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Ferreira M, Turner A, Jha AN. Controlled Release of Radioactive Water from the Fukushima Daiichi Nuclear Power Plant: Should We Be Concerned? Environ Sci Technol 2024; 58:4840-4843. [PMID: 38453167 PMCID: PMC10956427 DOI: 10.1021/acs.est.3c08702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Indexed: 03/09/2024]
Affiliation(s)
- Maria
F. Ferreira
- School
of Biological and Marine Sciences, University
of Plymouth, Drake Circus, Plymouth PL4 8AA, U.K.
| | - Andrew Turner
- School
of Geography, Earth and Environmental Sciences, University of Plymouth, Drake Circus, Plymouth PL4 8AA, U.K.
| | - Awadhesh N. Jha
- School
of Biological and Marine Sciences, University
of Plymouth, Drake Circus, Plymouth PL4 8AA, U.K.
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Jung T, Milenković I, Balci Y, Janoušek J, Kudláček T, Nagy Z, Baharuddin B, Bakonyi J, Broders K, Cacciola S, Chang TT, Chi N, Corcobado T, Cravador A, Đorđević B, Durán A, Ferreira M, Fu CH, Garcia L, Hieno A, Ho HH, Hong C, Junaid M, Kageyama K, Kuswinanti T, Maia C, Májek T, Masuya H, Magnano di San Lio G, Mendieta-Araica B, Nasri N, Oliveira L, Pane A, Pérez-Sierra A, Rosmana A, Sanfuentes von Stowasser E, Scanu B, Singh R, Stanivuković Z, Tarigan M, Thu P, Tomić Z, Tomšovský M, Uematsu S, Webber J, Zeng HC, Zheng FC, Brasier C, Horta Jung M. Worldwide forest surveys reveal forty-three new species in Phytophthora major Clade 2 with fundamental implications for the evolution and biogeography of the genus and global plant biosecurity. Stud Mycol 2024; 107:251-388. [PMID: 38600961 PMCID: PMC11003442 DOI: 10.3114/sim.2024.107.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 01/15/2024] [Indexed: 04/12/2024] Open
Abstract
During 25 surveys of global Phytophthora diversity, conducted between 1998 and 2020, 43 new species were detected in natural ecosystems and, occasionally, in nurseries and outplantings in Europe, Southeast and East Asia and the Americas. Based on a multigene phylogeny of nine nuclear and four mitochondrial gene regions they were assigned to five of the six known subclades, 2a-c, e and f, of Phytophthora major Clade 2 and the new subclade 2g. The evolutionary history of the Clade appears to have involved the pre-Gondwanan divergence of three extant subclades, 2c, 2e and 2f, all having disjunct natural distributions on separate continents and comprising species with a soilborne and aquatic lifestyle and, in addition, a few partially aerial species in Clade 2c; and the post-Gondwanan evolution of subclades 2a and 2g in Southeast/East Asia and 2b in South America, respectively, from their common ancestor. Species in Clade 2g are soilborne whereas Clade 2b comprises both soil-inhabiting and aerial species. Clade 2a has evolved further towards an aerial lifestyle comprising only species which are predominantly or partially airborne. Based on high nuclear heterozygosity levels ca. 38 % of the taxa in Clades 2a and 2b could be some form of hybrid, and the hybridity may be favoured by an A1/A2 breeding system and an aerial life style. Circumstantial evidence suggests the now 93 described species and informally designated taxa in Clade 2 result from both allopatric non-adaptive and sympatric adaptive radiations. They represent most morphological and physiological characters, breeding systems, lifestyles and forms of host specialism found across the Phytophthora clades as a whole, demonstrating the strong biological cohesiveness of the genus. The finding of 43 previously unknown species from a single Phytophthora clade highlight a critical lack of information on the scale of the unknown pathogen threats to forests and natural ecosystems, underlining the risk of basing plant biosecurity protocols mainly on lists of named organisms. More surveys in natural ecosystems of yet unsurveyed regions in Africa, Asia, Central and South America are needed to unveil the full diversity of the clade and the factors driving diversity, speciation and adaptation in Phytophthora. Taxonomic novelties: New species: Phytophthora amamensis T. Jung, K. Kageyama, H. Masuya & S. Uematsu, Phytophthora angustata T. Jung, L. Garcia, B. Mendieta-Araica, & Y. Balci, Phytophthora balkanensis I. Milenković, Ž. Tomić, T. Jung & M. Horta Jung, Phytophthora borneensis T. Jung, A. Durán, M. Tarigan & M. Horta Jung, Phytophthora calidophila T. Jung, Y. Balci, L. Garcia & B. Mendieta-Araica, Phytophthora catenulata T. Jung, T.-T. Chang, N.M. Chi & M. Horta Jung, Phytophthora celeris T. Jung, L. Oliveira, M. Tarigan & I. Milenković, Phytophthora curvata T. Jung, A. Hieno, H. Masuya & M. Horta Jung, Phytophthora distorta T. Jung, A. Durán, E. Sanfuentes von Stowasser & M. Horta Jung, Phytophthora excentrica T. Jung, S. Uematsu, K. Kageyama & C.M. Brasier, Phytophthora falcata T. Jung, K. Kageyama, S. Uematsu & M. Horta Jung, Phytophthora fansipanensis T. Jung, N.M. Chi, T. Corcobado & C.M. Brasier, Phytophthora frigidophila T. Jung, Y. Balci, K. Broders & I. Milenković, Phytophthora furcata T. Jung, N.M. Chi, I. Milenković & M. Horta Jung, Phytophthora inclinata N.M. Chi, T. Jung, M. Horta Jung & I. Milenković, Phytophthora indonesiensis T. Jung, M. Tarigan, L. Oliveira & I. Milenković, Phytophthora japonensis T. Jung, A. Hieno, H. Masuya & J.F. Webber, Phytophthora limosa T. Corcobado, T. Majek, M. Ferreira & T. Jung, Phytophthora macroglobulosa H.-C. Zeng, H.-H. Ho, F.-C. Zheng & T. Jung, Phytophthora montana T. Jung, Y. Balci, K. Broders & M. Horta Jung, Phytophthora multipapillata T. Jung, M. Tarigan, I. Milenković & M. Horta Jung, Phytophthora multiplex T. Jung, Y. Balci, K. Broders & M. Horta Jung, Phytophthora nimia T. Jung, H. Masuya, A. Hieno & C.M. Brasier, Phytophthora oblonga T. Jung, S. Uematsu, K. Kageyama & C.M. Brasier, Phytophthora obovoidea T. Jung, Y. Balci, L. Garcia & B. Mendieta-Araica, Phytophthora obturata T. Jung, N.M. Chi, I. Milenković & M. Horta Jung, Phytophthora penetrans T. Jung, Y. Balci, K. Broders & I. Milenković, Phytophthora platani T. Jung, A. Pérez-Sierra, S.O. Cacciola & M. Horta Jung, Phytophthora proliferata T. Jung, N.M. Chi, I. Milenković & M. Horta Jung, Phytophthora pseudocapensis T. Jung, T.-T. Chang, I. Milenković & M. Horta Jung, Phytophthora pseudocitrophthora T. Jung, S.O. Cacciola, J. Bakonyi & M. Horta Jung, Phytophthora pseudofrigida T. Jung, A. Durán, M. Tarigan & M. Horta Jung, Phytophthora pseudoccultans T. Jung, T.-T. Chang, I. Milenković & M. Horta Jung, Phytophthora pyriformis T. Jung, Y. Balci, K.D. Boders & M. Horta Jung, Phytophthora sumatera T. Jung, M. Tarigan, M. Junaid & A. Durán, Phytophthora transposita T. Jung, K. Kageyama, C.M. Brasier & H. Masuya, Phytophthora vacuola T. Jung, H. Masuya, K. Kageyama & J.F. Webber, Phytophthora valdiviana T. Jung, E. Sanfuentes von Stowasser, A. Durán & M. Horta Jung, Phytophthora variepedicellata T. Jung, Y. Balci, K. Broders & I. Milenković, Phytophthora vietnamensis T. Jung, N.M. Chi, I. Milenković & M. Horta Jung, Phytophthora ×australasiatica T. Jung, N.M. Chi, M. Tarigan & M. Horta Jung, Phytophthora ×lusitanica T. Jung, M. Horta Jung, C. Maia & I. Milenković, Phytophthora ×taiwanensis T. Jung, T.-T. Chang, H.-S. Fu & M. Horta Jung. Citation: Jung T, Milenković I, Balci Y, Janoušek J, Kudláček T, Nagy ZÁ, Baharuddin B, Bakonyi J, Broders KD, Cacciola SO, Chang T-T, Chi NM, Corcobado T, Cravador A, Đorđević B, Durán A, Ferreira M, Fu C-H, Garcia L, Hieno A, Ho H-H, Hong C, Junaid M, Kageyama K, Kuswinanti T, Maia C, Májek T, Masuya H, Magnano di San Lio G, Mendieta-Araica B, Nasri N, Oliveira LSS, Pane A, Pérez-Sierra A, Rosmana A, Sanfuentes von Stowasser E, Scanu B, Singh R, Stanivuković Z, Tarigan M, Thu PQ, Tomić Z, Tomšovský M, Uematsu S, Webber JF, Zeng H-C, Zheng F-C, Brasier CM, Horta Jung M (2024). Worldwide forest surveys reveal forty-three new species in Phytophthora major Clade 2 with fundamental implications for the evolution and biogeography of the genus and global plant biosecurity. Studies in Mycology 107: 251-388. doi: 10.3114/sim.2024.107.04.
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Affiliation(s)
- T. Jung
- Mendel University in Brno, Faculty of Forestry and Wood Technology, Department of Forest Protection and Wildlife Management, Phytophthora Research Centre, 613 00 Brno, Czech Republic
- Phytophthora Research and Consultancy, 83131 Nussdorf, Germany
| | - I. Milenković
- Mendel University in Brno, Faculty of Forestry and Wood Technology, Department of Forest Protection and Wildlife Management, Phytophthora Research Centre, 613 00 Brno, Czech Republic
- University of Belgrade, Faculty of Forestry, 11030 Belgrade, Serbia
| | - Y. Balci
- USDA-APHIS Plant Protection and Quarantine, 4700 River Road, Riverdale, Maryland, 20737 USA
| | - J. Janoušek
- Mendel University in Brno, Faculty of Forestry and Wood Technology, Department of Forest Protection and Wildlife Management, Phytophthora Research Centre, 613 00 Brno, Czech Republic
| | - T. Kudláček
- Mendel University in Brno, Faculty of Forestry and Wood Technology, Department of Forest Protection and Wildlife Management, Phytophthora Research Centre, 613 00 Brno, Czech Republic
- University of Greifswald, Institute for Mathematics and Computer Science & Center for Functional Genomics of Microbes, 17489 Greifswald, Germany
| | - Z.Á. Nagy
- Mendel University in Brno, Faculty of Forestry and Wood Technology, Department of Forest Protection and Wildlife Management, Phytophthora Research Centre, 613 00 Brno, Czech Republic
| | - B. Baharuddin
- Departement of Plant Pest and Disease, Faculty of Agriculture, Hasanuddin University, Makassar, 90245, South Sulawesi, Indonesia
| | - J. Bakonyi
- HUN-REN Centre for Agricultural Research, Plant Protection Institute, ELKH, 1022 Budapest, Hungary
| | - K.D. Broders
- Smithsonian Tropical Research Institute, Apartado Panamá, República de Panamá
- USDA, Agricultural Research Service, National Center for Agricultural Utilization Research, Mycotoxin Prevention and Applied Microbiology Research Unit, Peoria, IL, 61604, USA
| | - S.O. Cacciola
- Department of Agriculture, Food and Environment, University of Catania, 95123 Catania, Italy
| | - T.-T. Chang
- Forest Protection Division, Taiwan Forestry Research Institute, Taipei, Taiwan
| | - N.M. Chi
- Forest Protection Research Centre, Vietnamese Academy of Forest Sciences, 10000 Hanoi, Vietnam
| | - T. Corcobado
- Mendel University in Brno, Faculty of Forestry and Wood Technology, Department of Forest Protection and Wildlife Management, Phytophthora Research Centre, 613 00 Brno, Czech Republic
| | - A. Cravador
- MED—Mediterranean Institute for Agriculture, Environment and Development & CHANGE—Global Change and Sustainability Institute, University of Algarve, 8005-130 Faro, Portugal
| | - B. Đorđević
- Mendel University in Brno, Faculty of Forestry and Wood Technology, Department of Forest Protection and Wildlife Management, Phytophthora Research Centre, 613 00 Brno, Czech Republic
| | - A. Durán
- Fiber Research and Development, Asia Pacific Resources International Limited (APRIL), 28300 Pangkalan Kerinci, Riau, Indonesia
| | - M. Ferreira
- Plant Diagnostic Center, Department of Plant Pathology and Crop Physiology, Louisiana State University Agricultural Center, Baton Rouge, Louisiana, USA
| | - C.-H. Fu
- Forest Protection Division, Taiwan Forestry Research Institute, Taipei, Taiwan
| | - L. Garcia
- Universidad Nacional Agraria, Carretera Norte, Managua 11065, Nicaragua
| | - A. Hieno
- River Basin Research Center, Gifu University, Gifu, 501-1193, Japan
| | - H.-H. Ho
- Department of Biology, State University of New York, New Paltz, New York 12561, USA
| | - C. Hong
- Hampton Roads Agricultural Research and Extension Center, Virginia Tech, Virginia Beach, VA 23455, USA
| | - M. Junaid
- Departement of Plant Pest and Disease, Faculty of Agriculture, Hasanuddin University, Makassar, 90245, South Sulawesi, Indonesia
| | - K. Kageyama
- River Basin Research Center, Gifu University, Gifu, 501-1193, Japan
| | - T. Kuswinanti
- Departement of Plant Pest and Disease, Faculty of Agriculture, Hasanuddin University, Makassar, 90245, South Sulawesi, Indonesia
| | - C. Maia
- Centre of Marine Sciences (CCMAR), University of Algarve, 8005-139 Faro, Portugal
| | - T. Májek
- Mendel University in Brno, Faculty of Forestry and Wood Technology, Department of Forest Protection and Wildlife Management, Phytophthora Research Centre, 613 00 Brno, Czech Republic
| | - H. Masuya
- Forestry and Forest Products Research Institute (FFPRI), Tsukuba, Ibaraki, 305-8687, Japan
| | - G. Magnano di San Lio
- University Mediterranea of Reggio Calabria, Department of Agriculture, 89124 Reggio Calabria, Italy
| | | | - N. Nasri
- The United Graduate School of Agricultural Science, Ehime University, Matsuyama, 790-8566, Japan
| | - L.S.S. Oliveira
- Research and Development, Bracell, Alagoinhas, Bahia 48030-300, Brazil
| | - A. Pane
- Department of Agriculture, Food and Environment, University of Catania, 95123 Catania, Italy
| | - A. Pérez-Sierra
- Forest Research, Alice Holt Lodge, Farnham, Surrey GU10 4LH, UK
| | - A. Rosmana
- Departement of Plant Pest and Disease, Faculty of Agriculture, Hasanuddin University, Makassar, 90245, South Sulawesi, Indonesia
| | - E. Sanfuentes von Stowasser
- Laboratorio de Patología Forestal, Facultad Ciencias Forestales y Centro de Biotecnología, Universidad de Concepción, 4030000 Concepción, Chile
| | - B. Scanu
- Department of Agricultural Sciences, University of Sassari, Viale Italia 39A, 07100 Sassari, Italy
| | - R. Singh
- Plant Diagnostic Center, Department of Plant Pathology and Crop Physiology, Louisiana State University Agricultural Center, Baton Rouge, Louisiana, USA
| | - Z. Stanivuković
- University of Banja Luka, Faculty of Forestry, 78000 Banja Luka, Bosnia and Herzegovina
| | - M. Tarigan
- Fiber Research and Development, Asia Pacific Resources International Limited (APRIL), 28300 Pangkalan Kerinci, Riau, Indonesia
| | - P.Q. Thu
- Forest Protection Research Centre, Vietnamese Academy of Forest Sciences, 10000 Hanoi, Vietnam
| | - Z. Tomić
- Center for Plant Protection, Croatian Agency for Agriculture and Food, 10000 Zagreb, Croatia
| | - M. Tomšovský
- Mendel University in Brno, Faculty of Forestry and Wood Technology, Department of Forest Protection and Wildlife Management, Phytophthora Research Centre, 613 00 Brno, Czech Republic
| | - S. Uematsu
- Laboratory of Molecular and Cellular Biology, Dept. of Bioregulation and Bio-interaction, Tokyo University of Agriculture and Technology, Fuchu, Tokyo, 183-8509, Japan
| | - J.F. Webber
- Forest Research, Alice Holt Lodge, Farnham, Surrey GU10 4LH, UK
| | - H.-C. Zeng
- The Institute of Bioscience and Biotechnology, Chinese Academy of Tropical Agricultural Sciences, Haikou 571101, Hainan, China
| | - F.-C. Zheng
- College of Environment and Plant Protection, Hainan University, Baodoa Xincun, Danzhou City, Hainan 571737, China
| | - C.M. Brasier
- Forest Research, Alice Holt Lodge, Farnham, Surrey GU10 4LH, UK
| | - M. Horta Jung
- Mendel University in Brno, Faculty of Forestry and Wood Technology, Department of Forest Protection and Wildlife Management, Phytophthora Research Centre, 613 00 Brno, Czech Republic
- Phytophthora Research and Consultancy, 83131 Nussdorf, Germany
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Ferreira M, Delagarde R, Edouard N. Nitrogen balance in dairy cows fed low-nitrogen diets based on various proportions of fresh grass and maize silage. Animal 2023; 17:100976. [PMID: 37757524 DOI: 10.1016/j.animal.2023.100976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 08/17/2023] [Accepted: 08/25/2023] [Indexed: 09/29/2023] Open
Abstract
To ensure sustainable and efficient production, dairy farms must reduce their environmental impacts and nitrogen losses, which are sources of pollution, while increasing their feed self-sufficiency. Grass-based dairy systems, frequently combine fresh grass with maize silage when grass is scarce or during dietary transitions. However, the effects of combining fresh grass and maize silage on cow performance and N excretion are poorly known. This study aimed to quantify the effects of increasing the proportion of maize silage in a fresh grass diet on cow N flows and metabolism, in the context of grass-based dairy systems. Four proportions of maize silage in a fresh grass diet (objectives of 0, 17, 34 and 51% DM of maize silage) were investigated. The experiment was performed in a 4 × 3 Latin square design using eight lactating cows during three 3-week periods. DM intake (DMI), milk yield, faeces and urine outputs, and their N concentrations were measured for each cow. The fresh grass CP concentration was lower than planned (106 ± 13.0 g/kg DM). This resulted in very low dietary CP concentration, which decreased from 108 to 86 g/kg DM when maize silage in the diet increased from 0 to 51% DM, respectively. DM intake and milk yield both decreased linearly by 3.3 kg/day from 0 to 51% DM of maize silage in the diet. Thus, N intake decreased linearly by 100 g/day from 0 to 51% DM of maize silage in the diet. The N concentration of milk was highest for the diet with 0% DM of maize silage. Nitrogen excreted in faeces and urine decreased linearly by 29 and 23 g/day, respectively, from 0 to 51% DM of maize silage in the diet. The low dietary N concentration resulted in low ruminal NH3-N concentrations (8 mg/L, on average) and urinary urea excretion (down to 8% urea N in urinary N). Increasing the proportion of maize silage in an unusually low-N grass diet, without protein-rich concentrates, induced highly N-deficient diets with minimal N losses in faeces and urine but large and unsustainable decreases in DMI and milk yield.
