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Correia C, Fernandes S, Filipe P. Subungual Exostosis of the Second Finger. Actas Dermosifiliogr 2024; 115:T405. [PMID: 38340987 DOI: 10.1016/j.ad.2024.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 01/08/2023] [Indexed: 02/12/2024] Open
Affiliation(s)
- C Correia
- Dermatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), Lisboa, Portugal.
| | - S Fernandes
- Dermatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), Lisboa, Portugal; Faculty of Medicine, University of Lisbon, Lisboa, Portugal
| | - P Filipe
- Dermatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), Lisboa, Portugal; Faculty of Medicine, University of Lisbon, Lisboa, Portugal
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Correia C, Fernandes S, Filipe P. Subungual Exostosis of the Second Finger. Actas Dermosifiliogr 2024; 115:405. [PMID: 36842476 DOI: 10.1016/j.ad.2023.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 01/08/2023] [Indexed: 02/28/2023] Open
Affiliation(s)
- C Correia
- Dermatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), Lisbon, Portugal.
| | - S Fernandes
- Dermatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), Lisbon, Portugal; Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - P Filipe
- Dermatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), Lisbon, Portugal; Faculty of Medicine, University of Lisbon, Lisbon, Portugal
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Das A, Azarudheen S, Chandrasekaran B, Fernandes S, Davis F. The plausible effects of wearing face masks on sports performance - A scoping review. Sci Sports 2023; 38:S0765-1597(23)00133-8. [PMID: 38620146 PMCID: PMC10300654 DOI: 10.1016/j.scispo.2022.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 12/29/2022] [Indexed: 04/17/2024]
Abstract
Objectives The objectives of this scoping review are to discuss, firstly, the positive aspects of wearing face masks during training (such as a barrier to COVID-19 transmission, air pollutant exposure, and adding load on respiratory resistance flow); secondly, the negative aspects (adverse effects on body temperature and hypoxia risks); and thirdly, the training responses of wearing face masks on aerobic and anaerobic performance. News Besides social distancing and hand hygiene, wearing a face mask is proposed to be the prime advocacy for virus containment. During the period of high risk of contamination, the return to sport guidelines proposed by international and national sport federations included wearing face masks during training sessions. However, it is necessary to discuss the pros and cons of wearing face masks during exercise. Prospects Although it was essential to wear a face mask during exercise or sport-specific training, there is conflicting evidence on the implications of the use of face masks on physical, physiological as well as psychological well-being or performance. Based on the conflicting empirical findings and anecdotal evidence, certain recommendations have been made for adequate use of face masks during exercise; both to break the chain of transmission and prevent the physiological compromise expected from wearing face masks during exercise. The present review can help stakeholders balance sport guidelines in the event of a respiratory virus pandemic with athlete safety. Conclusion Conflicting evidence of mechanistic links between the dose of exercise and the possible adverse effects associated with exercising with face masks is available. Adequately powered studies with strong methodological quality on appropriate selection of masks and usage based on the intensity, duration, and type of sport, age, and gender is needed now for the stakeholders to make informed decisions with respect to exercising with face masks.
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Affiliation(s)
- A Das
- Department of Sports Science and Yoga, Ramakrishna Mission Vivekananda Educational and Research Institute, Belur Math, Howrah, West Bengal, India
- Department of Exercise and Sports Sciences, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
| | - S Azarudheen
- Department of Exercise and Sports Sciences, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
- Center for Sports Science, Medicine and Research, Manipal Academy of Higher Education, Manipal, India
| | - B Chandrasekaran
- Department of Exercise and Sports Sciences, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
- Center for Sports Science, Medicine and Research, Manipal Academy of Higher Education, Manipal, India
| | - S Fernandes
- Department of Exercise and Sports Sciences, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
- Center for Sports Science, Medicine and Research, Manipal Academy of Higher Education, Manipal, India
| | - F Davis
- Department of Exercise and Sports Sciences, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
- Center for Sports Science, Medicine and Research, Manipal Academy of Higher Education, Manipal, India
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Rastogi S, Fernandes S, Sasi N, Kashyap D, Tansir G, Kumar A, Gamangati S, Barwad A, Ahmed Shamim S. 127P Outcomes of advanced chordoma from dedicated sarcoma medical oncology clinic from a tertiary care center in North India. ESMO Open 2023. [DOI: 10.1016/j.esmoop.2023.101073] [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: 04/05/2023] Open
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Fernandes S, Pereira G, Bexiga R. Bimodal milk flow and overmilking in dairy cattle: risk factors and consequences. Animal 2023; 17:100716. [PMID: 36791490 DOI: 10.1016/j.animal.2023.100716] [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: 07/26/2022] [Revised: 01/11/2023] [Accepted: 01/12/2023] [Indexed: 01/21/2023] Open
Abstract
To maximise the return on capital invested in the milking parlour, the largest number of cows should be milked gently and completely in the shortest possible time. Bimodal milk flow and overmilking negatively influence the efficiency of the milk removal process and teat health. This observational study had the objective of investigating the prevalence of bimodal milk flow and overmilking, determining which individual and farm-related variables are associated with these occurrences, and determining the association of overmilking and bimodal milk flow with milk yield and with short- and long-term teat changes. Twenty-one farms were visited once during the study period, wherein the milking routine was timed, the teat condition was assessed, and dynamic evaluation of the milking vacuum was performed. A total of 606 vacuum graphic records were obtained, with an average of 29 ± 3 records per farm, in order to indirectly evaluate the milk flow and thus determine the occurrence of bimodal milking and overmilking time. The average percentage of bimodality per farm was 41.7%. The median overmilking time was 59 seconds, and on average, 78.3% of the cows in a herd were overmilked longer than 30 seconds. An association was found at cow level between the occurrence of bimodal milk flow and days in milk, the total stimulation time, parity, and the preparation lag time. The increase in the mean total stimulation time and the number of passes during preparation were associated with a decrease in the proportion of bimodality in the herd. Parity, reattachment of the milking unit and milking in manual mode were associated with an increase in overmilking time of an individual cow. The presence of a clogged air bleed hole in the claw and the reduction of the cluster removal milk flow threshold were associated with an increase in the herd's median overmilking time. The average milk flow decreased with the increase in overmilking time and with the occurrence of bimodal milk flow. An association was also found between the occurrence of bimodal milk flow and decreased milk yield. A mean of 78.4% of cows per farm had short-term teat changes in at least one teat, and 33.6% of evaluated cows per farm displayed at least one teat with hyperkeratosis. These results emphasise the association of bimodality and overmilking on milking efficiency and reinforce the importance of the milkers' actions and the functioning of the milking parlour for its prevention.
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Affiliation(s)
- S Fernandes
- Serbuvet, Lda, Quinta de Cima, 2000-465 Santarém, Portugal
| | - G Pereira
- CIISA - Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Avenida da Universidade Técnica, 1300-477 Lisboa, Portugal; Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), 1300-477 Lisboa, Portugal
| | - R Bexiga
- Serbuvet, Lda, Quinta de Cima, 2000-465 Santarém, Portugal; CIISA - Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Avenida da Universidade Técnica, 1300-477 Lisboa, Portugal; Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), 1300-477 Lisboa, Portugal.
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Tansir G, Rastogi S, Fernandes S, Ahmed Shamim S, Dhamija E, Barwad A, Pandey R. 76P Thoracic synovial sarcoma: A single-center, real-world analysis of treatment paradigms and clinical outcomes. ESMO Open 2023. [DOI: 10.1016/j.esmoop.2023.101113] [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: 04/05/2023] Open
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Lopes Bruno A, Mira M, Cardoso C, Guimaraes A, Rodrigues P, Miguel I, Bento S, Luis A, Fernandes S, Fragoso S, Vaz F. 55P Evolution of genetic testing after ovarian cancer (OC) diagnosis. ESMO Open 2023. [DOI: 10.1016/j.esmoop.2023.100835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023] Open
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Correia C, Fernandes S, Soares-de-Almeida L, Filipe P. Hyperkeratotic Yellow-Brown Papules on the Feet. Actas Dermosifiliogr 2023; 114:T159-T160. [PMID: 36473520 DOI: 10.1016/j.ad.2021.07.033] [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: 03/04/2021] [Accepted: 07/26/2021] [Indexed: 12/12/2022] Open
Affiliation(s)
- C Correia
- Dermatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), Lisboa, Portugal.
| | - S Fernandes
- Dermatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), Lisboa, Portugal
| | - L Soares-de-Almeida
- Dermatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), Lisboa, Portugal
| | - P Filipe
- Dermatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), Lisboa, Portugal; Faculty of Medicine, Dermatology Universitary Clinic, University of Lisbon, Lisboa, Portugal; Dermatology Research Unit, Instituto de Medicina Molecular (IMM), Universidad de Lisboa, Lisboa, Portugal
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Correia C, Fernandes S, Soares-de-Almeida L, Filipe P. Hyperkeratotic Yellow-Brown Papules on the Feet. Actas Dermosifiliogr 2023; 114:159-160. [PMID: 35850233 DOI: 10.1016/j.ad.2021.07.027] [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: 03/04/2021] [Revised: 06/15/2021] [Accepted: 07/26/2021] [Indexed: 02/06/2023] Open
Affiliation(s)
- C Correia
- Dermatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), Lisbon, Portugal.
| | - S Fernandes
- Dermatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), Lisbon, Portugal
| | - L Soares-de-Almeida
- Dermatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), Lisbon, Portugal
| | - P Filipe
- Dermatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), Lisbon, Portugal; Faculty of Medicine, Dermatology Universitary Clinic, University of Lisbon, Lisbon, Portugal; Dermatology Research Unit, Instituto de Medicina Molecular (IMM), University of Lisbon, Lisbon, Portugal
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Ribeiro Silva M, Ribeiro Queiros P, Santos Silva G, Teixeira R, Fernandes S, Almeida J, Fonseca P, Oliveira M, Goncalves H, Rodrigues A, Primo J, Fontes-Carvalho R. Predictors of AF recurrence in patients with paroxysmal AF undergoing catheter ablation: new predictors coming? Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.591] [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
Recurrence of atrial fibrillation (AF) after catheter ablation (CA) is estimated to be between 20% and 45% and the prediction of recurrence AF in patients (pts) with paroxysmal AF undergoing CA remains challenging.
Purpose
To determine the clinical and procedural predictors of recurrence AF after CA in pts with paroxysmal AF.
Methods
Single-centre retrospective study that included all pts with paroxysmal AF who underwent AF CA between 2017 and 2019. Ablation procedures included radiofrequency and second-generation cryoballoon CA. All pts underwent cardiac computed tomography prior the procedure. AF recurrence was defined as any recurrence of AF, atrial flutter or atrial tachycardia >30 seconds (recorded in 12-lead electrocardiogram or Holter) after 90 days of CA. The independent association between clinical and procedural variables and AF recurrence was evaluated with Cox regression analysis.
Results
We included 351 pts, 63,5% male and with a mean age of 57,1±11,4 years. CHADSVASCscore ≥2 points were present in 43,7% of the pts, median duration of AF prior the intervention was 3 years (IQR 1–6) and most pts were treated with some antiarrhythmic drug at the time of CA (56,9%). Overall, median follow-up was 27 months (IQR 19–39).
AF recurrence was present in 96 pts (27,4%), on average, 15,2±10,4 months after CA.
Univariate logistic regression identified female gender, thyroid disease, left atrium (LA) enlargement (defined as LA indexed volume >34 mL/m2 or LA diameter >38mm for female or >40mm for male), coronary calcium score >100, epicardial adipose tissue volume, number of previous electric cardioversions, treatment with antiarrhythmic drugs prior CA and the extent of CA (only pulmonary vein isolation (PVI) or PVI and ablation of other lesions) as predictors of recurrence AF after CA in pts with paroxysmal AF (p<0,05 for all).
Cox regression analysis identified female gender (OR 1,615, 95% CI 1,005–2,597; p=0,008), LA enlargement (OR 2,084, 95% CI 1,207–3,596; p=0,008) and coronary calcium score >100 (OR 1,958, 95% CI 1,133–3,385; p=0,016) as independent predictors of AF recurrence.
Conclusions
In our cohort, AF recurrence was significantly higher in pts with LA enlargement, with coronary calcium score >100 and female gender pts.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Ribeiro Silva
- Hospital Center of Vila Nova de Gaia/Espinho , Vila Nova de Gaia , Portugal
| | - P Ribeiro Queiros
- Hospital Center of Vila Nova de Gaia/Espinho , Vila Nova de Gaia , Portugal
| | - G Santos Silva
- Hospital Center of Vila Nova de Gaia/Espinho , Vila Nova de Gaia , Portugal
| | - R Teixeira
- Hospital Center of Vila Nova de Gaia/Espinho , Vila Nova de Gaia , Portugal
| | - S Fernandes
- Leiria Hospital Centre, Cardiology , Leiria , Portugal
| | - J Almeida
- Hospital Center of Vila Nova de Gaia/Espinho , Vila Nova de Gaia , Portugal
| | - P Fonseca
- Hospital Center of Vila Nova de Gaia/Espinho , Vila Nova de Gaia , Portugal
| | - M Oliveira
- Hospital Center of Vila Nova de Gaia/Espinho , Vila Nova de Gaia , Portugal
| | - H Goncalves
- Hospital Center of Vila Nova de Gaia/Espinho , Vila Nova de Gaia , Portugal
| | - A Rodrigues
- Hospital Center of Vila Nova de Gaia/Espinho , Vila Nova de Gaia , Portugal
| | - J Primo
- Hospital Center of Vila Nova de Gaia/Espinho , Vila Nova de Gaia , Portugal
| | - R Fontes-Carvalho
- Hospital Center of Vila Nova de Gaia/Espinho , Vila Nova de Gaia , Portugal
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Fernandes S, Saleiro C, Palma A, Faim D, Dias J, Borges I, Santos I, Andrade H, Martins H, Pires A. Characterization and long-term follow-up of children with brugada syndrome: experience from a tertiary paediatric referral centre. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Brugada syndrome (BrS) is an autosomal dominant channelopathy, which typically presents in young adults. It can also be diagnosed in children, but data in this age group is scarce.
