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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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Fernandes S, Williams E, Finlayson N, Stewart H, Dhaliwal C, Dorward DA, Wallace WA, Akram AR, Stone J, Dhaliwal K, Williams GOS. Fibre-based fluorescence-lifetime imaging microscopy: a real-time biopsy guidance tool for suspected lung cancer. Transl Lung Cancer Res 2024; 13:355-361. [PMID: 38496695 PMCID: PMC10938104 DOI: 10.21037/tlcr-23-638] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 01/23/2024] [Indexed: 03/19/2024]
Abstract
Lung cancer is the most common cause of cancer-related deaths worldwide. Early detection improves outcomes, however, existing sampling techniques are associated with suboptimal diagnostic yield and procedure-related complications. Autofluorescence-based fluorescence-lifetime imaging microscopy (FLIM), a technique which measures endogenous fluorophore decay rates, may aid identification of optimal biopsy sites in suspected lung cancer. Our fibre-based fluorescence-lifetime imaging system, utilising 488 nm excitation, which is deliverable via existing diagnostic platforms, enables real-time visualisation and lifetime analysis of distal alveolar lung structure. We evaluated the diagnostic accuracy of the fibre-based fluorescence-lifetime imaging system to detect changes in fluorescence lifetime in freshly resected ex vivo lung cancer and adjacent healthy tissue as a first step towards future translation. The study compares paired non-small cell lung cancer (NSCLC) and non-cancerous tissues with gold standard diagnostic pathology to assess the performance of the technique. Paired NSCLC and non-cancerous lung tissues were obtained from thoracic resection patients (N=21). A clinically compatible 488 nm fluorescence-lifetime endomicroscopy platform was used to acquire simultaneous fluorescence intensity and lifetime images. Fluorescence lifetimes were calculated using a computationally-lightweight, rapid lifetime determination method. Fluorescence lifetime was significantly reduced in ex vivo lung cancer, compared with non-cancerous lung tissue [mean ± standard deviation (SD), 1.79±0.40 vs. 2.15±0.26 ns, P<0.0001], and fluorescence intensity images demonstrated distortion of alveolar elastin autofluorescence structure. Fibre-based fluorescence-lifetime imaging demonstrated good performance characteristics for distinguishing lung cancer, from adjacent non-cancerous tissue, with 81.0% sensitivity and 71.4% specificity. Our novel fibre-based fluorescence-lifetime imaging system, which enables label-free imaging and quantitative lifetime analysis, discriminates ex vivo lung cancer from adjacent healthy tissue. This minimally invasive technique has potential to be translated as a real-time biopsy guidance tool, capable of optimising diagnostic accuracy in lung cancer.
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Affiliation(s)
- Susan Fernandes
- Translational Healthcare Technologies Group, Centre for Inflammation Research, Institute for Regeneration and Repair, The University of Edinburgh, Edinburgh, UK
- Department of Respiratory Medicine, NHS Lothian, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Elvira Williams
- Translational Healthcare Technologies Group, Centre for Inflammation Research, Institute for Regeneration and Repair, The University of Edinburgh, Edinburgh, UK
| | - Neil Finlayson
- Translational Healthcare Technologies Group, Centre for Inflammation Research, Institute for Regeneration and Repair, The University of Edinburgh, Edinburgh, UK
- Institute for Integrated Micro and Nano Systems, School of Engineering, The University of Edinburgh, Edinburgh, UK
| | - Hazel Stewart
- Translational Healthcare Technologies Group, Centre for Inflammation Research, Institute for Regeneration and Repair, The University of Edinburgh, Edinburgh, UK
| | - Catharine Dhaliwal
- Department of Pathology, NHS Lothian, Western General Hospital, Edinburgh, UK
| | - David A. Dorward
- Translational Healthcare Technologies Group, Centre for Inflammation Research, Institute for Regeneration and Repair, The University of Edinburgh, Edinburgh, UK
- Department of Pathology, NHS Lothian, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - William A. Wallace
- Department of Pathology, NHS Lothian, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Ahsan R. Akram
- Translational Healthcare Technologies Group, Centre for Inflammation Research, Institute for Regeneration and Repair, The University of Edinburgh, Edinburgh, UK
- Department of Respiratory Medicine, NHS Lothian, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - James Stone
- Translational Healthcare Technologies Group, Centre for Inflammation Research, Institute for Regeneration and Repair, The University of Edinburgh, Edinburgh, UK