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Affiliation(s)
- M Ferreira
- PEGASE, INRAE, Institut Agro, 35590 Saint-Gilles, France
| | - R Delagarde
- PEGASE, INRAE, Institut Agro, 35590 Saint-Gilles, France
| | - N Edouard
- PEGASE, INRAE, Institut Agro, 35590 Saint-Gilles, France.
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Leng JX, Huang CC, Qazi JJ, Carpenter DJ, Natarajan BD, Arshad M, Ferreira M, Schultz O, Moravan MJ, Mullikin TC, Reitman ZJ, Kirkpatrick JP, Floyd SR, Salama AKS, Fecci P, Chmura SJ, Hong JC, Salama JK. Clinical Outcomes Following an Initial Stereotactic Radiosurgery Course for Brain Metastases from Melanoma. Int J Radiat Oncol Biol Phys 2023; 117:e128. [PMID: 37784684 DOI: 10.1016/j.ijrobp.2023.06.924] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Brain metastases (BM) are common in melanoma patients. The effect of gene mutations is not well characterized since first-line metastatic therapy has shifted from chemotherapy (CHT) to molecularly targeted therapies (TT) and immunotherapy (IO). We report outcomes of melanoma BM patients stratified by molecular subtype and pre-stereotactic radiosurgery (SRS) systemic therapy. MATERIALS/METHODS We identified all patients completing an initial SRS course for BM at two institutions between 1/2015 and 12/2020. Patients who had prior WBRT and/or resection were eligible. Demographic and clinical parameters were collected, along with melanoma tumor molecular characteristics. Intracranial progression (ICP) was defined as any radiographic distant and/or in-field progression per multidisciplinary consensus. Overall survival (OS) and freedom from ICP (FFICP) were estimated via the Kaplan Meier method. RESULTS From a total of 1383 SRS BM patients, we identified 118 (8.5%) with melanoma. Median follow up was 8.7 months, median age 64 years (IQR 51-72), 81% had cutaneous origin, and 55% had a KPS of 90-100. Molecular subtypes included BRAF (45%), NRAS (9.3%), and c-KIT (3.4%). Overall, 61% received IO prior to SRS, while 25% and 9.3% received TT and CHT prior to SRS respectively. 60% of patients harboring a mutation received IO as first line therapy, 10% received TT, and 30% received both TT and IO prior to SRS. BRAFmut patients more likely to have received TT prior to SRS (43% vs 9.2%, p<0.001) compared to BRAFwt patients. Median OS was 9.7 months (95% CI 7.8-13) and was not significantly different from non-melanoma patients (p = 0.6). Median FFICP was worse for melanoma patients (5.9 mos, 95% CI 3.5-8.5) than non-melanoma patients (8.96 mos, 95% CI 8.2-9.7, p = 0.009). A total of 72 ICP events occurred, with 56 (77.8%) distant ICP cases, 3 (4.2%) in-field ICP, and 13 (18%) ICP events that were radionecrosis (RN) only. RN was associated with the presence of a targetable mutation (18% vs 2%, p = 0.006) and receipt of TT pre-SRS (36% vs 9.8%, p = 0.001). BRAFmut patients had significantly worse FFICP (3.8 mos, 95% CI 3.0-6.8) compared to BRAFwt patients (8.5 mos, 95% CI 5.8-30.2, p = 0.006), although median OS was not significantly different (9.6 mos, 95% CI 6.9-16 vs 10.7 mos, 95% CI 6.7-15.5, p = 0.8). NRASmut was associated with better FFICP (29 mos, 95% CI 2.94-NA, p = 0.02). CONCLUSION In this modern, multi-institutional cohort of SRS patients, melanoma BM patients had worse FFICP compared to non-melanoma BM patients, and BRAFmut patients had worse FFICP than BRAFwt patients. RN was associated with mutational status and receipt of TT pre-SRS. OS did not vary significantly across groups. This analysis may help inform systemic therapy decisions and future genomic studies for patients with BMs from melanoma.
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Affiliation(s)
- J X Leng
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC
| | - C C Huang
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC
| | - J J Qazi
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC
| | - D J Carpenter
- Department of Radiation Oncology, Duke University Cancer Center, Durham, NC
| | - B D Natarajan
- Department of Medicine, University of North Carolina, Chapel Hill, NC
| | - M Arshad
- Department of Radiation and Cellular Oncology, University of Chicago, Chicago, IL
| | - M Ferreira
- Duke University Medical Center, Durham, NC
| | - O Schultz
- University of Chicago Pritzker School of Medicine, Chicago, IL
| | - M J Moravan
- Department of Radiation Oncology, Washington University in St. Louis, St. Louis, MO
| | - T C Mullikin
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC
| | | | - J P Kirkpatrick
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC
| | - S R Floyd
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC
| | | | - P Fecci
- Duke University Medical Center, Department of Neurosurgery, Durham, NC
| | - S J Chmura
- Department of Medicine, University of North Carolina, Chapel Hill, NC
| | - J C Hong
- Department of Radiation Oncology, University of California San Francisco, San Francisco, CA; University of California, San Francisco, Bakar Computational Health Sciences Institute, San Francisco, CA
| | - J K Salama
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC; Durham VA Health Care System, Durham, NC
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Sousa E, Pinto M, Ferreira M, Monteiro C. Neurocognitive and psychological comorbidities in patients with self-limited centrotemporal spike epilepsy. A case-control study. Rev Neurol 2023; 76:153-158. [PMID: 36843175 PMCID: PMC10364023 DOI: 10.33588/rn.7605.2022385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
INTRODUCTION Self-limited epilepsy with centrotemporal spikes (SeLECTS) is the most frequent self-limited focal epilepsy. This study aimed to assess the cognitive, behavioral, and other neuropsychological aspects of children with SeLECTS, and compare them with a control group. SUBJECTS AND METHODS A case-control study was carried out between January and May 2022. Patients with SeLECTS, aged between 6 and 18 years, and followed-up at our hospital were selected for inclusion in the study. For each case, two age-matched controls were opportunistically recruited. All the participants performed the EpiTrack Junior® test, and their parents filled out the Child Behavior Checklist (CBCL). RESULTS Eighteen patients were included (mean age: 8.7 ± 1.7 years). At SeLECTS' diagnosis, 83% of cases had adequate psychomotor development, and 17% had a neurodevelopmental disorder. The EpiTrack-Junior® and the Total Problems CBCL scores were not influenced by the laterality of the epileptic focus nor by the number of seizures. 61% of cases showed mild or significant impairment in the EpiTrack-Junior® test versus 44% of controls (p = 0.712), and 39% of cases vs. 14% of controls had 'clinically significant' scores on the Total Problems CBCL scale (p = 0.087). CONCLUSIONS Although this study did not find statistically significant differences between cases and controls, it should be noted that most patients with SeLECTS had a mild or significant disability in executive functions. A considerable percentage of cases were in the pathological range regarding emotional/behavioral problems. This study highlights the importance of screening the cognitive, behavioral, and emotional problems in all patients with SeLECTS.
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Affiliation(s)
- E Sousa
- Centro Hospitalar do Tâmega e Sousa, Penafiel, Portugal
| | - M Pinto
- Centro Hospitalar do Tâmega e Sousa, Penafiel, Portugal
| | - M Ferreira
- Centro Hospitalar do Tâmega e Sousa, Penafiel, Portugal
| | - C Monteiro
- Centro Hospitalar do Tâmega e Sousa, Penafiel, Portugal
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Lima J, Ferreira M, Lopes M, Quaresma V, Azinhais P, Nunes P, Parada B, Ramos M, Figueiredo A. 100 years of history-making urology – the Portuguese urology association. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00170-7] [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: 02/12/2023]
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Jung T, Milenković I, Corcobado T, Májek T, Janoušek J, Kudláček1 T, Tomšovský M, Nagy Z, Durán A, Tarigan M, Sanfuentes von Stowasser E, Singh R, Ferreira M, Webber J, Scanu B, Chi N, Thu P, Junaid M, Rosmana A, Baharuddin B, Kuswinanti T, Nasri N, Kageyama K, Hieno A, Masuya H, Uematsu S, Oliva J, Redondo M, Maia C, Matsiakh I, Kramarets V, O’Hanlon R, Tomić Ž, Brasier C, Horta Jung M. Extensive morphological and behavioural diversity among fourteen new and seven described species in Phytophthora Clade 10 and its evolutionary implications. Persoonia 2022; 49:1-57. [PMID: 38234379 PMCID: PMC10792230 DOI: 10.3767/persoonia.2022.49.01] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 06/13/2022] [Indexed: 01/19/2024]
Abstract
During extensive surveys of global Phytophthora diversity 14 new species detected in natural ecosystems in Chile, Indonesia, USA (Louisiana), Sweden, Ukraine and Vietnam were assigned to Phytophthora major Clade 10 based on a multigene phylogeny of nine nuclear and three mitochondrial gene regions. Clade 10 now comprises three subclades. Subclades 10a and 10b contain species with nonpapillate sporangia, a range of breeding systems and a mainly soil- and waterborne lifestyle. These include the previously described P. afrocarpa, P. gallica and P. intercalaris and eight of the new species: P. ludoviciana, P. procera, P. pseudogallica, P. scandinavica, P. subarctica, P. tenuimura, P. tonkinensis and P. ukrainensis. In contrast, all species in Subclade 10c have papillate sporangia and are self-fertile (or homothallic) with an aerial lifestyle including the known P. boehmeriae, P. gondwanensis, P. kernoviae and P. morindae and the new species P. celebensis, P. chilensis, P. javanensis, P. multiglobulosa, P. pseudochilensis and P. pseudokernoviae. All new Phytophthora species differed from each other and from related species by their unique combinations of morphological characters, breeding systems, cardinal temperatures and growth rates. The biogeography and evolutionary history of Clade 10 are discussed. We propose that the three subclades originated via the early divergence of pre-Gondwanan ancestors > 175 Mya into water- and soilborne and aerially dispersed lineages and subsequently underwent multiple allopatric and sympatric radiations during their global spread. Citation: Jung T, Milenković I, Corcobado T, et al. 2022. Extensive morphological and behavioural diversity among fourteen new and seven described species in Phytophthora Clade 10 and its evolutionary implications. Persoonia 49: 1-57. https://doi.org/10.3767/persoonia.2022.49.01.