Purpose
To describe the clinical features, management and long-term follow-up of children with BrS history followed-up in a tertiary paediatric referral centre.
Methods
Single centre retrospective study of consecutive patients with history of BrS, defined as having a BrS positive phenotype (BrS(+)), or a negative phenotype-positive genotype (BrS(−)). They were all followed up in a paediatric heart rhythm clinic. Clinical and demographical data were collected and analysed according to the phenotype.
Results
30 patients were included, with a median age at diagnosis of 7 years (IQR 1–13) and a mean follow-up time of 7±3 years. Sixteen patients were BrS(+), predominantly male (n=13, 81%). 88% (n=14) performed a genetic test, which was positive in 57% (n=8); the most frequent mutation was SCN5A (n=5). Family history of BrS was present in 56% (n=9) and almost one third had family history of sudden cardiac death (SCD). Most of the patients had a type 1 Brugada ECG pattern (n=14) and 2 patients presented a fever and drug induced pattern, respectively. Fourteen patients were BrS(−), mostly female (n=11, 79%) with a loss-of-function mutation in the SCN5A gene (n=10). They all had family members with BrS, mainly from the paternal side, and 43% (n=6) mentioned SCD history. Although most of the patients were asymptomatic, the prevalence of rhythm or conduction disturbances was not infrequent, particularly in BrS(+) patients (n=12, 75%). Also, in this group and during follow-up, 3 patients had documented supraventricular tachyarrhythmias, and 2 patients had syncope episodes, one of which required an implantable cardioverter-defibrillator. No events were reported in the BrS(−) patients. Nine patients (n=9/30, 30%) were hospitalized, 3 due to an arrhythmic event (all in the BrS(+) group). Overall, no sudden cardiac death event was reported during follow-up.
Conclusion
In our study, although the majority of the patients were asymptomatic, the occurrence of arrhythmic events was not negligible, especially in the BrS(+) patients. Despite the significant family history, patients with BrS(−) had no events reported during follow-up. Nevertheless, the management of these patients is not clear cut, and a personalized therapeutic strategy with close follow-up is essential.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
| | - C Saleiro
- Coimbra Hospital and University Center , Coimbra , Portugal
| | - A Palma
- Coimbra Hospital and University Center, Paediatric Cardiology , Coimbra , Portugal
| | - D Faim
- Coimbra Hospital and University Center, Paediatric Cardiology , Coimbra , Portugal
| | - J Dias
- Coimbra Hospital and University Center, Paediatric Cardiology , Coimbra , Portugal
| | - I Borges
- Coimbra Hospital and University Center, Paediatric Cardiology , Coimbra , Portugal
| | - I Santos
- Coimbra Hospital and University Center, Paediatric Cardiology , Coimbra , Portugal
| | - H Andrade
- Coimbra Hospital and University Center, Paediatric Cardiology , Coimbra , Portugal
| | - H Martins
- Leiria Hospital Centre , Leiria , Portugal
| | - A Pires
- Coimbra Hospital and University Center, Paediatric Cardiology , Coimbra , Portugal
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Ganapathiraju M, Fernandes S. Consumer Behavior and Emotional Satisfaction: Ready-To-Cook Food Products in India. CM 2022. [DOI: 10.18137/cardiometry.2022.23.728740] [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: 11/08/2022] Open
Abstract
In this paper, we are trying to understand the consumer behavior on the Ready-to-cook (RTC) food products that belong to the sector of convenience food products. In India, the consumption of ready-to-cook products increased drastically after urbanization. According to the Indian RTC Market Outlook, the total market of ready-to-cook food products is expected to grow with a CAGR of more than 18% by the end of 2024. A survey has been conducted among the different age groups of people to understand their interests and critical factors, leading to their behavior patterns in buying and consuming ready-to-cook food products. The analysis of the collected data is conducted in Excel and R for an in-depth understanding. Two models are run on R to predict the significant factors in customers’ satisfaction level regarding ready-to-cook food products. The first model predicts that store and availability are significant at a 90% confidence interval. In contrast, consumption, quality, and discounts are significant at a 95% confidence interval according to consumers’ satisfaction levels concerning ready-to-cook food products. The second model predicts that store and packaging are significant at a 90% confidence interval. In contrast, consumption, taste, and discounts are significant at a 95% confidence interval according to consumers’ satisfaction levels in buying a particular brand in ready-to-cook food products. This study focuses on consumption patterns of ready-to-cook food products concerning the consumers of different professions, different income levels, different age groups, etc.
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Kapoor S, Fernandes S, Punia S. ‘Natural’ Label Halo Effect on Consumer Buying Behavior, Purchase Intention and Willingness to Pay for Skincare Products. CM 2022. [DOI: 10.18137/cardiometry.2022.23.741755] [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: 11/08/2022] Open
Abstract
Healthy skin will never go out of style, and the advancements and improvements in the cosmetics industry guarantee to provide improved products with a healthy and personal touch. However, for consumers, it is difficult to assess the quality and effectiveness of a product. Extrinsic cues like the “Natural” or “Organic” labels are used to help the consumer distinguish between alternatives. This paper analyses how the organic label biases the consumers’ buying behavior, perceived value, and finally, the consumer’s purchase decision and the price he willingly pays for the product (willingness to pay). This phenomenon is known as the natural label halo effect. It further means to reveal the connections between the effect of the ‘Natural’ label on the factors affecting buying behavior and it’s out-turn as emulated in the consumer’s perceived value. It intends to identify if those outcomes at last lead to positive buying decisions and greater willingness to pay. A quantitative study in an experimental online shopping scenario was conducted to understand the relations. Structural equation modeling (SEM) was done to test the hypothesized statements. The results show that the halo effect of the ‘Natural’ label positively influences the factors affecting consumer buying behavior and eventually improves the probability of the product being bought by the consumer and also the price the consumer is willing to pay for it through inferential beliefs on quality attributes and functional value evoked by the label. The study also reveals that natural skincare products are perceived to be more compliant with a consumer’s beliefs/attitudes relating to environmental protection and animal protection, which positively influences the propensity of a consumer towards buying the product and paying a high price for it by increasing the perceived functional and hedonic values associated with the natural cosmetic product.
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Sheikh S, Scheinberg M, Wei JCC, Tegzová D, Stohl W, Acayaba De Toledo R, Mucenic T, Abello Banfi MR, Maksimowicz-Mckinnon K, Abud-Mendoza C, Navarra S, García M, Garcia-De La Torre I, Liu A, Roy A, Wilde P, Fernandes S, Harris J, Roth D. POS0712 YEAR-4 OBSERVATIONAL FOLLOW-UP OF BELIMUMAB SAFETY (MORTALITY AND MALIGNANCIES) IN PATIENTS WITH SLE WHO COMPLETED A PHASE 4, 52-WEEK, RANDOMISED, DOUBLE-BLIND PLACEBO-CONTROLLED SAFETY STUDY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1993] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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
BackgroundBelimumab (BEL) is an approved systemic lupus erythematosus (SLE) treatment. Despite BEL clinical studies demonstrating a favourable benefit–risk profile, varying incidence rates of mortality and adverse events of special interest, including malignancies, require further evaluation.ObjectivesTo assess long-term safety following BEL therapy.MethodsThis was a Year (Yr)-4 post-treatment follow-up of the Phase 4, double-blind, placebo (PBO)-controlled Belimumab Assessment of Safety in SLE (BASE) study (GSK Study BEL115467; NCT01705977).1 Overall, 4003 adults with active, autoantibody-positive SLE received BEL (10 mg/kg IV) or PBO, plus standard therapy (ST), for 48 weeks. Patients (pts) then entered a Yr 2–5 follow-up period in which they received physician-directed ST. All pts were contacted annually by telephone, including pts who discontinued treatment. Mortality and new malignancies (including nonmelanoma skin cancer) were the endpoints collected, and rates summarised. We present Yr-4 follow-up data by Yr-1 treatment received.ResultsBaseline characteristics for the Yr-4 follow-up population (N=3204) were similar to the Yr-1 double-blind study population (N=4003). By the Yr-4 follow-up, cumulatively 12.7% and 11.0% of pts in the BEL and PBO Yr-1 groups had received BEL as part of physician-directed care, respectively (data not shown). As shown in the Table 1, cumulative follow-up adjusted mortality rates were lower in the BEL vs PBO Yr-1 treatment group for Yrs 2 to 4. Cumulative follow-up adjusted new primary malignancy rates were lower in the BEL vs PBO Yr-1 treatment group for Yrs 2 and 3, but similar in Yr 4.Table 1.Yr 1 plus Yrs 2–4 post-treatment* follow-up mortality and new primary malignancy rates by Yr-1 study treatmentPts with events per yr, n (%)Pt incidence rate per 100 pt-yrs(Cumulative rate, %)BELPBOTotalBELPBOTotalYr-1 (as-treated) populationN=2002N=2001N=4003Deaths13 (0.65)22 (1.10)35 (0.87)0.66 (0.65)1.11 (1.10)0.87New primary malignancies†9 (0.45)10 (0.50)19 (0.47)0.450.500.47Yr-2 (as-treated in Yr-1) populationN=1695N=1670N=3365Deaths9 (0.53)21 (1.26)30 (0.89)0.60 (1.10)1.18 (2.15)0.89 (1.62)New primary malignancies3 (0.18)7 (0.42)10 (0.30)0.34 (0.60)0.48 (0.85)0.41 (0.72)Yr-3 (as-treated in Yr-1) populationN=1659N=1630N=3289Deaths9 (0.54)17 (1.04)26 (0.79)0.58 (1.55)1.14 (3.00)0.86 (2.27)New primary malignancies, n (%)7 (0.42)9 (0.55)16 (0.49)0.37 (0.95)0.49 (1.25)0.43 (1.10)Yr-4 (as-treated in Yr-1) populationN=1622N=1582N=3204Deaths by MedDRA SOC14 (0.86)13 (0.82)27 (0.84)0.65 (2.25)1.07 (3.65)0.86 (2.95)Infections/infestations4 (0.25)5 (0.32)9 (0.28)Cardiac disorders2 (0.12)1 (0.06)3 (0.09)General disorders/ administration site conditions2 (0.12)2 (0.13)4 (0.12)Respiratory/thoracic/ mediastinal disorders2 (0.12)1 (0.06)3 (0.09)Nervous system disorders2 (0.12)1 (0.06)3 (0.09)Other‡2 (0.12)3 (0.18)5 (0.15)New primary malignancies10 (0.62)5 (0.32)15 (0.47)0.43 (1.45)0.44 (1.45)0.43 (1.45)*Pts in the post-treatment follow-up period are no longer receiving study treatment. †Includes nonmelanoma skin cancer.‡Contains 1 event for 5 distinct pts of each of renal/urinary disorders, and neoplasms (BEL); musculoskeletal/connective tissue disorders, injury/poisoning/procedural complications, and vascular disorders (PBO).MedDRA, Medical Dictionary for Regulatory Activities; SOC, system organ classConclusionPost-treatment Yr-4 follow-up results in BASE, the largest double-blind trial in pts with SLE to date, support the safety of BEL therapy, with no new BEL safety concerns identified in this analysis.References[1]Sheikh SZ, et al. Lancet Rheumatol 2020;3:e122–30AcknowledgementsThis analysis was funded by GlaxoSmithKline (GSK). Medical writing support was provided by Lulu Hill, MPharmacol, Fishawack Indicia Ltd. UK, part of Fishawack Health, and was funded by GSK.Disclosure of InterestsSaira Sheikh Consultant of: GSK, Grant/research support from: Pfizer, Morton Scheinberg Consultant of: GSK, Pfizer, Alnylam, AbbVie, PTC Therapeutics, James Cheng-Chung Wei Consultant of: TSH Biopharm, AbbVie, BMS, Celgene, Chugai, Eisai, Janssen, Novartis, Pfizer, Sanofi-Aventis, and UCB Pharma, Grant/research support from: AbbVie, Amgen, Astellas, BMS, Celgene, Eli Lilly, Gilead, Janssen, Novartis, Pfizer, Sun and UCB Pharma, Dana Tegzová: None declared, William Stohl Consultant of: GSK, Grant/research support from: GSK, Pfizer, Gilead, RICARDO ACAYABA DE TOLEDO Speakers bureau: AbbVie, Janssen, UCB, Novartis, Celltrion, Consultant of: AbbVie, Janssen, Novartis, UCB, Grant/research support from: Pfizer, AbbVie, Novartis, GSK, Tamara Mucenic Speakers bureau: Novartis, Janssen, BMS, AbbVie, Pfizer, Roche, Grant/research support from: GSK, Janssen, Roche, Eli Lilly, Gilead, UCB, Mauricio R Abello Banfi: None declared, Kathleen Maksimowicz-McKinnon Grant/research support from: Chemocentryx, Carlos Abud-Mendoza Speakers bureau: GSK, Lilly, Pfizer, Sandra Navarra Speakers bureau: Pfizer, Novartis, Johnson & Johnson, Consultant of: Biogen, Boehringer Ingelheim, Grant/research support from: Astellas, Mercedes García Speakers bureau: GSK, Janssen, Pfizer, Ignacio Garcia-De La Torre: None declared, Andrew Liu Shareholder of: GSK, Employee of: GSK, Abhishek Roy Employee of: GSK, Paul Wilde Shareholder of: GSK, Employee of: GSK, Sofia Fernandes Shareholder of: GSK, Employee of: GSK, Julia Harris Shareholder of: GSK, Employee of: GSK, David Roth Shareholder of: GSK, Employee of: GSK
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Pimentel G, Cruz A, Loureiro M, Fernandes S, Baixinho C, Marques A. AB1565-HPR REHABILITATION NURSES KNOWLEDGE ABOUT OSTEOPOROSIS AND FRAGILITY FRACTURES IN PORTUGAL. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3205] [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: 11/03/2022]
Abstract
BackgroundScientific evidence reveals gaps in health professionals’ knowledge about osteoporosis and fragility fractures, which impairs and influences the quality of care, namely in preventive actions.ObjectivesTo analyse knowledge of Rehabilitation Nurses about osteoporosis and fragility fractures to identify training needs of Rehabilitation Nurses.MethodsA cross-sectional study, integrated in a larger project, using an adapted questionnaire, made available online and disseminated by mailing list of “Ordem dos Enfermeiros” (Royal Colleague of Nursings) to all Portuguese Rehabilitation Nurses.ResultsThere were include 452 participants(10.3% of the 4 397 Rehabilitation Nurses), 17% perform functions in orthopaedics and traumatology service, 4.5% physical medicine and rehabilitation and 78.6% in other services, majority, 74.6% women. On average, 69.6% correct answers were identified regarding osteoporosis and fragility fractures. Results reveal that the main areas of knowledge deficit, in this study, are related to the concept and epidemiology of osteoporosis and fragility fractures and about the most appropriate diet. Nurses with higher academic degree (master’s degree) revealed more knowledge (p=0.01).ConclusionThis study reveals that the knowledge about osteoporosis and fragility fractures is low (<70% correct answers), thus there is an opportunity to improve the knowledge related to osteoporosis and fragility fractures among Specialist Nurses in Rehabilitation Nursing.References[1]Peng, L., Reynolds, N., He, A., Liu, M., Yang, J., She, P., & Zhang, Y. (2020). Osteoporosis knowledge and related factors among orthopedic nurses in Hunan province of China. International journal of orthopaedic and trauma nursing, 36, 100714. https://doi.org/10.1016/j.ijotn.2019.100714Disclosure of InterestsNone declared
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Fernandes S, Cruz I, Ladeiras-Lopes R, Diaz S, Silva M, Barros A, Saraiva F, Faria R, Almeida J, Fonseca P, Goncalves H, Oliveira M, Ferreira N, Primo J, Fontes-Carvalho R. Role of epicardial adipose tissue volume as predictor of atrial fibrillation recurrence. Europace 2022. [DOI: 10.1093/europace/euac053.146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Several studies have demonstrated the relation between general obesity and atrial fibrillation (AF). Epicardial adipose tissue (EAT), due to its local paracrine effect and the intimate relation with the atrium, could influence AF recurrence rates, but very few studies have explored this association.
