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Sousa S, Santos S, Alves CM, Gonçalves G, Carvalho C, Duarte R. Impact of annual TB screening on stone quarry workers in high-incidence Portuguese municipalities. Int J Tuberc Lung Dis 2024; 28:136-141. [PMID: 38454185 DOI: 10.5588/ijtld.23.0350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024] Open
Abstract
SETTING The Portuguese municipalities of Penafiel and Marco de Canaveses are high TB incidence areas, where stone quarry workers represent a vulnerable population.OBJECTIVE To assess the annual rate of TB infection (ARI) in stone quarry workers and to compare it with the TB notification rate in the general community.DESIGN An annual TB infection screening strategy using interferon-gamma release assay (IGRA) was implemented in 2018 for workers from high-risk stone quarries. A prospective cohort was enrolled and workers screened in periods of 2 years were included. IGRA-positive workers were referred for preventive treatment. ARI was calculated as the proportion of workers with IGRA conversion.RESULTS Of the 232 IGRA-negative workers in 2018, 20 tested positive in 2019 (8.6% ARI). Of 171 IGRA-negative workers in 2019, eight tested positive in 2021 (4.7% in 2 years). Two of the 150 IGRA-negative workers in 2021 tested positive in 2022 (1.3% ARI). ARI decreased by 84.9% between 2019 and 2022. In the two municipalities, the TB notification rate declined 23.9% between 2018 and 2021.CONCLUSION A more pronounced reduction in ARI was observed among stone quarry workers regularly screened for TB infection compared to the notification rate among the general population in high-incidence municipalities. A screening strategy for high-risk populations, together with enforced community measures, could foster risk reduction in the community..
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Affiliation(s)
- S Sousa
- Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Universidade do Porto, Porto, Estudo das Populações, ICBAS, Universidade do Porto, Porto
| | - S Santos
- Northern Regional Health Administration, Porto
| | - C M Alves
- Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Universidade do Porto, Porto, Instituto Superior Ave, Amares
| | - G Gonçalves
- Public Health Unit, Unidade Local de Saúde do Médio Ave, Vila Nova de Famalicão
| | - C Carvalho
- Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Universidade do Porto, Porto
| | - R Duarte
- Estudo das Populações, ICBAS, Universidade do Porto, Porto, EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Serviço de Pneumologia, Unidade Local de Saúde de Gaia/Espinho, Vila Nova de Gaia, Portugal
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Sousa S, Macedo R, Alves CM, Carvalho C, Gonçalves G, Duarte R. Coffee shops, a hub for TB clusters? Pulmonology 2024; 30:71-74. [PMID: 37236905 DOI: 10.1016/j.pulmoe.2023.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 04/21/2023] [Accepted: 04/24/2023] [Indexed: 05/28/2023] Open
Affiliation(s)
- S Sousa
- Multidisciplinary Unit for Biomedical Research (UMIB), Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, ICBAS-UP, Porto, Portugal.
| | - R Macedo
- National Reference Laboratory for Mycobacteria, Department of Infectious Diseases, National Institute of Health (INSA), Lisbon, Portugal
| | - C M Alves
- Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal; Northern Regional Health Administration, Portugal
| | - C Carvalho
- Multidisciplinary Unit for Biomedical Research (UMIB), Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, ICBAS-UP, Porto, Portugal
| | - G Gonçalves
- Public Health Unit, ACeS Ave-Famalicão, ARS Norte, Health Ministry, Portugal
| | - R Duarte
- Multidisciplinary Unit for Biomedical Research (UMIB), Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, ICBAS-UP, Porto, Portugal; EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Serviço de Pneumologia, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
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Sentís A, Prats-Uribe A, Peixoto VR, Caylà JA, Gomes MD, Sousa S, Duarte R, Carvalho I, Carvalho C. Decline of tuberculosis notification rate in different populations and regions in Portugal, 2010-2017. Pulmonology 2023; 29 Suppl 4:S36-S43. [PMID: 34544672 DOI: 10.1016/j.pulmoe.2021.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 08/11/2021] [Accepted: 08/12/2021] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Tuberculosis (TB) incidence declined in Portugal in recent decades, but trends differ between regions and population subgroups. We investigated these differences to inform prevention and control programmes. METHODS We extracted TB notifications from the Portuguese National TB Surveillance System (SVIG-TB) in 2010-2017, disaggregated by region, age group, nationality and HIV status. We calculated notification rates using denominators from the Portuguese National Institute of Statistics and the Joint United Nations Programme on HIV/AIDS and performed stratified time series analysis. We estimated interannual decline percentages and 95% confidence intervals (CI) using Poisson and binomial negative regression models. RESULTS The overall TB notification rate decreased from 25.7 to 17.5/100,000 population from 2010 to 2017 (5.2%/year) in Portugal. Interannual decline did not differ significantly between regions, but it was smaller amongst non-Portuguese nationals (-1.57% [CI: -4.79%, 1.75%] vs -5.85% [CI: -6.98%, -4.70%] in Portuguese nationals); children under five years of age (+1.77% [CI: -4.61%, 8.58%] vs -5.38% [CI: -6.33%, -4.42%] in other age groups); and HIV-negative people (-6.47% [CI: -9.10%, -3.77%] vs -11.29% [CI; -17.51%, -4.60%] in HIV-positive). CONCLUSIONS The decline in TB notification rates in Portugal during the study period has been steady. However, the decline amongst non-Portuguese nationals, children under five years of age and non-infected-HIV patients was lower. No significant differences were observed between regions. Changes in TB epidemiology in specific risk groups and geographical areas should be closely monitored to achieve the objectives of the End TB Strategy. We recommend intensifying screening of TB in the subpopulations identified.
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Affiliation(s)
- A Sentís
- Epiconcept, Epidemiology Department, Paris, France; Pompeu Fabra University (UPF), Barcelona, Spain
| | - A Prats-Uribe
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, United Kingdom
| | - V R Peixoto
- NOVA National School of Public Health, Public Health Research Centre, Universidade Nova de Lisboa, Lisbon, Portugal; Comprehensive Health Research Centre, Universidade Nova de Lisboa, Lisbon, Portugal
| | - J A Caylà
- Foundation of Tuberculosis Research Unit of Barcelona, Spain
| | - M D Gomes
- EPIUnit, Institute of Public Health, University of Porto, Porto, Portugal; National Tuberculosis Programme, Directorate-General of Health, Lisbon, Portugal
| | - S Sousa
- National Tuberculosis Programme, Directorate-General of Health, Lisbon, Portugal; Multidisciplinary Unit for Biomedical Research (UMIB), Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
| | - R Duarte
- EPIUnit, Institute of Public Health, University of Porto, Porto, Portugal; Public Health Science and Medical Education Department, Faculty of Medicine, University of Porto, Porto, Portugal; Pulmonology Department, Hospital Centre of Vila Nova de Gaia/Espinho EPE, Vila Nova de Gaia, Portugal
| | - I Carvalho
- National Tuberculosis Programme, Directorate-General of Health, Lisbon, Portugal; Pediatric Department, Hospital Centre of Vila Nova de Gaia/Espinho EPE, Vila Nova de Gaia, Portugal
| | - C Carvalho
- Multidisciplinary Unit for Biomedical Research (UMIB), Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal.
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Sousa S, Alves CM, Macedo R, Carvalho C, Gonçalves G, Duarte R. An investigation of TB infection and reinfection among stone quarry workers. Pulmonology 2023; 29:570-572. [PMID: 37263863 DOI: 10.1016/j.pulmoe.2023.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 05/04/2023] [Accepted: 05/05/2023] [Indexed: 06/03/2023] Open
Affiliation(s)
- S Sousa
- Multidisciplinary Unit for Biomedical Research (UMIB), Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, ICBAS-UP, Porto, Portugal.
| | - C M Alves
- Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal; Northern Regional Health Administration, Portugal
| | - R Macedo
- National Reference Laboratory for Mycobacteria, Department of Infectious Diseases, National Institute of Health (INSA), Lisbon, Portugal
| | - C Carvalho
- Multidisciplinary Unit for Biomedical Research (UMIB), Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, ICBAS-UP, Porto, Portugal
| | - G Gonçalves
- Public Health Unit, ACeS Ave-Famalicão, ARS Norte, Health Ministry, Portugal
| | - R Duarte
- Multidisciplinary Unit for Biomedical Research (UMIB), Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, ICBAS-UP, Porto, Portugal; EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Serviço de Pneumologia, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
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Gonçalves S, Soares C, Ribeiro R, Sousa S. Unveiling the Mystery: A Case Report on Oropharyngeal Synovial Sarcoma. Cureus 2023; 15:e44703. [PMID: 37809216 PMCID: PMC10552340 DOI: 10.7759/cureus.44703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2023] [Indexed: 10/10/2023] Open
Abstract
Synovial sarcoma, originating from mesenchymal cells, represents a rare and aggressive sarcoma subtype. This case report describes a rare occurrence of synovial sarcoma in the soft palate, with only a few cases described in the literature. A 38-year-old male presented with a painless mass on the soft palate, which raised suspicion of an abscess and emphasized the importance of considering malignancy in persistent or progressive soft tissue masses, even in atypical anatomical locations. The diagnostic workup, including imaging modalities such as maxillofacial computed tomography (CT) scan, magnetic resonance imaging (MRI), and positron emission tomography-fluorodeoxyglucose (PET-FDG) scan, played a crucial role in confirming the diagnosis and assessing disease extension. The standard treatment is the complete excision of the tumor. Nevertheless, when it comes to tumors located in the head and neck region, defining standardized margins proves to be a challenge. Radiotherapy can play an important role, particularly in those with tumors larger than 5 cm or positive margins. While chemotherapy offers certain advantages, its application remains a subject of controversy despite its potential benefits. Timely referral and multidisciplinary management are essential in optimizing patient outcomes. Although synovial sarcoma poses diagnostic and therapeutic challenges, advances in diagnostic techniques and personalized medicine offer hope for improved outcomes.
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Affiliation(s)
- Soraia Gonçalves
- Family Medicine, Unidade Local de Saúde do Alto Minho, Viana do Castelo, PRT
| | - Catarina Soares
- Family Medicine, Unidade Local de Saúde do Alto Minho, Viana do Castelo, PRT
| | - Rita Ribeiro
- Family Medicine, Unidade Local de Saúde do Alto Minho, Viana do Castelo, PRT
| | - Sílvia Sousa
- Family Medicine, Unidade Local de Saúde do Alto Minho, Viana do Castelo, PRT
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Correia S, Sousa S, Drummond M, Pinto P, Staats R, Brito D, Lousada N, Cardoso JS, Moita J. Diagnostic and therapeutic approach of central sleep apnea in heart failure - the role of adaptive servo-ventilation. A statement of the Portuguese society of pulmonology and the Portuguese sleep association. Pulmonology 2023; 29:138-143. [PMID: 35501278 DOI: 10.1016/j.pulmoe.2021.12.002] [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: 05/27/2021] [Revised: 11/30/2021] [Accepted: 12/01/2021] [Indexed: 10/18/2022] Open
Abstract
It is known that patients with heart failure (HF) have an increased risk of developing central sleep apnoea (CSA), with Cheyne-Stokes respiration. The development of servo-ventilation aimed to treat CSA and improve the quality of life (QoL) of these patients. A large randomized clinical study, SERVE-HF, was conducted in order to test this theory in patients with HF and reduced ejection fraction (HFrEF). The results from this trial seemed to indicate that, in these patients, there was no beneficial effect of the assisted ventilation in CSA treatment. More surprisingly, an increased rate of all-cause or cardiovascular mortality was observed. This has led to dramatic changes in clinical practice, with decreased frequency of servo-ventilation prescription across Europe, including Portugal, due to changes in the guidelines. However, SERVE-HF was conducted only in severe systolic HF patients with CSA, and caution must be taken when extrapolating these results to HF patients with preserved ejection fraction or CSA patients without HF. The study also showed poor adherence, methodological and statistical gaps, including study design, patient selection, data collection and analysis, treatment adherence, and group crossovers, which have not been discussed in the trial as potential confounding factors and raise several concerns. Moreover, the adaptive servo-ventilation (ASV) device used in SERVE-HF was unable to lower the minimum support pressure below 3 mm H20, and this has been suggested as one of the probable contributing reasons to the excess mortality observed in this study. This limitation has since been solved, and this ASV device is no longer used. This paper describes the results of a Portuguese Task Force on the treatment of central sleep apnoea in patients with chronic HF.