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Affiliation(s)
- T. Jung
- Mendel University in Brno, Faculty of Forestry and Wood Technology, Department of Forest Protection and Wildlife Management, Phytophthora Research Centre, 613 00 Brno, Czech Republic
- Phytophthora Research and Consultancy, 83131 Nussdorf, Germany
| | - I. Milenković
- Mendel University in Brno, Faculty of Forestry and Wood Technology, Department of Forest Protection and Wildlife Management, Phytophthora Research Centre, 613 00 Brno, Czech Republic
- University of Belgrade, Faculty of Forestry, 11030 Belgrade, Serbia
| | - T. Corcobado
- Mendel University in Brno, Faculty of Forestry and Wood Technology, Department of Forest Protection and Wildlife Management, Phytophthora Research Centre, 613 00 Brno, Czech Republic
| | - T. Májek
- Mendel University in Brno, Faculty of Forestry and Wood Technology, Department of Forest Protection and Wildlife Management, Phytophthora Research Centre, 613 00 Brno, Czech Republic
| | - J. Janoušek
- Mendel University in Brno, Faculty of Forestry and Wood Technology, Department of Forest Protection and Wildlife Management, Phytophthora Research Centre, 613 00 Brno, Czech Republic
| | - T. Kudláček1
- Mendel University in Brno, Faculty of Forestry and Wood Technology, Department of Forest Protection and Wildlife Management, Phytophthora Research Centre, 613 00 Brno, Czech Republic
| | - M. Tomšovský
- Mendel University in Brno, Faculty of Forestry and Wood Technology, Department of Forest Protection and Wildlife Management, Phytophthora Research Centre, 613 00 Brno, Czech Republic
| | - Z.Á Nagy
- Mendel University in Brno, Faculty of Forestry and Wood Technology, Department of Forest Protection and Wildlife Management, Phytophthora Research Centre, 613 00 Brno, Czech Republic
| | - A. Durán
- University of Belgrade, Faculty of Forestry, 11030 Belgrade, Serbia
- Research and Development, Asia Pacific Resources International Limited (APRIL), 28300 Pangkalan Kerinci, Riau, Indonesia
| | - M. Tarigan
- Research and Development, Asia Pacific Resources International Limited (APRIL), 28300 Pangkalan Kerinci, Riau, Indonesia
| | - E. Sanfuentes von Stowasser
- Laboratorio de Patología Forestal, Facultad Ciencias Forestales y Centro de Biotecnología, Universidad de Concepción, 4030000 Concepción, Chile
| | - R. Singh
- Plant Diagnostic Center, Department of Plant Pathology and Crop Physiology, Louisiana State University Agricultural Center, Baton Rouge, Louisiana, USA
| | - M. Ferreira
- Plant Diagnostic Center, Department of Plant Pathology and Crop Physiology, Louisiana State University Agricultural Center, Baton Rouge, Louisiana, USA
| | - J.F. Webber
- Forest Research, Alice Holt Lodge, Farnham, Surrey GU10 4LH, UK
| | - B. Scanu
- Department of Agricultural Sciences, University of Sassari, Viale Italia 39A, 07100 Sassari, Italy
| | - N.M. Chi
- Forest Protection Research Centre, Vietnamese Academy of Forest Sciences, 10000 Hanoi, Vietnam
| | - P.Q. Thu
- Forest Protection Research Centre, Vietnamese Academy of Forest Sciences, 10000 Hanoi, Vietnam
| | - M. Junaid
- Department of Plant Pest and Disease, Faculty of Agriculture, Hasanuddin University, Makassar, 90245, South Sulawesi, Indonesia
| | - A. Rosmana
- Department of Plant Pest and Disease, Faculty of Agriculture, Hasanuddin University, Makassar, 90245, South Sulawesi, Indonesia
| | - B. Baharuddin
- Department of Plant Pest and Disease, Faculty of Agriculture, Hasanuddin University, Makassar, 90245, South Sulawesi, Indonesia
| | - T. Kuswinanti
- Department of Plant Pest and Disease, Faculty of Agriculture, Hasanuddin University, Makassar, 90245, South Sulawesi, Indonesia
| | - N. Nasri
- Department of Forest Conservation, Faculty of Forestry, Hasanuddin University, Makassar, 90245, South Sulawesi, Indonesia
| | - K. Kageyama
- River Basin Research Center, Gifu University, Gifu, 501-1193, Japan
| | - A. Hieno
- River Basin Research Center, Gifu University, Gifu, 501-1193, Japan
| | - H. Masuya
- Forestry and Forest Products Research Institute (FFPRI), Tsukuba, Ibaraki, 305-8687, Japan
| | - S. Uematsu
- Laboratory of Molecular and Cellular Biology, Dept. of Bioregulation and Bio-interaction, Tokyo University of Agriculture and Technology, Fuchu, Tokyo, 183-8509, Japan
| | - J. Oliva
- Department of Crop and Forest Sciences, University of Lleida, Lleida 25198, Spain
| | - M. Redondo
- Department of Forest Mycology and Plant Pathology, Swedish University of Agricultural Sciences, 750 07 Uppsala, Sweden
| | - C. Maia
- Centre of Marine Sciences (CCMAR), University of Algarve, 8005-139 Faro, Portugal
| | - I. Matsiakh
- Ukrainian National Forestry University, Pryrodna st.19, 79057, Lviv, Ukraine
| | - V. Kramarets
- Ukrainian National Forestry University, Pryrodna st.19, 79057, Lviv, Ukraine
| | - R. O’Hanlon
- Department of Agriculture, Food and the Marine, Dublin 2, D02 WK12, Ireland
| | - Ž. Tomić
- Center for Plant Protection, Croatian Agency for Agriculture and Food, 10000 Zagreb, Croatia
| | - C.M. Brasier
- Forest Research, Alice Holt Lodge, Farnham, Surrey GU10 4LH, UK
| | - M. Horta Jung
- Mendel University in Brno, Faculty of Forestry and Wood Technology, Department of Forest Protection and Wildlife Management, Phytophthora Research Centre, 613 00 Brno, Czech Republic
- Phytophthora Research and Consultancy, 83131 Nussdorf, Germany
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Gaspar L, Hesse J, Yalçin M, Santos B, Carvalhas-Almeida C, Ferreira M, Moita J, Relogio A, Cavadas C, Alvaro A. The impact of obstructive sleep apnea treatment with continuous positive airway pressure on the biological clock. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Chang S, Parvathaneni U, Laramore G, Humphreys I, Moe K, Patel A, Ferreira M, Rodriguez C, Cranmer L, Futran N, Barber B, Houlton J, Abuzeid W, Jafari A, Rizvi Z, Cash H, Liao J. Surgical Resection and Intensity Modulated Proton Therapy for Esthesioneuroblastoma. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1341] [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: 10/31/2022]
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De Almeida JPL, Martinho S, Campos G, Alves P, Rosa J, Ferreira M, Goncalves L. Predicting the long-termoutcome of patients admitted with acute heart failure to the emergency department using renal markers. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1048] [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: 11/12/2022] Open
Abstract
Abstract
Introduction
Renal dysfunction is one of the most important comorbidities in patients with chronic heart failure (HF) and frequently accentuated in the setting of acute HF (AHF). Serum creatinine and blood urea nitrogen (BUN) have been classically used as markers of renal dysfunction, despite having several limitations. High (BUN)/creatinine ratio has been associated with higher mortality in patients with HF. We aimed to predict the long-term outcome of patients admitted with acute heart failure to the emergency department using renal markers.
Methods
900 patients admitted to our emergency department diagnosed with AHF were retrospectively analysed. Patients were divided into 4 groups according to BUN and SCr on admission:
– BUN ≤33 mg/dL and SCr ≤1.56 mg/dL (group LowBUN/LowCr), n=544;
– BUN ≤33 mg/dL and SCr >1.56 mg/dl (group LowBUN/HighCr), n=25;
– BUN >33 mg/dL and SCr ≤1.56 mg/dL (group HighBUN/LowCr), n=131;
– BUN >33 mg/dL and SCr >1.56 mg/dL (group HighBUN/HighCr), n=200;
The primary end-point of this study was the occurrence of all-cause mortality during follow-up.
Results
The median (IQR) BUN level on admission was 28.0 (20) mg/dL, median (IQR) SCr level on admission was 1.15 (0.73) mg/d, mean age was 81±7 years, 50.8% (n=457) were women and median follow up was 7 months. A total of 41.2% patients were diabetic, 21.7% had at least mild COPD, CAD was present in 28.9% of cases, 44.0% had valvular heart disease and 68.4% patients had atrial fibrillation.
Creatinine, BUN and Cr/BUN ratio predicted survival at 6 months (p<0.05).
Survival was the lowest in the group HighBUN/HighCr and the highest in the group LowBUN/LowCr. As expected, BUN/Cr ratio was the highest in group HighBUN/LowCr and the lowest in group LowBUN/HighCr.
Conclusions
Despite not having the highest BUN/Cr ratio, patients with BUN >33 mg/dL and SCr >1.56 mg/dL showed the worst prognosis.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
| | - S Martinho
- University Hospitals of Coimbra , Coimbra , Portugal
| | - G Campos
- University Hospitals of Coimbra , Coimbra , Portugal
| | - P Alves
- University Hospitals of Coimbra , Coimbra , Portugal
| | - J Rosa
- University Hospitals of Coimbra , Coimbra , Portugal
| | - M Ferreira
- University Hospitals of Coimbra , Coimbra , Portugal
| | - L Goncalves
- University Hospitals of Coimbra , Coimbra , Portugal
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De Almeida JPL, Martinho S, Rosa J, Campos G, Cunha M, Ferreira M, Costa C, Marinho V, Goncalves L. Does my TAVR patient have cardiac amyloidosis? Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1685] [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
Introduction
Aortic stenosis (AS) is highly age-related, and its prevalence is increasing rapidly in high-income countries. There are 2 major types of amyloid protein responsible for cardiac amyloidosis (CA) - transthyretin (TTR) and immunoglobulin lightchain (AL). Previous cohorts report an incidence ranging from 9 to 16% for the presence of CA in patients with AS referred for TAVR. These patients appear to have a similar prognosis to those with lone AS when undergoing TAVR, but a trend toward worse prognosis if left treated. We aimed to investigate the prevalence of CA in patients with severe AS referred for TAVR in the Portuguese population.
Methods
We prospectively recruited 60 consecutive patients referred for TAVR at our tertiary center between November 2020 and May 2021. 59 patients agreed to participate and signed an informed consent, approved by the local Ethics Commission. All patients performed coronary angiogram, echocardiogram, thoracic abdominal pelvic CT scan, ECG, bone scintigraphy (99mTc-3,3-diphosphono-1,2-propanodicarboxylic acid [DPD]) and blood and urine monoclonal immunoglobulin testing. (Figure 1).
Results
About half (54.2%) of patients were male, average age was 82 years and the prevalence of ischemic heart disease and cardiovascular risk factors was high. About one third of patients had atrial fibrillation and 27.1% were pacemaker carriers. Echocardiographic baseline findings were: maximum aortic valve gradient 72.77±18.18 mmHg; mean aortic valve gradient 43.49±11.60; aortic valve area 0.65±0.15 cm2; interventricular septum thickness 1.30±0.23 cm; left ventricular ejection fraction (LVEF) 52.06±11.35%; E/E' 14.63±7.5; tricuspid annular plane systolic excursion 19.2±4mm; right ventricle/ right atrial gradient 38.1±14.32mmHg.
CA was diagnosed in 6 (10.2%) patients. Perugini grade was 1 (n=3) and 3 (n=3). One patient (Perugini grade = 3) was found to have plasma cell dyscrasia, producing monoclonal IgG Kappa protein. CA patients were all male, older (86.5 vs 81.30 years, p=0.049), more frequently pacemaker carriers (66.7 vs 22.6%, p=0.041) and had a tendency to have a thicker interventricular septum (1.48 vs 1.28 cm, p=0.065).
Conclusions
We show that in the Portuguese population, the prevalence of CA in severe AS patients referred for TAVI is in line with what is observed in other countries. This has important consequences regarding the diagnosis and management of these patients.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
| | - S Martinho
- University Hospitals of Coimbra , Coimbra , Portugal
| | - J Rosa
- University Hospitals of Coimbra , Coimbra , Portugal
| | - G Campos
- University Hospitals of Coimbra , Coimbra , Portugal
| | - M Cunha
- University Hospitals of Coimbra , Coimbra , Portugal
| | - M Ferreira
- University Hospitals of Coimbra , Coimbra , Portugal
| | - C Costa
- University Hospitals of Coimbra , Coimbra , Portugal
| | - V Marinho
- University Hospitals of Coimbra , Coimbra , Portugal
| | - L Goncalves
- University Hospitals of Coimbra , Coimbra , Portugal
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Ferreira M, Vasconcelos L, Lacerda M, Costa J. P09.07.A Signs and Symptoms in the last days of life of the glioblastoma patients - A Descriptive and Retrospective Study. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.165] [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
Despite scientific advances to develop techniques for early diagnosis and treatment of glioblastoma, the disease continues to have a remarkably poor prognosis. Studies have shown that in patients with glioblastoma, not only the presence of end-of-life signs and symptoms but also their frequency differs from those in the rest of cancer patients. The complexity of glioblastoma symptoms makes the integration of a palliative care philosophy essential.
Objective
To identify the main signs and symptoms that occur in patients with glioblastoma in their last seven days of life in a neuro-oncology ward.
Material and Methods
This was a descriptive and retrospective study regarding the signs and symptoms in the last seven days of life of patients with glioblastoma who were admitted to the neurology ward of a national oncology reference center. The patients were admitted after neuro-oncologist consultations between 2019 and 2020. The data collection instrument used was based on the document “The Last Hours of Living”. Confidentiality of the participants was guaranteed, and authorization was obtained from the institution’s ethics committee.
Results
The sample had 17 patients (13 men and 4 women), with an average hospital stay of 17.3 days. The men and women had average ages of 61.8 and 63 years, respectively. Clinical and nursing records revealed that the most prevalent signs and symptoms were “decreased level of consciousness” (94%); “rare and unexpected events” (94%); “respiratory dysfunction” (88%); and “loss of ability to swallow” (76%). In the last seven days of life, the approximate times of presentation for these signs and symptoms were: decreased level of consciousness, 6 days; rare and unexpected events, 2 days; respiratory dysfunction, 3 days; and loss of ability to swallow, 6 days. Support was requested from the in-hospital palliative care support team for 76.4% of patients.
Conclusion
The identification of reduced level of consciousness and alterations in swallowing as the most prevalent symptoms is consistent with the findings of previous studies. The prevalence of rare and unexpected events (such as fever, myoclonus and seizures) aligns with previous studies that indicated a difference in the signs and symptoms presented by patients with glioblastoma in the last days of life and patients with other oncological diseases. In this sense, the instrument used for data collection may not be the most appropriate for the population with primary central nervous system tumors. The decreased level of consciousness and impaired communication can complicate the assessment of signs and symptoms, such as pain, nausea, anxiety and depression. It is essential to conduct research studies with more representative samples. The recording of the signs and symptoms presented, as well as interventions and the evaluation of their effectiveness, are essential to ensure the quality of end-of-life.
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Affiliation(s)
- M Ferreira
- Lisbon Portuguese Institute of Oncology , Lisbon , Portugal
| | - L Vasconcelos
- Lisbon Portuguese Institute of Oncology , Lisbon , Portugal
| | - M Lacerda
- Lisbon Portuguese Institute of Oncology , Lisbon , Portugal
| | - J Costa
- Lisbon Portuguese Institute of Oncology , Lisbon , Portugal
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Ferreira M, Costa J, Antão D, Silva E, Passos J, Vilares M, Vasques H, Patrocínio I, Silva C, Santos F, Salgado D, Lacerda M. P11.74.A Plexiform Neurofibromas prevalence and treatment modalities in a referral comprehensive cancer center. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.263] [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
Background
Neurofibromatosis type 1 (NF1) is the most common tumor predisposition syndrome, with an incidence of 1/3500. Plexiform neurofibromas (PN) are benign tumors that can occur along the nerve sheath throughout the body, with unpredictable growth and with risk of malignant transformation. Symptoms will depend on their size and location, and include pain, deformity and functional impairment. There is a great variability in the PN severity and impact on quality-of-life (QOL). An unknown percentage of NF1 patients may need treatment, either medical and/or surgical.
Objectives
To assess the frequency of PN in a NF1 population followed in a comprehensive cancer center.
Material and Methods
Retrospective study. All patients with NF1 and PN followed in our center, between 31/12/2000 and 31/12/2021.
Results
Of 438 NF1 patients, 185 had PN (42%). 52 NF1 patients with PN were children (≤ 18). The most common symptoms were pain in 71 people (38,4%), deformity in 70 (37,8%) and functional impairment in 69 (37,3%). Several patients had a combination of these symptoms. Different treatment modalities were used for PN: medical, surgical or both. In this study, 54 patients (29,1%) were treated with MEK inhibitors (selumetinib), 74 patients (40%) were treated surgically and 12,4% (23) needed a combined approach (medical and surgical treatment).
Conclusion
PN are frequent in NF1 patients. A significant percentage is symptomatic and will require treatment, surgical, medical or both. There is no standard of care for PN NF1. The timing and sequence of medical and surgical treatment is yet to be defined.
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Affiliation(s)
- M Ferreira
- Lisbon Portuguese Institute of Oncology , Lisbon , Portugal
| | - J Costa
- Lisbon Portuguese Institute of Oncology , Lisbon , Portugal
| | - D Antão
- Lisbon Portuguese Institute of Oncology , Lisbon , Portugal
| | - E Silva
- Lisbon Portuguese Institute of Oncology , Lisbon , Portugal
| | - J Passos
- Lisbon Portuguese Institute of Oncology , Lisbon , Portugal
| | - M Vilares
- Lisbon Portuguese Institute of Oncology , Lisbon , Portugal
| | - H Vasques
- Lisbon Portuguese Institute of Oncology , Lisbon , Portugal
| | - I Patrocínio
- Lisbon Portuguese Institute of Oncology , Lisbon , Portugal
| | - C Silva
- Lisbon Portuguese Institute of Oncology , Lisbon , Portugal
| | - F Santos
- Lisbon Portuguese Institute of Oncology , Lisbon , Portugal
| | - D Salgado
- Lisbon Portuguese Institute of Oncology , Lisbon , Portugal
| | - M Lacerda
- Lisbon Portuguese Institute of Oncology , Lisbon , Portugal
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Pinto JC, Oliveira S, Duarte L, Ferreira M, Marques C, Casimiro C. Chyloperitoneum due to gastric carcinoma: a case report. Oxf Med Case Reports 2022; 2022:omac062. [PMID: 35769185 PMCID: PMC9235027 DOI: 10.1093/omcr/omac062] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 05/02/2022] [Accepted: 05/03/2022] [Indexed: 11/12/2022] Open
Abstract
Chyloperitoneum is a rare manifestation of gastric carcinoma, generally occurring late in the course of the disease with a poor prognosis. We report an unusual case of chyloperitoneum in a patient with gastric carcinoma. A 61-year-old male patient presented with postprandial fullness, nausea and weight loss. The upper gastrointestinal endoscopy demonstrated a stenosing lesion of the esophagogastric junction. A biopsy was made and revealed a signet-ring cell gastric adenocarcinoma. The staging CT scan showed multiple abdominal lymphadenopathies and mild ascites. The patient underwent a staging laparoscopy that revealed a large carcinoma of the gastric cardia and a milky-appearing peritoneal fluid. A peritoneal washing and abdominal drainage were performed. The fluid analysis showed a high concentration of triglycerides, compatible with a chyloperitoneum. The patient started medium chain triglycerides-based diet with good response. This case report emphasizes that chyloperitoneum should be considered when assessing patients with gastric carcinoma.
