IPO Porto, Porto, Portugal
| | - R Valenca-Filipe
- Serviço de Cirurgia Plástica e Reconstrutiva, IPO Porto, Porto, Portugal
| | - M Ribeiro
- Serviço de Cirurgia Plástica e Reconstrutiva, IPO Porto, Porto, Portugal
| | - J Mendes
- LABIOMEP, INEGI-LAETA, Faculdade de Engenharia, Universidade do Porto, Porto, Portugal
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Ruiz A, Torzsok K, Ribeiro M, Broqué H, Aponte J, Marangoni F. EP-2107 DQA gamma Analysis evaluation criteria for prostate SBRT using MLC InCise 2 of a Cyberknife-M6. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32527-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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