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Affiliation(s)
- S Correia
- Hospital Pedro Hispano, Porto, Portugal.
| | - S Sousa
- Centro Hospitalar de Setubal, Portugal
| | - M Drummond
- Centro Hospitalar Universitario do Porto, Porto, Portugal
| | - P Pinto
- Centro Hospitalar Universitario Lisboa Norte, Lisboa, Portugal
| | - R Staats
- Centro Hospitalar Universitario Lisboa Norte, Lisboa, Portugal
| | - D Brito
- Centro Hospitalar Universitario Lisboa Norte, Lisboa, Portugal
| | - N Lousada
- Centro Hospitalar Universitario Lisboa Norte, Lisboa, Portugal
| | - J S Cardoso
- Centro Hospitalar Universitário de São João, Portugal
| | - J Moita
- Centro Hospitalar e Universitario de Coimbra, Portugal
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Cebola P, Almeida AM, Campos A, Moleirinho-Alves P, Sousa S, Paço J, Caroça C, Manso C. Assessment of upper airway collapse in obstructive sleep apnea - Computed tomography versus drug induced sleep endoscopy - pilot study. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Tomé C, Oliveira-Ramos F, Campanilho-Marques R, Mourão AF, Sousa S, Martins AP, Costa Reis P, Pinheiro Torres R, Melo AT, Teixeira RL, Gonçalves M, Santos MJ, Graça L, Fonseca JE, Moura RA. POS0496 CHILDREN WITH JUVENILE IDIOPATHIC ARTHRITIS HAVE ALTERATIONS IN B AND T FOLLICULAR CELL SUBSETS IN PERIPHERAL BLOOD. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4767] [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
BackgroundJuvenile idiopathic arthritis (JIA) is the most common rheumatic disease in children1. Our group has recently demonstrated that extended oligoarticular (eoJIA) and polyarticular JIA (pJIA) mostly evolve to a rheumatoid arthritis (RA) like phenotype in adulthood2. Disturbances in B cells, T follicular helper (Tfh) and T follicular regulatory (Tfr) cell immune responses are associated with the pathogenesis of RA3,4, but their exact role in JIA development is not entirely known.ObjectivesThe main goal of this study was to characterize the frequency and phenotype of B, Tfh and Tfr cells in peripheral blood of children with eoJIA and pJIA when compared to healthy controls and children with persistent oligoarticular JIA (poJIA).MethodsBlood samples were collected from children with eoJIA (n=5), pJIA (n=11) and poJIA (n=19) treated with disease modifying anti-rheumatic drugs. A group of age-matched healthy individuals (n=8) was used as control. Peripheral blood mononuclear cells were isolated and the frequency and phenotype of B, Tfh and Tfr cells were evaluated by flow cytometry.ResultsThe frequency of B, Tfh and Tfr cells was similar between JIA patients and controls. Children with eoJIA and pJIA, but not poJIA, had higher levels of naïve B cells and lower frequencies of post-switch memory B cells and plasmablasts when compared to controls. Th17-like Tfh cells were significantly increased in all JIA patients when compared to controls. B cell phenotype was similar between JIA patients and controls, but a reduced activated phenotype of Tfh cells was observed in JIA patients in comparison to controls.ConclusionChanges in B and Tfh cell subpopulations, but not in Tfr cells, were found in peripheral blood of children with JIA when compared to controls. The increased frequencies of Th17-like Tfh cells detected in JIA when compared to controls suggests a potential role of these cells in JIA pathogenesis. A treatment effect on the activation state of B, Tfh and Tfr cells cannot be excluded.References[1]Ravelli, A. & Martini, A. Juvenile Idiopathic Arthritis. Lancet 369, 767–778 (2007).[2]Oliveira-ramos, F. et al. Juvenile idiopathic arthritis in adulthood: fulfillment of classification criteria for adult rheumatic diseases, long-term outcomes and predictors of inactive disease, functional status and damage. 1–10 (2016)[3]Moura, R. A., Graca, L. & Fonseca, J. E. To B or not to B the conductor of rheumatoid arthritis orchestra. Clin. Rev. Allergy Immunol. 43, 281–291 (2012).[4]Deng, J., Wei, Y., Fonseca, V. R., Graca, L. & Yu, D. T follicular helper cells and T follicular regulatory cells in rheumatic diseases. Nat. Rev. Rheumatol. 15, 475–490 (2019).AcknowledgementsC. Tomé was supported by a fellowship from Fundação para a Ciência e a Tecnologia (FCT) (PD/BD/135520/2018), Portugal. This work was supported by a grant from Sociedade Portuguesa de Reumatologia.Disclosure of InterestsNone declared.
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Cipriano É, Lopes P, Sousa S, Afonso M, Bartosch C, Abreu M. 810P Hormonal receptors in uterine leiomyosarcomas: How far is a primary tumor from multiple metastases? Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1252] [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: 11/29/2022] Open
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Carvalho M, Leal F, Mota S, Aguiar A, Sousa S, Nunes J, Calhaz-Jorge C. The effect of denudation and injection timing in the reproductive outcomes of ICSI cycles: new insights into the risk of in vitro oocyte ageing. Hum Reprod 2021; 35:2226-2236. [PMID: 32951048 DOI: 10.1093/humrep/deaa211] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 07/23/2020] [Indexed: 12/30/2022] Open
Abstract
STUDY QUESTION Does the time elapsed between oocyte pick-up (OPU) and denudation or injection affect the probability of achieving a live birth (LB) in ICSI cycles? SUMMARY ANSWER Prolonged oocyte culture before denudation (>4 h) was associated with an increase in clinical pregnancy (CP), LB and cumulative LB (CLB) rates when compared with earlier denudation timings. WHAT IS KNOWN ALREADY Oocyte maturation is a complex and dynamic process involving structural and biochemical modifications in the cell necessary to support fertilization and early embryo development. While meiotic competence is easily identifiable by the presence of an extruded first polar body, cytoplasmic maturation cannot be assessed microscopically. Culturing oocytes with their surrounding cumulus cells (CCs) prior to ICSI can enhance the completion of in vitro cytoplasmic maturation; conversely, prolonged culture may induce cell degeneration. The optimal culture intervals prior to oocyte denudation and/or injection have not yet been established and may prove relevant for the improvement of ICSI reproductive outcomes. STUDY DESIGN, SIZE, DURATION This is a single-centre retrospective cohort analysis of 1378 ICSI cycles performed between January 2005 and October 2018. Data were categorized according to: (i) the time interval between OPU and denudation (<3 h, 3-4 h and ≥4 h), (ii) the time interval between denudation and ICSI (<1.5 h, 1.5-2 h, ≥2 h) and (iii) the time interval between OPU and ICSI (<5 h, 5-6 h and ≥6 h). The effect of these timings on fertilization, CP, LB and CLB rates were compared. The culture intervals between different procedures were dependent exclusively on laboratory workload. PARTICIPANTS/MATERIALS, SETTING, METHODS ICSI cycles performed in women younger than 40 years old using autologous gametes with at least one metaphase II injected oocyte were included. The effect of oocyte culture duration prior to denudation and injection of the oocytes was compared using multivariable regression accounting for potential confounding variables. MAIN RESULTS AND THE ROLE OF CHANCE Fertilization and oocyte damage rate after ICSI was found to be independent of the time interval to denudation (<3 h, 3-4 h and ≥4 h) and/or injection (<5 h, 5-6 h and ≥6 h). Extending oocyte culture before denudation significantly improved CP (29.5%, 42.7% and 50.6%, respectively), LB (25.1%, 34.4% and 40.7%, respectively) and CLB rates (26.0%, 36.1% and 42.2%, respectively), particularly if the time interval was at least 4 h. Additionally, LB (31.7%, 35.8% and 27.4%, respectively) and CLB rates (34.2%, 36.6% and 27.7%, respectively) were also dependent on the time from OPU to injection. LIMITATIONS, REASONS FOR CAUTION This study is limited by its retrospective nature and potential unmeasured confounding cannot be excluded. Furthermore, the effect of even shorter or longer periods of culture before denudation and/or injection were not evaluated and should not be extrapolated from these results. WIDER IMPLICATIONS OF THE FINDINGS Our findings propose new evidence of a previously unrecognized protective effect of the CCs-oocyte interactions in human ART, raising the question of a possible downstream effect in embryogenesis which significantly affects LB rates. Additionally, this is the first study to suggest a negative effect of further extending culture before ICSI on LB and CLB rates, thus potentially allowing for the narrowing of an optimal ICSI time interval. Simple strategies such as the establishment of more effective time frames to perform these procedures and adjusting laboratory practice may prove beneficial, ultimately improving ICSI reproductive outcomes. STUDY FUNDING/COMPETING INTEREST(S) None. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- M Carvalho
- Reproductive Medicine Unit, Department of Obstetrics, Gynaecology and Reproductive Medicine, Santa Maria University Hospital, Lisbon, Portugal
| | - F Leal
- Reproductive Medicine Unit, Department of Obstetrics, Gynaecology and Reproductive Medicine, Santa Maria University Hospital, Lisbon, Portugal
| | - S Mota
- Reproductive Medicine Unit, Department of Obstetrics, Gynaecology and Reproductive Medicine, Santa Maria University Hospital, Lisbon, Portugal
| | - A Aguiar
- Reproductive Medicine Unit, Department of Obstetrics, Gynaecology and Reproductive Medicine, Santa Maria University Hospital, Lisbon, Portugal
| | - S Sousa
- Reproductive Medicine Unit, Department of Obstetrics, Gynaecology and Reproductive Medicine, Santa Maria University Hospital, Lisbon, Portugal
| | - J Nunes
- Reproductive Medicine Unit, Department of Obstetrics, Gynaecology and Reproductive Medicine, Santa Maria University Hospital, Lisbon, Portugal
| | - C Calhaz-Jorge
- Reproductive Medicine Unit, Department of Obstetrics, Gynaecology and Reproductive Medicine, Santa Maria University Hospital, Lisbon, Portugal.,Faculdade de Medicina da Universidade de Lisboa,, Lisbon, Portugal
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Sousa S, Duarte E, Mesquita M, Saraiva S. Energetic Valorization of Cereal and Exhausted Coffee Wastes Through Anaerobic Co-digestion With Pig Slurry. Front Sustain Food Syst 2021. [DOI: 10.3389/fsufs.2021.642244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
In the past years, there has been steady growth in work relating to improve resource efficiency through waste minimization and bioenergy recovery to mitigate climate change. Agro-food industries produce large amounts of bio-waste, challenging innovative energetic valorization strategies in the framework of circular economy principles. Anaerobic digestion (AD) technology is an interesting route to stabilize organic matter and produce biogas as a renewable energy source. This study involves continuous co-digestion of pig slurry (PS), cereal and exhausted coffee wastes (CECW) performed in a continuously stirred tank reactor, with a hydraulic retention time (HRT) of 16 days under at mesophilic conditions (36.9 ± 0.3°C). The experimental trials, were designed to include different cereal and exhausted coffee liquor (CECL) shares in the feeding mixture, corresponding to different PS to CECL ratios (PS:CECL), respectively: 100:0 (T0), 90:10 (T1), 80:20 (T2), and 70:30 (T3), in terms of percentage of inlet feeding rate (v:v). The results obtained for the feeding rate (70:30) yield to the highest specific methane production (SMP = 341 ml.gVS−1) led to a 3.5-fold improvement in comparison with the reference scenario. The synergetic effect between the microbial consortia of PS and the high carbon to nitrogen ratio (C/N) of CECL explain the improvements achieved. The maximum soluble chemical oxygen demand (SCOD) reduction (84.0%) due to the high content and soluble chemical oxygen demand to total chemical oxygen demand ratio (SCOD/TCOD) corroborate the results achieved. The digester stability, evaluated by specific energetic loading rate, was below the limit (0.4 d−1). Results from ANOVA showed a significant effect of CECL on the resulting GPR and SMP values. Additionally, Tukey's “Honest Significant Difference” method, confirmed statistically significant differences between the trials T3-T0, T3-T1, T3-T2, and T2-T0. Thus, co-digestion of PS and of CECL seems to be a promising approach for bioenergy recovery and promoting biowastes circularity.