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Affiliation(s)
- J C Pinto
- Serviço de Cirurgia Geral , Centro Hospitalar Tondela Viseu EPE, Viseu, Portugal
| | - S Oliveira
- Serviço de Cirurgia Geral , Centro Hospitalar Tondela Viseu EPE, Viseu, Portugal
| | - L Duarte
- Serviço de Cirurgia Geral , Centro Hospitalar Tondela Viseu EPE, Viseu, Portugal
| | - M Ferreira
- Serviço de Cirurgia Geral , Centro Hospitalar Tondela Viseu EPE, Viseu, Portugal
| | - C Marques
- Serviço de Cirurgia Geral , Centro Hospitalar Tondela Viseu EPE, Viseu, Portugal
| | - C Casimiro
- Serviço de Cirurgia Geral , Centro Hospitalar Tondela Viseu EPE, Viseu, Portugal
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Mazeda C, Antao J, Ferreira M, Aguiar R, Barcelos A, Ferreira PG. AB0290 COMPARATIVE FEATURES AND LONGITUDINAL BEHAVIOUR OF RHEUMATOID ARTHRITIS-ASSOCIATED UIP VERSUS IDIOPATHIC PULMONARY FIBROSIS: A SINGLE CENTRE COHORT STUDY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundInterstitial lung diseases (ILDs) are a group of heterogeneous lung disorders with variable prognosis. Idiopathic pulmonary fibrosis (IPF) is the main idiopathic interstitial pneumonia and rheumatoid arthritis (RA) is the commonest cause of connective tissue disease related-ILD. In fact, ILD is the most frequent form of respiratory involvement in RA, with 10% patients having clinically significant disease, frequently imposing significant morbi-mortality. RA-ILD can potentially comprise different disease patterns with distinct prognosis, with usual interstitial pneumonia (UIP) being the most frequent radio-histological pattern. Several studies have suggested that the RA-UIP disease course and survival may be clinically similar to IPF.ObjectivesThis study aimed to investigate comparative clinical features, longitudinal behaviour and healthcare resource utilization between local cohorts of RA-UIP and IPF patients.MethodsRetrospective and descriptive study including all IPF and RA-ILD cases diagnosed and followed in the ILD outpatient clinic of secondary hospital between 2015 and 2020. All patients with RA diagnosis met classification criteria of 2010 ACR/EULAR and IPF patients were diagnosed according to 2018 ATS/ERS/JRS/ALAT clinical guidelines. Socio-demographic, clinical data and longitudinal lung function (functional vital capacity (FVC) and lung diffusion capacity for carbon monoxide (DLCO)) were collected. A statistical analysis was performed; p-value <0.05 was statistically significant.Results:Table 1.Baseline clinical characteristics of all patients are listed in table.IFPn=22RA-UIPn=14pAge, years (mean±SD)74.5±1.875.5±9.40.75Sex (M/F), n17/54/100.006Smoking Status0.31Smoker (%)00Ex-smoker (%)64.642.9Smoking load53.1±7.935.8±22.20.48Baseline dyspnea (mMRC)0.070 (%)07.11 (%)13.628.62 (%)54.550.03 (%)18.214.34 (%)13.60Cough (%)86.442.90.01Time from respiratory symptoms until diagnosis (months)20.5±3.411.6±9.70.09Elevated titers of Rheumatoid Factor, n-10Elevated titers of anti-CCP, n-11Baseline lung function FVC, % predicted73.0±14.991.3±19.80.007 DLCO, % predicted42.1±18.660.3±21.20.046-minute walking distance at baseline (meters)341.8±147,7346.2±132.30.95In RA-UIP group, 86% of patients reported preceding articular symptoms, with lung disease being diagnosed after a median of 11 years (IQ range 2-13). All patients had a UIP/probable UIP pattern in HRCT. Regarding baseline FVC and DLCO, the RA-UIP group revealed better lung function compared to the IPF group. All patients with RA-UIP received some form of immunomodulation treatment. Around 78.4% of patients were on low dose prednisolone. Additionally, 64.2% received treatment with mycophenolate mofetil, 21.4% with rituximab, 7.1% with azathioprine and 7.1% with hydroxychloroquine. Regarding IPF patients, about 86.4% were treated with antifibrotics (nintedanib or pirfenidone). From the global population study only 27.3% and 14.3% of IPF and RA-UIP patients, respectively, were referred for respiratory rehabilitation. There were significant differences regarding FVC (p=0.002) and DLCO (p=0.003) decline over time between groups. Comparing to RA-UIP, IPF patients experienced a greater number of acute exacerbations (4 vs 27;p=0.06) and had more respiratory-related emergency visits. IPF patients also had a higher rate of hospitalizations, most of them respiratory-related. There was a clear trend towards higher mortality during follow-up in the IPF group compared to the RA-UIP group (40% vs 21,4%;p=0.23), although not reaching statistical significance.ConclusionRA-UIP patients appear to be less symptomatic and have a shorter symptomatic period at diagnosis. IPF patients had worse lung function at diagnosis. IPF patients showed a higher tendency to acute exacerbations and had a greater unplanned health care resources utilization. There was also a non-significant trend towards higher mortality during follow-up in the IPF group.Disclosure of InterestsCarolina Mazeda: None declared, Joana Antao: None declared, Margarida Ferreira: None declared, Renata Aguiar: None declared, Anabela Barcelos: None declared, Pedro G Ferreira Speakers bureau: Boehringer Ingelheim, Novartis, Roche, Glaxo
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Ourô S, Ferreira M, Roquete P, Maio R. Transanal versus laparoscopic total mesorectal excision: a comparative study of long-term oncological outcomes. Tech Coloproctol 2022; 26:279-290. [PMID: 35050434 DOI: 10.1007/s10151-022-02570-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 01/07/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND Transanal total mesorectal excision (TaTME) is the most recent approach developed to improve pelvic dissection in surgery for mid and low rectal tumors. There are still inconsistencies regarding the technique's oncological results. The aim of this study was to analyze clinical and oncological outcomes of the learning curve of TaTME in comparison to laparoscopic TME (lapTME). METHODS Rectal cancer patients who had TaTME and lapTME in two Portuguese colorectal units between March 2016 and December 2018 were eligible. Primary endpoints were 5-year overall survival, disease-free survival, and local recurrence. Secondary endpoints were clinical and pathological outcomes. RESULTS Forty-four patients underwent TaTME (29 men) and 39 lapTME (27 men) with a median age of 69 and 66 (p = 0.093), respectively. No differences were observed concerning baseline characteristics, emphasizing their comparability. In the TaTME group, there were more hand-sewn anastomosis (0 lapTME versus 7 TaTME, p = 0.018) with significantly less distance to the dentate line (40 mm lapTME versus 20 mm TaTME, p = 0.005) and significantly more loop ileostomies performed (28 lapTME versus 41 TaTME, p = 0.001). There were no differences in post-operative mortality, morbidity, readmissions, and stoma closure. Groups were similar in relation to specimen quality, margins, and resectability; however, TaTME had a significantly higher node yield (14 lapTME versus 20 TaTME, p = 0.002). Finally, no disparities were noted in oncological outcomes, namely local and distant recurrence, 5-year overall survival, and disease-free survival. CONCLUSIONS Even with the disadvantage of the learning curve of a new technique, TaTME appears to be comparable to lapTME, with similar long-term oncological outcomes. It has, however, a demanding learning curve, significant risk for morbidity and should be used only for selected patients.
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Affiliation(s)
- S Ourô
- Consultant in General and Colorectal Surgery, Surgical Department of Hospital Beatriz Ângelo, Avenida Carlos Teixeira 514, Loures, Portugal.
- NOVA Medical School, Lisbon, Portugal.
| | - M Ferreira
- Consultant in General Surgery, Surgical Department of Hospital Beatriz Ângelo, Lisbon, Portugal
| | - P Roquete
- Consultant in General Surgery, Surgical Department of Hospital da Luz, Lisbon, Portugal
| | - R Maio
- Consultant in General Surgery, Head of the Surgical Department of Hospital Beatriz Ângelo, Lisbon, Portugal
- Full Professor of Surgery, NOVA Medical School, Lisbon, Portugal
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Martinho M, Cale R, Alegria S, Ferreira F, Loureiro MJ, Judas T, Ferreira M, Gomes A, Delerue F, Pereira H. High-risk acute pulmonary embolism in a Portuguese centre: are we doing enough? Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1918] [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: 11/12/2022] Open
Abstract
Abstract
Introduction
For high-risk acute Pulmonary Embolism patients (HR-PE pts), reperfusion treatment is imperative to improve mortality. Although systemic thrombolysis (ST) is generally an appropriate first-line therapy, several population-based studies report its underuse. Data on epidemiology, management and outcomes of HR-PE in Portugal is scarce.
Purpose
Estimate the reperfusion rate in HR-PE pts, the reasons for non-reperfusion (NR) and how it influences outcomes.
Methods
Retrospective single-centre registry of consecutive HR-PE pts between 2008–2018, defined by the 2019 ESC guidelines criteria. Independent predictors for NR were assessed by multivariate logistic regression. The cumulative incidence of PE-related mortality at 30 days was calculated according to the Kaplan-Meier method and differences stratified by reperfusion were assessed using the log-rank test.
Results
Of a total of 1955 pts admitted with acute PE, 74 (3.8%) had HD instability at admission (mean age 68±15 years). The majority of pts (68.5%) came from the emergency department while the remaining 31.5% were already hospitalized for other reasons. The total reperfusion rate was 50% - 35pts were submitted to systemic thrombolysis, 1pt to first-line percutaneous embolectomy and 1pt to rescue endovascular treatment. Age was an independent predictor of NR (63±17 vs 73±12, p=0.02) with >75 years representing 15 times the risk of non-treatment (OR 15.5, 95% CI 3.23–74.25, p<0.001). Absolute contraindication for thrombolysis was present in 29.7% (22pts), with recent major surgery (13pts) and recent cerebral event (8pts) as the most common reasons. The presence of an absolute contraindication for systemic thrombolysis was also an independent predictor of NR (66.7% vs 13.6%; OR 13.3, 95% CI 2.51–70.65, p=0.002). Being hospitalized was associated with the presence of absolute contraindications for thrombolysis (68.2% vs 14.0%, p<0.001) and was also an independent predictor of NR (38% vs 77.3%; OR 8.49, 95% CI 1.56–46.11, p=0.013). PE-related death at 30 days was 28.4% (21pts), which was significantly lower in the reperfusion group (17.1% vs 38.9%, p=0.042). At a mean follow-up of 2.5±3.3 years, survival rate was 33.8% (figure 1).
Conclusions
Low reperfusion rate due to contraindications for thrombolysis was associated with high PE-related mortality. This data suggests that it is necessary to implement interventional alternative strategies, at a national level, to improve outcomes.
Funding Acknowledgement
Type of funding sources: None. Figure 1. Survival rate according to reperfusion.
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Affiliation(s)
- M Martinho
- Hospital Garcia de Orta, Almada, Portugal
| | - R Cale
- Hospital Garcia de Orta, Almada, Portugal
| | - S Alegria
- Hospital Garcia de Orta, Almada, Portugal
| | - F Ferreira
- Hospital Garcia de Orta, Almada, Portugal
| | | | - T Judas
- Hospital Garcia de Orta, Almada, Portugal
| | - M Ferreira
- Hospital Garcia de Orta, Almada, Portugal
| | - A Gomes
- Hospital Garcia de Orta, Almada, Portugal
| | - F Delerue
- Hospital Garcia de Orta, Almada, Portugal
| | - H Pereira
- Hospital Garcia de Orta, Almada, Portugal
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De Almeida J, Milner J, Rosa J, Coutinho R, Ferreira M, Goncalves L. Estimating pVO2 and prognosis through cardiac exercise stress test in a heart failure population. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0852] [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: 11/15/2022] Open
Abstract
Abstract
Background
Compared with the cardiac exercise stress test, more commonly used to assess the presence of ischemia, the cardiopulmonary exercise test has the advantage of providing expired gas analysis. According to current guidelines, cardiopulmonary exercise testing should be considered to stratify the risk of adverse events and to provide measures of survival improvement in heart failure populations. However, cardiac exercise stress test is more readily available and widespread than cardiopulmonary exercise testing. We aimed to compare prognostic information given by estimated pVO2 – which can be obtained from cardiac exercise stress test – and real measured pVO2 – which requires cardiopulmonary exercise test – in a heart failure population.
Methods
We conducted a retrospective analysis of 214 patients with HF underwent cardiac exercise stress test and accessed their 5 year survival. Non-urgent transplanted (UNOS Status 2) patients were censored alive on the date of the transplant. Duringthe cardiopulmonary exercise test, cardiac exercise stress test data simultaneously collected. Based on protocol stage achieved, estimated METs were used to calculate estimated pVO2 (pVO2 = estimated METs x 3.5). Estimated and real pVO2 were correlated using Pearson correlation and the age-adjusted prognostic power of each was determined using Cox proportional hazardsanalysis.
Results
164 patients were male (77%) and the mean age of the population was 56±10 years. 78 (36%) patients had an ischemic etiology. Within 5 years from testing, 46 patients died (21.5%) and 55 patients (26%) were transplanted. Naughton modified (n=165) was the most commonly used protocol, followed by Naughton (n=39) and Bruce (n=10). Estimated pVO2 and measured pVO2 correlated significantly (R=0.66, p<0.01) (Figure 1). Both estimated (HR=0.91, 95% CI 0.86–0.95, p<0.01) and measured pVO2 (HR=0.86, 95% CI 0.80–0.91, p<0.01) strongly predicted prognosis in this population.
Conclusions
Estimated pVO2 correlated with measured pVO2 and strongly predicted prognosis in this heart failure population. Because it can be obtained from conventional cardiac exercise testing, it may become an alternative prognostic tool to cardiopulmonary testing.
Funding Acknowledgement
Type of funding sources: None. Figure 1. Measured vs estimated pVO2
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Affiliation(s)
| | - J Milner
- University Hospitals of Coimbra, Coimbra, Portugal
| | - J Rosa
- University Hospitals of Coimbra, Coimbra, Portugal
| | - R Coutinho
- University Hospitals of Coimbra, Coimbra, Portugal
| | - M Ferreira
- University Hospitals of Coimbra, Coimbra, Portugal
| | - L Goncalves
- University Hospitals of Coimbra, Coimbra, Portugal
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Martinho M, Cale R, Alegria S, Ferreira F, Loureiro MJ, Judas T, Ferreira M, Gomes A, Delerue F, Pereira H. Reperfusion in high-risk acute pulmonary embolism: can the PESI score predict outcomes? Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1898] [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
Introduction
Acute pulmonary embolism (PE) is one of the leading causes of cardiovascular death worldwide. Haemodynamic (HD) instability defines high risk (HR) of early mortality and reperfusion treatment is the standard of care for rapid relieve of right ventricle (RV) overload in these situations. The impact of reperfusion in long-term outcomes is not well established. The PE Severity Index (PESI) score is used to stratify the risk of early death in HD stable patients (pts) and was not validated to predict outcomes in HR-PE.
Purpose
Estimate the prognostic performance of the PESI score in HR-PE and study its possible interaction in acute and long-term outcomes of reperfusion in HR-PE pts.
Methods
Retrospective single-centre study of consecutive HR-PE pts, defined by the 2019 ESC guidelines criteria, between 2008–2018. Logistic regression analysis was performed to test for an interaction between tertiles of the PESI score and reperfusion in early-mortality (during hospitalization and at 30 days) as well as 1-year MACE (a composite of cardiovascular mortality, PE recurrence or chronic thromboembolic pulmonary hypertension).
Results
Of a total of 1955 PE pts, 102 fulfilled the inclusion criteria (72.5% pts initially presented with HD instability with the remaining developing HR-PE after hospital admission). Mean age was 68±15 years and 60% were females. In-hospital and 30-day mortality were 39.6% and 43.0%, respectively. At one-year follow-up, MACE was 55.0%. Mean PESI at the time of HR-PE diagnosis was 200±39 and showed significant differences for in-hospital mortality (189±38 vs 217±34; OR 1.02, 95% CI 1.00–1.03, p<0.001), 30-day mortality (191±38 vs 214±36; OR 1.02, 95% CI 1.00–1.03, p=0.004) and 1y-MACE (186±41 vs 214±32; OR 1.02, 95% CI 1.01–1.03, p<0.001). Total reperfusion rate was 57.8% and was also associated with lower in-hospital mortality (OR 0.45, 95% CI 0.20–1.02; p=0.057), 30-day mortality (OR 0.35, 95% CI 0.15–0.80; p=0.012) and 1y-MACE (OR 0.35, 95% CI 0.15–0.80; p=0.014). The benefit of reperfusion was significantly influenced by the PESI score categorized by tertiles (figure 1).