Purpose
In this study we aimed to evaluate if EAT could be a predictor of AF recurrence after an AF ablation procedure.
Methods
We included all consecutive patients submitted to AF ablation (2017-2019) who performed a computed tomography scan prior to the procedure. EAT volume was semi-automatically reconstructed by manually tracing the pericardium. Adipose tissue was defined in the range between -150 and -50 Hounsfield units. Recurrence was defined as any documented (ECG/Holter) episode of AF, atrial flutter or atrial tachycardia after 3 months of the procedure. Logistic regression with a restricted cubic polynomial transformation was used to model the non-linear relationship between recurrence and EAT volumes. Inspection of the partial effect curves suggested that a cutoff for EAT volume ≥80mL could stratify patients at risk of recurrence and a Time-to-event analysis was carried.
Results
A total of 354 patients (66% male, median age 57 years [IQR 48–65] and 21% persistent AF) were included. During a median follow-up of 34 months [IQR 24-43], 117 patients (33%) had AF recurrence. These patients had a significantly greater EAT volume (76 mL [IQR 55-111] vs 72 mL [IQR 48-95], p=0.03) when compared to those without recurrence. Also, patients with higher EAT volume (≥ 80mL) had a higher risk of recurrence compared to patients with lower volume (Figure 1, log-rank test p=0.007). After adjusting for clinical risk factors (age, gender, hypertension, diabetes mellitus, obesity, thyroid disease, AF type and left atrial enlargement), higher EAT volume did not remain an independent predictor of AF recurrence (Figure 2, HR 1.25 [95% CI, 0.83-1.86] p=0.3).
Conclusion
In this cohort of patients with AF submitted to catheter ablation, EAT volume ≥80mL was associated with increased risk of AF recurrence. However, it was not an independent predictor of AF recurrence after adjustment to clinical risk factors.
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Affiliation(s)
| | - I Cruz
- Faculty of Medicine University of Porto, Porto, Portugal
| | - R Ladeiras-Lopes
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - S Diaz
- Faculty of Medicine University of Porto, Cardiovascular Research and Development Centre, Department of Surgery and Physiology, Porto, Portugal
| | - M Silva
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - A Barros
- Faculty of Medicine University of Porto, Cardiovascular Research and Development Centre, Department of Surgery and Physiology, Porto, Portugal
| | - F Saraiva
- Faculty of Medicine University of Porto, Cardiovascular Research and Development Centre, Department of Surgery and Physiology, Porto, Portugal
| | - R Faria
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - J Almeida
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - P Fonseca
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - H Goncalves
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - M Oliveira
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - N Ferreira
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - J Primo
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - R Fontes-Carvalho
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
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Fernandes S, Ladeiras-Lopes R, Cruz I, Silva G, Diaz S, Barros A, Saraiva F, Faria R, Almeida J, Fonseca P, Goncalves H, Oliveira M, Ferreira N, Primo J, Fontes-Carvalho R. Higher coronary calcium score is associated with increased risk of atrial fibrillation recurrence. Europace 2022. [DOI: 10.1093/europace/euac053.140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
Patients with atrial fibrillation (AF) referred for catheter ablation routinely undergo cardiac computed tomography (CCT) for procedure planning. An opportunistic evaluation of coronary artery calcium score (CACS) can be an important tool to improve clinical care. It is already known that CACS is associated with a high risk of AF development, particularly if values are above 100, but few data are available regarding the impact of CACS in AF recurrence after ablation.
Purpose
To assess the impact of CACS on atrial fibrillation recurrence following catheter ablation.
Methods
Retrospective, single-centre cohort study of consecutive patients with AF undergoing CCT for ablation procedure planning, from 2017 to 2019. Baseline clinical and demographical data were collected. Patients with known history of coronary artery disease (CAD) and moderate to severe valvular heart disease were excluded. CACS was assessed using the Agatston method. Recurrence was defined as any documented episode of AF, atrial flutter or atrial tachycardia after 3 months from procedure. Patients were stratified in CACS<100 and CACS≥100. Explorative analysis incorporated Kaplan-Meier survival curves and Cox regression.
Results
A total of 354 patients were included, with a mean age of 56 ± 12 years, 66% male and 21% with persistent AF. More than half of the patients had a CACS>0 (n=185, 52%) and 63 patients (18%) had a CACS≥100. Patients with CACS≥100 were older (63 ± 7 vs 54 ± 12 years, p<0.001), had higher prevalence of hypertension (68% vs 43%, p<0.001) and diabetes mellitus (21% vs 10%, p=0.012) and higher left atrial volume (39 ± 9 vs 35 ± 9 ml/m2, p=0.018). After a median observation time of 34 months (IQR 24-43), 117 patients (33%) had AF recurrence.
CACS≥100 was associated with increased risk of AF recurrence (unadjusted Cox regression: hazard ratio [HR] 1.85; 95% confidence interval [CI], 1.23-2.79, p=0.003) (Fig. 1). After covariate adjustment (age, gender, hypertension, diabetes mellitus, obesity, thyroid disease, AF type and left atria enlargement) CACS≥100 remained an independent predictor of the risk of AF recurrence (HR, 1.68; 95% CI, 1.05-2.70, p=0.03) as well as persistent AF (HR, 1.91; 95% CI, 1.23-3.00, p=0.004) (Fig. 2).
Conclusion
In patients with AF undergoing catheter ablation, without previous history of CAD, a CACS≥100 was independently associated with a 68% increase in the risk of AF recurrence.
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Affiliation(s)
| | - R Ladeiras-Lopes
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - I Cruz
- Faculty of Medicine University of Porto, Porto, Portugal
| | - G Silva
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - S Diaz
- Faculty of Medicine University of Porto, Cardiovascular Research and Development Centre, Department of Surgery and Physiology, Porto, Portugal
| | - A Barros
- Faculty of Medicine University of Porto, Cardiovascular Research and Development Centre, Department of Surgery and Physiology, Porto, Portugal
| | - F Saraiva
- Faculty of Medicine University of Porto, Cardiovascular Research and Development Centre, Department of Surgery and Physiology, Porto, Portugal
| | - R Faria
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - J Almeida
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - P Fonseca
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - H Goncalves
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - M Oliveira
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - N Ferreira
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - J Primo
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - R Fontes-Carvalho
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
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Fernandes S, Ladeiras-Lopes R, Cruz I, Silva G, Silva M, Queiros P, Diaz S, Barros A, Saraiva F, Faria R, Almeida J, Fonseca P, Ferreira N, Primo J, Fontes-Carvalho R. Association of epicardial adipose tissue and coronary artery calcium score in patients with atrial fibrillation. Europace 2022. [DOI: 10.1093/europace/euac053.300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
Both coronary artery calcium (CAC) and epicardial adipose tissue (EAT) had been implicated in coronary artery disease (CAD) and risk of future adverse cardiovascular events. There are scarce data regarding the assessment and association of EAT volume and CAC score (CACS) in atrial fibrillation (AF) patients.
Purpose
To assess the association between EAT volume and the presence and severity of CAC in patients with AF.
Methods
Retrospective and single-centre study including consecutive patients with AF undergoing contrast-enhanced cardiac computed tomography for catheter ablation planning, from 2017 to 2019. Patients with known history of CAD and moderate to severe valvular heart disease were excluded. Baseline clinical and demographical data were collected, as well as their cardiovascular risk, based on the SCORE (Systematic Coronary Risk Evaluation) system and cardiovascular risk categories. We assessed CACS (Agatston method) and EAT volume and analysed their association. EAT was defined as the adipose tissue accumulated between the visceral pericardium and the myocardium and was semi-automatically reconstructed by manually tracing the pericardium. Patients were split into three groups according to CACS: 0, 1-99 and ≥100. A logistic regression (LR) analysis was performed to explore the relationship between EAT volume and the presence of CAC (CACS>0), adjusted for age, gender, obesity, diabetes mellitus and hypertension.
Results
A total of 354 patients were included, with a mean age of 56 ± 12 years, 66% male and 21% with persistent AF. A CHA2DS2-VASc score ≥2 was present in 130 (37%) patients and most patients had low to moderate cardiovascular risk (n=213, 82%). More than half of the patients had a CACS>0 (n=185, 52%), of which 63 patients (18%) had a CACS≥100. The mean EAT volume was 79 ± 39 ml. There was a significant association between EAT volume and the presence of CAC: CACS=0 69 ± 34 ml vs CACS 1-99 84 ± 38 ml vs CACS ≥100 95 ± 45 ml (p<0.001) (Fig. 1). After covariate adjustment (LR model R2 = 0.373, p <0.0001), the presence of CAC was not associated with EAT volume (OR 1.00, 95%CI 1.00 - 1.01, p=0.2) or obesity, and only with higher age, male gender, hypertension and diabetes mellitus (Fig. 2).
Conclusion
In our cohort of patients with AF undergoing catheter ablation we observed an association between EAT and CACS. Nevertheless, EAT volume was not an independent predictor of CACS and only the classical cardiovascular risk factors remained significant.
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Affiliation(s)
| | - R Ladeiras-Lopes
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - I Cruz
- Faculty of Medicine University of Porto, Porto, Portugal
| | - G Silva
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - M Silva
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - P Queiros
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - S Diaz
- Faculty of Medicine University of Porto, Cardiovascular Research and Development Centre, Department of Surgery and Physiology, Porto, Portugal
| | - A Barros
- Faculty of Medicine University of Porto, Cardiovascular Research and Development Centre, Department of Surgery and Physiology, Porto, Portugal
| | - F Saraiva
- Faculty of Medicine University of Porto, Cardiovascular Research and Development Centre, Department of Surgery and Physiology, Porto, Portugal
| | - R Faria
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - J Almeida
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - P Fonseca
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - N Ferreira
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - J Primo
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - R Fontes-Carvalho
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
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Fernandes S, Marques N, Goga L. The complexity of neuropsychiatric manifestations of COVID-19 in South Africa. S Afr Med J 2022; 112:313-316. [PMID: 35587242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 04/29/2022] [Indexed: 06/15/2023] Open
Abstract
SARS-CoV-2 was first identified in Wuhan City, China, in 2019. Initially it was associated with the development of pulmonary disease, but research over the past 2 years has identified effects on multiple systems. Neuropsychiatric manifestations of COVID-19 have been reported in countries around the world, including new-onset psychosis in patients with no personal or family psychiatric history. We present the first case series describing neuropsychiatric manifestations of patients in Johannesburg, South Africa (SA). All four patients presented with their index-episode psychosis, and evidence of COVID-19 infection. The patients had varied psychiatric presentations, from delirium and psychosis to mania, and all responded well to low doses of antipsychotics. One patient had newly diagnosed HIV in addition to COVID-19. Further research is needed to determine the prevalence of neuropsychiatric manifestations in acute SARS-CoV-2 infections in SA.