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Levitt EE, Syan SK, Sousa S, Costello MJ, Rush B, Samokhvalov AV, McCabe RE, Kelly J, MacKillop J. Optimizing screening for depression, anxiety disorders, and post-traumatic stress disorder in inpatient addiction treatment: A preliminary investigation. Addict Behav 2021; 112:106649. [PMID: 32979691 DOI: 10.1016/j.addbeh.2020.106649] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 08/31/2020] [Accepted: 09/05/2020] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Substance use disorders (SUD) are frequently comorbid with other psychiatric conditions, but a comprehensive diagnostic assessment is often not feasible clinically. Efficient psychometrically-validated screening tools exist for commonly comorbid conditions, but cutoff accuracies have typically not been evaluated in addiction treatment settings. This study examined the performance of several widely-used screening measures in relation to diagnostic status from a clinical interview to identify and validate cutoff scores in an inpatient SUD treatment setting. METHOD Participants were 99 patients in a large residential SUD treatment program in Ontario, Canada. Participants completed a screening battery, including the Patient Health Questionnaire - 9 (PHQ-9), Generalized Anxiety Disorder - 7 (GAD-7), and Post-Traumatic Stress Disorder Checklist-5 (PCL-5), and underwent a semi-structured diagnostic clinical interview. Receiver operating characteristic curves were used to determine optimal cutoff scores on the screening tool against the interview-based diagnosis. RESULTS Area under the curve (AUC) was statistically significant for all screens and were as follows: PHQ-9 = 0.70 (95% CI = 0.59-0.80), GAD-7 = 0.74 (95% CI = 0.63-0.84), and PCL-5 = 0.79 (95% CI = 0.66-0.91). The optimal accuracy cutoff scores based on sensitivity and specificity were: PHQ-9 ≥ 16, GAD-7 ≥ 9, the PCL-5 ≥ 42. CONCLUSIONS In general, the candidate screeners performed acceptably in this population. However, the optimal cutoff scores were notably higher than existing guidelines for depression and PTSD, potentially due to the general elevations in negative affectivity among individuals initiating SUD treatment. Further validation of these cutoff values is warranted. PUBLIC HEALTH SIGNIFICANCE This study provides modified screening cutoff scores for major depression, anxiety disorders, and post-traumatic stress disorder in addiction treatment settings.
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Affiliation(s)
- E E Levitt
- Peter Boris Centre for Addiction Research, McMaster University & St. Joseph's Health Care, Hamilton, Canada; Homewood Research Institute, Guelph, Canada
| | - S K Syan
- Peter Boris Centre for Addiction Research, McMaster University & St. Joseph's Health Care, Hamilton, Canada; Homewood Research Institute, Guelph, Canada
| | - S Sousa
- Homewood Research Institute, Guelph, Canada
| | | | - B Rush
- Homewood Research Institute, Guelph, Canada; Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - A V Samokhvalov
- Homewood Research Institute, Guelph, Canada; Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - R E McCabe
- Peter Boris Centre for Addiction Research, McMaster University & St. Joseph's Health Care, Hamilton, Canada
| | - J Kelly
- Recovery Research Institute, Massachusetts General Hospital, Boston, MA, USA
| | - J MacKillop
- Peter Boris Centre for Addiction Research, McMaster University & St. Joseph's Health Care, Hamilton, Canada; Homewood Research Institute, Guelph, Canada.
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Gonzalez-Bermejo J, Hajage D, Durand-Zaleski I, Arnal JM, Cuvelier A, Grassion L, Jaffre S, Lamia B, Pontier S, Prigent A, Rabec C, Raherison-Semjen C, Saint Raymond C, Soler J, Trzepizur W, Winck JC, Aguiar M, Chaves H, Conde B, Guimarães MJ, Lopes P, Mineiro A, Moreira S, Pamplona P, Rodrigues CM, Sousa S, Antón A, Córdoba-Izquierdo A, Embid C, Esteban González C, Ezzine F, Garcia P, González M, Guerassimova I, López D, Lujan M, Martí Beltran S, Martinez JM, Masa F, Pascual N, Peñacoba N, Resano P, Rey L, Rodríguez Jerez F, Roncero A, Sancho Chinesta J, Sayas Catalán J. Respiratory support in COPD patients after acute exacerbation with monitoring the quality of support (Rescue2-monitor): an open-label, prospective randomized, controlled, superiority clinical trial comparing hospital- versus home-based acute non-invasive ventilation for patients with hypercapnic chronic obstructive pulmonary disease. Trials 2020; 21:877. [PMID: 33092618 PMCID: PMC7578582 DOI: 10.1186/s13063-020-04672-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 08/12/2020] [Indexed: 12/03/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is expected to be the 3rd leading cause of death worldwide by 2020. Despite improvements in survival by using acute non-invasive ventilation (NIV) to treat patients with exacerbations of COPD complicated by acute hypercapnic respiratory failure (AHRF), these patients are at high risk of readmission and further life-threatening events, including death. Recent studies suggested that NIV at home can reduce readmissions, but in a small proportion of patients, and with a high level of expertise. Other studies, however, do not show any benefit of home NIV. This could be related to the fact that respiratory failure in patients with stable COPD and their response to mechanical ventilation are influenced by several pathophysiological factors which frequently coexist in the same patient to varying degrees. These pathophysiological factors might influence the success of home NIV in stable COPD, thus long-term NIV specifically adapted to a patient's "phenotype" is likely to improve prognosis, reduce readmission to hospital, and prevent death. In view of this conundrum, Rescue2-monitor (R2M), an open-label, prospective randomized, controlled study performed in patients with hypercapnic COPD post-AHRF, will investigate the impact of the quality of nocturnal NIV on the readmission-free survival. The primary objective is to show that any of 3 home NIV strategies ("rescue," "non-targeted," and "targeted") will improve readmission-free survival in comparison to no-home NIV. The "targeted" group of patients will receive a treatment with personalized (targeted) ventilation settings and extensive monitoring. Furthermore, the influence of comorbidities typical for COPD patients, such as cardiac insufficiency, OSA, or associated asthma, on ventilation outcomes will be taken into consideration and reasons for non-inclusion of patients will be recorded in order to evaluate the percentage of ventilated COPD patients that are screening failures. ClinicalTrials.gov NCT03890224 . Registered on March 26, 2019.
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O'Shaughnessy J, Sousa S, Cruz J, Fallowfield L, Auvinen P, Pulido C, Cvetanovic A, Wilks S, Ribeiro L, Burotto M, Klingbiel D, Messeri D, Alexandrou A, Trask P, Fredriksson J, Machackova Z, Stamatovic L. 165MO Patient (pt) preference for the pertuzumab-trastuzumab fixed-dose combination for subcutaneous use (PH FDC SC) in HER2-positive early breast cancer (EBC): Primary analysis of the open-label, randomised crossover PHranceSCa study. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.287] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Abstract
IntroductionPsychosocial Education is defined as give to the patient structured, systematic and didactic information about mental illness and his treatment. Actually is one the most frequent rehabilitation approaches, being used in several mental health departments. The good results obtained by this approach are congruent with the principles and guidelines defined for best practices in rehabilitation process (Rummel-Kluge et al, 2006).AimsDescribe a psycho educative b-learning program develop to reduce self-stigma in schizophrenic individuals.MethodsA psycho educative B-Learning program was developed using the results of other studies. This program was after applied during 4 months with 21 schizophrenic individuals followed in a psychiatric department, evaluated in a pre and pos-test model.ResultsThe program includes 10 sessions intentionally prepared for those individuals, given information to reduced self-stigma using topics such us myths, stereotypes, self-esteem, self-confidence, relapse prevention, social interaction, feel include in the community, being able to ask for help and to recover. All those topics where discuss using Moodle platform from Porto University within a group in the presence of the therapist and individually at home. A sociodrama group was also developed.ConclusionsThis approach seems to empower the individuals, allowing them to achieve the program by their own rhythm and to participate within a group but also to be in contact using the Moodle platform, decreasing feeling of loneliness. Primary results seem to be good, with low relapse, low absenteeism in class and some success in finding a job.
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Briosa A, Almeida AR, Gomes AC, Pereira AR, Marques A, Alegria S, Sebaiti D, Santos J, Carrington M, Miranda R, Joao I, Sousa S, Pereira H. 475 A rare cause of right ventricular mass. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Intracardiac masses are always a challenging diagnosis, especially when it involves the right side of the heart. There are multiples etiologies that can be responsible for these masses, namely thrombosis, neoplasm or vegetations. Occasionally, these may be related to an autoimmune process not yet discovered.
Case Report
17-year-old male, with a previous history of genital ulcers, medicated with penicillin with complete resolution of symptoms.
In January 2019, he started an history of recurrent fever, associated with right anterior thoracalgia, weight loss and oral afthosis. He went to the emergency department several times, where he was medicated with antibiotic, with partial symptom relief.