- Centre for Photonics and Photonic Materials, Department of Physics, The University of Bath, Bath, UK
| | - Kevin Dhaliwal
- Translational Healthcare Technologies Group, Centre for Inflammation Research, Institute for Regeneration and Repair, The University of Edinburgh, Edinburgh, UK
- Department of Respiratory Medicine, NHS Lothian, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Gareth O. S. Williams
- Translational Healthcare Technologies Group, Centre for Inflammation Research, Institute for Regeneration and Repair, The University of Edinburgh, Edinburgh, UK
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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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Cohen S, Gurvitz M, Burns KM, Wheaton O, Panigrahy A, Umfleet L, Loman M, Brown N, Cotts T, Ermis P, Fernandes S, Gaydos S, Hoskoppal A, Lindsay I, Markham LW, Nyman A, Rodriguez FH, Smith CC, Stylianou M, Trachtenberg F, Zaidi AN. Design of A Multi-Institutional Neurocognitive Discovery Study in Adult Congenital Heart Disease (MINDS-ACHD). Am Heart J 2023; 262:131-139. [PMID: 37084934 DOI: 10.1016/j.ahj.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 03/31/2023] [Accepted: 04/02/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND Neurocognitive dysfunction (NCD) is a common comorbidity among children with congenital heart disease (CHD). However, it is unclear how underlying CHD and its sequelae combine with genetics and acquired cardiovascular and neurological disease to impact NCD and outcomes across the lifespan in adults with CHD. METHODS The Multi-Institutional Neurocognitive Discovery Study in Adults with Congenital Heart Disease (MINDS-ACHD) is a partnership between the Pediatric Heart Network (PHN) and the Adult Alliance for Research in Congenital Cardiology (AARCC) that examines objective and subjective neurocognitive function and genetics in young ACHD. This multicenter cross-sectional pilot study is enrolling 500 young adults between 18 and 30 years with moderate or severe complexity CHD at 14 centers in North America. Enrollment includes 4 groups (125 participants each): 1) d-looped Transposition of the Great Arteries (d-TGA); 2) Tetralogy of Fallot (TOF); 3) single ventricle (SV) physiology; and 4) "other moderately or severely complex CHD." Participants complete the standardized tests from the NIH Toolbox Cognitive Battery, the NeuroQoL, the Hospital Anxiety and Depression Scale, and the PROMIS Global QoL measure. Clinical and demographic variables are collected by interview and medical record review, and an optional biospecimen is collected for genetic analysis. Due to the COVID-19 pandemic, participation may be done remotely. Tests are reviewed by a Neurocognitive Core Laboratory. CONCLUSIONS MINDS-ACHD is the largest study to date characterizing NCD in young adults with moderate or severely complex CHD in North America. Its results will provide valuable data to inform screening and management strategies for NCD in ACHD and improve lifelong care.
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Affiliation(s)
- Scott Cohen
- Children's Wisconsin, Medical College of Wisconsin, Milwaukee, WI; Alliance for Adult Research in Congenital Cardiology
| | - Michelle Gurvitz
- Boston Children's Hospital, Boston, MA; Alliance for Adult Research in Congenital Cardiology
| | | | | | - Ashok Panigrahy
- University of Pittsburgh Medical Center, Children's Hospital of Pittsburgh, Pittsburgh, PA
| | - Laura Umfleet
- Children's Wisconsin, Medical College of Wisconsin, Milwaukee, WI
| | - Michelle Loman
- Children's Wisconsin, Medical College of Wisconsin, Milwaukee, WI
| | - Nicole Brown
- Heart Institute, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Tim Cotts
- University of Michigan, Ann Arbor, MI; Alliance for Adult Research in Congenital Cardiology
| | - Peter Ermis
- Texas Children's Hospital, Baylor College of Medicine, Houston, TX; Alliance for Adult Research in Congenital Cardiology
| | - Susan Fernandes
- Stanford University School of Medicine, Palo Alto, CA; Alliance for Adult Research in Congenital Cardiology
| | | | - Arvind Hoskoppal
- University of Pittsburgh Medical Center, Children's Hospital of Pittsburgh, Pittsburgh, PA; Alliance for Adult Research in Congenital Cardiology
| | - Ian Lindsay
- Primary Children's Hospital, University of Utah, Salt Lake City, UT
| | - Larry W Markham
- Riley Hospital for Children and Indiana University School of Medicine, Indianapolis, IN
| | - Annique Nyman
- Children's Hospital of Philadelphia, Philadelphia, PA
| | - Fred H Rodriguez
- Emory University School of Medicine, Atlanta, GA; Alliance for Adult Research in Congenital Cardiology
| | | | | | | | - Ali N Zaidi
- Icahn School of Medicine at Mount Sinai, New York, NY; Alliance for Adult Research in Congenital Cardiology.