Conclusions
Although the PESI score stratifies HD stable pts, in this population it was able to predict cardiovascular outcomes in HR-PE pts. Furthermore, it showed a significant interaction with the prognostic impact of reperfusion in early and late cardiovascular outcomes.
Funding Acknowledgement
Type of funding sources: None. Figure 1. Interaction between PESI and reperfusion
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Affiliation(s)
- M Martinho
- Hospital Garcia de Orta, Almada, Portugal
| | - R Cale
- Hospital Garcia de Orta, Almada, Portugal
| | - S Alegria
- Hospital Garcia de Orta, Almada, Portugal
| | - F Ferreira
- Hospital Garcia de Orta, Almada, Portugal
| | | | - T Judas
- Hospital Garcia de Orta, Almada, Portugal
| | - M Ferreira
- Hospital Garcia de Orta, Almada, Portugal
| | - A Gomes
- Hospital Garcia de Orta, Almada, Portugal
| | - F Delerue
- Hospital Garcia de Orta, Almada, Portugal
| | - H Pereira
- Hospital Garcia de Orta, Almada, Portugal
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Pereira AR, Cale R, Ferreira F, Alegria S, Morgado G, Martins AC, Ferreira M, Gomes A, Judas T, Gonzalez F, Lohmann C, Repolho D, Santos P, Loureiro MJ, Pereira H. One-year follow-up of continuous aspiration mechanical thrombectomy for the management of intermediate-high and high-risk pulmonary embolism: what is the line between utility and futility? Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1922] [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: 11/15/2022] Open
Abstract
Abstract
Introduction
Percutaneous catheter-directed treatments have emerged at the last decade for the management of acute high- or intermediate-high-risk pulmonary embolism (PE). Good short-term efficacy and safety have been published, but there are limited data regarding medium- to long-term outcomes.
Purpose
This study aimed to evaluate 1-year all-cause mortality of acute high- and intermediate-high-risk PE patients (pts) treated with continuous aspiration mechanical thrombectomy.
Methods
Twenty-nine consecutive pts with acute central PE (mean age 67.2±14.4 years; 72.4% female; 24.1% active cancer; Charlson comorbidity index 4.5±2.1; 82.8% in class>III of original PESI score; 44.8% high-risk PE) were treated with the Indigo Mechanical Thrombectomy System (Penumbra, Inc) between 03/2018 and 03/2020. Clinical success was defined as improvement in hemodynamic and/or oxygenation parameters or pulmonary hypertension or right heart strain at 48 hours after intervention plus survival to hospital discharge. Data regarding severe adverse events potentially related to the procedure, in-hospital and 1-year all-cause mortality were collected.
Results
Clinical success was 75.9%, with a significant improvement in mean paO2/fiO2 ratio (+77.1±103.2; p<0.01), shock index (−0.4±0.4, p<0.01), need for aminergic support (−75.0%, p<0.01), right ventricular function (66.6%, p<0.01) and systolic pulmonary arterial pressure (−10.2±11.5mmHg, p<0.01) at 48 hours after procedure. In-hospital survival rate was 82.8% but severe adverse events potentially related to the procedure occurred in 3 pts (10.3%). One-year follow-up was completed in 93.1% of cases and all-cause mortality rate was 34.5% (n=10 of which half occurred during the index hospital stay). Higher scores of Charlson comorbidity index (5.8±1.9 vs 3.7±1.9, p=0.01) and de novo atrial fibrillation at admission (40% vs 0%, p<0.01) were associated with higher 1-year all-cause mortality occurrence and were identified as 2 independent risk predictors by multivariate Cox regression. Kaplan-Meier curves confirmed its significant influence in 1-year survival free of adverse event (Figure). Time among diagnosis and percutaneous treatment (p=0.99), PESI score (p=0.24) and other clinical, haemodynamic and echocardiographic features did not influence mortality and suggest similarity of the PE severity at baseline. Technical characteristics were also not associated with mortality.
Conclusions
Aspiration thrombectomy for acute high- and intermediate-high-risk PE was feasible with a high clinical success rate. One-year all-cause mortality rate was elevated and predicted by high comorbidity index and de novo atrial fibrillation at admission. This data support the national expansion of this new PE treatment, but probably and as similar to other invasive techniques, we need to take into account comorbidities and avoid futility in multimorbidity pts.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- A R Pereira
- Hospital Garcia de Orta, Cardiology, Almada, Portugal
| | - R Cale
- Hospital Garcia de Orta, Cardiology, Almada, Portugal
| | - F Ferreira
- Hospital Garcia de Orta, Cardiology, Almada, Portugal
| | - S Alegria
- Hospital Garcia de Orta, Cardiology, Almada, Portugal
| | - G Morgado
- Hospital Garcia de Orta, Cardiology, Almada, Portugal
| | - A C Martins
- Hospital Garcia de Orta, Cardiology, Almada, Portugal
| | - M Ferreira
- Hospital Garcia de Orta, Internal Medicine, Almada, Portugal
| | - A Gomes
- Hospital Garcia de Orta, Internal Medicine, Almada, Portugal
| | - T Judas
- Hospital Garcia de Orta, Internal Medicine, Almada, Portugal
| | - F Gonzalez
- Hospital Garcia de Orta, Intensive Medicine, Almada, Portugal
| | - C Lohmann
- Hospital Garcia de Orta, Intensive Medicine, Almada, Portugal
| | - D Repolho
- Hospital Garcia de Orta, Cardiology, Almada, Portugal
| | - P Santos
- Hospital Garcia de Orta, Cardiology, Almada, Portugal
| | - M J Loureiro
- Hospital Garcia de Orta, Cardiology, Almada, Portugal
| | - H Pereira
- Hospital Garcia de Orta, Cardiology, Almada, Portugal
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Dehem A, Mazieres J, Chour A, Guisier F, Ferreira M, Boussageon M, Girard N, Moro-Sibilot D, Cadranel J, Zalcman G, Ricordel C, Wislez M, Munck C, Poulet CH, Gauvain C, Descarpentries C, Wasielewski E, Cortot A, Baldacci S. 1341P NRAS mutated non-small cell lung cancer (NSCLC) patients: Characteristics and outcomes. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Dias-Carvalho A, Ferreira M, Fernandes A, Reis-Mendes A, Duarte-Araújo M, Ferreira R, Carvalho F, Capela J, Fernandes E, Sá S, Costa V. The long-term neurotoxicity of doxorubicin in the brain of adult CD-1 mice. Toxicol Lett 2021. [DOI: 10.1016/s0378-4274(21)00663-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Martin M, Ferreira M, Taelman J, Eguizabal C, Chuv. d. Sous. Lopes SM. P–803 Novel culture conditions for the improvement of the in vitro expansion of human male fetal germ cells. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Study question
Do different ECMs/substrates and growth media culture conditions improve in vitro male human primordial germ cell (hPGC) expansion?
Summary answer
We achieved in vitro expansion improvement of male hPGCs with specific growth factors such as LIF, EGF, FGF2 and GDNF on gelatin- and vitronectin-coating cultures.
What is known already
PGCs are the precursors of male and female gametes, which are specified during early mammalian post-implantation embryonic development. PGCs undergo sequential cell divisions to differentiate into pro-spermatogonia (pSPG). In vitro propagation of pSPG could be important to understand the transition to spermatogonial stem cells (SSCs), important for fertility preservation in patients with infertility. Here, we aimed at performing a comparative analysis on in vitro feeder-free culture systems, based on different extracellular matrix (ECM) and growth media culture conditions, to support the expansion of the male germline stem cell populations using second trimester human male gonads as primary material.
Study design, size, duration
We collected human 2nd trimester male fetal gonads from elective abortions. Male gonads were dissected in saline solution (0.9% NaCl) and were either fixed overnight in 4% paraformaldehyde (PFA) for immunohistochemistry or disaggregated by enzymatic digestion for in vitro culture.
Participants/materials, setting, methods
After differential plating, fetal cells were cultured for 6 days. Disaggregated gonads were cultured with two different growing media (Medium 1 supplemented with LIF, EGF, FGF–2 and GDNF and Medium 2 supplemented with RA, BMP 4 and Activin A) on gelatin, laminin, vitronectin or matrigel coated plates. Cultured cells were immunostained, quantified for the expression of DDX4 and POU5F1 after 3 days (D3) and 6 days (D6) of culture.
Main results and the role of chance
We pursued to evaluate whether germ cells dissociated from a pool of male fetal gonads could propagate in vitro when cultured for D6 in different conditions.
We observed that expansion of POU5F1-positive early PGCs and DDX4-positive late PGCs was only observed when cells were plated on gelatin or vitronectin and cultured with Medium 1, containing the growth factors LIF, EGF, FGF2 and GDNF. However, a reduced percentage of PGCs was observed in all four different coatings when grown with Medium 2, containing RA, BMP4 and Activin A.
We analyzed the relative expression of the PGC markers POU5F1, DDX4 and MAGEA4 in histological sections of gonads from embryos at 18.5 weeks of gestation. Two populations of hPGCs were observed: ∼10–30% of the gonadal cells expressed solely DDX4 (late PGCs), whereas less than 10% of gonadal cells expressed POU5F1 (early PGCs). SOX9 and STARD1 expression was evaluated, confirming the presence of Sertoli cells and Leydig cells, respectively.
Limitations, reasons for caution
Due to the limited and difficulty to obtain human fetal tissue, a limited number of samples were used.
Wider implications of the findings: We expanded human male fetal germ cells in vitro for D6 on gelatin and vitronectin coated plates with Medium 1, containing growth factors LIF, EGF, FGF2 and GDNF. Our findings provide a 2D culture system to expand hPGCs that could be useful to study propagation to pSPGs and eventually SSCs.
Trial registration number
Not applicable
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Affiliation(s)
- M Martin
- Basque Centre for Blood Transfusion and Human Tissues, Cell therapy- Stem Cells and Tissues, Barrio Labeaga s/n- Galdakao 48960, Spain
- Biocruces Bizkaia, Health Research Institute, Cruces Plaza- 48903 Barakaldo, Spain
| | - M Ferreira
- Leiden University Medical Center, Department of Anatomy and Embryology, Einthovenweg 20- Leiden 2333 ZC, The Netherlands
| | - J Taelman
- Leiden University Medical Center, Department of Anatomy and Embryology, Einthovenweg 20- Leiden 2333 ZC, The Netherlands
| | - C Eguizabal
- Basque Centre for Blood Transfusion and Human Tissues, Cell therapy- Stem Cells and Tissues, Barrio Labeaga s/n- Galdakao 48960, Spain
- Biocruces Bizkaia, Health Research Institute, Cruces Plaza- 48903 Barakaldo, Spain
| | - S M Chuv. d. Sous. Lopes
- Leiden University Medical Center, Department of Anatomy and Embryology, Einthovenweg 20- Leiden 2333 ZC, The Netherlands
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Betus C, Dupas T, Denis M, Persello A, Erraud A, Pele T, Ferreira M, Leroux A, Lebreton J, Tessier A, De Waard M, Rozec B, Lauzier B. Post-natal activity of cardiac O-GlcNAcase is regulated to maintain physiological levels of O-GlcNAc. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2021.04.115] [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: 11/26/2022]
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Ferreira M, Persello A, Souab F, Gaillard C, Denis M, Blangy-Letheule A, Erraud A, Maillard A, Dupas T, Bigot-Corbel E, Rozec B, Lauzier B. O-GlcNAcylation blood levels are increased in response to stress induced by cardiopulmonary bypass. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2021.04.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Costa RA, Sá S, Pereira AT, Ferreira M, Vingada JV, Eira C. Threats to seabirds in Portugal: integrating data from a rehabilitation centre and stranding network. EUR J WILDLIFE RES 2021. [DOI: 10.1007/s10344-021-01483-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Blondon M, Jimenez D, Robert‐Ebadi H, Del Toro J, Lopez‐Jimenez L, Falga C, Skride A, Font L, Vazquez FJ, Bounameaux H, Monreal M, Prandoni P, Brenner, B, Farge‐Bancel D, Barba R, Di Micco P, Bertoletti L, Schellong S, Tzoran I, Reis A, Bosevski M, Malý R, Verhamme P, Caprini JA, My Bui H, Adarraga MD, Agud M, Aibar J, Aibar MA, Alfonso J, Amado C, Arcelus JI, Baeza C, Ballaz A, Barba R, Barbagelata C, Barrón M, Barrón‐Andrés B, Blanco‐Molina A, Botella E, Camon AM, Castro J, Caudevilla MA, Cerdà P, Chasco L, Criado J, de Ancos C, de Miguel J, Demelo‐Rodríguez P, Díaz‐Peromingo JA, Díez‐Sierra J, Díaz‐Simón R, Domínguez IM, Encabo M, Escribano JC, Falgá C, Farfán AI, Fernández‐Capitán C, Fernández‐Reyes JL, Fidalgo MA, Flores K, Font C, Francisco I, Gabara C, Galeano‐Valle F, García MA, García‐Bragado F, García‐Mullor MM, Gavín‐Blanco O, Gavín‐Sebastián O, Gil‐Díaz A, Gómez‐Cuervo C, González‐Martínez J, Grau E, Guirado L, Gutiérrez J, Hernández‐Blasco L, Jara‐Palomares L, Jaras MJ, Jiménez D, Joya MD, Jou I, Lacruz B, Lecumberri R, Lima J, Lobo JL, López‐Brull H, López‐Jiménez L, López‐Miguel P, López‐Núñez JJ, López‐Reyes R, López‐Sáez JB, Lorente MA, Lorenzo A, Loring M, Madridano O, Maestre A, Marchena PJ, Martín del Pozo M, Martín‐Martos F, Martínez‐Baquerizo C, Mella C, Mellado M, Mercado MI, Moisés J, Morales MV, Muñoz‐Blanco A, Muñoz‐Guglielmetti D, Muñoz‐Rivas N, Nart E, Nieto JA, Núñez MJ, Olivares MC, Ortega‐Michel C, Ortega‐Recio MD, Osorio J, Otalora S, Otero R, Parra P, Parra V, Pedrajas JM, Pellejero G, Pérez‐Jacoiste A, Peris ML, Pesántez D, Porras JA, Portillo J, Reig L, Riera‐Mestre A, Rivas A, Rodríguez‐Cobo A, Rodríguez‐Matute C, Rogado J, Rosa V, Rubio CM, Ruiz‐Artacho P, Ruiz‐Giménez N, Ruiz‐Ruiz J, Ruiz‐Sada P, Sahuquillo JC, Salgueiro G, Sampériz A, Sánchez‐Muñoz‐Torrero JF, Sancho T, Sigüenza P, Sirisi M, Soler S, Suárez S, Suriñach JM, Tiberio G, Torres MI, Tolosa C, Trujillo‐Santos J, Uresandi F, Usandizaga E, Valle R, Vela JR, Vidal G, Vilar C, Villares P, Zamora C, Gutiérrez P, Vázquez FJ, Vanassche T, Vandenbriele C, Verhamme P, Hirmerova J, Malý R, Salgado E, Benzidia I, Bertoletti L, Bura‐Riviere A, Crichi B, Debourdeau P, Espitia O, Farge‐Bancel D, Helfer H, Mahé I, Moustafa F, Poenou G, Schellong S, Braester A, Brenner B, Tzoran I, Amitrano M, Bilora F, Bortoluzzi C, Brandolin B, Ciammaichella M, Colaizzo D, Dentali F, Di Micco P, Giammarino E, Grandone E, Mangiacapra S, Mastroiacovo D, Maida R, Mumoli N, Pace F, Pesavento R, Pomero F, Prandoni P, Quintavalla R, Rocci A, Siniscalchi C, Tufano A, Visonà A, Vo Hong N, Zalunardo B, Kalejs RV, Maķe K, Ferreira M, Fonseca S, Martins F, Meireles J, Bosevski M, Zdraveska M, Mazzolai L, Caprini JA, Tafur AJ, Weinberg I, Wilkins H, Bui HM. Comparative clinical prognosis of massive and non-massive pulmonary embolism: A registry-based cohort study. J Thromb Haemost 2021; 19:408-416. [PMID: 33119949 DOI: 10.1111/jth.15146] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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: 06/02/2020] [Revised: 09/29/2020] [Accepted: 10/21/2020] [Indexed: 01/16/2023]
Abstract
AIMS Little is known about the prognosis of patients with massive pulmonary embolism (PE) and its risk of recurrent venous thromboembolism (VTE) compared with non-massive PE, which may inform clinical decisions. Our aim was to compare the risk of recurrent VTE, bleeding, and mortality after massive and non-massive PE during anticoagulation and after its discontinuation. METHODS AND RESULTS We included all participants in the RIETE registry who suffered a symptomatic, objectively confirmed segmental or more central PE. Massive PE was defined by a systolic hypotension at clinical presentation (<90 mm Hg). We compared the risks of recurrent VTE, major bleeding, and mortality using time-to-event multivariable competing risk modeling. There were 3.5% of massive PE among 38 996 patients with PE. During the anticoagulation period, massive PE was associated with a greater risk of major bleeding (subhazard ratio [sHR] 1.72, 95% confidence interval [CI] 1.28-2.32), but not of recurrent VTE (sHR 1.15, 95% CI 0.75-1.74) than non-massive PE. An increased risk of mortality was only observed in the first month after PE. After discontinuation of anticoagulation, among 11 579 patients, massive PE and non-massive PE had similar risks of mortality, bleeding, and recurrent VTE (sHR 0.85, 95% CI 0.51-1.40), but with different case fatality of recurrent PE (11.1% versus 2.4%, P = .03) and possibly different risk of recurrent fatal PE (sHR 3.65, 95% CI 0.82-16.24). CONCLUSION In this large prospective registry, the baseline hemodynamic status of the incident PE did not influence the risk of recurrent VTE, during and after the anticoagulation periods, but was possibly associated with recurrent PE of greater severity.