Three months later, he returned to medical attention due to an episode of abundant hemoptysis, followed by hematemesis and cough. At hospital admission, he was hemodynamically stable, tachycardic (100/min) and with occasional episodes of cough. Cardiac and pulmonary auscultation were unremarkable. Thoracic CT revealed the presence of pulmonary thromboembolism (PTE) and a large mass in the right ventricle (RV). It was performed an echocardiogram (echo) that confirmed the presence of a large mass in the RV (50x53mm) from which a projecting hypermobile mass appeared to prolapse into the right atrium.
Taking into account the diagnosis of PTE and the presence of a right ventricular mass, the patient was hospitalized and started anticoagulation. The case was immediately discussed with cardiac surgery, that confirmed that there was no surgical indication. During hospitalization, there were no more episodes of hemoptysis or hematemesis.Consecutive echos were performed, that did not reveal a significant decrease in mass dimensions despite anticoagulation. Viral serologies and autoimmunity panel were all negative. Cardiac RMI was performed raising the suspicion of a possible mass covered with thrombus.
After discussion with rheumatology, and according to clinical signs, the hypothesis of vasculitis was placed, and the patient started treatment with steroids. This treatment had to be suspended after a few days due to an infectious intercurrence. After a course of antibiotic therapy, the patient started therapy with cyclophosphamide with good clinical and echocardiographic response (reduced mass dimensions).
It was admitted Behçet’s disease with cardiac complications, and the patient was referred to the rheumatology consultation.
Conclusion
Behçet’s disease is a multi-system, chronic disorder that behaves like vasculitis.There are some typical clinical manifestations associated with this disease, such as oral and genital afthosis, uveitis, arthritis, skin lesions and nervous system involvement.Presentations with cardiac symptoms are one of the extremely rare manifestations of this disease, posing a challenge for the treating physician.
Abstract 475 Figure. Right ventricular mass
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Affiliation(s)
- A Briosa
- Hospital Garcia de Orta, Lisbon, Portugal
| | | | - A C Gomes
- Hospital Garcia de Orta, Lisbon, Portugal
| | | | - A Marques
- Hospital Garcia de Orta, Lisbon, Portugal
| | - S Alegria
- Hospital Garcia de Orta, Lisbon, Portugal
| | - D Sebaiti
- Hospital Garcia de Orta, Lisbon, Portugal
| | - J Santos
- Hospital Garcia de Orta, Lisbon, Portugal
| | - M Carrington
- Hospital Espirito Santo de Evora, Evora, Portugal
| | - R Miranda
- Hospital Garcia de Orta, Lisbon, Portugal
| | - I Joao
- Hospital Garcia de Orta, Lisbon, Portugal
| | - S Sousa
- Hospital Garcia de Orta, Lisbon, Portugal
| | - H Pereira
- Hospital Garcia de Orta, Lisbon, Portugal
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Giatti S, Batista dos Santos R, Aielo AN, Alves da Silva W, Parise B, Pio-Abreu A, Sousa S, Bortolotto L, Lotufo P, Bensenor I, Drager LF. Association Of salt intake with obstructive sleep apnea: data from the ElSA-Brasil Cohort. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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18
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Sousa S, Lunet N, Gelormini M, Jewell J, Morais I, Albuquerque G, Casal S, Pinho O, Breda J, Padrão P. A multicentre study of street foods purchased in urban areas of Central Asia: the FEEDCities Project. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz185.311] [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
Street food (SF) is a strong tradition in Central Asia, where urbanization and westernization of food habits is occurring. Research on SF consumption is scarce, and crucial to understand its implications for public health. This study aims to describe the SF purchases in urban areas of Tajikistan, Kyrgyzstan, Turkmenistan and Kazakhstan.
Methods
A cross-sectional study was conducted in Dushanbe, Bishkek, Ashgabat and Almaty in 2016/2017. SF markets (n = 34) and vending sites (n = 270) were selected by random and systematic sampling. Data on customers’ characteristics and food items purchased was collected by direct observation. Nutritional composition of the food items (n = 852) was obtained by laboratorial analysis (n = 582) or food composition tables and labels (n = 270).
Results
A total of 714 customers were identified. The most commonly purchased foods and beverages were savoury pastries/snacks (23.2%), main dishes (19.0%), sweet pastries/confectionery (17.9%), tea/coffee (11.3%) and soft drinks/juices (9.8%). Fruit was the least frequently purchased food (1.1%). Nearly one-third of customers purchased industrial food items; this proportion was significantly higher in Kazakhstan (43.2%) and Turkmenistan (32.3%). The median energy content of a SF purchase ranged between 352kcal (Tajikistan) and 568kcal (Turkmenistan). The median saturated (SFA) and trans fat contents were 4.74g and 0.36g, respectively; the highest values were 9.01g for SFA (Turkmenistan) and 0.60g for trans fat (Kazakhstan), accounting for 40.6% and 27.3% of the maximum daily recommendations, respectively. Sodium-potassium ratio was far above recommended, reaching the highest values of 6.57 and 5.17 in Tajikistan and Kyrgyzstan.
Conclusions
Frequent purchase of industrial food reflects a shift to a westernized dietary pattern. Public health policies in these settings should aim to increase fruit availability and to improve SF nutritional composition, namely its lipid profile and sodium content.
Key messages
A relevant proportion of customers bought industrial foods, while fruit was rarely purchased, reflecting the nutrition transition process that is occurring in developing countries. Street food meals showed concerning levels of saturated fat, trans-fat and sodium, which must be considered when designing strategies targeted to improve the urban food environment in these settings.
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Affiliation(s)
- S Sousa
- EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
| | - N Lunet
- EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | | | | | | | - G Albuquerque
- EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - S Casal
- EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- REQUIMTE, Faculdade de Farmácia, Universidade do Porto, Porto, Portugal
| | - O Pinho
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
- REQUIMTE, Faculdade de Farmácia, Universidade do Porto, Porto, Portugal
| | - J Breda
- WHO EURO, Copenhagen, Denmark
| | - P Padrão
- EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
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Abstract
Twin-to-twin transfusion syndrome (TTTS) is a serious complication typical of monochorionic pregnancies. Cases in dichorionic pregnancies have been described. The authors present a case report of a presumed TTTS in a dichorionic pregnancy followed at our institution in which the patient presented to the emergency department at 31 4/7 weeks' gestation complaining of lack of fetal movements. Both fetuses did not show any cardiac activity. On the first twin, an oligohydramnios was present and his bladder was not visualised and, on the second twin, a polyhydramnios and an augmented bladder were visualised. Pathological findings of the fetuses were compatible with a diagnosis of TTTS and placental study confirmed the presence of a dichorionic/diamniotic placenta, with superficial vessels crossing the dividing membrane.
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Affiliation(s)
| | - Ana Catarina Lai
- Pathology, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal
| | - Sílvia Sousa
- Obstetrics and Gynecology, Centro Hospitalar de Leiria, Leiria, Portugal
| | - Raquel Pina
- Pathology, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal
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Marinheiro R, Parreira L, Amador P, Mesquita D, Farinha J, Fonseca M, Esteves A, Pinheiro A, Sousa S, Silva M, Lopes C, Fernandes A, Guerreiro A, Chambel D, Caria R. P3563The influence of circadian patterand obstructive sleep apnean of blood pressure in nocturnal arrhythmias in hypertensive patients. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0426] [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
There is growing evidence suggesting hypertension is related to the occurrence of arrhythmias. When occurring predominantly during the night, two potential entities commonly present in hypertensive patients could be related with increased arrhythmogenesis: (1) the lack of normal nocturnal dipping of blood pressure (BP) (non-dipping pattern of hypertension) or (2) obstructive sleep apnea (OSA). Thus, nocturnal arrhythmias (NAs) can identify hypertensive patients with OSA and/or non-dipping pattern, both related with adverse outcomes.
Aims
To determine if NAs are related with non-dipping hypertension, OSA or both.
Methods
We studied hypertensive patients who performed ambulatory blood pressure monitoring (ABPM) and also polysomnography and 24-hour Holter monitoring. Non-dipping pattern was considered when nocturnal BP reduction was inferior to 10%. Based on Holter monitoring, NAs were present when atrial fibrillation, frequent premature atrial contractions (PACs) (>30 PACs/hour), runs of >4 consecutive PACs, frequent premature ventricular contractions (PVCs) (>30PVCs/hour) or runs of >4 consecutive PVCs were present predominantly during sleeping hours. During polyssonography, apnoea/hypopnoea index (AHI) and oxygen saturation (SaO2) were analysed. Moderate to severe OSA was considered when AHI >15.
Results
We studied 104 patients [median age 62 (54–70) years, 65% male): 42 (40%) had moderate to severe OSA (median AHI=11 (6–26), mean SaO2=94% (92–95)] and 64 (61%) were non-dippers. NAs occurred in 18 patients (17%) and they were independently associated with AHI (Odds Ratio (OR) for a one unit increase 1.04, 95% confidence interval (CI) 1.01–1.07, p=0.03) but not with SaO2 (OR 0.96, CI 0.78–1.19, p=0.73) nor non-dipping pattern (OR 1.23, CI 0.38–3.98, p=0.72). No interaction was found between OSA and non-dipping hypertension (p=0.35). In patients with dipping pattern (n=40), AHI was higher in NAs patients comparing with no NAs patients (median AHI 29 versus 10, p=0.04), while in those with non-dipping pattern (n=64), AHI was not statistically different between patients with and without NAs (21 versus 11, p=0.12) (figure).
Figure 1
Conclusion
In this population of hypertensive patients, the presence of NAs was associated with OSA severity (i.e AHI), but not with the non-dipping pattern of hypertension. The importance of obstructive events in arrhythmogenesis seemed to be more pronounced in dipping patients, suggesting the abnormal high blood pressure during the night may also have some impact on NAs in non-dipping patients. Overall, our results suggest that OSA screening should be considered when nocturnal arrhythmias are detected in hypertensive patients, but ABPM should not be forgotten since multiple mechanisms can be involved in nocturnal arrhythmogenesis.
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Affiliation(s)
| | - L Parreira
- Hospital Center of Setubal, Setubal, Portugal
| | - P Amador
- Hospital Center of Setubal, Setubal, Portugal
| | - D Mesquita
- Hospital Center of Setubal, Setubal, Portugal
| | - J Farinha
- Hospital Center of Setubal, Setubal, Portugal
| | - M Fonseca
- Hospital Center of Setubal, Setubal, Portugal
| | - A Esteves
- Hospital Center of Setubal, Setubal, Portugal
| | - A Pinheiro
- Hospital Center of Setubal, Setubal, Portugal
| | - S Sousa
- Hospital Center of Setubal, Setubal, Portugal
| | - M Silva
- Hospital Center of Setubal, Setubal, Portugal
| | - C Lopes
- Hospital Center of Setubal, Setubal, Portugal
| | - A Fernandes
- Hospital Center of Setubal, Setubal, Portugal
| | - A Guerreiro
- Hospital Center of Setubal, Setubal, Portugal
| | - D Chambel
- Hospital Center of Setubal, Setubal, Portugal
| | - R Caria
- Hospital Center of Setubal, Setubal, Portugal
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Marinheiro R, Parreira L, Amador P, Mesquita D, Farinha J, Fonseca M, Esteves A, Pinheiro A, Sousa S, Silva M, Lopes C, Chambel D, Santos B, Carradas C, Caria R. P3795Should we also screen for obstructive sleep apnea in patients presenting with excessive supraventricular ectopic activity? Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0640] [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
It is recommended to consider obstructive sleep apnoea (OSA) screening in atrial fibrillation (AF) patients with risk factors, due to the strong evidence of an association between these two entities. Excessive supraventricular ectopic activity (ESVEA) has been proposed to be a risk factor for AF. However, strong evidence between ESVEA and OSA has not been established.