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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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Wood HAC, Ehrlich K, Yerolatsitis S, Kufcsák A, Quinn TM, Fernandes S, Norberg D, Jenkins NC, Young V, Young I, Hamilton K, Seth S, Akram A, Thomson RR, Finlayson K, Dhaliwal K, Stone JM. Tri-mode optical biopsy probe with fluorescence endomicroscopy, Raman spectroscopy, and time-resolved fluorescence spectroscopy. J Biophotonics 2023; 16:e202200141. [PMID: 36062395 DOI: 10.1002/jbio.202200141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 07/30/2022] [Accepted: 09/01/2022] [Indexed: 06/15/2023]
Abstract
We present an endoscopic probe that combines three distinct optical fibre technologies including: A high-resolution imaging fibre for optical endomicroscopy, a multimode fibre for time-resolved fluorescence spectroscopy, and a hollow-core fibre with multimode signal collection cores for Raman spectroscopy. The three fibers are all enclosed within a 1.2 mm diameter clinical grade catheter with a 1.4 mm end cap. To demonstrate the probe's flexibility we provide data acquired with it in loops of radii down to 2 cm. We then use the probe in an anatomically accurate model of adult human airways, showing that it can be navigated to any part of the distal lung using a commercial bronchoscope. Finally, we present data acquired from fresh ex vivo human lung tissue. Our experiments show that this minimally invasive probe can deliver real-time optical biopsies from within the distal lung - simultaneously acquiring co-located high-resolution endomicroscopy and biochemical spectra.
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Affiliation(s)
- Harry Alexander Charles Wood
- Centre for Photonics and Photonic Materials, University of Bath, Bath, UK
- Translational Healthcare Technologies Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Katjana Ehrlich
- Translational Healthcare Technologies Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
- Scottish Universities Physics Alliance (SUPA), Institute of Photonics and Quantum Science, Heriot-Watt University, Edinburgh, UK
| | - Stephanos Yerolatsitis
- Centre for Photonics and Photonic Materials, University of Bath, Bath, UK
- Translational Healthcare Technologies Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
- The College of Optics and Photonics (CREOL), University of Central Florida, Orlando, Florida, USA
| | - András Kufcsák
- Translational Healthcare Technologies Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Tom Michael Quinn
- Translational Healthcare Technologies Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Susan Fernandes
- Translational Healthcare Technologies Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Dominic Norberg
- Translational Healthcare Technologies Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Nia Caitlin Jenkins
- Translational Healthcare Technologies Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Vikki Young
- Translational Healthcare Technologies Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Irene Young
- Translational Healthcare Technologies Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Katie Hamilton
- Translational Healthcare Technologies Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Sohan Seth
- Translational Healthcare Technologies Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Ahsan Akram
- Translational Healthcare Technologies Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Robert Rodrick Thomson
- Translational Healthcare Technologies Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
- Scottish Universities Physics Alliance (SUPA), Institute of Photonics and Quantum Science, Heriot-Watt University, Edinburgh, UK
| | - Keith Finlayson
- Translational Healthcare Technologies Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Kevin Dhaliwal
- Translational Healthcare Technologies Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - James Morgan Stone
- Centre for Photonics and Photonic Materials, University of Bath, Bath, UK
- Translational Healthcare Technologies Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
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12
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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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13
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Jenkins NC, Ehrlich K, Kufcsak A, Yerolatsitis S, Fernandes S, Young I, Hamilton K, Wood HAC, Quinn T, Young V, Akram AR, Stone JM, Thomson RR, Finlayson K, Dhaliwal K, Seth S. Computational Fluorescence Suppression in Shifted Excitation Raman Spectroscopy. IEEE Trans Biomed Eng 2023; PP. [PMID: 37022914 DOI: 10.1109/tbme.2023.3243866] [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: 02/12/2023]
Abstract
Fiber-based Raman spectroscopy in the context of in vivo biomedical application suffers from the presence of background fluorescence from the surrounding tissue that might mask the crucial but inherently weak Raman signatures. One method that has shown potential for suppressing the background to reveal the Raman spectra is shifted excitation Raman spectroscopy (SER). SER collects multiple emission spectra by shifting the excitation by small amounts and uses these spectra to computationally suppress the fluorescence background based on the principle that Raman spectrum shifts with excitation while fluorescence spectrum does not. We introduce a method that utilizes the spectral characteristics of the Raman and fluorescence spectra to estimate them more effectively, and compare this approach against existing methods on real world datasets.