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Affiliation(s)
- S Fernandes
- Division of Neuropsychiatry, Department of Psychiatry, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
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Smythe T, Inglis-Jassiem G, Conradie T, Kamalakannan S, Fernandes S, van-Niekerk SM, English R, Webster J, Hameed S, Louw QA. Access to health care for people with stroke in South Africa: a qualitative study of community perspectives. BMC Health Serv Res 2022; 22:464. [PMID: 35395847 PMCID: PMC8993457 DOI: 10.1186/s12913-022-07903-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 03/31/2022] [Indexed: 11/24/2022] Open
Abstract
Background Incidence of stroke is increasing in sub-Saharan Africa. People who survive stroke experience disability and require long-term care. Health systems in South Africa (SA) are experiencing important challenges, and services in the public health system for people with stroke (PWS) are fragmented. We aimed to explore the perspectives and experiences of PWS related to stroke care services to inform health system strengthening measures. Methods In-depth interviews with 16 PWS in urban and rural areas in the Western and Eastern Cape Provinces of SA were conducted between August and October 2020. PWS were recruited through existing research networks, non-government organisations and organisations of persons with disabilities by snowball sampling. Interviews were transcribed, coded, and thematically analysed. We used the conceptual framework of access to health care as proposed by Levesque et al. to map and inform barriers to accessing health care from the user perspective. Results PWS recognised the need for health care when they experienced signs of acute stroke. Health literacy on determinants of stroke was low. Challenges to accessing stroke care include complex pathways to care, physical mobility related to stroke, long travel distances and limited transport options, waiting times and out of pocket expenses. The perceived quality of services was influenced by cultural beliefs, attitudinal barriers, and information challenges. Some PWS experienced excellent care and others particularly poor care. Positive staff attitude, perceived competence and trustworthiness went in hand with many technical and interpersonal deficits, such as long waiting times and poor staff attitude that resulted in poor satisfaction and reportedly poor outcomes for PWS. Conclusions Strategic leadership, governance and better resources at multiple levels are required to address the unmet demands and needs for health care of PWS. Stroke care could be strengthened by service providers routinely providing information about prevention and symptoms of stroke, treatment, and services to patients and their social support network. The role of family members in continuity of care could be strengthened by raising awareness of existing resources and referral pathways, and facilitating connections within services. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07903-9.
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Affiliation(s)
- T Smythe
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK.
| | - G Inglis-Jassiem
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Stellenbosch University, Cape Town, South Africa
| | - T Conradie
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Stellenbosch University, Cape Town, South Africa
| | - S Kamalakannan
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK.,Public Health Foundation of India, Indian Institute of Public Health Hyderabad, SACDIR, Hyderabad, India
| | - S Fernandes
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - S M van-Niekerk
- Department of Physical Therapy & Rehabilitation Science, College of Health Sciences, Qatar University, Doha, Qatar
| | - R English
- Division of Health Systems and Public Health, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - J Webster
- Department of Disease Control, Faculty of Infectious & Tropical Diseases, London School of Tropical Health and Medicine, London, UK
| | - S Hameed
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK
| | - Q A Louw
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Stellenbosch University, Cape Town, South Africa
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Sá-Sousa A, Rodrigues T, Fernandes S, Santos AM, Garcia-Lema I, Costa ED, Chaves Loureiro C, Boechat JL, Baía Reis A, Figueiredo D, Fonseca JA, Neves AL, Jácome C. ConectAR: Collaborative network of patients with asthma and carers actively involved in health research. A protocol for patient and public involvement. Eur Ann Allergy Clin Immunol 2022. [PMID: 35261226 DOI: 10.23822/eurannaci.1764-1489.249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Summary Patients and Public Involvement in every stage of the patient-centred health research cycle is the key to the development of innovative solutions with an impact on patients' care. This protocol describes the development of ConectAR, a network to promote the involvement of patients with asthma and their carers in the health research cycle. This protocol comprehends 4 tasks: 1) define the mission, vision, governance and activities of the network through focus groups; 2) establish the communication strategy and tools; 3) test the feasibility of the network in a Delphi study on the research priorities for asthma in Portugal; and 4) coordination and dissemination activities. This network will improve research by ensuring that patients and carers have an active role in the co-creation of impactful solutions for asthma.
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Affiliation(s)
- A Sá-Sousa
- Department of Community Medicine, Health Information and Decision (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal.,Center for Health Technology and Services Research (CINTESIS.UP), University of Porto, Porto, Portugal
| | - T Rodrigues
- Center for Health Technology and Services Research (CINTESIS.UP), University of Porto, Porto, Portugal.,Centro Hospitalar Vila Nova de Gaia Espinho (CHVNGE), Vila Nova de Gaia, Porto, Portugal
| | - S Fernandes
- Human Reproduction Unit, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - A M Santos
- Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, Portugal
| | - I Garcia-Lema
- Department of Community Medicine, Health Information and Decision (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal.,Center for Health Technology and Services Research (CINTESIS.UP), University of Porto, Porto, Portugal
| | - E D Costa
- Department of Design, Faculty of Fine Arts, University of Porto, Porto, Portugal
| | - C Chaves Loureiro
- Pneumology Unit, Hospitais da Universidade de Coimbra, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.,Centre of Pneumology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - J L Boechat
- Center for Health Technology and Services Research (CINTESIS.UP), University of Porto, Porto, Portugal.,Basic and Clinical Immunology Unit, Department of Pathology, Faculty of Medicine, University of Porto, Portugal
| | - A Baía Reis
- Centre for Media and Communication, University of Passau, Passau, Germany
| | - D Figueiredo
- Center for Health Technology and Services Research (CINTESIS.UP), University of Porto, Porto, Portugal.,Center for Health Technology and Services Research (CINTESIS.UA), School of Health Sciences, University of Aveiro, Aveiro, Portugal
| | - J A Fonseca
- Department of Community Medicine, Health Information and Decision (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal.,Center for Health Technology and Services Research (CINTESIS.UP), University of Porto, Porto, Portugal.,Allergy Unit, Instituto CUF Porto e Hospital CUF Porto, Porto, Portugal
| | - A L Neves
- Department of Community Medicine, Health Information and Decision (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal.,Center for Health Technology and Services Research (CINTESIS.UP), University of Porto, Porto, Portugal.,Imperial NIHR Patient Safety Translational Research Centre, Institute of Global Health Innovation, Imperial College London, London, U.K
| | - C Jácome
- Department of Community Medicine, Health Information and Decision (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal.,Center for Health Technology and Services Research (CINTESIS.UP), University of Porto, Porto, Portugal
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22
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Brito J, Silva P, Valente Silva B, Pereira S, Silverio Antonio P, Morais P, Rigueira J, Placido R, David C, Silva D, Fernandes S, Ribeiro J, Pinto FJ, Almeida A. Long term left ventricular impairment after SARS-COV2 infection. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.105] [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
Funding Acknowledgements
Type of funding sources: None.
Introduction
The impact of acute infection by SARS-COV2 on the cardiovascular system has been previously reported in the literature, with a higher propensity in patients with more serious pattern of disease and pro-inflammatory status. Nevertheless, the long-term burden and sequels of COVID-19 on the cardiovascular system is still unknown.
Purpose
To evaluate the long-term impact of COVID-19 on left ventricular function in patients with severe clinical presentation requiring intensive care hospitalization.
Methods
This was a single-center observational, prospective study which included patients requiring admission to the Intensive Care Unit (ICU) due to COVID-19 infection from January to November 2020. All discharged patients were contacted to perform a clinical, electrocardiographic and echocardiographic evaluation and those who accepted were included on the protocol. Baseline and clinical characteristics were collected from clinical reports. For the global longitudinal strain (GLS) analysis all patients with significant wall motion abnormalities and valvular cardiopathy were excluded. Statistical analysis was performed with Mann-Whitney and a safety cut-off was established with ROC curve analysis.
Results
A total of 43 patients were included (mean age 64 ± 12, 67.4% males). During SARS-COV2 infection 49% presented with severe ARDS and 51% with moderate, 35% required invasive mechanical ventilation, 14% noninvasive mechanical ventilation and 52% with high nasal flow cannula. On the follow-up analysis, fatigue was the most reported in symptom (52% patients) and the majority did not present other signs or symptoms suggestive of heart failure, with the mean NT-proBNP of 49 ± 389 pg/dL. The standard ECG and echocardiogram did not show significant changes with a mean LVEF of 58 ± 7.8 and mean TAPSE of 21 ± 4. The strain analysis showed low value of GLS (mean GLS of -17.14 ± 2.36) for a reference cut-off of -18%, suggesting subclinical left ventricular dysfunction in this subset of patients with preserved ejection fraction. Maximum CPR values during ICU did not correlate either with the extent of disease evolvement in CT (p= NS) or ARDS severity (p= NS). Nevertheless, maximum CPR correlated significantly with GLS reduction (R = 0.44, p = 0.019). A CPR value higher than iger30mg/dL had 100% specificity for GLS reduction and a cut-off of 14gm/dL reported a sensitivity of 65% and specificity pf 75% for reduction in GLS.
Conclusion
In our study, we reported subclinical impairment in left ventricular function detected with global longitudinal strain after serious infection with SARS-COV2. The detected myocardial dysfunction was related with higher inflammatory as expressed by CPR values. Long-term monitoring of these patients should be undertaken in order to timely detect late complications. Abstract Figure.
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Affiliation(s)
- J Brito
- Santa Maria University Hospital CHLN Lisbon Academic Medical Centre, Lisbon, Portugal
| | - P Silva
- Santa Maria University Hospital CHLN Lisbon Academic Medical Centre, Lisbon, Portugal
| | - B Valente Silva
- Santa Maria University Hospital CHLN Lisbon Academic Medical Centre, Lisbon, Portugal
| | - S Pereira
- Santa Maria University Hospital CHLN Lisbon Academic Medical Centre, Lisbon, Portugal
| | - P Silverio Antonio
- Santa Maria University Hospital CHLN Lisbon Academic Medical Centre, Lisbon, Portugal
| | - P Morais
- Santa Maria University Hospital CHLN Lisbon Academic Medical Centre, Lisbon, Portugal
| | - J Rigueira
- Santa Maria University Hospital CHLN Lisbon Academic Medical Centre, Lisbon, Portugal
| | - R Placido
- Santa Maria University Hospital CHLN Lisbon Academic Medical Centre, Lisbon, Portugal
| | - C David
- Santa Maria University Hospital CHLN Lisbon Academic Medical Centre, Lisbon, Portugal
| | - D Silva
- Santa Maria University Hospital CHLN Lisbon Academic Medical Centre, Lisbon, Portugal
| | - S Fernandes
- Santa Maria University Hospital CHLN Lisbon Academic Medical Centre, Lisbon, Portugal
| | - J Ribeiro
- Santa Maria University Hospital CHLN Lisbon Academic Medical Centre, Lisbon, Portugal
| | - FJ Pinto
- Santa Maria University Hospital CHLN Lisbon Academic Medical Centre, Lisbon, Portugal
| | - A Almeida
- Santa Maria University Hospital CHLN Lisbon Academic Medical Centre, Lisbon, Portugal
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23
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Fernandes S, Rodrigues da Silva E, New York B, Macedo P, Gonçalves R, Camara S, Larco R, Maciel A. Cutoff Points for Grip Strength in Screening for Sarcopenia in Community-Dwelling Older-Adults: A Systematic Review. J Nutr Health Aging 2022; 26:452-460. [PMID: 35587757 DOI: 10.1007/s12603-022-1788-6] [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] [Indexed: 11/29/2022]
Abstract
BACKGROUND Currently, different cutoff points for handgrip strength (HGS) have been used to estimate the prevalence of sarcopenia. In addition, the variability of equipment and protocols for this assessment can significantly influence the early detection of this important public health problem. Thus, this review aims to identify the different cutoff points for HGS adopted for older men and women in screening for sarcopenia. OBJECTIVES this review aims to identify the different cutoff points for HGS adopted for older men and women in screening for sarcopenia. METHODS In accordance with the PRISMA 2020 recommendations, which included published studies from the last 10 years, from 6 databases, in 3 different languages. RESULTS 19.730 references were identified, of which 62 were included for the review. All references analyzed used algorithms and definitions of sarcopenia already known in the literature. Of the studies found, 16 chose to develop cutoff values for HGS based on their own population. The variation in cutoff points was evident when compared between gender and regions of the world. CONCLUSION It has become evident that there is a variability of normative values for HGS in sarcopenia screening. In addition, this systematic review shows the difference in the cutoff points used between the consensuses and those developed for each population.
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Affiliation(s)
- S Fernandes
- Sabrina Fernandes, Universidade Federal do Rio Grande do Norte, Brazil,
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24
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Correia C, Fernandes S, Soares-de-Almeida L, Filipe P. Exuberant lichenoid eruption after Oxford-AstraZeneca COVID-19 vaccine: a singular case. J Eur Acad Dermatol Venereol 2021; 36:e268-e270. [PMID: 34913207 DOI: 10.1111/jdv.17872] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 12/07/2021] [Indexed: 12/17/2022]
Affiliation(s)
- C Correia
- Dermatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), Lisbon, Portugal
| | - S Fernandes
- Dermatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), Lisbon, Portugal
| | - L Soares-de-Almeida
- Dermatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), Lisbon, Portugal.,Dermatology University Clinic, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - P Filipe
- Dermatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), Lisbon, Portugal.,Dermatology University Clinic, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
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25
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Macková A, Fernandes S, Matejíček J, Vilémová M, Holý V, Liedke M, Martan J, Vronka M, Potoček M, Bábor P, Butterling M, Attallah A, Hirschmann E, Wagner A, Havránek V. Radiation damage evolution in pure W and W-Cr-Hf alloy caused by 5 MeV Au ions in a broad range of dpa. Nuclear Materials and Energy 2021. [DOI: 10.1016/j.nme.2021.101085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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26
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Fernandes S, Ladeiras-Lopes R, Faria R, Ferreira W, Carvalho M, Almeida J, Fonseca P, Oliveira M, Goncalves H, Ferreira N, Primo J, Fontes-Carvalho R. Coronary calcification by computed tomography in patients with paroxysmal and persistent atrial fibrillation undergoing catheter ablation. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0425] [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
Cardiac computed tomography (CCT) is routinely performed for pulmonary vein isolation (PVI) planning in patients with paroxysmal or persistent atrial fibrillation (AF). This imaging method can also identify coronary artery calcium (CAC).
Purpose
To evaluate the prevalence of CAC in patients with paroxysmal and persistent AF undergoing catheter ablation.
Methods
Cross-sectional study including patients with AF/atrial flutter (AFL) undergoing CCT for ablation procedure planning from 2017 to 2019. Baseline clinical and demographic data were collected and CAC score was assessed using the Agatston method. Patients with paroxysmal and persistent AF/AFL (defined according to 2020 European Society of Cardiology guidelines for the diagnosis and management of AF) were compared.