Objective
We aimed to determine if ESVEA is associated with moderate to severe OSA since its treatment may prevent AF.
Methods
We studied patients who performed polysomnography and 24-hour Holter monitoring. Patients with atrial fibrillation were excluded. ESVEA was defined as more than 30 PACs per hour (frequent PACs) or runs of >4 consecutive PACs. The circadian pattern of PACs was also evaluated. Sleeping hours were used to define “nocturnal”. Moderate to severe OSA was defined when polyssonography demonstrated a apnoea/hypopnoea index (AHI) >15. We examined the association between ESVEA and moderate to severe OSA during wakefulness and sleep.
Results
We studied 290 patients [median age 65 (55–72) years, 62% males, body mass index (BMI) 30 (27–34)]. 112 (38%) had moderate to severe OSA. Median AHI was 11 (5–24) and mean oxygen saturation was 94% (92–95). Median PACs was 35 (9–117) and 29 patients (10%) had frequent PACs. Runs of >4PACs occurred in 114 patients (39%). Forty-three patients (15%) had predominant nocturnal PACs and 42 (14%) had nocturnal runs of PACs. Multivariate logistic regression analysis demonstrated only nocturnal PACs were associated with moderate to severe OSA (p=0.027) (table 1).
Multivariate logistic regression Odds Ratio 95% Confidence Interval p-value Male gender 4.49 2.48–8.17 <0.001 Body mass index (kg/m2) 1.09 1.03–1.15 0.002 Nocturnal PACs 4.12 1.17–14.46 0.027 Variables not included in the model: age, number of PACs/h, frequent PACs (>30 PAcs/hour), runs of PACs (>4 consecutive PACs), nocturnal frequent PACs and nocturnal runs of PACs.
Conclusion
OSA screening in patients presenting with nocturnal PACs should be routinely considered, especially in male and obese. Treating moderate to severe OSA patients with CPAP has a potential benefit in preventing ESVEA and consequently AF.
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Affiliation(s)
| | - L Parreira
- Hospital Center of Setubal, Setubal, Portugal
| | - P Amador
- Hospital Center of Setubal, Setubal, Portugal
| | - D Mesquita
- Hospital Center of Setubal, Setubal, Portugal
| | - J Farinha
- Hospital Center of Setubal, Setubal, Portugal
| | - M Fonseca
- Hospital Center of Setubal, Setubal, Portugal
| | - A Esteves
- Hospital Center of Setubal, Setubal, Portugal
| | - A Pinheiro
- Hospital Center of Setubal, Setubal, Portugal
| | - S Sousa
- Hospital Center of Setubal, Setubal, Portugal
| | - M Silva
- Hospital Center of Setubal, Setubal, Portugal
| | - C Lopes
- Hospital Center of Setubal, Setubal, Portugal
| | - D Chambel
- Hospital Center of Setubal, Setubal, Portugal
| | - B Santos
- Hospital Center of Setubal, Setubal, Portugal
| | - C Carradas
- Hospital Center of Setubal, Setubal, Portugal
| | - R Caria
- Hospital Center of Setubal, Setubal, Portugal
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Matos I, Sousa S, Coelho P. An unusual tongue base cyst: a case-report. Int J Oral Maxillofac Surg 2019. [DOI: 10.1016/j.ijom.2019.03.727] [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: 11/24/2022]
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Matos I, Machado M, Nogueira R, Rosa J, Grangeia D, Messias H, Santos J, Sousa S. Oral mucosal melanoma - a retrospective study in a portuguese population. Int J Oral Maxillofac Surg 2019. [DOI: 10.1016/j.ijom.2019.03.246] [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: 11/15/2022]
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Matos I, Machado M, Semedo C, Santos J, Sousa S. Parotid malignant melanoma - a case-report of a primary or metastatic tumor? Int J Oral Maxillofac Surg 2019. [DOI: 10.1016/j.ijom.2019.03.677] [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: 10/26/2022]
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Matos I, Machado M, Semedo C, Bitoque S, Santos J, Sousa S. Oral mucosal melanoma in situ: a case-report. Int J Oral Maxillofac Surg 2019. [DOI: 10.1016/j.ijom.2019.03.675] [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: 11/29/2022]
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Monteiro A, Silva J, Sousa S, Gonçalves D, Azevedo N, Rodrigues L, Pacheco G. Height and Postural Deviations of the Spine in School-Age Children: Evaluation with Idiag® Spinal Mouse®. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz034.082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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)
- A Monteiro
- CICS - Centro Interdisciplinar em Ciências da Saúde, ISAVE - Instituto Superior de Saúde
| | - J Silva
- CICS - Centro Interdisciplinar em Ciências da Saúde, ISAVE - Instituto Superior de Saúde
| | - S Sousa
- CICS - Centro Interdisciplinar em Ciências da Saúde, ISAVE - Instituto Superior de Saúde
| | - D Gonçalves
- CICS - Centro Interdisciplinar em Ciências da Saúde, ISAVE - Instituto Superior de Saúde
| | - N Azevedo
- CICS - Centro Interdisciplinar em Ciências da Saúde, ISAVE - Instituto Superior de Saúde
| | - L Rodrigues
- CICS - Centro Interdisciplinar em Ciências da Saúde, ISAVE - Instituto Superior de Saúde
| | - G Pacheco
- CICS - Centro Interdisciplinar em Ciências da Saúde, ISAVE - Instituto Superior de Saúde
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Francisco C, Silva J, Sousa S, Gonçalves D, Azevedo N, Rodrigues L, Pacheco G. Association between School Backpack Weight and the Appearance of Postural Changes in School-Age Children. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz034.068] [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)
- C Francisco
- CICS - Centro Interdisciplinar em Ciências da Saúde, ISAVE - Instituto Superior de Saúde, Portugal
| | - J Silva
- CICS - Centro Interdisciplinar em Ciências da Saúde, ISAVE - Instituto Superior de Saúde, Portugal
| | - S Sousa
- CICS - Centro Interdisciplinar em Ciências da Saúde, ISAVE - Instituto Superior de Saúde, Portugal
| | - D Gonçalves
- CICS - Centro Interdisciplinar em Ciências da Saúde, ISAVE - Instituto Superior de Saúde, Portugal
| | - N Azevedo
- CICS - Centro Interdisciplinar em Ciências da Saúde, ISAVE - Instituto Superior de Saúde, Portugal
| | - L Rodrigues
- CICS - Centro Interdisciplinar em Ciências da Saúde, ISAVE - Instituto Superior de Saúde, Portugal
| | - G Pacheco
- CICS - Centro Interdisciplinar em Ciências da Saúde, ISAVE - Instituto Superior de Saúde, Portugal
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Coelho S, Abreu MH, Sales C, Lopes AR, Sousa MF, Couto R, Pousa I, Ferreira A, Ferreira M, Vieira C, Leal C, Castro F, Sousa S, Pereira D. Abstract P1-15-19: Carboplatin-addition in neoadjuvant treatment of women with triple negative breast cancer (TNBC): Prognostic value in real-world patients. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p1-15-19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
The addition of carboplatin to an anthracycline/taxane-based chemotherapy(CT) in neoadjuvant setting has been suggested to improve pathological complete response(pCR) in TNBC. However, the impact of pCR in prognosis is unknown. We aim to study the value and feasibility of the addition of carboplatin in neoadjuvant setting.
Methods
Demographic and clinical data of TNBC patients treated with neoadjuvant CT in a comprehensive cancer center between 2010-2018 were retrospectively collected. Two cohorts were defined: one treated with Carboplatin/Paclitaxel followed by dose-dense Doxorrubicin/Cyclophosphamide(CP-AC) and other with AC followed by Docetaxel(AC-D). Median follow-up time was 3.1 and 6.9 years, respectively. pCR was defined as absence of residual invasive tumor in breast/axilla. Survival analysis using Kaplan-Meier method and Cox proportional-hazards model were applied. Statistical significance was set at p<0.05.
Results
One-hundred and sixty patients were enrolled: 78 CP-AC and 38 AC-D. Groups were balanced regarding patients and tumor characteristics with exception of pre-menopausal status, more frequent in CP-AC(68% vs 47%;p=.04). Age at diagnosis was 47(28-76)years, the majority had ECOG 0(92%) ductal carcinomas(82%), clinicalT2/3 stages(76%), grade 3(81%) with lymph node involvement(N+)(57%). 14% had Inflammatory breast cancer(IBC)(CP-AC 14%;AC-D 13%; p=.9).
Neutropenia was the most prevalent adverse event(G3/4: CP-AC 61%;AC-D 16%;p=.02), 12% and 16% of febrile neutropenia(p=.8). G3/4 thrombocytopenia occurred only in CP-AC(6%). Hypersensitivity reactions were more prevalent in CP-AC(19% vs 2.7%;p=.02), majority to paclitaxel, all G1/2. Hospital admission occurred in 12%(CP-AC 13%;AC-D 9%; p=.8). There were no treatment-related deaths. Treatment schedule was complete in 89%(CP-AC 87%;AC-D 92%;p=.5), with 20% dose reductions(CP-AC 25%;AC-D 11%;p=0.9).
pCR was achieved in 42%(CP-AC 50%;AC-D 28%;p=.03). 1- and 3-year disease-free survival(DFS) was 94%/85% for CP-AC and 72%/58% for AC-D(p=.3). Risk of recurrence was higher in IBC(HR 25.1;CI95% 7.7-81.3;p<.0001), N+ disease(HR 3.6;CI95% 1.2-10.5;p=.02) and non-pCR(HR 10.9;CI95% 2.3-52.3,p=.003). N+ disease was associated with higher recurrence only in AC-D(HR 11.7;CI95% 1.3-104;p=.03).
Cancer-related deaths were 20%(CP-AC 10%;AC-D 40%;p=.001). 1- and 2-year overall survival (OS) was 99%/95% for CP-AC and 70%/61% for AC-D(p=.06). N+ disease was associated with higher risk of death in AC-D(HR 6.3;CI95% 1.1-24.6;p=.04). Risk of death was independently associated with IBC(HR 4.1;CI95% 2.1-18.7; p=.001) but not with N+ disease(HR 2.7;CI95% 0.8-9.5;p=.13) or pCR(HR 4.1;CI95% 0.9-19.7;p=.08) although pCR was statistically significant in univariate analysis (1- and 2-year OS 97% vs 92% and 94% vs 86% for pCR and non-PCR;p=.003).
Conclusions
Carboplatin addition clearly increased pCR with a trend to DFS and OS benefit. This regimen was associated with more, nevertheless manageable, adverse events with most of the patients able to tolerate and complete the full-dose regimen. Though we did not find a subgroup of patients that benefit with carboplatin regimen, we should consider avoiding AC-D at least in N+ disease.