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Affiliation(s)
- Nia C. Jenkins
- School of Informatics, University of Edinburgh, 10 Crichton Street, Edinburgh, U.K
| | - Katjana Ehrlich
- Translational Healthcare Technology Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh, U.K
| | - Andras Kufcsak
- Translational Healthcare Technology Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh, U.K
| | - Stephanos Yerolatsitis
- Centre for Photonics and Photonic Materials, University of Bath, Claverton Down, Bath, U.K
| | - Susan Fernandes
- Translational Healthcare Technology Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh, U.K
| | - Irene Young
- Translational Healthcare Technology Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh, U.K
| | - Katie Hamilton
- Translational Healthcare Technology Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh, U.K
| | - Harry A. C. Wood
- Centre for Photonics and Photonic Materials, University of Bath, Claverton Down, Bath, U.K
| | - Tom Quinn
- Translational Healthcare Technology Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh, U.K
| | - Vikki Young
- Translational Healthcare Technology Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh, U.K
| | - Ahsan R. Akram
- Translational Healthcare Technology Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh, U.K
| | - James M. Stone
- Centre for Photonics and Photonic Materials, University of Bath, Claverton Down, Bath, U.K
| | - Robert R. Thomson
- Translational Healthcare Technology Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh, U.K
| | - Keith Finlayson
- Translational Healthcare Technology Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh, U.K
| | - Kevin Dhaliwal
- Translational Healthcare Technology Group, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh, U.K
| | - Sohan Seth
- School of Informatics, University of Edinburgh, 10 Crichton Street, Edinburgh, U.K
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14
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Wang Q, Fernandes S, Williams GOS, Finlayson N, Akram AR, Dhaliwal K, Hopgood JR, Vallejo M. Deep learning-assisted co-registration of full-spectral autofluorescence lifetime microscopic images with H&E-stained histology images. Commun Biol 2022; 5:1119. [PMID: 36271298 PMCID: PMC9586936 DOI: 10.1038/s42003-022-04090-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 10/10/2022] [Indexed: 11/28/2022] Open
Abstract
Autofluorescence lifetime images reveal unique characteristics of endogenous fluorescence in biological samples. Comprehensive understanding and clinical diagnosis rely on co-registration with the gold standard, histology images, which is extremely challenging due to the difference of both images. Here, we show an unsupervised image-to-image translation network that significantly improves the success of the co-registration using a conventional optimisation-based regression network, applicable to autofluorescence lifetime images at different emission wavelengths. A preliminary blind comparison by experienced researchers shows the superiority of our method on co-registration. The results also indicate that the approach is applicable to various image formats, like fluorescence in-tensity images. With the registration, stitching outcomes illustrate the distinct differences of the spectral lifetime across an unstained tissue, enabling macro-level rapid visual identification of lung cancer and cellular-level characterisation of cell variants and common types. The approach could be effortlessly extended to lifetime images beyond this range and other staining technologies.
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Affiliation(s)
- Qiang Wang
- Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK.
| | - Susan Fernandes
- Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Gareth O S Williams
- Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Neil Finlayson
- Institute for Integrated Micro and Nano Systems, School of Engineering, University of Edinburgh, Edinburgh, UK
| | - Ahsan R Akram
- Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Kevin Dhaliwal
- Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - James R Hopgood
- Institute for Digital Communications, School of Engineering, University of Edinburgh, Edinburgh, UK
| | - Marta Vallejo
- School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh, UK
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15
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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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16
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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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Broberg CS, van Dissel A, Minnier J, Aboulhosn J, Kauling RM, Ginde S, Krieger EV, Rodriguez F, Gupta T, Shah S, John AS, Cotts T, Kay WA, Kuo M, Dwight C, Woods P, Nicolarsen J, Sarubbi B, Fusco F, Antonova P, Fernandes S, Grewal J, Cramer J, Khairy P, Gallego P, O'Donnell C, Hannah J, Dellborg M, Rodriguez-Monserrate CP, Muhll IV, Pylypchuk S, Magalski A, Han F, Lubert AM, Kay J, Yeung E, Roos-Hesselink J, Baker D, Celermajer DS, Burchill LJ, Wilson WM, Wong J, Kutty S, Opotowsky AR. Long-Term Outcomes After Atrial Switch Operation for Transposition of the Great Arteries. J Am Coll Cardiol 2022; 80:951-963. [PMID: 36049802 DOI: 10.1016/j.jacc.2022.06.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 05/02/2022] [Accepted: 06/07/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND For patients with d-loop transposition of the great arteries (d-TGA) with a systemic right ventricle after an atrial switch operation, there is a need to identify risks for end-stage heart failure outcomes. OBJECTIVES The authors aimed to determine factors associated with survival in a large cohort of such individuals. METHODS This multicenter, retrospective cohort study included adults with d-TGA and prior atrial switch surgery seen at a congenital heart center. Clinical data from initial and most recent visits were obtained. The composite primary outcome was death, transplantation, or mechanical circulatory support (MCS). RESULTS From 1,168 patients (38% female, age at first visit 29 ± 7.2 years) during a median 9.2 years of follow-up, 91 (8.8% per 10 person-years) met the outcome (66 deaths, 19 transplantations, 6 MCS). Patients experiencing sudden/arrhythmic death were younger than those dying of other causes (32.6 ± 6.4 years vs 42.4 ± 6.8 years; P < 0.001). There was a long duration between sentinel clinical events and end-stage heart failure. Age, atrial arrhythmia, pacemaker, biventricular enlargement, systolic dysfunction, and tricuspid regurgitation were all associated with the primary outcome. Independent 5-year predictors of primary outcome were prior ventricular arrhythmia, heart failure admission, complex anatomy, QRS duration >120 ms, and severe right ventricle dysfunction based on echocardiography. CONCLUSIONS For most adults with d-TGA after atrial switch, progress to end-stage heart failure or death is slow. A simplified prediction score for 5-year adverse outcome is derived to help identify those at greatest risk.