Results
A total of 474 patients were included (441 with AF and 33 with AFL), with a mean age of 57±12 years, of which 295 (62%) were males. CHA2DS2-VASc score was ≥1 (male) or ≥2 (female) in 278 (64%) patients and most patients had a low to moderate cardiovascular risk (259, 80%). CAC was identified in 254 (54%) patients. AF/AFL was paroxysmal in 348 (75%) patients and persistent in 116 (25%). Baseline characteristics and cardiovascular risk factors were similar between groups except for diabetes mellitus (33 [10%] vs 22 [20%], p=0.012) and valvular heart disease (13 [4%] vs 18 [16%], p<0.001) that were more prevalent in patients with persistent AF/AFL. Patients with persistent AF/AFL had higher left atrial volume and left ventricle mass (36±8 vs 43±12 ml/m2, p<0.001 and 90±22 vs 96±22 g/m2, p=0.041). CAC was more frequently present in patients with persistent AF/AFL (175 [50%] vs 72 [62%], p=0.028), especially CAC score >100 (58 [17%] vs 35 [30%], p=0.002). After multivariate analysis, CAC score>100 remained an independent predictor of persistent AF/AFL (OR 2.12, 95% CI 1.18–3.82, p=0.013) along with higher left atrial volume (OR 1.06, 95% CI 1.03–1.08, p<0.001).
Conclusion
In this study, coronary artery calcium was present in more than half of AF/FLA patients undergoing catheter ablation. Patients with persistent AF/AFL showed higher calcium scores and this could derive from chronic, more advanced disease. Especially in those patients, opportunistic CV risk screening and CAC-guided clinical management might be clinically useful.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
| | - R Ladeiras-Lopes
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - R Faria
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - W Ferreira
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - M Carvalho
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - J Almeida
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - P Fonseca
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - M Oliveira
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - H Goncalves
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - N Ferreira
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - J Primo
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - R Fontes-Carvalho
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
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27
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Fernandes S, Ladeiras-Lopes R, Faria R, Ferreira W, Carvalho M, Almeida J, Fonseca P, Oliveira M, Goncalves H, Ferreira N, Primo J, Fontes-Carvalho R. Coronary artery calcium in patients with atrial fibrillation undergoing catheter ablation – an opportunity to personalize cardiovascular and thromboembolic risk management. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2470] [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
There is a well-established association between atrial fibrillation (AF) and coronary artery disease (CAD). Coronary artery calcium score (CACS) is a helpful tool to refine cardiovascular risk stratification and guide strategies of cardiovascular (CV) primary prevention.
Purpose
To evaluate the prevalence and clinical implications of CACS in terms of CV and thromboembolic risk stratification and preventive therapies, in patients with AF and atrial flutter (AFL) undergoing catheter ablation.
Methods
Cross-sectional study including patients with AF/AFL undergoing multidetector computed tomography (MDCT) for ablation procedure planning from 2017 to 2019. Baseline clinical and demographical data were collected. CV and thromboembolic risks were evaluated based on the SCORE (Systematic Coronary Risk Evaluation) system and CHA2DS2-VASc score. CACS was assessed in patients without history of coronary artery disease using the Agatston method.
Results
A total of 474 patients were included (441 with AF and 33 with AFL, mean age of 58±10 years, 62% male). Excluding those over 70 years of age (n=50, 11%), most patients had low (n=69, 22%) or moderate (n=188, 60%) CV risk and 277 (64%) patients had a CHA2DS2-VASc score ≥1 (male) or ≥2 (female). Overall, 265 patients (65%) were under chronic anticoagulation and 157 (39%) were under statin therapy. CAC was present in 254 (54%) patients and showed a multivessel distribution in 62% of the cases. The left main stem was affected in 81 (17%) patients and the left anterior descending artery in 211 (45%). Incorporating CACS>100 as a variable in CHA2DS2-VASc score (vascular disease parameter in patients without history of vascular disease) would have resulted in a significant score reclassification (n=87, 20%) and identification of new potential candidates for anticoagulation (n=12, 3%). Additional, anticoagulation would be indicated as a class IA recommendation in more 26 (6%) patients. Twenty three percent of patients with zero calcium were taking statins, and only 7% of patients with a CACS >300 were on high-intensity statin therapy. According to the recommendations and based on their CACS and current therapy, 103 (25%) patients would be candidates for statin therapy and 69 (17%) patients would be candidates for changes in the current statin therapy intensity (Table 1).
Conclusion
In our study, more than half of the patients undergoing MDCT before AF/AFL catheter ablation had coronary calcium above zero. Our findings suggest that an opportunistic evaluation of CACS can be clinically valuable in thromboembolic risk stratification and management of preventive pharmacological strategies such as anticoagulation and statins.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
| | - R Ladeiras-Lopes
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - R Faria
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - W Ferreira
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - M Carvalho
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - J Almeida
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - P Fonseca
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - M Oliveira
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - H Goncalves
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - N Ferreira
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - J Primo
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - R Fontes-Carvalho
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
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Cabral M, Fernandes S, Santos LG, Carvalho M, Carvalho R, Santos B, Loureiro MF, Morais J. Is there a real difference in approach between women and men with non-ST-segment elevation myocardial infarction? Insights from a multicentre national registry. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1193] [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
In patients with non-ST-elevation myocardial infarction (NSTEMI), the early invasive strategy has shown benefit in morbidity and mortality, especially in intermediate-to-high risk patients. However, women still seem to have a lower revascularization rate, regardless of the risk.
The aim of this study is to describe our clinical practice reality about the performance of the invasive strategy between genders among NSTEMI patients, in Portugal.
The authors performed a retrospective analysis of patients admitted with NSTEMI included in the Portuguese Registry on Acute Coronary Syndromes (ProACS) between October 2010 and February 2021. A propensity score matching included baseline characteristics and previous history was applied. Comparison tests and log-rank test were performed. A p-value less than 0.05 was considered statistically significant.
A total of 11858 patients with NSTEMI were included, of which 71.3% (n=8450) were men. After the propensity score performing, 4458 patients were analysed, 50.0% (n=2229) men. Table 1 shows the most important baseline characteristics.
The authors found a significant delay in hospital admission after the onset of symptoms in women (median of 6 hours and 48 minutes) compared to men (median of 5 hours) (p<0.01). Grace score was higher in males (mean 153 points) than in females (mean 145 points) (p<0.01).
The cardiac catheterization was performed in 82.9% (n=3695) of the patients, with no difference between genders (p-value=0.19), as shown in table 2. Among those who underwent cardiac catheterisation, the presence of significant stenosis and coronary occlusion was greater in males, for almost all localizations. The absence of obstructive coronary lesions was more common in females (p-value<0.01).
During hospitalization, sustained ventricular tachycardia was more prevalent in males (p-value =0.01), with no significant difference for other complications or in-hospital mortality.
A 1-year follow-up of 2351 patients (1184 men and 1163 women) was analysed, with survival of 91.2% (n=1080) in men and 91.0% (n=1056) in women, with no significant difference (p-value=0.80).
In conclusion, we observed that women are admitted to the hospital later than men and have a lower Grace score at admission. However, the standardized analysis of the groups allows us to infer that the invasive strategy does not seem to be less frequent or late in women, as observed in other populations. A more recent analysis, including risk groups, would be interesting to clarify the results.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Cabral
- Leiria Hospital Centre, Leiria, Portugal
| | | | - L G Santos
- Leiria Hospital Centre, Leiria, Portugal
| | - M Carvalho
- Leiria Hospital Centre, Leiria, Portugal
| | - R Carvalho
- Leiria Hospital Centre, Leiria, Portugal
| | - B Santos
- Leiria Hospital Centre, Leiria, Portugal
| | - M F Loureiro
- Portuguese Society of Cardiology, National Center for Data Collection in Cardiology, Coimbra, Portugal
| | - J Morais
- Leiria Hospital Centre, Leiria, Portugal
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29
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Fernandes S, Martins C, Silva RA. CytoPath®Easy processing method validation through cervical self-sampling. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab120.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Liquid-based cytology is mostly used for the identification of pre-neoplastic and neoplastic cells of cérvix uteri, and many manual and automatic methodologies are available on the market. This study aims to validate a new manual liquid-based processing method - the CytoPath® Easy Kit, for its routine use in some cytology laboratories.
Methods
For this purpose, 45 cervical samples, obtained by self-sampling of women aged 18–58 years old were used: 30 were collected and processed with the CytoPath® Easy Kit and 15 samples were collected and processed by Thinprep®, as a control. Parameters evaluated were cellularity, thickness and cellular overlap of the imprint, undesirable background/debris, morphological preservation and staining properties of the sample. The presence and quantity of metaplastic and/or endocervical cells of the transformation zone was also compared between methods.
Results
The results obtained show that CytoPath® Easy Kit allows the representation of the sample with a very satisfactory cellularity, in a thin layer of cells and without excessive overlap, presenting a reasonably clean background. Statistically, both methods present similar results (P > 0.9999), both globally and for each of the parameters evaluated individually. These results allow to validate the use of this new method in the cytological routine.
Conclusions
This Kit proves to be very useful, allowing the laboratory to screen cervical cytology samples, without the need for large investments and with reliable microscopic results. This has particular interest for laboratories of poor or developing countries as well for services processing small number of samples.
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Affiliation(s)
- S Fernandes
- Centro de Investigação em Saúde e Ambiente da Escola Superior de Saúde do Instituto Politécnico do Porto (CISA-ESS
- P.PORTO), Rua Dr. António Bernardino de Almeida 400, 4200-072 Porto, Portugal
| | - C Martins
- Centro de Investigação em Saúde e Ambiente da Escola Superior de Saúde do Instituto Politécnico do Porto (CISA-ESS
- P.PORTO), Rua Dr. António Bernardino de Almeida 400, 4200-072 Porto, Portugal
| | - R A Silva
- Centro de Investigação em Saúde e Ambiente da Escola Superior de Saúde do Instituto Politécnico do Porto (CISA-ESS
- P.PORTO), Rua Dr. António Bernardino de Almeida 400, 4200-072 Porto, Portugal
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30
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Sheikh S, Scheinberg M, Wei JCC, Tegzová D, Stohl W, Mucenic T, Punwaney R, Kurrasch R, Harris J, Muzaffar S, Fernandes S, Fox NL, Liu A, Quasny H, Roth D. AB0288 SAFETY OF BELIMUMAB IN PATIENTS WITH ACTIVE SYSTEMIC LUPUS ERYTHEMATOSUS: YEAR 2 FOLLOW-UP OF A LARGE PHASE 4, RANDOMISED, DOUBLE-BLIND, PLACEBO-CONTROLLED STUDY. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2552] [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
Background:Belimumab (BEL), a recombinant human monoclonal antibody that inhibits B-lymphocyte stimulator (BLyS), is approved for the treatment of systemic lupus erythematosus (SLE). Clinical studies have yielded varying incidence rates of mortality and adverse events of special interest, such as malignancies, thereby necessitating large-scale, long-term assessment following BEL exposure.Objectives:To assess all-cause mortality and new primary malignancies during post-treatment Year 2 follow-up in adult patients with active, autoantibody-positive SLE who received intravenous (IV) BEL or placebo (PBO), plus standard therapy in the 52-week double-blind treatment period of the ongoing BASE trial.1Methods:This was a post-treatment follow-up of the Phase 4, double-blind study (BASE1; GSK Study BEL115467; NCT01705977), which randomised 4019 adults with active SLE and receiving standard therapy to BEL (10 mg/kg IV) or PBO on Days 0, 14, 28, and monthly thereafter until Week 48. All patients (including those who discontinued BEL before the end-of-treatment phase) were contacted by phone annually (+/-30-day time window). Rates of mortality and new primary malignancy are summarised for Year 2 follow-up, presented by the treatment received during the 52-week double-blind treatment period (Year 1).Results:Baseline patient characteristics and disease activity collected at the start of the study, evaluated in patients with Year 2 follow-up were similar to the overall Year 1 study population. Cumulatively by Year 2 follow-up, 10.7% and 9.5% of patients had been exposed to commercial BEL in the BEL and PBO groups, respectively. Cumulative follow-up adjusted mortality and malignancy rates (per 100 patient years) were lower in the BEL vs PBO Year 1 treatment group (Table 1).Conclusion:Year 2 follow-up results of BASE, the largest clinical trial of SLE to date,1 provide continued support for the BEL safety profile. No new BEL safety concerns were identified in patients with active, autoantibody-positive SLE receiving standard therapy.Funding: GSKReferences:[1]Sheikh SZ, et al. Lancet Rheum. 2020 (ePub ahead of print) doi.org/10.1016/S2665-9913(20)30355-6Table 1.Year 2 post-treatment* follow-up mortality and new primary malignancy rates by study treatment during Year 1BELPBOTotalYear 1 as-treated populationN=2002N=2001N=4003Year 1 deaths, n (%)13 (0.65)22 (1.10)35 (0.87)Year 1 new primary malignancies, n (%)9 (0.45)10 (0.50)19 (0.47)Year 2 (as-treated in Year 1) populationN=1681N=1666N=3347Year 2 deaths by MedDRA SOC, n (%)9 (0.54)21 (1.26)30 (0.90)Cardiac disorders2 (0.12)6 (0.36)8 (0.24)Infections and infestations4 (0.24)2 (0.12)6 (0.18)Uncoded1 (0.06)3 (0.18)4 (0.12)General disorders/administration site conditions1 (0.06)2 (0.12)3 (0.09)Gastrointestinal disorders1 (0.06)1 (0.06)2 (0.06)Neoplasms02 (0.12)2 (0.06)Other05 (0.30)†5 (0.15)Cumulative deaths by Year 2 follow-up, n (%)22 (1.10)43 (2.15)65 (1.62)Incidence rate per 100 patient years0.601.180.89Year 2 new primary malignancies by MedDRA SOC, n (%)3 (0.18)4 (0.24)7 (0.21)Neoplasms2 (0.12)4 (0.24)6 (0.18)Hepatobiliary disorders1 (0.06)01 (0.03)Cumulative malignancies by Year 2 follow-up, n (%)12 (0.60)14 (0.70)26 (0.65)Patient incidence rate per 100 patient years0.340.400.37*Patients in the post-treatment follow-up period are no longer receiving study treatment; †1 event/patient: blood/lymphatic system, musculoskeletal/connective tissue, nervous system, psychiatric, and renal/urinary disorders.MedDRA, Medical Dictionary for Regulatory Activities; SOC, system organ class.Acknowledgements:Medical writing assistance was provided by Katalin Bartus, PhD, Fishawack Indicia Ltd., UK, part of Fishawack Health, and was funded by GSK.Disclosure of Interests:Saira Sheikh Grant/research support from: Pfizer, Morton Scheinberg Consultant of: GSK, Pfizer, Alnylam, AbbVie, PTC Therapeutics, James Cheng-Chung Wei Consultant of: TSH Biopharm, AbbVie, BMS, Celgene, Chugai, Eisai, Janssen, Novartis, Pfizer, Sanofi-Aventis and UCB pharma, Grant/research support from: AbbVie, Amgen, Astellas, BMS, Celgene, Eli Lilly, Gilead, Janssen, Novartis, Pfizer Sun and UCB, Dana Tegzová: None declared, William Stohl Consultant of: GSK, Grant/research support from: GSK, Pfizer, Gilead, Tamara Mucenic Speakers bureau: Novartis, Janssen, BMS, AbbVie, Pfizer, Roche, Grant/research support from: GSK, Janssen, Roche, Eli Lilly, Gilead, UCB, Raj Punwaney Shareholder of: GSK, Employee of: GSK, Regina Kurrasch Shareholder of: GSK, Employee of: GSK, Julia Harris Shareholder of: GSK, Employee of: GSK, Saima Muzaffar Shareholder of: GSK, Employee of: GSK, Sofia Fernandes Shareholder of: GSK, Employee of: GSK, Norma Lynn Fox Shareholder of: GSK, Employee of: GSK, Andrew Liu Shareholder of: GSK, Employee of: GSK, Holly Quasny Shareholder of: GSK, Employee of: GSK, David Roth Shareholder of: GSK, Employee of: GSK
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Cabral M, Fernandes S, Santos LG, Carvalho R, Sa FM, Martins H, Pernencar S, Ruivo C, Santos B, Morais J. An outbreak of infective endocarditis during the COVID-19 pandemic? - an observational retrospective single centre study. European Heart Journal. Acute Cardiovascular Care 2021. [PMCID: PMC8227352 DOI: 10.1093/ehjacc/zuab020.184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Funding Acknowledgements Type of funding sources: None. Infective endocarditis (IE) is described as an uncommon and challenging infective
disease, due to its presentation variability. Its mortality remains high besides the
better disease knowledge and therapeutic progress. The aim of this study was to describe the clinical features and the incidence of IE.