Citation Format: Coelho S, Abreu MH, Sales C, Lopes AR, Sousa MF, Couto R, Pousa I, Ferreira A, Ferreira M, Vieira C, Leal C, Castro F, Sousa S, Pereira D. Carboplatin-addition in neoadjuvant treatment of women with triple negative breast cancer (TNBC): Prognostic value in real-world patients [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-15-19.
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Affiliation(s)
- S Coelho
- Instituto Portugues de Oncologia do Porto Francisco Gentil, EPE, Oporto, Portugal
| | - MH Abreu
- Instituto Portugues de Oncologia do Porto Francisco Gentil, EPE, Oporto, Portugal
| | - C Sales
- Instituto Portugues de Oncologia do Porto Francisco Gentil, EPE, Oporto, Portugal
| | - AR Lopes
- Instituto Portugues de Oncologia do Porto Francisco Gentil, EPE, Oporto, Portugal
| | - MF Sousa
- Instituto Portugues de Oncologia do Porto Francisco Gentil, EPE, Oporto, Portugal
| | - R Couto
- Instituto Portugues de Oncologia do Porto Francisco Gentil, EPE, Oporto, Portugal
| | - I Pousa
- Instituto Portugues de Oncologia do Porto Francisco Gentil, EPE, Oporto, Portugal
| | - A Ferreira
- Instituto Portugues de Oncologia do Porto Francisco Gentil, EPE, Oporto, Portugal
| | - M Ferreira
- Instituto Portugues de Oncologia do Porto Francisco Gentil, EPE, Oporto, Portugal
| | - C Vieira
- Instituto Portugues de Oncologia do Porto Francisco Gentil, EPE, Oporto, Portugal
| | - C Leal
- Instituto Portugues de Oncologia do Porto Francisco Gentil, EPE, Oporto, Portugal
| | - F Castro
- Instituto Portugues de Oncologia do Porto Francisco Gentil, EPE, Oporto, Portugal
| | - S Sousa
- Instituto Portugues de Oncologia do Porto Francisco Gentil, EPE, Oporto, Portugal
| | - D Pereira
- Instituto Portugues de Oncologia do Porto Francisco Gentil, EPE, Oporto, Portugal
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Martins-Branco D, Ferreira SC, Pereira I, André S, Varelas A, Leal C, Esteves S, Abreu MH, Sousa S, Moreira A, Brito M. Abstract P1-18-05: Management of bone marrow involvement in advanced breast cancer: Retrospective multicenter cohort study. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p1-18-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Optimal management of bone marrow metastasis (BMM) in advanced breast cancer (ABC) remains unknown. Associated severe cytopenias often urge treatment, but they are also a challenging factor for delivering chemotherapy (CT). Since BMM in ABC is infrequent, available data are scarce.
Aim: Clinical and prognostic characterization of ABC patients with BMM and its management; evaluation of the effectiveness of treating BMM with more myelosuppressive CT regimen (that we hypothesized that could be more active in the BMM) Vs. less myelosuppressive regimen.
Methods: Retrospective cohort study of patients with pathological confirmation of BMM (positive myelogram or osteomedullary biopsy) between Jan'2010 and Dec'2016 in the two major Portuguese cancer centers. Patients with diagnosis of a second carcinoma or active hemato-oncological condition within 5 years before BMM were excluded. We considered the more myelosuppressive regimens those with > 5% risk of febrile neutropenia according to Truong et al 2015(1). Kaplan-Meier and log-rank methodology were used to estimate survival and Cox regression to identify the covariates with independent prognostic value. Statistical level of significance was 5%.
Results: We included 74 patients: 74% with disease stage I-III at presentation, 74% ductal and 12% lobular invasive carcinomas, 58% grade 2 and 27% grade 3, 80% hormone receptor + / HER2-, 4% HER2+ and 12% triple negative (TN). Median time from ABC diagnosis to BMM was 10 months (IQR 2-36), synchronous in 34%. At diagnosis of BMM, median age was 57 years-old (IQR 47-65), 57% were post-menopausal, 97% had bone metastasis, 50% had visceral metastasis, 53% performed ≥ 2 previous palliative systemic treatments and 53% were exposed to bisphosphonates. The most frequent immunohistochemistry change in BMM biopsy was the loss of progesterone receptor expression (37%). Bicytopenia (anemia/thrombocytopenia) was the trigger for BMM investigation in 69% of cases, with grade 3-4 anemia in 16% and grade 3-4 thrombocytopenia in 26%. Median survival after BMM diagnosis was 5 months (95% CI, 3-11); overall survival at 12 and 24 months were 35% (CI 26-48%) and 24% (CI 15-36%), respectively. First treatment after BMM was CT in 58% (median survival, 11 months) and endocrine therapy in 14% (median survival, 3 months). An anti-HER2 regimen was used in 4% and 22% did not receive any treatment after BMM. On multivariate analysis, TN subtype (HR 4.02, CI 1.46-11.01), thrombocytopenia (G0 reference; G1-2: HR 2.47, CI 1.11-5.56; G3-4: HR 4.89, CI 1.85-12.91) and ≥ 2 palliative systemic treatments (HR 2.77, CI 1.46-5.27) were associated with worse prognosis. Within those treated with CT, there was a trend for a deleterious survival effect of more myelosuppressive regimens (HR 2.19, CI 0.94-5.09; 5 months Vs. 14 months, n=31), after controlling for subtype, number of previous regimens and thrombocytopenia.
Conclusion: BMM was not a late event in ABC disease course and had worse prognosis in multi-treated patients, in TN subtype and in the presence of thrombocytopenia. No benefit was shown with the use of more myelosuppressive CT regimens.
(1)Truong J et al, Ann Oncol. 2016 Apr;27(4):608-18.
Citation Format: Martins-Branco D, Ferreira SC, Pereira I, André S, Varelas A, Leal C, Esteves S, Abreu MH, Sousa S, Moreira A, Brito M. Management of bone marrow involvement in advanced breast cancer: Retrospective multicenter cohort study [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-18-05.
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Affiliation(s)
- D Martins-Branco
- Instituto Português de Oncologia de Lisboa, Lisbon, Portugal; Instituto Português de Oncologia do Porto, Oporto, Portugal
| | - SC Ferreira
- Instituto Português de Oncologia de Lisboa, Lisbon, Portugal; Instituto Português de Oncologia do Porto, Oporto, Portugal
| | - I Pereira
- Instituto Português de Oncologia de Lisboa, Lisbon, Portugal; Instituto Português de Oncologia do Porto, Oporto, Portugal
| | - S André
- Instituto Português de Oncologia de Lisboa, Lisbon, Portugal; Instituto Português de Oncologia do Porto, Oporto, Portugal
| | - A Varelas
- Instituto Português de Oncologia de Lisboa, Lisbon, Portugal; Instituto Português de Oncologia do Porto, Oporto, Portugal
| | - C Leal
- Instituto Português de Oncologia de Lisboa, Lisbon, Portugal; Instituto Português de Oncologia do Porto, Oporto, Portugal
| | - S Esteves
- Instituto Português de Oncologia de Lisboa, Lisbon, Portugal; Instituto Português de Oncologia do Porto, Oporto, Portugal
| | - MH Abreu
- Instituto Português de Oncologia de Lisboa, Lisbon, Portugal; Instituto Português de Oncologia do Porto, Oporto, Portugal
| | - S Sousa
- Instituto Português de Oncologia de Lisboa, Lisbon, Portugal; Instituto Português de Oncologia do Porto, Oporto, Portugal
| | - A Moreira
- Instituto Português de Oncologia de Lisboa, Lisbon, Portugal; Instituto Português de Oncologia do Porto, Oporto, Portugal
| | - M Brito
- Instituto Português de Oncologia de Lisboa, Lisbon, Portugal; Instituto Português de Oncologia do Porto, Oporto, Portugal
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Albuquerque GN, Costa RG, Barba FJ, Gómez B, Ribeiro NL, Beltrão Filho EM, Sousa S, Santos JG, Lorenzo JM. Effect of organic acids on the quality of sheep “buchada”: From food safety to physicochemical, nutritional, and sensorial evaluation. J FOOD PROCESS PRES 2019. [DOI: 10.1111/jfpp.13877] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- G. N. Albuquerque
- Programa de Pós Graduação em Tecnologia Agroalimentar Universidade Federal da Paraíba Bananeiras‐Paraíba Brasil
| | - R. G. Costa
- Programa de Pós Graduação em Tecnologia Agroalimentar Universidade Federal da Paraíba Bananeiras‐Paraíba Brasil
| | - Francisco J. Barba
- Preventive Medicine and Public Health, Food Science, Toxicology and Forensic Medicine Department, Nutrition and Food Science Area Universitat de València València Spain
| | - Belén Gómez
- Centro Tecnológico de la Carne de Galicia Ourense Spain
| | - N. L. Ribeiro
- Programa de Pós Graduação em Tecnologia Agroalimentar Universidade Federal da Paraíba Bananeiras‐Paraíba Brasil
| | - E. M. Beltrão Filho
- Programa de Pós Graduação em Tecnologia Agroalimentar Universidade Federal da Paraíba Bananeiras‐Paraíba Brasil
| | - S. Sousa
- Programa de Pós Graduação em Tecnologia Agroalimentar Universidade Federal da Paraíba Bananeiras‐Paraíba Brasil
| | - J. G. Santos
- Programa de Pós Graduação em Tecnologia Agroalimentar Universidade Federal da Paraíba Bananeiras‐Paraíba Brasil
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Sousa S, Magalhães Alves C, Marques F, Correia AM, Duarte R, Carvalho C. Cost-effectiveness of tuberculosis screening in stone quarries in Northern Portugal. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.443] [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)
- S Sousa
- Public Health Unit South Sousa Valley, Northern Regional Health Administration, Paredes, Portugal
| | - C Magalhães Alves
- Public Health Unit Low Tamega, Northern Regional Health Administration, Marco de Canaveses, Portugal
| | - F Marques
- Public Health Unit South Sousa Valley, Northern Regional Health Administration, Paredes, Portugal
| | - AM Correia
- Regional Department of Public Health, Northern Regional Health Administration; Public Health Unit - Braga, Northern Regional Health Administration, Porto, Portugal
| | - R Duarte
- National Tuberculosis Program, National-Directorate of Health; Epidemiology Research Unit (EpiUnit) - Institute of Public Health, University of Porto; Departamento de Ciências de Saúde Pública, Ciências Forenses e Educação Médica, Faculty of Medicine, Uni, Porto, Portugal
| | - C Carvalho
- Public Health Unit South Sousa Valley, Northern Regional Health Administration; Regional Department of Public Health, Northern Regional Health Administration; Multidisciplinary Unit for Biomedical Research (UMIB), Institute of Biomedical Sciences Abel S, Porto, Portugal
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Affiliation(s)
- K. Abrahale
- EPIUnit - Unidade de Investigação em Epidemiologia; Instituto de Saúde Pública; Universidade do Porto; Porto Portugal
| | - S. Sousa
- EPIUnit - Unidade de Investigação em Epidemiologia; Instituto de Saúde Pública; Universidade do Porto; Porto Portugal
- Faculdade de Ciências da Nutrição; Alimentação da Universidade do Porto; Porto Portugal
| | - G. Albuquerque
- EPIUnit - Unidade de Investigação em Epidemiologia; Instituto de Saúde Pública; Universidade do Porto; Porto Portugal
| | - P. Padrão
- EPIUnit - Unidade de Investigação em Epidemiologia; Instituto de Saúde Pública; Universidade do Porto; Porto Portugal
- Faculdade de Ciências da Nutrição; Alimentação da Universidade do Porto; Porto Portugal
| | - N. Lunet
- EPIUnit - Unidade de Investigação em Epidemiologia; Instituto de Saúde Pública; Universidade do Porto; Porto Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica; Faculdade de Medicina da Universidade do Porto; Porto Portugal