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Affiliation(s)
- Marc Blondon
- Division of Angiology and Hemostasis Geneva University Hospitals and Faculty of Medicine Geneva Switzerland
| | - David Jimenez
- Respiratory Department Hospital Ramón y Cajal and Medicine Department Universidad de Alcalá (IRYCIS) Madrid Spain
| | - Helia Robert‐Ebadi
- Division of Angiology and Hemostasis Geneva University Hospitals and Faculty of Medicine Geneva Switzerland
| | - Jorge Del Toro
- Department of Internal Medicine Hospital General Universitario Gregorio Marañón Madrid Spain
| | | | - Conxita Falga
- Department of Internal Medicine Hospital de Mataro Barcelona Spain
| | - Andris Skride
- Department of Cardiology Ospedale Pauls Stradins Clinical University Hospital Riga Latvia
| | - Llorenç Font
- Department of Haematology Hospital de Tortosa Verge de la Cinta Tarragona Spain
| | | | - Henri Bounameaux
- Division of Angiology and Hemostasis Geneva University Hospitals and Faculty of Medicine Geneva Switzerland
| | - Manuel Monreal
- Department of Internal Medicine Hospital Germans Trias i Pujol Badalona Spain
- Universidad Catolica de Murcia Murcia Spain
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Pontes R, Junqueira F, Paiva M, Ferreira M, Oliveira N, Costa V. Intracranial subdural haematoma following dural puncture accidental: clinical case. Rev Esp Anestesiol Reanim (Engl Ed) 2021; 68:103-106. [PMID: 32854941 DOI: 10.1016/j.redar.2020.05.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/22/2020] [Accepted: 05/26/2020] [Indexed: 06/11/2023]
Abstract
Intracranial subdural hematoma is a rare, but potentially lethal complication of neuraxial procedures. Considering the high frequency of neuraxial techniques in the obstetric population, parturients are more susceptible to this fearful complication. The diagnosis is often masked and delayed because it shares similar clinical characteristics with posdural puncture headache, with headache being the most common symptom. This case report describes a timely diagnosis and successful management of an intracranial subdural hematoma, after unintentional dural puncture during labour epidural analgesia. Postpartum headache following epidural analgesia, remains a clinical challenge for the caring team, requiring a close follow-up and awareness for non-benign causes that require prompt management, avoiding devastating consequences.
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Affiliation(s)
- R Pontes
- Departamento de Anestesiología, Centro Hospitalario Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.
| | - F Junqueira
- Departamento de Anestesiología, Centro Hospitalario Universitario de Lisboa Central, Lisboa, Portugal
| | - M Paiva
- Departamento de Anestesiología, Centro Hospitalario Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - M Ferreira
- Departamento de Anestesiología, Centro Hospitalario Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - N Oliveira
- Departamento de Anestesiología, Centro Hospitalario Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - V Costa
- Departamento de Anestesiología, Centro Hospitalario Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
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Ferreira M, Güney S, Kuźniarska-Biernacka I, Soares OSGP, Figueiredo JL, Pereira MFR, Neves IC, Fonseca AM, Parpot P. Electrochemical oxidation of diclofenac on CNT and M/CNT modified electrodes. NEW J CHEM 2021. [DOI: 10.1039/d1nj01117k] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Successful electrochemical oxidation of diclofenac, a non-steroidal anti-inflammatory drug considered as an emerging pollutant, was investigated on CNT, Pt/CNT and Ru/CNT modified electrodes based on Carbon Toray in aqueous media.
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Affiliation(s)
- M. Ferreira
- CQUM
- Centro de Química
- Escola de Ciências
- Universidade do Minho
- Braga
| | - S. Güney
- Department of Chemistry
- Technical University of Istanbul
- 34467 Sarıyer/İstanbul
- Turkey
| | | | - O. S. G. P. Soares
- Laboratório de Catálise e Materiais (LCM)
- Laboratório Associado LSRE-LCM, Departamento de Engenharia Química
- Faculdade de Engenharia
- Universidade do Porto
- 4200-465 Porto
| | - J. L. Figueiredo
- Laboratório de Catálise e Materiais (LCM)
- Laboratório Associado LSRE-LCM, Departamento de Engenharia Química
- Faculdade de Engenharia
- Universidade do Porto
- 4200-465 Porto
| | - M. F. R. Pereira
- Laboratório de Catálise e Materiais (LCM)
- Laboratório Associado LSRE-LCM, Departamento de Engenharia Química
- Faculdade de Engenharia
- Universidade do Porto
- 4200-465 Porto
| | - I. C. Neves
- CQUM
- Centro de Química
- Escola de Ciências
- Universidade do Minho
- Braga
| | - A. M. Fonseca
- CQUM
- Centro de Química
- Escola de Ciências
- Universidade do Minho
- Braga
| | - P. Parpot
- CQUM
- Centro de Química
- Escola de Ciências
- Universidade do Minho
- Braga
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Rodrigues P, Cunha V, Oliva-Teles L, Ferreira M, Guimarães L. Norfluoxetine and venlafaxine in zebrafish larvae: Single and combined toxicity of two pharmaceutical products relevant for risk assessment. J Hazard Mater 2020; 400:123171. [PMID: 32593945 DOI: 10.1016/j.jhazmat.2020.123171] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [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: 02/20/2020] [Revised: 05/25/2020] [Accepted: 06/07/2020] [Indexed: 06/11/2023]
Abstract
Antidepressant metabolites are found in natural and waste waters. However, investigation of their toxic effects on aquatic animals, single or in mixture with other occurring psychoactive drugs, has been neglected. Here, effects of 80hpf exposure to norfluoxetine (0.64-400 ng/L), venlafaxine (16-10000 ng/L) or their combination (3.2 ng/L +2000 ng/L, respectively) were investigated in embryos and zebrafish larvae. Mortality, embryonic malformations, sensorymotor reflexes and the expression of 34 genes involved in the toxicants mode-of-action (MoA) and metabolism were evaluated (i.e. monoamine receptors and transporters, nuclear receptors, and detoxification transporters and enzymes). Compared to controls, norfluoxetine treatments only caused depigmentation of embryos and larvae. Venlafaxine-exposed larvae exhibited depigmentation and spinal deformities, impaired sensorymotor reflexes, alterations in the expression of genes belonging to the serotonergic, noradrenergic and dopaminergic pathways, as well as nuclear receptors related to lipid and drug metabolism. The mixture elicited distinct interaction effects, depending on the level of biological organisation analysed and the neurotransmitter pathways affected; synergism (lethality), no interaction (sensorymotor reflexes), antagonism and inverse agonism (gene expression). The results call for investigation of the toxicity of pharmaceutical metabolites single and in mixture, as well as their risk assessment in approaches accounting for possible interactions with other endocrine-disrupting compounds.
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Affiliation(s)
- P Rodrigues
- CIIMAR/CIMAR - Interdisciplinary Centre of Marine and Environmental Research, University of Porto, Terminal de Cruzeiros do Porto de Leixões, Avenida General Norton de Matos, s/n, 4450-208 Matosinhos, Portugal
| | - V Cunha
- CIIMAR/CIMAR - Interdisciplinary Centre of Marine and Environmental Research, University of Porto, Terminal de Cruzeiros do Porto de Leixões, Avenida General Norton de Matos, s/n, 4450-208 Matosinhos, Portugal
| | - L Oliva-Teles
- CIIMAR/CIMAR - Interdisciplinary Centre of Marine and Environmental Research, University of Porto, Terminal de Cruzeiros do Porto de Leixões, Avenida General Norton de Matos, s/n, 4450-208 Matosinhos, Portugal; Faculdade de Ciências da Universidade do Porto, Rua do Campo Alegre, s/n, 4169-007, Porto, Portugal
| | - M Ferreira
- CIIMAR/CIMAR - Interdisciplinary Centre of Marine and Environmental Research, University of Porto, Terminal de Cruzeiros do Porto de Leixões, Avenida General Norton de Matos, s/n, 4450-208 Matosinhos, Portugal; School of Marine Studies, Faculty of Science, Technology and Environment, The University of The South Pacific, Laucala Bay Road, Suva, Fiji
| | - L Guimarães
- CIIMAR/CIMAR - Interdisciplinary Centre of Marine and Environmental Research, University of Porto, Terminal de Cruzeiros do Porto de Leixões, Avenida General Norton de Matos, s/n, 4450-208 Matosinhos, Portugal.
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31
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Costa RA, Sá S, Pereira AT, Ângelo AR, Vaqueiro J, Ferreira M, Eira C. Prevalence of entanglements of seabirds in marine debris in the central Portuguese coast. Mar Pollut Bull 2020; 161:111746. [PMID: 33068788 DOI: 10.1016/j.marpolbul.2020.111746] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 06/09/2020] [Revised: 10/05/2020] [Accepted: 10/05/2020] [Indexed: 06/11/2023]
Abstract
Plastic pollution and the subsequent entanglement of marine animals is a global and increasing problem. In this study we present an analysis of the seabirds recorded as entangled by a rehabilitation centre and an associated marine animal stranding network, along the central coast of Portugal, between 2008 and 2018. Results show a high annual rate of entangled seabirds (average 6.9%) compared to other studies and fisheries related materials are a relevant cause of seabird entanglement (82%) compared to other debris. When comparing age classes, juveniles were more vulnerable to entanglement than other age classes in the species studied. Regarding the rehabilitation of entangled seabirds, the release rate was higher in non-fishing material entanglement cases. In conclusion, this study highlights the impact of fisheries related material on marine fauna and the need for reinforcement of the existing legislation for protecting seabirds and the implementation of mitigation measures associated with fishing activities.
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Affiliation(s)
- R A Costa
- CESAM & Departamento de Biologia, Universidade de Aveiro, Campus de Santiago, 3810-193 Aveiro, Portugal.
| | - S Sá
- CESAM & Departamento de Biologia, Universidade de Aveiro, Campus de Santiago, 3810-193 Aveiro, Portugal; Sociedade Portuguesa de Vida Selvagem, Estação de Campo de Quiaios, 3081-101 Figueira da Foz, Portugal
| | - A T Pereira
- CESAM & Departamento de Biologia, Universidade de Aveiro, Campus de Santiago, 3810-193 Aveiro, Portugal; Sociedade Portuguesa de Vida Selvagem, Estação de Campo de Quiaios, 3081-101 Figueira da Foz, Portugal
| | - A R Ângelo
- CESAM & Departamento de Biologia, Universidade de Aveiro, Campus de Santiago, 3810-193 Aveiro, Portugal
| | - J Vaqueiro
- CESAM & Departamento de Biologia, Universidade de Aveiro, Campus de Santiago, 3810-193 Aveiro, Portugal; Sociedade Portuguesa de Vida Selvagem, Estação de Campo de Quiaios, 3081-101 Figueira da Foz, Portugal
| | - M Ferreira
- Sociedade Portuguesa de Vida Selvagem, Estação de Campo de Quiaios, 3081-101 Figueira da Foz, Portugal
| | - C Eira
- CESAM & Departamento de Biologia, Universidade de Aveiro, Campus de Santiago, 3810-193 Aveiro, Portugal; Sociedade Portuguesa de Vida Selvagem, Estação de Campo de Quiaios, 3081-101 Figueira da Foz, Portugal
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Lopes J, Monteiro M, Campos D, Saleiro C, Costa S, Sousa J, Puga L, Gomes A, Silva J, Ferreira M, Goncalves L. Isolated apical perfusion defect in SPECT-CT scans, is there any prognostic value? Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0276] [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
Myocardial perfusion imaging (MPI) plays a significant role in diagnostic and therapeutic decision making in coronary artery disease (CAD). An isolated apical defect in the 17th segment in SPECT/CT scans is a common finding, sometimes attributed to the apical thinning phenomenon. However, the clinical significance of apical thinning or other isolated apical defects is unknown.
Purpose
The purpose of this study is to assess the prognostic impact of an isolated apical perfusion defect (17th segment) in patients (P) with suspicion of significant CAD.
Methods
A cohort of 612 consecutive P that underwent a MPI test with a SPECT/CT scanner, between January 2017 and December 2017, in a single nuclear medicine centre, was included in this retrospective study.
The inclusion criteria for this study were either a normal perfusion exam (group 1 – G1) or only an isolated apical defect in the 17th segment, either reversible suggesting ischemia (group 2 – G2) or fixed suggesting necrosis (group 3 – G3). Images with and without attenuation correction were analysed. Mean follow-up was 29±4 months.
The chi square test was used for categorical variables, and analysis of variance for continuous variables. Binary logistic regression was used to control for confounding.
Results
A total of 612 P were included (57% male sex, mean age of 69±10) and divided in G1 (n=494, 80.7%), G2 (n=62, 10%) and G3 (n=56, 9.2%). P in G3 had higher body mass index (31±7, p=0.028) and higher prevalence of dyslipidemia (84%, p=0.001), while P in G1 had lower ejection fraction at rest (54±15, p=0.001). There was no association between the presence of isolated apical defect and all- cause mortality (G1 = 7.3% vs G2 = 6.5% vs G3 = 5.4%, p=0.851). There was a statistically significant difference between groups in the referral for coronary angiography in the bivariate analysis (G1 = 7.9% vs G2 = 35.5% vs G3 = 10.7%, p=0.001), but this association did not remain when accounted for potential confounders (angina, ejection fraction, previous CAD and diabetes) – OR=3.94, 95% CI: [0.968–16.093], p=0.056.
In those P that underwent coronary angiography, there was no statistically significant difference between the 3 groups in revascularization of significant CAD (G1 = 38.5% vs G2 = 36.4% vs G3 = 50%, p=0.830). During the follow-up time, 11 P of group 1 suffered an acute coronary syndrome (ACS), but there were no events in group 2 or 3.
Conclusion
Isolated apical myocardial defect on a SPECT/CT exam has no association with all-cause mortality in this patients. There is no significant difference in referral for coronary angiography or need for coronary revascularization between P with normal exams and P with isolated apical defects.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- J Lopes
- University Hospitals of Coimbra, Cardiology, Coimbra, Portugal
| | - M Monteiro
- University Hospitals of Coimbra, Nuclear Medicine, Coimbra, Portugal
| | - D Campos
- University Hospitals of Coimbra, Cardiology, Coimbra, Portugal
| | - C Saleiro
- University Hospitals of Coimbra, Cardiology, Coimbra, Portugal
| | - S Costa
- University Hospitals of Coimbra, Internal Medicine, Coimbra, Portugal
| | - J Sousa
- University Hospitals of Coimbra, Cardiology, Coimbra, Portugal
| | - L Puga
- University Hospitals of Coimbra, Cardiology, Coimbra, Portugal
| | - A Gomes
- University Hospitals of Coimbra, Cardiology, Coimbra, Portugal
| | - J Silva
- University Hospitals of Coimbra, Cardiology, Coimbra, Portugal
| | - M Ferreira
- University Hospitals of Coimbra, Cardiology, Coimbra, Portugal
| | - L Goncalves
- University Hospitals of Coimbra, Cardiology, Coimbra, Portugal
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Cartier N, Chesnay A, N'diaye D, Thorey C, Ferreira M, Haillot O, Bailly É, Desoubeaux G. Candida nivariensis: Identification strategy in mycological laboratories. J Mycol Med 2020; 30:101042. [PMID: 32919860 DOI: 10.1016/j.mycmed.2020.101042] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 08/17/2020] [Accepted: 08/18/2020] [Indexed: 10/23/2022]
Abstract
Candida nivariensis is a cryptic fungal species classified within the Candida glabrata complex. It was described for the first time in 2005 by the means of DNA sequencing. We report a rare case of C. nivariensis deep-seated infection occurring in a 77-year-old man hospitalized for cysto-prostatectomy. Phenotypic testing based on the direct examination and the macroscopic features of the in vitro culture initially suggested C. glabrata species, while MALDI-TOF mass spectrometry enables correct identification. The isolate was found resistant to fluconazole, like in almost 20% of the reported cases. Herein, we present our practical strategy to reliably characterize this rare cryptic species. To date, MALDI-TOF mass spectrometry-based analysis showed very good results for such a purpose.