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Affiliation(s)
- Craig S Broberg
- Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA.
| | - Alexandra van Dissel
- Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA; Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Jessica Minnier
- School of Public Health, Oregon Health and Science University, Portland, Oregon, USA
| | | | | | - Salil Ginde
- Children's Hospital of Wisconsin, Milwaukee, Wisconsin, USA
| | - Eric V Krieger
- University of Washington Medical Center and Seattle Children's Hospital, Seattle, Washington, USA
| | | | - Tripti Gupta
- Ochsner Medical Center, New Orleans, Louisiana, USA
| | | | | | - Timothy Cotts
- University of Michigan Medical Center, Ann Arbor, Michigan, USA
| | - W Aaron Kay
- Krannert Institute of Cardiology, Indianapolis, Indiana, USA
| | - Marissa Kuo
- Ochsner Medical Center, New Orleans, Louisiana, USA
| | - Cindy Dwight
- Krannert Institute of Cardiology, Indianapolis, Indiana, USA
| | - Patricia Woods
- Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA
| | | | | | | | | | - Susan Fernandes
- Stanford University, School of Medicine, Departments of Pediatrics and Medicine, Palo Alto, California, USA
| | - Jasmine Grewal
- St. Paul's Hospital, Division of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jonathan Cramer
- Children's Hospital, Omaha & University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Paul Khairy
- Montreal Heart Institute, Montreal, Quebec, Canada
| | | | - Clare O'Donnell
- Green Lane Paediatric and Congenital Cardiac Service, Auckland City Hospital, Auckland, New Zealand
| | - Jane Hannah
- Green Lane Paediatric and Congenital Cardiac Service, Auckland City Hospital, Auckland, New Zealand
| | - Mikael Dellborg
- Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Carla P Rodriguez-Monserrate
- Boston Children's Hospital, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA; Department of Medicine, Division of Cardiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | | | | | | | - Frank Han
- University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Adam M Lubert
- Cincinnati Children's Hospital Medical Center, Heart Institute, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Joseph Kay
- Colorado University School of Medicine, Denver, Colorado, USA
| | - Elizabeth Yeung
- Colorado University School of Medicine, Denver, Colorado, USA
| | | | - David Baker
- University of Sydney and Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - David S Celermajer
- University of Sydney and Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Luke J Burchill
- Royal Melbourne Hospital, Department of Medicine, Melbourne, Victoria, Australia
| | - William M Wilson
- Royal Melbourne Hospital, Department of Medicine, Melbourne, Victoria, Australia
| | - Joshua Wong
- Royal Melbourne Hospital, Department of Medicine, Melbourne, Victoria, Australia
| | - Shelby Kutty
- Johns Hopkins University, Baltimore, Maryland, USA
| | - Alexander R Opotowsky
- Boston Children's Hospital, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA; Department of Medicine, Division of Cardiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA; Cincinnati Children's Hospital Medical Center, Heart Institute, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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18
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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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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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Cahan EM, Maturi J, Bailey P, Fernandes S, Addala A, Kibrom S, Krissberg JR, Smith SM, Shah S, Wang E, Saynina O, Wise PH, Chamberlain LJ. The Impact of Telehealth Adoption During COVID-19 Pandemic on Patterns of Pediatric Subspecialty Care Utilization. Acad Pediatr 2022; 22:1375-1383. [PMID: 35318159 PMCID: PMC8933868 DOI: 10.1016/j.acap.2022.03.010] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 03/13/2022] [Accepted: 03/16/2022] [Indexed: 01/18/2023]
Abstract
OBJECTIVE The COVID-19 pandemic prompted health systems to rapidly adopt telehealth for clinical care. We examined the impact of demography, subspecialty characteristics, and broadband availability on the utilization of telehealth in pediatric populations before and after the early period of the COVID-19 pandemic. METHODS Outpatients scheduled for subspecialty visits at sites affiliated with a single quaternary academic medical center between March-June 2019 and March-June 2020 were included. The contribution of demographic, socioeconomic, and broadband availability to visit completion and telehealth utilization were examined in multivariable regression analyses. RESULTS Among visits scheduled in 2020 compared to 2019, in-person visits fell from 23,318 to 11,209, while telehealth visits increased from 150 to 7,675. Visits among established patients fell by 15% and new patients by 36% (P < .0001). Multivariable analysis revealed that completed visits were reduced for Hispanic patients and those with reduced broadband; high income, private non-HMO insurance, and those requesting an interpreter were more likely to complete visits. Those with visits scheduled in 2020, established patients, those with reduced broadband, and patients older than 1 year were more likely to complete TH appointments. Cardiology, oncology, and pulmonology patients were less likely to complete scheduled TH appointments. CONCLUSIONS Following COVID-19 onset, outpatient pediatric subspecialty visits shifted rapidly to telehealth. However, the impact of this shift on social disparities in outpatient utilization was mixed with variation among subspecialties. A growing reliance on telehealth will necessitate insights from other healthcare settings serving populations of diverse social and technological character.