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Sales C, Vieira I, Cassiano M, Oliveira C, Vieira C, Ferreira M, Rodrigues A, Ferreira A, Pousa M, Couto R, Leal C, Abreu J, Teixeira M, Pereira D, Sousa S, Abreu M. Genetic signatures always suggest undertreatment? Experience with PAM50. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy270.210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Rodrigues AM, Canhão H, Marques A, Ambrósio C, Borges J, Coelho P, Costa L, Fernandes S, Gonçalves I, Gonçalves M, Guerra M, Marques ML, Pimenta S, Pinto P, Sequeira G, Simões E, Teixeira L, Vaz C, Vieira-Sousa E, Vieira R, Alvarenga F, Araújo F, Barcelos A, Barcelos F, Barros R, Bernardes M, Canas da Silva J, Cordeiro A, Costa M, Cunha-Miranda L, Cruz M, Duarte AC, Duarte C, Faustino A, Figueiredo G, Fonseca JE, Furtado C, Gomes J, Lopes C, Mourão AF, Oliveira M, Pimentel-Santos FM, Ribeiro A, Sampaio da Nóvoa T, Santiago M, Silva C, Silva-Dinis A, Sousa S, Tavares-Costa J, Terroso G, Vilar A, Branco JC, Tavares V, Romeu JC, da Silva J. Portuguese recommendations for the prevention, diagnosis and management of primary osteoporosis - 2018 update. Acta Reumatol Port 2018; 43:10-31. [PMID: 29602163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND Advances in osteoporosis (OP)case definition, treatment options, optimal therapy duration and pharmacoeconomic evidence in the national context motivated the Portuguese Society of Rheumatology (SPR) to update the Portuguese recommendations for the diagnosis and management of osteoporosis published in 2007. METHODS SPR bone diseases' working group organized meetings involving 55 participants (rheumatologists, rheumatology fellows and one OP specialist nurse) to debate and develop the document. First, the working group selected 11 pertinent clinical questions for the diagnosis and management of osteoporosis in standard clinical practice. Then, each question was investigated through literature review and draft recommendations were built through consensus. When insufficient evidence was available, recommendations were based on experts' opinion and on good clinical practice. At two national meetings, the recommendations were discussed and updated. A draft of the recommendations full text was submitted to critical review among the working group and suggestions were incorporated. A final version was circulated among all Portuguese rheumatologists before publication and the level of agreement was anonymously assessed using an online survey. RESULTS The 2018 SPR recommendations provide comprehensive guidance on osteoporosis prevention, diagnosis, fracture risk assessment, pharmacological treatment initiation, therapy options and duration of treatment, based on the best available evidence. They attained desirable agreement among Portuguese rheumatologists. As more evidence becomes available, periodic revisions will be performed. Target audience and patient population: The target audience for these guidelines includes all clinicians. The target patient population includes adult Portuguese people. Intended use: These recommendations provide general guidance for typical cases. They may not be appropriate in all situations - clinicians are encouraged to consider this information together with updated evidence and their best clinical judgment in individual cases.
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Sousa S, Sampaio A, Marques P, Gonçalves O, Crego A. PO2-7WHITE MATTER ANOMALIES IN THE INHIBITORY CIRCUITRY OF YOUNG BINGE DRINKERS: A DIFFUSION TENSOR IMAGING STUDY. Alcohol Alcohol 2017. [DOI: 10.1093/alcalc/agx074.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Fontes-Sousa M, Lobo S, Salta S, Lopes P, Lobo J, Sousa S, Henrique R, Jeronimo C. Epigenetic biomarkers in breast cancer: Preliminary results from H3K27m3 assessment in endocrine-treatment resistance. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx363.052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Fidalgo M, Moscoso J, Sousa S, Cabanes D. Affinity of Listeria sp. proteins to cAMP and role in virulence. Porto Biomed J 2017; 2:231. [DOI: 10.1016/j.pbj.2017.07.128] [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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Marques P, Ferreira F, Soares AP, Nunes J, Sousa S, Aguiar A, Calhaz-Jorge C. Clinico-biochemical characteristics of 229 Portuguese infertile women with polycystic ovary syndrome: clinical relevance and relationship with fertility treatment results. CLIN EXP OBSTET GYN 2016. [DOI: 10.12891/ceog3147.2016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Aquino J, Rocha AP, Reis AL, Pereira M, Sousa S, Henriques M. [Familiar hypokalemic periodic paralysis: an uncommon cause of acute flaccid paralysis]. Rev Neurol 2016; 63:478-479. [PMID: 27819406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- J Aquino
- Centro Hospitalar de Leiria, Leiria, Portugal
| | - A P Rocha
- Centro Hospitalar de Leiria, Leiria, Portugal
| | - A L Reis
- Centro Hospitalar de Leiria, Leiria, Portugal
| | - M Pereira
- Centro Hospitalar de Leiria, Leiria, Portugal
| | - S Sousa
- Hospital Pediatrico de Coimbra, 3000 Coimbra, Portugal
| | - M Henriques
- Centro Hospitalar de Leiria, Leiria, Portugal
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Marconi A, Di Marcantonio P, D'Odorico V, Cristiani S, Maiolino R, Oliva E, Origlia L, Riva M, Valenziano L, Zerbi FM, Abreu M, Adibekyan V, Allende Prieto C, Amado PJ, Benz W, Boisse I, Bonfils X, Bouchy F, Buchhave L, Buscher D, Cabral A, Canto Martins BL, Chiavassa A, Coelho J, Christensen LB, Delgado-Mena E, de Medeiros JR, Di Varano I, Figueira P, Fisher M, Fynbo JPU, Glasse ACH, Haehnelt M, Haniff C, Hansen CJ, Hatzes A, Huke P, Korn AJ, Leão IC, Liske J, Lovis C, Maslowski P, Matute I, McCracken RA, Martins CJAP, Monteiro MJPFG, Morris S, Morris T, Nicklas H, Niedzielski A, Nunes NJ, Palle E, Parr-Burman PM, Parro V, Parry I, Pepe F, Piskunov N, Queloz D, Quirrenbach A, Rebolo Lopez R, Reiners A, Reid DT, Santos N, Seifert W, Sousa S, Stempels HC, Strassmeier K, Sun X, Udry S, Vanzi L, Vestergaard M, Weber M, Zackrisson E. EELT-HIRES the high-resolution spectrograph for the E-ELT. ACTA ACUST UNITED AC 2016. [DOI: 10.1117/12.2231653] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [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]
Affiliation(s)
| | | | - V. D'Odorico
- INAF - Osservatorio Astronomico di Trieste (Italy)
| | - S. Cristiani
- INAF - Osservatorio Astronomico di Trieste (Italy)
| | | | - E. Oliva
- INAF - Osservatorio Astrofisico di Arcetri (Italy)
| | - L. Origlia
- INAF - Osservatorio Astronomico di Bologna (Italy)
| | - M. Riva
- INAF - Osservatorio Astronomico di Brera (Italy)
| | | | | | | | | | | | - P. J. Amado
- Instituto de Astrofísica de Andalucía (Spain)
| | | | - I. Boisse
- Lab. d'Astrophysique de Marseille (France)
| | - X. Bonfils
- Observatoire de Science de l'Univ. de Grenoble (France)
| | | | | | | | | | | | - A. Chiavassa
- Lab. Lagrange, Univ. Côte d'Azur, Observatoire de la Côte d'Azur (France)
| | | | | | | | | | - I. Di Varano
- Leibniz-Institut für Astrophysik Potsdam (Germany)
| | | | | | | | | | | | | | | | - A. Hatzes
- Thüringer Landessternwarte Tautenburg (Germany)
| | - P. Huke
- Univ. of Göttingen (Germany)
| | | | - I. C. Leão
- Federal Univ. of Rio Grande do Norte (Brazil)
| | | | | | | | | | | | | | | | | | | | | | | | | | - E. Palle
- Instituto de Astrofísica de Canarias (Spain)
| | | | - V. Parro
- Instituto Mauá de Tecnologia (Brazil)
| | - I. Parry
- Univ. of Cambridge (United Kingdom)
| | - F. Pepe
- Univ. de Genève (Switzerland)
| | | | | | | | | | | | | | | | | | | | | | | | - X. Sun
- Univ. of Cambridge (United Kingdom)
| | - S. Udry
- Univ. de Genève (Switzerland)
| | - L. Vanzi
- Pontificia Univ. Católica de Chile (Chile)
| | | | - M. Weber
- Leibniz-Institut für Astrophysik Potsdam (Germany)
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Littler S, Whalley H, Sousa S, Taylor S. CRISPR/Cas-9-mediated targeting of TP53 and MYC to investigate antimitotic mode of action. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)61073-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Teixeira L, Cordeiro I, Sousa S, Duarte A, Canas da Silva J, Cordeiro A, Santos M. SAT0237 Nailfold Capillaroscopy Findings in Scleroderma Patients – Prognostic Implications. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.6109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Duarte A, Cordeiro I, Sousa S, Teixeira L, Cordeiro A, Santos M. AB0428 Cardiac Involvement in Systemic Sclerosis – A Portuguese Reality:. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Cordeiro I, Duarte AC, Ferreira JF, Gonçalves MJ, Meirinhos T, Rocha TM, Romão VC, Sousa S, Guedes M, Conde M, Abreu C, Aleixo MJ, Santos MJ. Recommendations for Vaccination in Adult Patients with Systemic Inflammatory Rheumatic Diseases from the Portuguese Society of Rheumatology. Acta Reumatol Port 2016; 41:112-130. [PMID: 27606471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Serious infections are a major cause of morbidity and mortality in systemic inflammatory rheumatic disease (SIRD) patients. Although vaccination may prevent numerous infections, vaccination uptake rates are low in this group of patients. OBJECTIVES To develop evidence-based recommendations for vaccination in SIRD patients. METHODS We searched MEDLINE (until 31 October 2014) and EMBASE (until 14 December 2014) databases, as well as the ACR and EULAR congress abstracts (2011-2014). Patients with any systemic inflammatory rheumatic disease were included and all vaccines were considered. Any safety and efficacy outcomes were admitted. Search results were submitted to title and abstract selection, followed by detailed review of suitable studies. Data were subsequently pooled according to the type of vaccine and the SIRD considered. Results were presented and discussed by a multidisciplinary panel and systematic literature review (SLR)-derived recommendations were voted according to the Delphi method. The level of agreement among rheumatologists was assessed using an online survey. RESULTS Eight general and seven vaccine-specific recommendations were formulated. Briefly, immunization status should routinely be assessed in all SIRD patients. The National Vaccination Program should be followed and some additional vaccines are recommended. To maximize the efficacy of vaccination, vaccines should preferably be administered 4 weeks before starting immunosuppression or, if possible when disease activity is controlled. Non-live vaccines are safe in SIRD, including immunosuppressed patients. The safety of live attenuated vaccines in immunosuppressed patients deserves further ascertainment, but might be considered in particular situations. DISCUSSION The present recommendations combine scientific evidence with the multidisciplinary expertise of our taskforce panel and attained desirable agreement among Portuguese rheumatologists. Vaccination recommendations need to be updated on a regular basis, as more scientific data regarding vaccination efficacy and safety, emergent infectious threats, new vaccines as well as new immunomodulatory therapies become available.