Furthermore, we try to identify the risk factors associated with early mortality. A retrospective study was conducted and all patients diagnosed with definite or
possible IE between January 2015 and June 2020, according to the modified Duke criteria,
were included. Patient selection and information collection were obtained through
medical records. Outcomes were in-hospital and 3 months after discharge mortality. Group comparisons and multivariate logistic regression analysis were performed. A
p-value less than 0.05 is statistically significant. We analysed 51 patients, which 41 were admitted between 2015 and 2019 with a mean
incidence of 8.2 cases per year. In 2020, 10 cases were diagnosed, corresponding to a
percentual increase of 143.9%. Of the 51 patients, 70.6% were male. The mean age was 65 years. Fever was the main
presentation feature at admission. We counted 33.3% prosthetic valve endocarditis (PVE)
and 5.9% IE device-related. The most common pathogens were Streptococcus gallolyticus
(13.7%) and Streptococcus oralis (13.7%). 35 patients (68.6%) had local complications
and 26 patients (51%) had systemic complications. One-third of the patients was
referenced to surgical treatment. Overall in-hospital mortality was 19.6% and early
mortality at 3 months was 27.5%. In the univariate analysis, early mortality was higher in diabetes mellitus (DM)
patients (p < 0.01) and in those who developed sepsis during hospitalization
(p = 0.04). In multivariate logistic regression, only DM (OR = 15.8, 95% CI [3.2, 79.0])
was shown to be an independent factor of mortality. The incidence of IE increased during the first semester of 2020, possibly due to the
increased attention given to patients with fever. Diabetes mellitus was found to be the
only independent predictor of mortality. More national multicentre studies are needed.
Predictive factors of 3 months mortality | Survivors (n = 37) | Non-survivors (n = 14) | p-value |
---|
Age, med (IQ) | 70.0 (23.0) | 70.5
(14.0) | 0.42 | Female, n(%) | 11
(29.7) | 4 (28.6) | 1.00 | Diabetes
mellitus, n(%) | 6 (16.2) | 11
(78.6) | <0.01 | Local complication,
n(%) | 24 (64.9) | 11 (78.4) | 0.50 | Sepsis,
n(%) | 2 (5.4) | 4
(28.6) | 0.04 |
Univariate analysis (resumed version). med-median, IQ-interquartile range,
n-absolute frequency Abstract
Figure. ROC curve for logistic regression model ![]()
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Affiliation(s)
- M Cabral
- Leiria Hospital Centre, Leiria, Portugal
| | | | - LG Santos
- Leiria Hospital Centre, Leiria, Portugal
| | - R Carvalho
- Leiria Hospital Centre, Leiria, Portugal
| | - FM Sa
- Pedro Hispano hospital, Matosinhos, Portugal
| | - H Martins
- Leiria Hospital Centre, Leiria, Portugal
| | | | - C Ruivo
- Leiria Hospital Centre, Leiria, Portugal
| | - B Santos
- Leiria Hospital Centre, Leiria, Portugal
| | - J Morais
- Leiria Hospital Centre, Leiria, Portugal
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RODRIGUES A, Fernandes S, Bustorff M, Tavares I, Sampaio S, Pestana M. POS-764 REFRACTORY CYTOMEGALOVIRUS INFECTION: FROM CMV MUTATIONS TO VALPROATE TREATMENT. Kidney Int Rep 2021. [DOI: 10.1016/j.ekir.2021.03.796] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Fernandes S, Cerqueira-Silva T, Pinto A, Miranda-Scippa Â. Lithium treatment and estimate glomerular filtration rate in bipolar disorder patients: A cross-sectional study. Eur Psychiatry 2021. [PMCID: PMC9471255 DOI: 10.1192/j.eurpsy.2021.236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Lithium has been the mainstay therapy for bipolar disorder (BD) for decades, but there is little consensus regarding its possible effects on kidney function and the rate of change in estimated glomerular flow rate (eGFR) over time. Objectives To describe patients with BD regarding their renal function and their sociodemographic and clinical characteristics potentially related to eGFR. Methods This is a cross-sectional study with an initial sample of 95 patients with BD. Multiple linear regression analysis was applied to investigate the association of lithium serum levels and their duration of treatment with eGFR, independent of confounding factors. We excluded patients without data regarding any of the variables from the final model. Results In the multivariable analysis, the model was composed of eight variables (Figure 1). The mean duration of treatment was 10 years (Figure 2). Serum lithium level was associated with low levels of eGFR (β = -18.06 [-34.70 - -1.42], p = 0.03); among the other variables, only age remained associated with it (β = -0.72 (-1.10 - -0.33), p = <0.01).Note: *P<0.05 ![]() ![]() Conclusions We replicated the correlation between serum lithium levels and eGFR. Our results contradict the claim that duration of treatment with lithium correlates with lower levels of eGFR, while suggesting serum lithium level could be a possible early marker of lithium nephrotoxicity. Disclosure No significant relationships.
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Fernandes S, Fond G, Zendjidjian X, Michel P, Lançon C, Berna F, Schurhoff F, Aouizerate B, Henry C, Etain B, Samalin L, Leboyer M, Misdrahi D, Llorca PM, Coldefy M, Auquier P, Baumstarck K, Boyer L. A conceptual framework to develop a patient-reported experience measure of the quality of mental health care: a qualitative study of the PREMIUM project in France. J Mark Access Health Policy 2021; 9:1885789. [PMID: 33680364 PMCID: PMC7906613 DOI: 10.1080/20016689.2021.1885789] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Background: The objective of this study was to develop a conceptual framework to define a domain map describing the experience of patients with severe mental illnesses (SMIs) on the quality of mental health care. Methods: This study used an exploratory qualitative approach to examine the subjective experience of adult patients (18-65 years old) with SMIs, including schizophrenia (SZ), bipolar disorder (BD) and major depressive disorder (MDD). Participants were selected using a purposeful sampling method. Semistructured interviews were conducted with 37 psychiatric inpatients and outpatients recruited from the largest public hospital in southeastern France. Transcripts were subjected to an inductive analysis by using two complementary approaches (thematic analysis and computerized text analysis) to identify themes and subthemes. Results: Our analysis generated a conceptual model composed of 7 main themes, ranked from most important to least important as follows: interpersonal relationships, care environment, drug therapy, access and care coordination, respect and dignity, information and psychological care. The interpersonal relationships theme was divided into 3 subthemes: patient-staff relationships, relations with other patients and involvement of family and friends. All themes were spontaneously raised by respondents. Conclusion: This work provides a conceptual framework that will inform the subsequent development of a patient-reported experience measure to monitor and improve the performance of the mental health care system in France. The findings showed that patients with SMIs place an emphasis on the interpersonal component, which is one of the important predictors of therapeutic alliance. Trial registration: NCT02491866.
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Affiliation(s)
- S Fernandes
- Aix-Marseille Univ, School of Medicine - La Timone Medical Campus, EA 3279: CEReSS - Health Service Research and Quality of Life Center, Marseille, France
- CONTACT S Fernandes
| | - G Fond
- Aix-Marseille Univ, School of Medicine - La Timone Medical Campus, EA 3279: CEReSS - Health Service Research and Quality of Life Center, Marseille, France
| | - X Zendjidjian
- Aix-Marseille Univ, School of Medicine - La Timone Medical Campus, EA 3279: CEReSS - Health Service Research and Quality of Life Center, Marseille, France
| | - P Michel
- Aix-Marseille Univ, School of Medicine - La Timone Medical Campus, EA 3279: CEReSS - Health Service Research and Quality of Life Center, Marseille, France
| | - C Lançon
- Aix-Marseille Univ, School of Medicine - La Timone Medical Campus, EA 3279: CEReSS - Health Service Research and Quality of Life Center, Marseille, France
| | - F Berna
- FondaMental Foundation, Créteil, France
| | | | | | - C Henry
- FondaMental Foundation, Créteil, France
| | - B Etain
- FondaMental Foundation, Créteil, France
| | - L Samalin
- FondaMental Foundation, Créteil, France
| | - M Leboyer
- FondaMental Foundation, Créteil, France
| | | | - PM Llorca
- FondaMental Foundation, Créteil, France
| | - M Coldefy
- Institute for Research and Information in Health Economics (IRDES), Paris, France
| | - P Auquier
- Aix-Marseille Univ, School of Medicine - La Timone Medical Campus, EA 3279: CEReSS - Health Service Research and Quality of Life Center, Marseille, France
| | - K Baumstarck
- Aix-Marseille Univ, School of Medicine - La Timone Medical Campus, EA 3279: CEReSS - Health Service Research and Quality of Life Center, Marseille, France
| | - L Boyer
- Aix-Marseille Univ, School of Medicine - La Timone Medical Campus, EA 3279: CEReSS - Health Service Research and Quality of Life Center, Marseille, France
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Caqueo-Urízar A, Urzúa A, Mena-Chamorro P, Boucekine M, Richieri R, Auquier P, Fernandes S, Fond G, Boyer L. Cross-Cultural Adaptation and Validation of the Quality of Life Questionnaire for Caregivers of Patients with Schizophrenia (S-CGQoL) in Latin America. Encephale 2021; 47:291-298. [PMID: 33551123 DOI: 10.1016/j.encep.2020.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 08/20/2020] [Accepted: 09/19/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The aim of this study was to adapt and validate the Schizophrenia Caregiver's Quality of Life Questionnaire (S-CGQoL) for use in the Hispanic-American population from the caregiver's perspective. METHODS A cross-sectional instrumental model was used, with a sample of 253 caregivers of patients suffering of Schizophrenia in Bolivia, Peru and Chile. The psychometric properties of the S-CGQoL were tested through construct validity, reliability and some aspects of external validity. In addition, in order to assess the nature of the different items across the three countries, a Differential Performance Analysis (DPA) was conducted. RESULTS A confirmatory factor analysis showed that the scale structure was well correlated to the initial structure of the QoL-MDS. The results confirmed the existence of adequate reliability indicators (α>.70 and ω>.80) and the absence of FIDs supporting the invariance of item calibrations among the three Latin American countries. CONCLUSIONS The adaptation and validation of the S-CGQoL questionnaire demonstrate adequate psychometric properties to assess the quality of life of caregivers in samples of middle-income countries in Latin America.
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Affiliation(s)
- A Caqueo-Urízar
- Instituto de Alta Investigación, Universidad de Tarapacá, Arica, Chile.
| | - A Urzúa
- Escuela de Psicología, Universidad Católica del Norte, Antofagasta, Chile
| | - P Mena-Chamorro
- Escuela de Psicología y Filosofía, Universidad de Tarapacá, Arica, Chile
| | - M Boucekine
- Aix-Marseille Univ, EA 3279-Public Health, Chronic Diseases and Quality of Life - Research Unit, 13005 Marseille, France
| | - R Richieri
- Aix-Marseille Université, CNRS, École Centrale Marseille, UMR, 7249, Institut Fresnel, Marseille, France
| | - P Auquier
- Aix-Marseille Univ, EA 3279-Public Health, Chronic Diseases and Quality of Life - Research Unit, 13005 Marseille, France
| | - S Fernandes
- Aix-Marseille Univ, EA 3279-Public Health, Chronic Diseases and Quality of Life - Research Unit, 13005 Marseille, France
| | - G Fond
- Aix-Marseille Univ, EA 3279-Public Health, Chronic Diseases and Quality of Life - Research Unit, 13005 Marseille, France
| | - L Boyer
- Aix-Marseille Univ, EA 3279-Public Health, Chronic Diseases and Quality of Life - Research Unit, 13005 Marseille, France
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Fragoso AC, Fernandes S, Madureira AM, Estevão-Costa J. Acute respiratory distress due to a bronchogenic cyst submitted to percutaneous drainage followed by thoracoscopic resection. Pulmonology 2021; 27:371-373. [PMID: 33454280 DOI: 10.1016/j.pulmoe.2020.12.007] [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: 11/03/2020] [Revised: 12/07/2020] [Accepted: 12/07/2020] [Indexed: 11/24/2022] Open
Affiliation(s)
- A C Fragoso
- Department of Pediatric Surgery, Faculty of Medicine, Hospital S. João, Porto, Portugal
| | - S Fernandes
- Department of Pediatric Surgery, Faculty of Medicine, Hospital S. João, Porto, Portugal
| | - A M Madureira
- Department of Radiology, Faculty of Medicine, Hospital S. João, Porto, Portugal
| | - J Estevão-Costa
- Department of Pediatric Surgery, Faculty of Medicine, Hospital S. João, Porto, Portugal.