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Affiliation(s)
- Eli M. Cahan
- Department of Pediatrics (EM Cahan, J Maturi, P Bailey, S Fernandes, A Addala, S Kibrom, JR Krissberg, SM Smith, S Shah, E Wang, PH Wise, and LJ Chamberlain), Stanford School of Medicine, Stanford, Calif,New York University School of Medicine (EM Cahan), New York, NY,Address correspondence to Eli M. Cahan, MS, Department of Pediatrics, Stanford School of Medicine, 770 Welch Road, #100, Stanford, CA 94305
| | - Jay Maturi
- Department of Pediatrics (EM Cahan, J Maturi, P Bailey, S Fernandes, A Addala, S Kibrom, JR Krissberg, SM Smith, S Shah, E Wang, PH Wise, and LJ Chamberlain), Stanford School of Medicine, Stanford, Calif
| | - Paige Bailey
- Department of Pediatrics (EM Cahan, J Maturi, P Bailey, S Fernandes, A Addala, S Kibrom, JR Krissberg, SM Smith, S Shah, E Wang, PH Wise, and LJ Chamberlain), Stanford School of Medicine, Stanford, Calif
| | - Susan Fernandes
- Department of Pediatrics (EM Cahan, J Maturi, P Bailey, S Fernandes, A Addala, S Kibrom, JR Krissberg, SM Smith, S Shah, E Wang, PH Wise, and LJ Chamberlain), Stanford School of Medicine, Stanford, Calif,Department of Medicine (S Fernandes), Stanford School of Medicine, Stanford, Calif
| | - Ananta Addala
- Department of Pediatrics (EM Cahan, J Maturi, P Bailey, S Fernandes, A Addala, S Kibrom, JR Krissberg, SM Smith, S Shah, E Wang, PH Wise, and LJ Chamberlain), Stanford School of Medicine, Stanford, Calif
| | - Sara Kibrom
- Department of Pediatrics (EM Cahan, J Maturi, P Bailey, S Fernandes, A Addala, S Kibrom, JR Krissberg, SM Smith, S Shah, E Wang, PH Wise, and LJ Chamberlain), Stanford School of Medicine, Stanford, Calif
| | - Jill R. Krissberg
- Department of Pediatrics (EM Cahan, J Maturi, P Bailey, S Fernandes, A Addala, S Kibrom, JR Krissberg, SM Smith, S Shah, E Wang, PH Wise, and LJ Chamberlain), Stanford School of Medicine, Stanford, Calif
| | - Stephanie M. Smith
- Department of Pediatrics (EM Cahan, J Maturi, P Bailey, S Fernandes, A Addala, S Kibrom, JR Krissberg, SM Smith, S Shah, E Wang, PH Wise, and LJ Chamberlain), Stanford School of Medicine, Stanford, Calif
| | - Sejal Shah
- Department of Pediatrics (EM Cahan, J Maturi, P Bailey, S Fernandes, A Addala, S Kibrom, JR Krissberg, SM Smith, S Shah, E Wang, PH Wise, and LJ Chamberlain), Stanford School of Medicine, Stanford, Calif
| | - Ewen Wang
- Department of Pediatrics (EM Cahan, J Maturi, P Bailey, S Fernandes, A Addala, S Kibrom, JR Krissberg, SM Smith, S Shah, E Wang, PH Wise, and LJ Chamberlain), Stanford School of Medicine, Stanford, Calif,Center for Policy, Outcomes, and Prevention (E Wang, O Saynina, PH Wise, and LJ Chamberlain), Stanford School of Medicine, Stanford, Calif,Department of Emergency Medicine (E Wang), Stanford School of Medicine, Stanford, Calif
| | - Olga Saynina
- Center for Policy, Outcomes, and Prevention (E Wang, O Saynina, PH Wise, and LJ Chamberlain), Stanford School of Medicine, Stanford, Calif
| | - Paul H. Wise
- Department of Pediatrics (EM Cahan, J Maturi, P Bailey, S Fernandes, A Addala, S Kibrom, JR Krissberg, SM Smith, S Shah, E Wang, PH Wise, and LJ Chamberlain), Stanford School of Medicine, Stanford, Calif,Center for Policy, Outcomes, and Prevention (E Wang, O Saynina, PH Wise, and LJ Chamberlain), Stanford School of Medicine, Stanford, Calif
| | - Lisa J. Chamberlain
- Department of Pediatrics (EM Cahan, J Maturi, P Bailey, S Fernandes, A Addala, S Kibrom, JR Krissberg, SM Smith, S Shah, E Wang, PH Wise, and LJ Chamberlain), Stanford School of Medicine, Stanford, Calif,Center for Policy, Outcomes, and Prevention (E Wang, O Saynina, PH Wise, and LJ Chamberlain), Stanford School of Medicine, Stanford, Calif
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30
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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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31
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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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32
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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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33
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Williams GOS, Williams E, Finlayson N, Erdogan AT, Wang Q, Fernandes S, Akram AR, Dhaliwal K, Henderson RK, Girkin JM, Bradley M. Full spectrum fluorescence lifetime imaging with 0.5 nm spectral and 50 ps temporal resolution. Nat Commun 2021; 12:6616. [PMID: 34785666 PMCID: PMC8595732 DOI: 10.1038/s41467-021-26837-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 10/15/2021] [Indexed: 11/23/2022] Open
Abstract
The use of optical techniques to interrogate wide ranging samples from semiconductors to biological tissue for rapid analysis and diagnostics has gained wide adoption over the past decades. The desire to collect ever more spatially, spectrally and temporally detailed optical signatures for sample characterization has specifically driven a sharp rise in new optical microscopy technologies. Here we present a high-speed optical scanning microscope capable of capturing time resolved images across 512 spectral and 32 time channels in a single acquisition with the potential for ~0.2 frames per second (256 × 256 image pixels). Each pixel in the resulting images contains a detailed data cube for the study of diverse time resolved light driven phenomena. This is enabled by integration of system control electronics and on-chip processing which overcomes the challenges presented by high data volume and low imaging speed, often bottlenecks in previous systems. High data volumes from multidimensional imaging techniques can lead to slow collection and processing times. Here, the authors implement multispectral fluorescence lifetime imaging microscopy (FLIM) that uses time-correlated photon counting technology to reach simultaneously high imaging rates combined with high spectral and temporal resolution.