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Affiliation(s)
- N Cartier
- Parasitologie - mycologie - médecine tropicale, CHRU de Tours, 37044 Tours, France
| | - A Chesnay
- Parasitologie - mycologie - médecine tropicale, CHRU de Tours, 37044 Tours, France; CEPR - Inserm U1100/équipe 3, faculté de médecine, université de Tours, 37032 Tours, France
| | - D N'diaye
- Médecine interne et maladies infectieuses, CHRU de Tours, 37044 Tours, France
| | - C Thorey
- Médecine interne et maladies infectieuses, CHRU de Tours, 37044 Tours, France
| | - M Ferreira
- CEPR - Inserm U1100/équipe 3, faculté de médecine, université de Tours, 37032 Tours, France; Pneumologie, CHRU de Tours, 37044 Tours, France
| | - O Haillot
- Urologie, CHRU de Tours, 37044 Tours, France
| | - É Bailly
- Parasitologie - mycologie - médecine tropicale, CHRU de Tours, 37044 Tours, France
| | - G Desoubeaux
- Parasitologie - mycologie - médecine tropicale, CHRU de Tours, 37044 Tours, France; CEPR - Inserm U1100/équipe 3, faculté de médecine, université de Tours, 37032 Tours, France.
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Bejan-Angoulvant T, Naccache JM, Caille A, Borie R, Nunes H, Ferreira M, Cadranel J, Crestani B, Cottin V, Marchand-Adam S. Evaluation of efficacy and safety of rituximab in combination with mycophenolate mofetil in patients with nonspecific interstitial pneumonia non-responding to a first-line immunosuppressive treatment (EVER-ILD): A double-blind placebo-controlled randomized trial. Respir Med Res 2020; 78:100770. [PMID: 32777737 DOI: 10.1016/j.resmer.2020.100770] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 05/14/2020] [Accepted: 05/18/2020] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Nonspecific interstitial pneumonia (NSIP) are rare but severe diseases, with high mortality and morbidity, with no effective pharmacological treatment allowing for long-term remission, and therefore no clear therapeutic recommendations. Classic immunosuppressants are used as first-line treatment, with only one third of patients being responders and no clear recommendations exist for the choice of the second-line therapy. The EvER-ILD study is the first one to prospectively evaluate the efficacy and safety of rituximab and mycophenolate mofetil (MMF) versus placebo and MMF in a broad range of NSIP patients that did not respond to a first-line therapy. A pharmacokinetic-pharmacodynamic analysis based on rituximab serum concentrations will allow identification of potential factors associated with therapeutic response and/or adverse effects. METHODS EvER-ILD study is a French multicenter, prospective, randomized, double blind, placebo-controlled, superiority trial. Patients with severe and progressive NSIP non-responding to a first line immunosuppressive treatment will be randomized in 2 groups of treatment: one course of rituximab plus 6 months MMF (RTX-MMF group) and one course of placebo plus 6 months MMF (Placebo-MMF group). The primary outcome is the change in Forced Vital Capacity (FVC, % of predicted) from baseline to 6 months. Several clinical, biological, and quality of life secondary outcomes will be measured at 3, 6 and 12 months. A sample size of 122 patients (61 patients per group) would allow to show a point difference between groups in the change of FVC at 6 months, based on a common standard deviation for FVC change of 8% with a power of 90%, alpha 5% two-sided, and anticipating an extreme 10% drop-out rate. ETHICS AND DISSEMINATION The protocol was approved by the French Research Ethics Committee (CPP Tours Ouest 1 2016-R28) on November 10, 2016, and by the French competent authority (ANSM, reference 160771A-22) on December 1st, 2016. This article refers to protocol V2, dated November 18, 2016. An independent data safety monitoring board will review safety and tolerability data for the duration of the trial. Results will be disseminated via peer reviewed publication and presentation at international conferences. TRIAL REGISTRATION NUMBER NCT02990286 (clinicaltrials.gov), EudraCT 2016-003026-16 (European Medicines agency).
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Affiliation(s)
- T Bejan-Angoulvant
- Service de Pharmacologie médicale, CHRU de Tours, Hôpital Bretonneau, Université de Tours, Tours, France
| | - J-Marc Naccache
- AP-HP, Hôpital Tenon, service de pneumologie, Site constitutif du centre de référence pour les maladies pulmonaires rares OrphaLung, and Sorbonne Université, Paris, France
| | - A Caille
- Inserm CIC1415, CHRU Tours, Université de Tours, Université de Nantes, SPHERE, U1246, Tours, France
| | - R Borie
- AP-HP, service de pneumologie, centre de compétences pour les maladies pulmonaires rares, Hôpital Bichat, Paris, France
| | - H Nunes
- Service de pneumologie, centre constitutif pour les maladies pulmonaires rares, hôpital Avicenne, CHU Paris Seine-Saint-Denis, Bobigny, France
| | - M Ferreira
- Service de Pneumologie, CHRU de Tours, Centre de compétences des maladies pulmonaires rares de la région Centre, Hôpital Bretonneau, Tours, France; Université de Tours, CEPR Inserm U1100, Tours, France
| | - J Cadranel
- AP-HP, Hôpital Tenon, service de pneumologie, Site constitutif du centre de référence pour les maladies pulmonaires rares OrphaLung, and Sorbonne Université, Paris, France
| | - B Crestani
- AP-HP, service de pneumologie, centre de compétences pour les maladies pulmonaires rares, Hôpital Bichat, Paris, France
| | - V Cottin
- Service de Pneumologie, Centre national coordonnateur de référence des maladies pulmonaires rares, Hôpital Louis Pradel, Hospices civils de Lyon, UMR 754, Université Claude Bernard Lyon 1, Lyon, France
| | - S Marchand-Adam
- Service de Pneumologie, CHRU de Tours, Centre de compétences des maladies pulmonaires rares de la région Centre, Hôpital Bretonneau, Tours, France; Université de Tours, CEPR Inserm U1100, Tours, France.
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Eyles JP, Ferreira M, Mills K, Lucas BR, Robbins SR, Williams M, Lee H, Appleton S, Hunter DJ. Is the Patient Activation Measure a valid measure of osteoarthritis self-management attitudes and capabilities? Results of a Rasch analysis. Health Qual Life Outcomes 2020; 18:121. [PMID: 32370751 PMCID: PMC7201682 DOI: 10.1186/s12955-020-01364-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 04/14/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Patient Activation Measure (PAM-13) was developed using Rasch analysis to assess knowledge, skills and confidence in the management of one's health. Previous studies report positive relationships between PAM-13 scores, self-management behaviours and longitudinal health outcomes in adults with chronic disease. There is little extant measurement property evidence for the use of PAM-13 in specific osteoarthritis (OA) populations. This study tested measurement properties of the PAM-13 in people living with hip and knee OA. METHODS Item response frequency analysis was conducted. Rasch analysis evaluated the fit of the PAM-13 data to the Rasch model. Model-data fit was evaluated using infit and outfit statistics; person/item reliability and person separation indices were computed. Unidimensionality was evaluated using Principal Components Analysis of Rasch residuals and the data were assessed for item redundancy. Differential Item Functioning (DIF) examined bias in respondent subgroups and correlations tested relationships between PAM-13 and other patient-reported outcomes. RESULTS Two-hundred-and-seventeen PAM-13 surveys were completed; there were no missing responses, floor or ceiling effects. Person and item reliability were acceptable (0.98 and 0.87 respectively) with good separation (person separation index 2.58). Unidimensionality was evaluated, with 49.4% of the variance explained by the first eigenvector. There was evidence of potential local response-dependence. The Rasch fit statistics were acceptable (except for item-2). There were some issues identified with targeting of the PAM-13 items to people with higher ability and the item difficulty order was different to that proposed in original cohorts. Significant DIF was identified for sex and educational level for a small number of items. PAM-13 scores were moderately correlated with depressive symptoms on the Depression Anxiety Stress Scale and Assessment of Quality of Life-6D. There were small correlations between PAM-13 and Knee injury and Osteoarthritis Outcome Score pain and activities of daily living scores. CONCLUSIONS This study provides some evidence of adequate person and item reliability, unidimensionality, and construct validity to support the use of PAM-13 to measure patient activation in people living with hip and knee OA. Possible limitations regarding targeting, different item difficulty order, DIF and local response dependence should be investigated in future research.
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Affiliation(s)
- J P Eyles
- Kolling Institute of Medical Research, Institute of Bone and Joint Research, Faculty of Medicine and Health, University of Sydney, Sydney, Australia. .,Department of Rheumatology, Royal North Shore Hospital , Sydney, Australia. .,Physiotherapy Department, Royal North Shore Hospital, Sydney, Australia.
| | - M Ferreira
- Kolling Institute of Medical Research, Institute of Bone and Joint Research, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Department of Rheumatology, Royal North Shore Hospital , Sydney, Australia
| | - K Mills
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - B R Lucas
- Kolling Institute of Medical Research, Institute of Bone and Joint Research, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Physiotherapy Department, Royal North Shore Hospital, Sydney, Australia
| | - S R Robbins
- Kolling Institute of Medical Research, Institute of Bone and Joint Research, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Department of Rheumatology, Royal North Shore Hospital , Sydney, Australia
| | - M Williams
- Physiotherapy Department, Royal North Shore Hospital, Sydney, Australia
| | - H Lee
- Rehabilitation Department, Hunters Hill Private Hospital, Sydney, Australia
| | - S Appleton
- Physiotherapy Department, Mount Wilga Private Hospital, Sydney, Australia
| | - D J Hunter
- Kolling Institute of Medical Research, Institute of Bone and Joint Research, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Department of Rheumatology, Royal North Shore Hospital , Sydney, Australia
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Mathur S, Ferreira M, Maia N, Martin C, Chowdhury N, Islam A, Singer L. Is Frailty Associated with Sarcopenia and Dynapenia in Lung Transplant Candidates? J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.501] [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: 11/27/2022] Open
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Silva S, Ferreira M, Oliveira AS, Magalhães C, Sousa ME, Pinto M, Sousa Lobo JM, Almeida IF. Evolution of the use of antioxidants in anti-ageing cosmetics. Int J Cosmet Sci 2020; 41:378-386. [PMID: 31220359 DOI: 10.1111/ics.12551] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [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: 04/09/2019] [Accepted: 06/17/2019] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Skin health and beauty are a cornerstone of general well-being in humans. Anti-ageing cosmetics are used to provide a healthy and youthful appearance. Among the different cosmetic actives, antioxidants are incorporated in anti-ageing products due to their beneficial effects in preventing and minimizing the signs of skin ageing. This work aims to understand how anti-ageing formulations changed in the past 7 years regarding pure antioxidants composition. METHODS Data were collected from anti-ageing formulations commercialized in main stores and pharmacies in the Portuguese market. The study started on 2011 and was updated with products launched or whose composition has been renewed on 2013, 2015 or 2018. RESULTS Ascorbic acid and tocopherol and their derivatives were consistently the most used antioxidants in anti-ageing formulations; followed by niacinamide and retinyl palmitate. Seven ascorbic acid derivatives are currently used in anti-ageing formulations while only three tocopherol derivatives were identified in this study. Several combinations of antioxidants were routinely found, mainly tocopherol (or tocopherol derivatives) with other antioxidants and tocopherol with tocopherol derivatives. We have not identified emerging antioxidants with great impact in anti-ageing formulations even though niacinamide and retinyl palmitate exhibited over 10% more usage in 2018. CONCLUSION This insight is relevant to the cosmetic industry providing a better understanding of the scientific-based formulation of modern cosmetics and supports the need for innovative antioxidants in anti-ageing cosmetics.
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Affiliation(s)
- S Silva
- Laboratory of Pharmaceutical Echnology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, Porto, 4050-313, Portugal
| | - M Ferreira
- Laboratory of Pharmaceutical Echnology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, Porto, 4050-313, Portugal
| | - A S Oliveira
- Laboratory of Pharmaceutical Echnology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, Porto, 4050-313, Portugal
| | - C Magalhães
- Laboratory of Pharmaceutical Echnology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, Porto, 4050-313, Portugal
| | - M E Sousa
- Laboratório de Química Orgânica e Farmacêutica, Departamento de Ciências Químicas, Faculdade de Farmácia, Universidade do Porto, Porto, 4050-313, Portugal.,Centro Interdisciplinar de Investigação Marinha e Ambiental (CIIMAR/CIMAR), Edifício do Terminal de Cruzeiros do Porto de Leixões, Universidade do Porto, Av. General Norton de Matos s/n4050-208, Matosinhos, Portugal
| | - M Pinto
- Laboratório de Química Orgânica e Farmacêutica, Departamento de Ciências Químicas, Faculdade de Farmácia, Universidade do Porto, Porto, 4050-313, Portugal.,Centro Interdisciplinar de Investigação Marinha e Ambiental (CIIMAR/CIMAR), Edifício do Terminal de Cruzeiros do Porto de Leixões, Universidade do Porto, Av. General Norton de Matos s/n4050-208, Matosinhos, Portugal
| | - J M Sousa Lobo
- Laboratory of Pharmaceutical Echnology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, Porto, 4050-313, Portugal.,UCIBIO, REQUIMTE, Laboratory of Pharmaceutical Technology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, Porto, 4050-313, Portugal
| | - I F Almeida
- Laboratory of Pharmaceutical Echnology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, Porto, 4050-313, Portugal.,UCIBIO, REQUIMTE, Laboratory of Pharmaceutical Technology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, Porto, 4050-313, Portugal
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Cracraft J, Ribas CC, d’Horta FM, Bates J, Almeida RP, Aleixo A, Boubli JP, Campbell KE, Cruz FW, Ferreira M, Fritz SC, Grohmann CH, Latrubesse EM, Lohmann LG, Musher LJ, Nogueira A, Sawakuchi AO, Baker P. The Origin and Evolution of Amazonian Species Diversity. Neotropical Diversification: Patterns and Processes 2020. [DOI: 10.1007/978-3-030-31167-4_10] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Queirós C, Paredes X, Avelino T, Bastos D, Ferreira M, Santos F, Santos A, Lopes M, Lourenço M, Pereira H, Nieto de Castro C. The influence of water on the thermophysical properties of 1-ethyl-3-methylimidazolium acetate. J Mol Liq 2020. [DOI: 10.1016/j.molliq.2019.111925] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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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Ferreira M, Ferreira H. Tail Dependence Under Sample Failures. Theory Probab Appl 2020. [DOI: 10.1137/s0040585x97t989751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Peyrière H, Mano Q, Tribout V, Jacquet JM, Ferreira M, De Carvalho E, Brosson I, Verdier J, Derrien J, Rousseau C, Reynes J. Distinct Profiles of Consumers of Psychoactive Substances in People Attending French Sexual Transmitted Infections Centers. AIDS Behav 2019; 23:3375-3383. [PMID: 31102107 DOI: 10.1007/s10461-019-02539-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The objective of this cross-sectional survey was to assess the prevalence of psychoactive substance use (PSU) in people attending 11 French Sexual Transmitted Infection Centers, and to specify their profiles (PSU and link with risky sexual behaviors) using the ascending hierarchical clustering method. Among the 5220 individuals who completed the survey, 55.6% were men and the median age was 24 years [IQR: 20-31]. Among the participants, 2751 (52.7%) reported PSU at least once in their life. Ascending hierarchical clustering identified seven distinct profiles of participants based on their PSU. This study shows a high prevalence of PSU and alcohol consumption in this young population. Moreover, subgroup analysis allowed identifying groups of psychoactive substance users who presented specific risks or vulnerabilities and who should be priority targets for interventions, particularly sexual minority groups.