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Fernandes S, Nogueira V, Lourenço J, Mendo S, Pereira R. Inter-species bystander effect: Eisenia fetida and Enchytraeus albidus exposed to uranium and cadmium. J Hazard Mater 2020; 399:122972. [PMID: 32526440 DOI: 10.1016/j.jhazmat.2020.122972] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 05/14/2020] [Accepted: 05/16/2020] [Indexed: 06/11/2023]
Abstract
The bystander effect is commonly defined as the observation of effects in nonirradiated cells and tissues when the later are in contact with irradiated cells/ tissues. More recently the occurrence of bystander effect between organisms of the same species has been also demonstrated. Nevertheless, there is limited knowledge about this effect between soil dwelling organisms from different taxonomic groups, as well as in response to stressors other than ionizing radiation. Moreover, data reporting this phenomenon for soil invertebrates are scarce. The results herein presented contribute for the understanding of the impacts of cadmium and uranium in the DNA integrity of two terrestrial oligochaetes species (Eisenia fetida and Enchytraeus albidus). The evaluation was based on the quantification of the effects in the DNA integrity of the coelomocytes using the alkaline comet assay technique. This work reports the existence of bystander signaling from terrestrial earthworms to enchytraeids and from enchytraeids to earthworms when the organisms were exposed to Cd. These results reinforce that the bystander effect seems to be related with the genotoxic activity of stressors, and not exclusive of radiotoxic contaminants. Further, the bystander effect occurs between different species and under real environmental conditions, even in complex matrices, as the soil.
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Affiliation(s)
- S Fernandes
- GreenUPorto - Sustainable Agrifood Production Research Center & Department of Biology, Faculty of Science, University of Porto, Rua do Campo Alegre s/n, Porto, Portugal.
| | - V Nogueira
- CIIMAR - Interdisciplinary Centre of Marine and Environmental Research and Department of Biology, Faculty of Science, University of Porto, Rua do Campo Alegre s/n, Porto, Portugal
| | - J Lourenço
- Department of Biology & CESAM, University of Aveiro, Campus de Santiago, 3810-193 Aveiro, Portugal
| | - S Mendo
- Department of Biology & CESAM, University of Aveiro, Campus de Santiago, 3810-193 Aveiro, Portugal
| | - R Pereira
- GreenUPorto - Sustainable Agrifood Production Research Center & Department of Biology, Faculty of Science, University of Porto, Rua do Campo Alegre s/n, Porto, Portugal
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Gross O, Agostini B, Belleval P, Cavé I, Citrini M, Fernandes S, Ghadi M, Graeve N, Gagnayre R. [Health care safety: The discrepancies between experience and degree of satisfaction of hospitalized patients observed in interviews performed by user representatives]. Rev Epidemiol Sante Publique 2020; 68:337-346. [PMID: 33162268 DOI: 10.1016/j.respe.2020.10.004] [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: 09/02/2019] [Revised: 05/18/2020] [Accepted: 10/10/2020] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION The purpose of this article is to present the results of a qualitative survey conducted by user representatives (URs) focusing on the health care safety experience of hospitalized patients. The authors wished to identify factors associated with safety of care and, more specifically, with the possibly ominous medical events reported by patients. METHODS After being trained with these objectives in mind, eight URs conducted semi-directive interviews with fourteen patients hospitalized in eleven separate hospital units in nine different hospitals. RESULTS Eight types of factors consisting in 30 contributing factors liable to be reported by patients were identified: 1) factors related to patients' basic needs; 2) personalization of care; 3) professional factors; 4) organizational factors; 5) communication factors; 6) caregiver responsiveness; 7) infectious risks; 8) continuity of care. Patients' overall feelings about their hospitalization remained excellent notwithstanding more tempered, even negative experiences. CONCLUSION This paradoxical result shows that the patients' actual experience is far more instructive than their degree of satisfaction. In light of this study, the acceptability of this type of research (i.e. research conducted by URs) is excellent and it also appears highly feasible, whatever the limitations imposed by organizational considerations.
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Affiliation(s)
- O Gross
- Laboratoire Éducations et pratiques de Santé (UR3412), Université Sorbonne Paris Nord, Paris, 74, rue Marcel-Cachin, 93017 Bobigny, France; Représentants d'usagers à l'Assistance publique-Hôpitaux de Paris, Paris, France.
| | - B Agostini
- Représentants d'usagers à l'Assistance publique-Hôpitaux de Paris, Paris, France
| | - P Belleval
- Représentants d'usagers à l'Assistance publique-Hôpitaux de Paris, Paris, France
| | - I Cavé
- Représentants d'usagers à l'Assistance publique-Hôpitaux de Paris, Paris, France
| | - M Citrini
- Représentants d'usagers à l'Assistance publique-Hôpitaux de Paris, Paris, France
| | - S Fernandes
- Représentants d'usagers à l'Assistance publique-Hôpitaux de Paris, Paris, France
| | - M Ghadi
- Représentants d'usagers à l'Assistance publique-Hôpitaux de Paris, Paris, France
| | - N Graeve
- Représentants d'usagers à l'Assistance publique-Hôpitaux de Paris, Paris, France
| | - R Gagnayre
- Laboratoire Éducations et pratiques de Santé (UR3412), Université Sorbonne Paris Nord, Paris, 74, rue Marcel-Cachin, 93017 Bobigny, France
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Fernandes S, Montenegro F, Cabral M, Carvalho R, Santos L, Ruivo C, Pernencar S, Morais J. Intraventricular conduction defects in patients with st-segment elevation myocardial infarction – the paradox of right bundle branch block. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1615] [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
Intraventricular conduction defects (IVCD) in patients with acute myocardial infarct (AMI) are predictors of a worse prognosis. When acquired they can be the result of an extensive myocardial damage.
Purpose
To assess the impact of IVCD, regardless of being previously known or presumed new, on in-hospital outcomes of patients with AMI with ST segment elevation (STEMI) or undetermined location.
Methods
From a series of patients included in the National Registry of Acute Coronary Syndrome between 10/1/2010 and 9/1/2019, were selected patients with STEMI or undetermined AMI, undergoing coronary angiography.
Results
7805 patients were included: 461 (5.9%) presenting left bundle branch block (LBBB), 374 (4.8%) with right bundle branch block (RBBB) and 6970 (89.3%) with no IVCD. Clinical characteristics as well as in-hospital outcomes are described in the table 1. An unexpected worse prognosis in patients with RBBB has motivated a multivariate analysis. RBBB remained an independent predictor of in-hospital mortality (OR 1.91, 95% CI 1.04–3.50, p=0.038), along with female gender (OR 1.73, 95% CI 1.11–2.68, p=0.015), Killip Class>1 (OR 2.26, 95% CI 1.45–3.53, p<0.001), left ventricular ejection fraction <50% (OR 3.93, 95% CI 2.19–7.05, p<0.001) and left anterior descending artery as the culprit lesion (OR 1.85, 95% CI 1.16–2.91, p=0.009).
Conclusion
In spite of an apparent better clinical profile, in the current large series of unselected STEMI patients, the presence of RBBB is associated with the worst in-hospital outcome. RBBB doubles the risk of death, being an independent predictor of in-hospital mortality.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
| | | | - M Cabral
- Leiria Hospital Centre, Leiria, Portugal
| | - R Carvalho
- Leiria Hospital Centre, Leiria, Portugal
| | - L Santos
- Leiria Hospital Centre, Leiria, Portugal
| | - C Ruivo
- Leiria Hospital Centre, Leiria, Portugal
| | | | - J Morais
- Leiria Hospital Centre, Leiria, Portugal
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Graca Santos L, Ribeiro Carvalho R, Fernandes S, Montenegro Sa F, Ruivo C, Soares F, Correia J, Pernencar S, Morais J. Ticagrelor pretreatment in patients with non-ST elevation acute coronary syndrome undergoing percutaneous coronary intervention. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1724] [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
Dual antiplatelet therapy is recommended in non-ST elevation acute coronary syndrome (NSTACS), regardless of the treatment strategy (invasive vs. conservative). Although prasugrel pretreatment is not recommended due to safety concerns, the timing of ticagrelor administration is still debated.
Aim
To investigate the clinical effects of ticagrelor pretreatment in NSTACS patients (pts) undergoing percutaneous coronary intervention.
Methods
Retrospective multicentre study of 5213 NSTACS pts who underwent percutaneous coronary intervention (PCI) up to 72 hours following hospital admission, between January 2013 and December 2018. Patients with prior chronic exposure to oral antithrombotics (except acetylsalicylic acid), not acutely managed with ticagrelor, and those with missing data were excluded. A total of 415 pts were included for analysis, 256 (61.6%) received ticagrelor pretreatment (Group 1) and 159 (38.3%) were treated with ticagrelor only in the catheterization laboratory (Group 2). The primary safety endpoint was a composite of in-hospital major bleeding, need for red blood cell transfusion or haemoglobin drop ≥2g/dL and the secondary endpoint of periprocedural events was a composite of PCI failure, bailout use of GPIIb/IIIa inhibitors and in-hospital re-infarction. Multivariate analysis was performed to determine the correlates of ticagrelor pretreatment and each of the endpoints. One-year follow up was achieved in 103 pts (24.8%).
Results
Overall, mean age was 62±11 years and 20.7% were female. Crude event rates did not differ regarding primary endpoint (16.5 vs 11.5%; p=0.17), while secondary endpoint was more frequent among group 2 (2.1% vs 7.1%; p=0.01). Multivariate analysis showed no association between the timing of ticagrelor administration and the primary safety endpoint, while periprocedural events were less frequent in pretreated pts (Figure 1A). At the Kaplan-Meier analysis, one-year cumulative event-free (all-cause death, stroke or re-infarction) rates did not differ (Figure 1B).
Conclusion
In this cohort of NSTACS pts undergoing PCI in the first 72 hours after hospital admission, ticagrelor pretreatment was associated with less periprocedural events with no compromise regarding safety, compared to treatment in the catheterization laboratory. Additional data is still needed to clarify these findings.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
| | | | - S Fernandes
- Hospital Santo Andre, Cardiology, Leiria, Portugal
| | | | - C Ruivo
- Hospital Santo Andre, Cardiology, Leiria, Portugal
| | - F Soares
- Hospital Santo Andre, Cardiology, Leiria, Portugal
| | - J Correia
- Hospital Santo Andre, Cardiology, Leiria, Portugal
| | - S Pernencar
- Hospital Santo Andre, Cardiology, Leiria, Portugal
| | - J Morais
- Hospital Santo Andre, Cardiology, Leiria, Portugal
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Fernandes S, Farzaneh S, Bendell LI. Abundance and distribution of beach litter with acutely toxic metal concentrations. Mar Pollut Bull 2020; 159:111479. [PMID: 32692673 DOI: 10.1016/j.marpolbul.2020.111479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 07/11/2020] [Accepted: 07/12/2020] [Indexed: 06/11/2023]
Abstract
We determined if colour, category (e.g., food packaging) or intertidal activity could explain the occurrence of litter with acute levels of metals. Six beaches were sampled; an industrial site, a local and remote park and three beaches. Food packaging accounted for 66% of litter with acute levels of metals found in 10% of samples. Acute levels were independent of colour and category, but dependent on intertidal region and its anthropogenic use. Litter with acute levels of cadmium and lead were recovered from the industrial intertidal and high concentrations of zinc and cadmium associated with candy wrappers were found on recreational beaches. In addition to the intrinsic and extrinsic loads that litter carries, also too are memory effects, i.e., the previous use of the item carries over its trace metal burden posing extreme risks to marine ecosystems. In the managing of risk associated with beach litter, legacy contaminants need be considered.
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Affiliation(s)
- S Fernandes
- Ecotoxicology Research Group, Department of Biological Sciences, Faculty of Science, Simon Fraser University, V5A 1S6, Burnaby, British Columbia, Canada
| | - S Farzaneh
- Ecotoxicology Research Group, Department of Biological Sciences, Faculty of Science, Simon Fraser University, V5A 1S6, Burnaby, British Columbia, Canada
| | - L I Bendell
- Ecotoxicology Research Group, Department of Biological Sciences, Faculty of Science, Simon Fraser University, V5A 1S6, Burnaby, British Columbia, Canada.
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Fernandes S, Pardo M. Binge drinking in high school students from Fafe, Portugal: prevalence and associated factors. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.1345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Binge drinking is defined, by 5 or more doses of alcohol on a single occasion (4 or more, in case of women). The excessive alchool consumption is the behavior with the most significant impact on youth mortality and morbidity. Binge drinking is a public health problem that can be preventable. The aim of this investigation was to estimate the prevalence of binge drinking and analyze the associated factors to this behaviour among high school students from Fafe, Portugal.
Methods
Cross-sectional study. Invited 1334 high-school students, aged between 15 and 19 to fill in an anonymous self-administered digital survey between May and June 2019, wich includes questions about alcohol sociodemographic characteristics, physical activity and smoking. Associations between binge drinking in the last 2 months and the several factors were analyzed through multivariated logistic regression, using IBM SPSS v.20, considering a significance level of 5%.