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Affiliation(s)
- Gareth O S Williams
- Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh, EH16 4TJ, UK
| | - Elvira Williams
- Centre for Advanced Instrumentation, Department of Physics, Durham University, South Road, Durham, DH1 3LE, UK
| | - Neil Finlayson
- School of Engineering, Institute for Integrated Micro and Nano Systems, University of Edinburgh, King's Buildings, Alexander Crum Brown Road, Edinburgh, EH9 3FF, UK
| | - Ahmet T Erdogan
- School of Engineering, Institute for Integrated Micro and Nano Systems, University of Edinburgh, King's Buildings, Alexander Crum Brown Road, Edinburgh, EH9 3FF, UK
| | - Qiang Wang
- Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh, EH16 4TJ, UK
| | - Susan Fernandes
- Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh, EH16 4TJ, UK
| | - Ahsan R Akram
- Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh, EH16 4TJ, UK
| | - Kev Dhaliwal
- Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh, EH16 4TJ, UK
| | - Robert K Henderson
- School of Engineering, Institute for Integrated Micro and Nano Systems, University of Edinburgh, King's Buildings, Alexander Crum Brown Road, Edinburgh, EH9 3FF, UK
| | - John M Girkin
- Centre for Advanced Instrumentation, Department of Physics, Durham University, South Road, Durham, DH1 3LE, UK.
| | - Mark Bradley
- School of Chemistry, University of Edinburgh, David Brewster Road, Edinburgh, EH9 3FJ, UK.
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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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35
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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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36
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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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Yerolatsitis S, Kufcsák A, Ehrlich K, Wood HAC, Fernandes S, Quinn T, Young V, Young I, Hamilton K, Akram AR, Thomson RR, Finlayson K, Dhaliwal K, Stone JM. Sub millimetre flexible fibre probe for background and fluorescence free Raman spectroscopy. J Biophotonics 2021; 14:e202000488. [PMID: 33855811 DOI: 10.1002/jbio.202000488] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 03/26/2021] [Accepted: 04/11/2021] [Indexed: 06/12/2023]
Abstract
Using the shifted-excitation Raman difference spectroscopy technique and an optical fibre featuring a negative curvature excitation core and a coaxial ring of high numerical aperture collection cores, we have developed a portable, background and fluorescence free, endoscopic Raman probe. The probe consists of a single fibre with a diameter of less than 0.25 mm packaged in a sub-millimetre tubing, making it compatible with standard bronchoscopes. The Raman excitation light in the fibre is guided in air and therefore interacts little with silica, enabling an almost background free transmission of the excitation light. In addition, we used the shifted-excitation Raman difference spectroscopy technique and a tunable 785 nm laser to separate the fluorescence and the Raman spectrum from highly fluorescent samples, demonstrating the suitability of the probe for biomedical applications. Using this probe we also acquired fluorescence free human lung tissue data.