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Sousa S, Gonçalves MJ, Inês LS, Eugénio G, Jesus D, Fernandes S, Terroso G, Romão VC, Cerqueira M, Raposo A, Couto M, Nero P, Sequeira G, Nóvoa T, Melo Gomes JA, da Silva JC, Costa L, Macieira C, Silva C, Silva JAP, Canhão H, Santos MJ. Clinical features and long-term outcomes of systemic lupus erythematosus: comparative data of childhood, adult and late-onset disease in a national register. Rheumatol Int 2016; 36:955-60. [PMID: 26979603 DOI: 10.1007/s00296-016-3450-2] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [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: 10/26/2015] [Accepted: 02/22/2016] [Indexed: 11/28/2022]
Abstract
Systemic lupus erythematosus (SLE) affects predominantly women at reproductive age but may present at any age. Age at disease onset has a modulating effect on presentation and course of disease, but controversies persist regarding its impact on long-term outcome. Our aims were to characterize clinical features, co-morbidities and cumulative damage in childhood-onset, adult-onset and late-onset SLE. Patients with childhood-onset SLE fulfilling ACR 1997 criteria were identified in a nationwide register-Reuma.pt/SLE (N = 89) and compared with adult-onset and late-onset counterparts matched 1:1:1 for disease duration. 267 SLE patients with mean disease duration of 11.9 ± 9.3 years were analyzed. Skin (62 %), kidney (58 %), neurological (11 %) and hematologic involvement (76 %) were significantly more common in childhood-onset SLE and disease activity was higher in this subset than in adult- and late-onset disease (SLEDAI-2K 3.4 ± 3.8 vs. 2.2 ± 2.7 vs. 1.6 ± 2.8, respectively; p = 0.004). Also, more childhood-onset patients received cyclophosphamide (10 %) and mycophenolate mofetil (34 %). A greater proportion of women (96 %), prevalence of arthritis (89 %) and anti-SSA antibodies (34 %) were noted in the adult-onset group. There was a significant delay in the diagnosis of SLE in older ages. Co-morbidities such as hypertension, diabetes and thyroid disease were significantly more frequent in late-onset SLE, as well as the presence of irreversible damage evaluated by the SLICC/ACR damage index (20 vs. 26 vs. 40 %; p < 0.001). Greater organ involvement as well as the frequent need for immunosuppressants supports the concept of childhood-onset being a more severe disease. In contrast, disease onset is more indolent but co-morbidity burden and irreversible damage are greater in late-onset SLE, which may have implications for patients' management.
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Affiliation(s)
- S Sousa
- Hospital Garcia de Orta, Almada, Portugal.
| | - M J Gonçalves
- Hospital de Santa Maria, Lisbon, Portugal.,Rheumatology Research Unit, Instituto de Medicina Molecular, Lisbon, Portugal
| | - L S Inês
- Hospitais da Universidade de Coimbra, Coimbra, Portugal.,School of Health Sciences, University of Beira Interior, Covilhã, Portugal
| | - G Eugénio
- Hospitais da Universidade de Coimbra, Coimbra, Portugal
| | - D Jesus
- Hospitais da Universidade de Coimbra, Coimbra, Portugal
| | - S Fernandes
- Instituto Português de Reumatologia, Lisbon, Portugal
| | - G Terroso
- Centro Hospitalar de São João, Porto, Portugal
| | - V C Romão
- Hospital de Santa Maria, Lisbon, Portugal.,Rheumatology Research Unit, Instituto de Medicina Molecular, Lisbon, Portugal
| | - M Cerqueira
- Hospital Conde de Bertiandos, Ponte de Lima, Portugal
| | - A Raposo
- Hospital Conde de Bertiandos, Ponte de Lima, Portugal
| | - M Couto
- Hospital de Viseu, Viseu, Portugal
| | - P Nero
- Hospital Egas Moniz, Lisbon, Portugal
| | - G Sequeira
- Centro Hospitalar de Faro, Faro, Portugal
| | - T Nóvoa
- Hospital Divino Espírito Santo, Ponta Delgada, Portugal
| | | | | | - L Costa
- Centro Hospitalar de São João, Porto, Portugal
| | - C Macieira
- Hospital de Santa Maria, Lisbon, Portugal
| | - C Silva
- Instituto Português de Reumatologia, Lisbon, Portugal
| | - J A P Silva
- Hospitais da Universidade de Coimbra, Coimbra, Portugal
| | - H Canhão
- Hospital de Santa Maria, Lisbon, Portugal.,Rheumatology Research Unit, Instituto de Medicina Molecular, Lisbon, Portugal
| | - M J Santos
- Hospital Garcia de Orta, Almada, Portugal.,Rheumatology Research Unit, Instituto de Medicina Molecular, Lisbon, Portugal
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Marques P, Ferreira F, Soares AP, Nunes J, Sousa S, Aguiar A, Calhaz-Jorge C. Clinico-biochemical characteristics of 229 Portuguese infertile women with polycystic ovary syndrome: clinical relevance and relationship with fertility treatment results. CLIN EXP OBSTET GYN 2016; 43:812-817. [PMID: 29944229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
PURPOSE Polycystic ovary syndrome (PCOS) affects 6-20% of reproductive-age women. The authors aimed to evaluate the characteristics of PCOS women and its relationship with fertility treatment outcomes. MATERIALS AND METHODS The authors reviewed records of PCOS women assisted at Hospital Santa Maria. Fertility treatment results were assessed as pregnancy rate, number of cycles, and miscarriage rate. RESULTS They identified 229 PCOS women, 179 (78.2%) had waist circumference > 80 cm, 72 (31.4%) had type 2 diabetes mellitus (T2DM) familial history and glucose abnormalities, hypertriglyceridemia and low cholesterol-HDL were detected in 23(10.1%), 15 (6.6%) and 103 (45.0%), respectively. Pregnancy was achieved in 164 women. The mean number of cycles to achieve pregnancy was 2.7 (±2.2). Statistical analysis identified factors associated with longer/higher number of treatments: primary infertility, T2DM familial history, hypertriglyceridemia, and low cholesterol-HDL. Waist circumference > 80 cm, older age, and increased LH level were associated with miscarriage. CONCLUSIONS Primary infertility, T2DM familial history, hypertriglyceridemia, low cholesterol-HDL, older age, waist circumference > 80 cm, and high LH may confer poorer fertility treatment results.
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Gonçalves MJ, Sousa S, Inês LS, Duarte C, Borges J, Silva C, Romão VC, Terroso G, Bernardes M, Cerqueira M, Raposo A, Sequeira G, Barcelos A, Macieira C, Canas da Silva J, Costa L, Pereira da Silva JA, Cunha-Miranda L, Da Silva JAP, Canhão H, Santos MJ. Characterization of damage in Portuguese lupus patients: analysis of a national lupus registry. Lupus 2014; 24:256-62. [DOI: 10.1177/0961203314555172] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background: Although the survival rate has considerably improved, many patients with systemic lupus erythematosus (SLE) develop irreversible organ damage. Objectives: The objectives of this paper are to characterize cumulative damage in SLE patients and identify variables associated with its presence and severity. Methods: A cross-sectional analysis of SLE patients from the Portuguese Lupus register Reuma.pt/SLE in whom damage assessment using the SLICC/ACR-Disability Index (SDI) was available was performed. Predictor factors for damage, defined as SDI ≥ 1, were determined by logistic regression analyses. A sub-analysis of patients with severe damage (SDI ≥ 3) was also performed. Results: In total, 976 patients were included. SDI was ≥1 in 365 patients, of whom 89 had severe damage. Musculoskeletal (24.4%), neuropsychiatric (24.1%) and ocular (17.2%) domains were the most commonly affected. Older age, longer disease duration, renal involvement, presence of antiphospholipid antibodies and current therapy with steroids were independently associated with SDI ≥ 1. The subpopulation with severe damage had, in addition, a greater interval between the first manifestation attributable to SLE and the clinical diagnosis as well as and more frequently early retirement due to SLE. Conclusions: This large lupus cohort confirmed that demographic and clinical characteristics as well as medication are independently associated with damage. Additionally, premature retirement occurs more often in patients with SDI ≥ 3. Diagnosis delay might contribute to damage accrual.
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Affiliation(s)
- M J Gonçalves
- Hospital de Santa Maria, Lisboa, Portugal
- Rheumatology Research Unit, Instituto de Medicina Molecular, Lisboa, Portugal
| | - S Sousa
- Hospital Garcia de Orta, Almada, Portugal
| | - L S Inês
- Hospitais da Universidade de Coimbra, Coimbra, Portugal
| | - C Duarte
- Hospitais da Universidade de Coimbra, Coimbra, Portugal
| | - J Borges
- Instituto Português de Reumatologia, Lisboa, Portugal
| | - C Silva
- Instituto Português de Reumatologia, Lisboa, Portugal
| | - V C Romão
- Hospital de Santa Maria, Lisboa, Portugal
- Hospital Garcia de Orta, Almada, Portugal
| | - G Terroso
- Hospital de São João, Porto, Portugal
| | | | - M Cerqueira
- Hospital Conde de Bertiandos, Ponte de Lima, Portugal
| | - A Raposo
- Hospital Conde de Bertiandos, Ponte de Lima, Portugal
| | | | | | - C Macieira
- Hospital de Santa Maria, Lisboa, Portugal
| | - J Canas da Silva
- Rheumatology Research Unit, Instituto de Medicina Molecular, Lisboa, Portugal
| | - L Costa
- Hospital de São João, Porto, Portugal
| | | | | | | | - H Canhão
- Hospital de Santa Maria, Lisboa, Portugal
- Rheumatology Research Unit, Instituto de Medicina Molecular, Lisboa, Portugal
| | - M J Santos
- Rheumatology Research Unit, Instituto de Medicina Molecular, Lisboa, Portugal
- Hospital Garcia de Orta, Almada, Portugal
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Gonzaga M, Sousa S, Ribeiro G, Gonçalves L, Neto M. Regional Program on Intervention in Prisons. Eur J Public Health 2014. [DOI: 10.1093/eurpub/cku165.118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Sousa S, Gonçalves M, Inês L, Duarte C, Fernandes S, Terroso G, Romão V, Cerqueira M, Raposo A, Couto M, Nero P, Novoa T, Pinto P, Melo Gomes J, Canas da Silva J, Costa L, Pereira da Silva J, Cunha-Miranda L, Da Silva J, Canhão H, Santos M. THU0026 Greater Diagnostic Delay in Early-Onset than in Late-Onset Systemic Lupus Erythematosus - Data from Reuma.Pt/Les: Table 1. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.5306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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