Results
A total of 786 students answered the survey (response rate 58.9%), 714 surveys were validated. The median age of participants was 17(1.074 sd) years and 54,8% were girls. The proportion of students from academic high school were 70.9%. Considering all the students estimated binge drinking prevalence was 28.6% (95%IC:25.35-31.79) and 41,5% (95%IC:36.9-45.8) within who have reported to drink. Binge drinking was associated with male gender (OR = 1.75; 95%IC:1.186-2.585), regulary cigarrete smoking (OR = 7.48; 95%IC: 3.422-16.347), being on 12th grade (OR = 2,677; 95%IC:1.625-4.412). There wasńt found association on binge drinking proportion between students from academic or vocational school.
Conclusions
Our study concluded that binge drinking is common among Fafe high school students. This study provides relevant information to public health authorities about the binge drinke behaviour on this population and makes possible to identify the most high-risk students of binge drinking in order to planning interventions.
Key messages
Binge drinking pattern is increasing among adolescents and young adults. Future preventive interventions on binge drinking are importante and should consider the associated factors of this behaviour.
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Affiliation(s)
- S Fernandes
- Public Health Unit, Primary Health Care Grouping of Alto Ave, Fafe, Portugal
| | - M Pardo
- Public Health Unit, Primary Health Care Grouping of Alto Ave, Fafe, Portugal
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Fernandes S, Patiño-Álvarez VM, Chavushyan V, Schlegel EM, Valdés JR. Multiwavelength analysis of the variability of the blazar 3C 273. Mon Not R Astron Soc 2020; 497:2066-2077. [PMID: 32778847 PMCID: PMC7403487 DOI: 10.1093/mnras/staa2013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 06/25/2020] [Accepted: 06/27/2020] [Indexed: 06/11/2023]
Abstract
We present multiwavelength light curves and polarimetric data of the Flat Spectrum Radio Quasar 3C 273 over 8 yr. The wavelength range of our data set extends from radio to gamma-rays. We found that the optical emission in this source is dominated by the accretion disc during the entire time-frame of study. We additionally find that in contrast with the observed behaviour in other blazars, 3C 273 does not show a correlation between the gamma-ray spectral index and the gamma-ray luminosity. Finally, we identified an anticorrelation between the 15 GHz and V-band light curves for the time-range JD 245 = 4860-5760, which we speculate is the consequence of the inner part of the accretion disc falling into the black hole, followed by the ejection of a component into the jet.
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Affiliation(s)
- S Fernandes
- Department of Physics and Astronomy, University of Texas at San Antonio, One UTSA Circle, San Antonio Texas, 78249 TX, USA
| | | | - V Chavushyan
- Instituto Nacional de Astrofísica, Óptica y Electrónica, Óptica y Electrónica, Luis Enrique Erro #1, Tonantzintla, Puebla 72840, México
| | - E M Schlegel
- Department of Physics and Astronomy, University of Texas at San Antonio, One UTSA Circle, San Antonio Texas, 78249 TX, USA
| | - J R Valdés
- Instituto Nacional de Astrofísica, Óptica y Electrónica, Óptica y Electrónica, Luis Enrique Erro #1, Tonantzintla, Puebla 72840, México
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Carvalho Sousa S, Fernandes S, Novais L, Verne M, Areias R, Dourado F, Ribeiro M. Acute gastroenteritis outbreak: epidemiology at the core of investigation. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.1329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
At 28th February 2020, local public health authorities were notified that an occupational activity center headed to adult individuals with disabilities, in Guimarães (Portugal), had several cases of users vomiting or with diarrhea during that week, requesting control measures.
Methods
An outbreak investigation was carried out, with case definition being someone with nausea, vomiting and/or diarrhea. An epidemic curve was made with the number of cases per date of symptoms onset. Attack rate was calculated as the number of cases in the occupational activity center divided by the number of people in the same center.
Results
Mild, self-limited acute symptoms of nausea, vomiting and/or diarrhea were identified in 18 individuals that attended the occupational activity center. The first case developed symptoms on 24th February (day 0); the second case appeared about 24 hours after; the peak occurred at day 4 with seven cases. Attack rate was 27% among users and 15% among monitors. The mean age was 40 years. Two cases went to the emergency department and were clinically diagnosed with acute viral gastroenteritis, no further care needed. Meals were served at a neighbor building, shared with another rehabilitation institution. The rehabilitation institution reported zero cases. Additionally, Hazard Analysis and Critical Control Point process was fully accomplished.
Conclusions
Clinical and epidemiological findings suggest a probable viral outbreak with person-to-person transmission. The incubation period is consistent with norovirus, the most common agent of viral gastroenteritis. No biological samples were collected, because symptoms were mild and there was no chance to do it. Environmental samples were not collected. Preventive hygiene measures were immediatly enhanced, namely hand washing, appropriate disinfection of contaminated surfaces and isolation if symptomatic. These measures are highly efficient breaking the chain of infection and that was obtained.
Key messages
Epidemiological findings are at the core of an outbreak investigation and support immediate implemention of effective control measures. Although laboratory results are important, they are not always available for outbreak investigation.
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Affiliation(s)
- S Carvalho Sousa
- Public Health Unit Alto Ave, Northern Regional Health Administration, Guimarães, Portugal
- Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
| | - S Fernandes
- Public Health Unit Alto Ave, Northern Regional Health Administration, Guimarães, Portugal
| | - L Novais
- Public Health Unit Alto Ave, Northern Regional Health Administration, Guimarães, Portugal
| | - M Verne
- Public Health Unit Alto Ave, Northern Regional Health Administration, Guimarães, Portugal
| | - R Areias
- Public Health Unit Alto Ave, Northern Regional Health Administration, Guimarães, Portugal
| | - F Dourado
- Public Health Unit Alto Ave, Northern Regional Health Administration, Guimarães, Portugal
| | - M Ribeiro
- Public Health Unit Alto Ave, Northern Regional Health Administration, Guimarães, Portugal
- Medical School, University of Minho, Braga, Portugal
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Fernandes S, Nogueira V, Antunes F, Lopes I, Pereira R. Studying the toxicity of SLE nS-LAS micelles to collembolans and plants: Influence of ethylene oxide units in the head groups. J Hazard Mater 2020; 394:122522. [PMID: 32200241 DOI: 10.1016/j.jhazmat.2020.122522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 03/09/2020] [Accepted: 03/10/2020] [Indexed: 06/10/2023]
Abstract
Mixed micelles of linear alkylbenzene sulfonic acid (LAS) and ether sulfate-based surfactants (SLEnS) can be added in household products and cleaning agents. SLEnS with higher ethylene oxide (EO) units in the head groups have economic and environmental advantages. This work aims to assess the influence of the number of EO units in the ecotoxicity of seven variants of SLEnS-LAS micelles (0-50 EO units) in soils. Ecotoxicological tests were carried out to assess emergence and growth of four plants species and reproduction of collembolans. Most of the variants inhibited plants growth at the highest concentrations (1237.5 μg SLEnS kg-1 of soildw). For reproduction, lower number of EO units resulted in EC50 from 924.2 (95 % CL: 760.7-1063.4) to 963.2 (95 % CL: 676.9-1249.6) μg SLEnS kg-1 of soildw, whereas for higher number of EO units (50 and 30) no inhibition was reported. Based on these results, we suggest that a higher number of EO units contribute to less hazardous formulations, confirming that different designs of surfactants may contribute to changes in the responses of terrestrial organisms. Therefore, we demonstrate that standardized ecotoxicological assays may contribute to more sustainable and effective formulations, when used upstream, prior to manufacture and marketing.
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Affiliation(s)
- S Fernandes
- GreenUPorto - Sustainable Agrifood Production Research Center and Department of Biology, Faculty of Science, University of Porto, Rua do Campo Alegre s/n, Porto, Portugal.
| | - V Nogueira
- CIIMAR - Interdisciplinary Centre of Marine and Environmental Research and Department of Biology, Faculty of Science, University of Porto, Rua do Campo Alegre s/n, Porto, Portugal
| | - F Antunes
- Department of Chemical Engineering & Chemical Process Engineering and Forest Products Research Centre (CIEPQPF), University of Coimbra, Coimbra, Portugal
| | - I Lopes
- Department of Biology & CESAM, University of Aveiro, Campus de Santiago, Aveiro, Portugal
| | - R Pereira
- GreenUPorto - Sustainable Agrifood Production Research Center and Department of Biology, Faculty of Science, University of Porto, Rua do Campo Alegre s/n, Porto, Portugal
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SANTOS A, Fernandes S, Dezoti C, Vattimo M, Schor N, Borges F. SUN-045 URINARY EXTRACELLULAR VESICLES AS BIOMARKER OF RENAL TUBULAR INJURY. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.568] [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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Magro F, Lopes S, Silva M, Coelho R, Portela F, Branquinho D, Correia L, Fernandes S, Cravo M, Caldeira P, Sousa HT, Patita M, Lago P, Ramos J, Afonso J, Redondo I, Machado P, Cornillie F, Lopes J, Carneiro F. Low Golimumab Trough Levels at Week 6 Are Associated With Poor Clinical, Endoscopic and Histological Outcomes in Ulcerative Colitis Patients: Pharmacokinetic and Pharmacodynamic Sub-analysis of the Evolution Study. J Crohns Colitis 2019; 13:1387-1393. [PMID: 30989180 DOI: 10.1093/ecco-jcc/jjz071] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS Golimumab has an established exposure-response relationship in patients with ulcerative colitis [UC]. However, the association of serum golimumab trough levels [TL] with objective markers of disease activity, such as endoscopic and histological activity scores and concentrations of biomarkers, remains less understood. This report describes the relationship of serum golimumab TL at the end of the induction period [Week 6] with clinical, endoscopic, histological, and biomarker parameters. METHODS This was an open-label, uncontrolled, prospective and interventional study. Moderate to severely active UC patients naïve to biologic therapy were treated with golimumab. Serum golimumab TL and faecal calprotectin levels were measured at baseline [Week 0 of induction] and Week 6. RESULTS A total of 34 patients completed the induction phase [Week 6] and were included in this analysis. Overall, 47.1% and 14.7% of patients achieved clinical response and remission with significantly higher serum golimumab TL in patients with early response or remission [3.7 μg/mL vs 1.3 μg/mL, p = 0.0013; and 3.1 μg/mL vs 1.7 μg/mL, p = 0.0164, respectively]. In addition, golimumab TL were significantly higher in patients achieving histological remission [4.2 μg/mL vs 1.7 μg/mL, p = 0.0049]. Week 6 golimumab TL were inversely correlated with the total Mayo score [rs = -0.546; p = 0.0008], the Mayo endoscopic subscore [rs = -0.381; p = 0.0262], the Geboes histological activity score [rs = -0.464; p = 0.0057], and faecal calprotectin levels [rs = -0.497; p = 0.0044]. CONCLUSIONS A higher early exposure to golimumab is associated with a better objective response in active UC patients and appears to drive the outcome at Week 6.
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Affiliation(s)
- F Magro
- Centro Hospitalar São João, Departamento de Gastrenterologia, Porto, Portugal.,Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - S Lopes
- Centro Hospitalar São João, Departamento de Gastrenterologia, Porto, Portugal
| | - M Silva
- Centro Hospitalar São João, Departamento de Gastrenterologia, Porto, Portugal
| | - R Coelho
- Centro Hospitalar São João, Departamento de Gastrenterologia, Porto, Portugal
| | - F Portela
- Centro Hospitalar Universitário de Coimbra, Departamento de Gastrenterologia, Coimbra, Portugal
| | - D Branquinho
- Centro Hospitalar Universitário de Coimbra, Departamento de Gastrenterologia, Coimbra, Portugal
| | - L Correia
- Centro Hospitalar Lisboa Norte, Departamento de Gastrenterologia, Lisboa, Portugal
| | - S Fernandes
- Centro Hospitalar Lisboa Norte, Departamento de Gastrenterologia, Lisboa, Portugal
| | - M Cravo
- Hospital Beatriz Ângelo, Departamento de Gastrenterologia, Loures, Portugal
| | - P Caldeira
- Centro Hospitalar Universitário do Algarve, Departamento de Ciências Biomédicas e Medicina, Universidade do Algarve, Algarve Biomedical Centre, Universidade do Algarve, Faro, Portugal
| | - H T Sousa
- Centro Hospitalar Universitário do Algarve, Departamento de Ciências Biomédicas e Medicina, Universidade do Algarve, Algarve Biomedical Centre, Universidade do Algarve, Faro, Portugal
| | - M Patita
- Hospital Garcia de Orta, Departamento de Gastrenterologia, Almada, Portugal
| | - P Lago
- Centro Hospitalar do Porto, Departamento de Gastrenterologia, Porto, Portugal
| | - J Ramos
- Centro Hospitalar Lisboa Central, Departamento de Gastrenterologia, Lisboa, Portugal
| | - J Afonso
- Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - I Redondo
- MSD Portugal, Medical Affairs, Paço de Arcos, Portugal
| | - P Machado
- MSD Portugal, Medical Affairs, Paço de Arcos, Portugal
| | | | - J Lopes
- Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - F Carneiro
- Faculdade de Medicina, Universidade do Porto, Porto, Portugal.,Instituto de Patologia e Imunologia Molecular da Universidade do Porto [Ipatimup], i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
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Oliveira I, Fernandes S, Pereira P, Fragoso S, Santos S, Rodrigues P, Parreira J, Louro P, Coelho I, Rodrigues F, Clara A, Luís A, Vaz F. Gastric cancer screening in BRCA 2 gene mutation carriers: Should it be recommended? Ann Oncol 2019. [DOI: 10.1093/annonc/mdz247.145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Pereira P, Oliveira I, Fernandes S, Clara A, Miguel I, Bento S, Fragoso S, Santos S, Rodrigues P, Parreira J, Rodrigues F, Silva I, Louro P, Vaz F, Luis A. Biliary tract cancers in Portuguese families with BRCA gene mutation: A retrospective study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz247.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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