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Affiliation(s)
| | - András Kufcsák
- Translational Healthcare Technologies Team, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Katjana Ehrlich
- Translational Healthcare Technologies Team, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
- Scottish Universities Physics Alliance (SUPA), Institute of Photonics and Quantum Sciences, Heriot-Watt University, Edinburgh, UK
| | | | - Susan Fernandes
- Translational Healthcare Technologies Team, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Tom Quinn
- Translational Healthcare Technologies Team, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Vikki Young
- Translational Healthcare Technologies Team, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Irene Young
- Translational Healthcare Technologies Team, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Katie Hamilton
- Translational Healthcare Technologies Team, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Ahsan R Akram
- Translational Healthcare Technologies Team, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Robert R Thomson
- Scottish Universities Physics Alliance (SUPA), Institute of Photonics and Quantum Sciences, Heriot-Watt University, Edinburgh, UK
| | - Keith Finlayson
- Translational Healthcare Technologies Team, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Kevin Dhaliwal
- Translational Healthcare Technologies Team, Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
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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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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, Williams G, Williams E, Ehrlich K, Stone J, Finlayson N, Bradley M, Thomson RR, Akram AR, Dhaliwal K. Solitary pulmonary nodule imaging approaches and the role of optical fibre-based technologies. Eur Respir J 2021; 57:2002537. [PMID: 33060152 PMCID: PMC8174723 DOI: 10.1183/13993003.02537-2020] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 09/29/2020] [Indexed: 12/18/2022]
Abstract
Solitary pulmonary nodules (SPNs) are a clinical challenge, given there is no single clinical sign or radiological feature that definitively identifies a benign from a malignant SPN. The early detection of lung cancer has a huge impact on survival outcome. Consequently, there is great interest in the prompt diagnosis, and treatment of malignant SPNs. Current diagnostic pathways involve endobronchial/transthoracic tissue biopsies or radiological surveillance, which can be associated with suboptimal diagnostic yield, healthcare costs and patient anxiety. Cutting-edge technologies are needed to disrupt and improve, existing care pathways. Optical fibre-based techniques, which can be delivered via the working channel of a bronchoscope or via transthoracic needle, may deliver advanced diagnostic capabilities in patients with SPNs. Optical endomicroscopy, an autofluorescence-based imaging technique, demonstrates abnormal alveolar structure in SPNs in vivo Alternative optical fingerprinting approaches, such as time-resolved fluorescence spectroscopy and fluorescence-lifetime imaging microscopy, have shown promise in discriminating lung cancer from surrounding healthy tissue. Whilst fibre-based Raman spectroscopy has enabled real-time characterisation of SPNs in vivo Fibre-based technologies have the potential to enable in situ characterisation and real-time microscopic imaging of SPNs, which could aid immediate treatment decisions in patients with SPNs. This review discusses advances in current imaging modalities for evaluating SPNs, including computed tomography (CT) and positron emission tomography-CT. It explores the emergence of optical fibre-based technologies, and discusses their potential role in patients with SPNs and suspected lung cancer.
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Affiliation(s)
- Susan Fernandes
- Centre for Inflammation Research, Queen's Medical Research Institute, The University of Edinburgh, Edinburgh, UK
| | - Gareth Williams
- Centre for Inflammation Research, Queen's Medical Research Institute, The University of Edinburgh, Edinburgh, UK
| | - Elvira Williams
- Centre for Inflammation Research, Queen's Medical Research Institute, The University of Edinburgh, Edinburgh, UK
| | - Katjana Ehrlich
- Centre for Inflammation Research, Queen's Medical Research Institute, The University of Edinburgh, Edinburgh, UK
| | - James Stone
- Centre for Inflammation Research, Queen's Medical Research Institute, The University of Edinburgh, Edinburgh, UK
- Centre for Photonics and Photonic Materials, Dept of Physics, The University of Bath, Bath, UK
| | - Neil Finlayson
- Centre for Inflammation Research, Queen's Medical Research Institute, The University of Edinburgh, Edinburgh, UK
- Institute for Integrated Micro and Nano Systems, School of Engineering, The University of Edinburgh, Edinburgh, UK
| | - Mark Bradley
- Centre for Inflammation Research, Queen's Medical Research Institute, The University of Edinburgh, Edinburgh, UK
- EaStCHEM, School of Chemistry, The University of Edinburgh, Edinburgh, UK
| | - Robert R. Thomson
- Centre for Inflammation Research, Queen's Medical Research Institute, The University of Edinburgh, Edinburgh, UK
- Institute of Photonics and Quantum Sciences, School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh, UK
| | - Ahsan R. Akram
- Centre for Inflammation Research, Queen's Medical Research Institute, The University of Edinburgh, Edinburgh, UK
| | - Kevin Dhaliwal
- Centre for Inflammation Research, Queen's Medical Research Institute, The University of Edinburgh, Edinburgh, UK
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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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Wiegers SE, Ryan T, Arrighi JA, Brown SM, Canaday B, Damp JB, Diaz-Gomez JL, Figueredo VM, Garcia MJ, Gillam LD, Griffin BP, Kirkpatrick JN, Klarich KW, Lui GK, Maffett S, Naqvi TZ, Patel AR, Poulin MF, Rose GA, Swaminathan M, Arrighi JA, Mendes LA, Adams JE, Brush JE, Dec GW, Denktas A, Fernandes S, Freeman R, Hahn RT, Halperin JL, Housholder-Hughes SD, Khan SS, Klarich KW, Lin CH, Marine JE, McPherson JA, Niazi K, Ryan T, Solomon MA, Spicer RL, Tam M, Wang A, Weissman G, Weitz HH, Williams ES. 2019 ACC/AHA/ASE Advanced Training Statement on Echocardiography (Revision of the 2003 ACC/AHA Clinical Competence Statement on Echocardiography): A Report of the ACC Competency Management Committee. J Am Soc Echocardiogr 2020; 32:919-943. [PMID: 31378259 DOI: 10.1016/j.echo.2019.04.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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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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50
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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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