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Affiliation(s)
- H Peyrière
- INSERM U1175/IRD UMI 233, Montpellier University, Montpellier, France.
- Département de Pharmacologie Médicale et Toxicologie, Hôpital Lapeyronie, 191 avenue du Doyen Gaston Giraud, 34295, Cedex 5 Montpellier, France.
| | - Q Mano
- Santé Publique France, French National Public Health Agency, Cire Occitanie, 94415, Saint-Maurice, France
| | - V Tribout
- Sexual Transmitted Infections Center, Montpellier University, Montpellier, France
| | - J M Jacquet
- Department of Infectious Diseases, Montpellier University Hospital, Montpellier, France
| | - M Ferreira
- Sexual Transmitted Infections Center, Perpignan, France
| | | | - I Brosson
- Sexual Transmitted Infections Center, Nîmes, France
| | - J Verdier
- Sexual Transmitted Infections Center, Perpignan, France
| | - J Derrien
- National Team of Intervention and Prevention in Health, Montpellier, France
| | - C Rousseau
- Santé Publique France, French National Public Health Agency, Cire Occitanie, 94415, Saint-Maurice, France
| | - J Reynes
- INSERM U1175/IRD UMI 233, Montpellier University, Montpellier, France
- Department of Infectious Diseases, Montpellier University Hospital, Montpellier, France
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Ferreira M, Fernandes H, Peres H, Teles AO, Belo I, Salgado J. Effect of solid-state fermentation on polyunsaturated fatty acid production by Mortierella alpina. J Biotechnol 2019. [DOI: 10.1016/j.jbiotec.2019.05.232] [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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Beleigoli A, Andrade A, Diniz M, Alvares R, Ferreira M, Silva L, Rodrigues M, Jacomassi L, Cerqueira A, Ribeiro A. Validation of Anthropometric Measures Self-Reported in a Randomized Controlled Trial of a Web-Based Platform for Weight Loss. Stud Health Technol Inform 2019; 266:30-36. [PMID: 31397298 DOI: 10.3233/shti190769] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION A great number of weight loss interventions have been delivered through digital solutions. Analysis of the effectiveness in terms of weight loss is fundamental to understand the real potential of digital technologies as tools for delivery of weight loss interventions. For this, we need accurate and reliable anthropometric data. For reasons of convenience, self-reported weight and height often replace actual measurements in these interventions. This might lead to misclassification of BMI status during selection of participants and to bias in the assessment of the outcomes. Therefore, it is fundamental to have validation studies of self-reported web-based data. OBJECTIVES We aimed to validate online self-reported height, weight and BMI in a POEmaS trial subsample. METHODS We included 12.5% of the POEmaS' population (n=159). Anthropometric data reported on the web-platform were compared to measured data by paired T-tests. Agreement was assessed by Bland-Altman plots. Multinomial regression was used to investigate factors associated with self-reported weight validity. RESULTS There was no significant difference between reported and measured weight (0.4 kg, SD 1.7; p=0.13) and BMI (0.03 kg/m2, SD 0.87; p=0.06). Reported height was on average 0.4 cm (SD 1.2) higher than the measured ones (p<0.001). For all anthropometric data, >=95% of the cases were within the limits of agreement. Higher measured BMI was the only factor associated with low accuracy of weight report. Each unit increase in BMI increased the odds that the reported weight was lower than the one measured (OR 1.13; 95%CI 1.01-1.26). DISCUSSION Self-reported weight and BMI change showed good agreement with measured ones. Since these are the primary outcomes of the POEmaS trial, the findings of the validation study suggest that the outcomes' accuracy is high and that it does not vary across gender, age, study group. These findings are relevant to digital health researchers and assessors and suggest that digital health interventions for weight loss might rely on self-reported assessment of outcomes. This might be particularly useful when other modes of assessment, such as anthropometry and e-scales, are not feasible or not available. However, we acknowledge that these results might not be applicable to low educated populations.
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Affiliation(s)
| | - A Andrade
- University of South Australia, Adelaide South Australia, Australia
| | - M Diniz
- Universidade Federal de Minas Gerais, Belo Horizonte Minas Gerais, Brazil
| | - R Alvares
- Universidade Federal de Minas Gerais, Belo Horizonte Minas Gerais, Brazil
| | - M Ferreira
- Universidade Federal de Minas Gerais, Belo Horizonte Minas Gerais, Brazil
| | - L Silva
- Universidade Federal de Minas Gerais, Belo Horizonte Minas Gerais, Brazil
| | - M Rodrigues
- Universidade Federal de Minas Gerais, Belo Horizonte Minas Gerais, Brazil
| | - L Jacomassi
- Universidade Federal de Minas Gerais, Belo Horizonte Minas Gerais, Brazil
| | - A Cerqueira
- Universidade Federal de Minas Gerais, Belo Horizonte Minas Gerais, Brazil
| | - A Ribeiro
- Universidade Federal de Minas Gerais, Belo Horizonte Minas Gerais, Brazil
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Wang HYC, Donovan EM, Nisbet A, South CP, Alobaidli S, Ezhil V, Phillips I, Prakash V, Ferreira M, Webster P, Evans PM. The stability of imaging biomarkers in radiomics: a framework for evaluation. Phys Med Biol 2019; 64:165012. [PMID: 31117063 DOI: 10.1088/1361-6560/ab23a7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
This paper studies the sensitivity of a range of image texture parameters used in radiomics to: (i) the number of intensity levels, (ii) the method of quantisation to select the intensity levels and (iii) the use of an intensity threshold. 43 commonly used texture features were studied for the gross target volume outlined on the CT component of PET/CT scans of 50 patients with non-small cell lung carcinoma (NSCLC). All cases were quantised for all values between 4 and 128 intensity levels using four commonly used quantisation methods. All results were analysed with and without a threshold range of -200 HU to 300 HU. Cases were ranked for each texture feature and for all quantisation methods with the Spearman's rank correlation coefficient determined to evaluate stability. Results showed large fluctuations in ranking, particularly for low numbers of levels, differences between quantisation methods and with the use of a threshold, with values Spearman's Rank Correlation for many parameters below 0.2. Our results demonstrated the sensitivity of radiomics features to the parameters used during analysis and highlight the risk of low reproducibility comparing studies with slightly different parameters. In terms of the lung cancer CT datasets, this study supports the use of 128 intensity levels, the same uniform quantiser applied to all scans and thresholding of the data. It also supports several of the features recommended in the literature for such studies such as skewness and kurtosis. A recommended framework is presented for curation of the data analysis process to ensure stability of results.
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Affiliation(s)
- H Y C Wang
- Centre for Vision, Speech and Signal Processing, University of Surrey, Guildford GU2 7XH, United Kingdom
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Alen Coutinho I, Ferreira D, Regateiro FS, Pita J, Ferreira M, Martins JF, Fonseca IA, Loureiro C, Todo-Bom A. Anaphylaxis in an emergency department: a retrospective 10-year study in a tertiary hospital. Eur Ann Allergy Clin Immunol 2019; 52:23-34. [PMID: 31287264 DOI: 10.23822/eurannaci.1764-1489.98] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Summary Background. Anaphylaxis is a potentially fatal medical emergency. The frequency of hospital admissions for anaphylaxis seems to be increasing in the recent decades. Objective. Characterize the patients admitted for anaphylaxis to the adult emergency department (ED) of a tertiary care hospital over a 10-year period, discriminating aetiologies, clinical features and therapy administered. Methods. Retrospective, descriptive and inferential study, evaluating age, sex, Manchester triage system, suspected allergen, site of allergen exposure, comorbidities, cofactors, clinical findings and symptoms, treatment and management. Patients admitted between January 2007 and December 2016 were included. Results. Forty-three patients were enrolled: 23 males, mean age 54.3 ± 16.2 years, n = 22 had history of allergic disease. Two patients were triaged as non-urgent. The most frequently suspected causes of anaphylaxis were: drugs (33%, n = 14), Hymenoptera venoms (23%, n = 10), foods (21%, n = 9) and iodinated contrast products (12%, n = 5). Adrenaline was used in 88% of the episodes (n = 38), 55% of which (n = 21) intramuscularly. Mortality was registered in one case. At discharge, adrenaline auto-injector was prescribed in 7% (n = 3) of the patients, and Allergy and Clinical Immunology consultation (ACIC) was requested in 65% of the episodes (n = 28). Statistically significant associations (p minor 0.05) were established: a, anaphylaxis to drugs associated with a low intramuscular adrenaline use and with frequent oxygen therapy; b, anaphylaxis to food associated with intramuscular adrenaline administration; c, anaphylaxis to Hymenoptera venom associated with male sex; and d, anaphylaxis to iodinated contrasts associated with referral to ACIC and with shock. All obese patients developed shock. Conclusions. Anaphylaxis is a life-threatening condition that requires early recognition. Although most patients received adrenaline, administration was not always performed by the recommended route and only a few patients were prescribed adrenaline auto-injector.
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Affiliation(s)
- I Alen Coutinho
- Serviço de Imunoalergologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - D Ferreira
- Serviço de Medicina Interna, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - F S Regateiro
- Serviço de Imunoalergologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - J Pita
- Serviço de Imunoalergologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - M Ferreira
- Serviço de Medicina Interna, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - J F Martins
- Serviço de Medicina Intensiva, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - I A Fonseca
- Serviço de Urgência, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - C Loureiro
- Serviço de Imunoalergologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - A Todo-Bom
- Serviço de Imunoalergologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
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Figueiredo MC, Dias H, Amendoeira J, Spínola A, André C, Godinho C, Duarte A, Pintor M, Ferreira M. O8 Impact evaluation of literacy on health in school from the third cycle of basic education: a scoping review. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz098.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M C Figueiredo
- Health Higher School of Santarém, Monitoring Unity of Health Indicators (UMIS), IPSantarém Research Unit, Polytechnic Institute of Santarém, Santarém, PORTUGAL
| | - H Dias
- Health Higher School of Santarém, Monitoring Unity of Health Indicators (UMIS), IPSantarém Research Unit, Polytechnic Institute of Santarém, Santarém, PORTUGAL
- Centre for Health Technology and Services Research (CINTESIS), University of Porto, Porto, PORTUGAL
| | - J Amendoeira
- Health Higher School of Santarém, Monitoring Unity of Health Indicators (UMIS), IPSantarém Research Unit, Polytechnic Institute of Santarém, Santarém, PORTUGAL
- Center for Interdisciplinary Research in Health (CIIS), Universidade Católica Portuguesa, Lisbon, PORTUGAL
| | - A Spínola
- Health Higher School of Santarém, Monitoring Unity of Health Indicators (UMIS), IPSantarém Research Unit, Polytechnic Institute of Santarém, Santarém, PORTUGAL
- Centre for Health Technology and Services Research (CINTESIS), University of Porto, Porto, PORTUGAL
| | - C André
- Health Higher School of Santarém, Monitoring Unity of Health Indicators (UMIS), IPSantarém Research Unit, Polytechnic Institute of Santarém, Santarém, PORTUGAL
| | - C Godinho
- Health Higher School of Santarém, Monitoring Unity of Health Indicators (UMIS), IPSantarém Research Unit, Polytechnic Institute of Santarém, Santarém, PORTUGAL
| | - A Duarte
- Health Higher School of Santarém, Monitoring Unity of Health Indicators (UMIS), Polytechnic Institute of Santarém, Santarém, PORTUGAL
| | - M Pintor
- Health Higher School of Santarém, Monitoring Unity of Health Indicators (UMIS), Polytechnic Institute of Santarém, Santarém, PORTUGAL
| | - M Ferreira
- Health Higher School of Santarém, Monitoring Unity of Health Indicators (UMIS), Polytechnic Institute of Santarém, Santarém, PORTUGAL
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47
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Cunha C, Fernandes M, Santos M, Ferreira M, Caiado A, Miranda P, Azevedo P, Manso M, Oliveira J, Barreira S, Féria L, Maio R. ERAS® program in the “elderly” - can we still improve even in the extremes? Clin Nutr ESPEN 2019. [DOI: 10.1016/j.clnesp.2019.03.052] [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: 11/26/2022]
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48
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André C, Amendoeira J, Figueiredo MC, Martins MR, Pinto C, Nunes M, Rainha L, Godinho A, Ferreira M, Pintor M, Oliveira M. O9 Here4You - Footsteps… Building the future: An action research project to prevent tobacco consumption in the 3rd Cycle. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz098.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- C André
- Health Higher School of Santarém, Monitoring Unity of Health Indicators (UMIS), IPSantarém Research Unit, Polytechnic Institute of Santarém, Santarém, PORTUGAL
| | - J Amendoeira
- Health Higher School of Santarém, Monitoring Unity of Health Indicators (UMIS), IPSantarém Research Unit, Polytechnic Institute of Santarém, Santarém, PORTUGAL
- Centre for Interdisciplinary Research in Health (CIIS), Universidade Católica Portuguesa, Lisbon, PORTUGAL
| | - M C Figueiredo
- Health Higher School of Santarém, Monitoring Unity of Health Indicators (UMIS), IPSantarém Research Unit, Polytechnic Institute of Santarém, Santarém, PORTUGAL
| | - M R Martins
- Care Unit in the Community Chamusca/Golegã, ACES Lezíria, Santarém, PORTUGAL
- Health Higher School of Santarém, Monitoring Unity of Health Indicators (UMIS), Santarém, PORTUGAL
| | - C Pinto
- Care Unit in the Community Chamusca/Golegã, ACES Lezíria, Santarém, PORTUGAL
- Health Higher School of Santarém, Monitoring Unity of Health Indicators (UMIS), Santarém, PORTUGAL
| | - M Nunes
- Care Unit in the Community Chamusca/Golegã, ACES Lezíria, Santarém, PORTUGAL
- Health Higher School of Santarém, Monitoring Unity of Health Indicators (UMIS), Santarém, PORTUGAL
| | - L Rainha
- Health Higher School of Santarém, Monitoring Unity of Health Indicators (UMIS), Santarém, PORTUGAL
- Vila Franca de Xira Hospital, Vila Franca de Xira, PORTUGAL
| | - A Godinho
- Health Higher School of Santarém, Monitoring Unity of Health Indicators (UMIS), Santarém, PORTUGAL
- São Francisco Xavier Hospital, Lisbon, PORTUGAL
| | - M Ferreira
- Health Higher School of Santarém, Monitoring Unity of Health Indicators (UMIS), Santarém, PORTUGAL
- Santarém District Hospital, Santarém, PORTUGAL
| | - M Pintor
- Health Higher School of Santarém, Monitoring Unity of Health Indicators (UMIS), Santarém, PORTUGAL
| | - M Oliveira
- Health Higher School of Santarém, Monitoring Unity of Health Indicators (UMIS), Santarém, PORTUGAL
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49
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Ferreira M, Duarte J, Campos S, Dias H. O54 Health Literacy in 3rd cycle Schoolchildren: Preliminary study in a North interior school of Portugal. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz094.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M Ferreira
- Health Higher School of Viseu, Centro de Estudos em Educação, Tecnologias e Saúde (CI&DETS), Polytechnic Institute of Viseu, Viseu, PORTUGAL
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra, Coimbra, PORTUGAL
| | - J Duarte
- Health Higher School of Viseu, Centro de Estudos em Educação, Tecnologias e Saúde (CI&DETS), Polytechnic Institute of Viseu, Viseu, PORTUGAL
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra, Coimbra, PORTUGAL
| | - S Campos
- Health Higher School of Viseu, Centre for Studies in Education and Innovation (CI&DEI), Polytechnic Institute of Viseu, Viseu, PORTUGAL
| | - H Dias
- Health HigherSchool of Santarém, Monitoring Unity of Health Indicators (UMIS), Polytechnic Institute of Santarém, Santarém, PORTUGAL
- Centre for Health Technology and Services Research (CINTESIS), University of Porto, Porto, PORTUGAL
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50
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Santos MJ, Ferreira E, Ferreira M. O6 Sexual and Reproductive Health Literacy in College Students. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz098.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- M J Santos
- Health Higher School, University of Trás-os-Montes e Alto Douro, Vila Real, PORTUGAL
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra, Coimbra, PORTUGAL
| | - E Ferreira
- Faculty of Sciences and Psychology, University of Porto, Porto, PORTUGAL
| | - M Ferreira
- Health Higher School of Viseu, Polytechnic Institute of Viseu, Viseu, PORTUGAL
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra, Coimbra, PORTUGAL
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