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McGee AE, Alibegashvili T, Elfgren K, Frey B, Grigore M, Heinonen A, Jach R, Jariene K, Kesic V, Küppers V, Kyrgiou M, Leeson S, Louwers J, Mazurec M, Mergui J, Pedro A, Šavrova A, Siegler E, Tabuica U, Trojnarska D, Trzeszcz M, Turyna R, Volodko N, Cruickshank ME. European consensus statement on expert colposcopy. Eur J Obstet Gynecol Reprod Biol 2023; 290:27-37. [PMID: 37716200 DOI: 10.1016/j.ejogrb.2023.08.369] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 08/07/2023] [Accepted: 08/18/2023] [Indexed: 09/18/2023]
Abstract
BACKGROUND Following the publication of the European consensus statement on standards for essential colposcopy in 2020, the need for standards relating to more complex and challenging colposcopy practice was recognised. These standards relate to colposcopy undertaken in patients identified through cervical screening and tertiary referrals from colposcopists who undertake standard colposcopy only. This set of recommendations provides a review of the current literature and agreement on care for recognised complex cases. With good uptake of human papillomavirus (HPV) immunisation, we anticipate a marked reduction in cervical disease over the next decade. Still, the expert colposcopist will continue to be vital in managing complex cases, including previous cervical intraepithelial neoplasia (CIN)/complex screening histories and multi-zonal disease. AIMS To provide expert guidance on complex colposcopy cases through published evidence and expert consensus. MATERIAL & METHODS Members of the EFC and ESGO formed a working group to identify topics considered to be the remit of the expert rather than the standard colposcopy service. These were presented at the EFC satellite meeting, Helsinki 2021, for broader discussion and finalisation of the topics. RESULTS & DISCUSSION The agreed standards included colposcopy in pregnancy and post-menopause, investigation and management of glandular abnormalities, persistent high-risk HPV+ with normal/low-grade cytology, colposcopy management of type 3 transformation zones (TZ), high-grade cytology and normal colposcopy, colposcopy adjuncts, follow-up after treatment with CIN next to TZ margins and follow-up after treatment with CIN with persistent HPV+, and more. These standards are under review to create a final paper of consensus standards for dissemination to all EFC and ESGO members.
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Affiliation(s)
- A E McGee
- Aberdeen Centre for Women's Health Research (ACWHR), University of Aberdeen, UK.
| | - T Alibegashvili
- Department of Gynaecology, Georgian National Screening Center, Tbilisi, Georgia
| | - K Elfgren
- Karolinska Institutet, Stockholm, Sweden
| | - B Frey
- Frauenklinik Baselland, Switzerland
| | - M Grigore
- Department of Obstetrics and Gynaecology, University of Medicine and Pharmacy "Grigore T. Popa" Iasi, Romania
| | - A Heinonen
- Department of Obstetrics and Gynecology, University of Helsinki, and Helsinki University Hospital
| | - R Jach
- Institute of Nursing and Obstetrics, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
| | - K Jariene
- Department of Obstetrics and Gynecology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - V Kesic
- Faculty of Medicine, University of Belgrade, Clinic of Obstetrics and Gynaecology, Clinical Center of Serbia, Belgrade, Serbia
| | - V Küppers
- Frauenheilkunde & Geburtshilfe, Zytologisches Labor, Dysplasie-Sprechstunde, Düsseldorf, Germany
| | - M Kyrgiou
- IRDB, MDR & Surgery and Cancer, Faculty of Medicine, Imperial College London, UK
| | - S Leeson
- West London Gynaecological Cancer Centre, Imperial College NHS Trust, UK; Department of Obstetrics and Gynaecology, Ysbyty Gwynedd, Betsi Cadwaladr University Health Board, Wales, UK
| | - J Louwers
- Diakonessenhuis, Bosboomstraat 1, 3582 KE, Utrecht, the Netherlands
| | - M Mazurec
- Corfamed Woman's Health Center, Kluczborska, Wroclaw, Poland; Department of Pathology and Clinical Cytology, University Hospital in Wroclaw, Poland
| | - J Mergui
- Department of Gynecological and Breast Surgery and Oncology, Pitié-Salpêtrière, Assistance Publique des Hôpitaux de Paris (AP-HP), University Hospital, Paris, France
| | - A Pedro
- Department of Obstetrics and Gynaecology, CUF Sintra Hospital, Sintra, Portugal
| | - A Šavrova
- Gynaecology Centre, North Estonia Medical Centre, Estonia
| | - E Siegler
- The Israeli Society of Colposcopy and Cervical and Vulvar Pathology, Peretz Berenstein St, Haifa, Israel
| | - U Tabuica
- Department of Obstetrics and Gynaecology, State University of Medicine and Pharmacy, Referral Center of Colposcopy, Chisinau, Moldavia
| | - D Trojnarska
- Institute of Nursing and Obstetrics, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
| | - M Trzeszcz
- Corfamed Woman's Health Center, Kluczborska, Wroclaw, Poland; Department of Pathology and Clinical Cytology, University Hospital in Wroclaw, Poland
| | - R Turyna
- Institute for the Care of Mother and Child, Prague 4, Czech Republic; Third Faculty of Medicine, Charles University, Prague 10, Czech Republic; Institute of Postgraduate Education in Health Care - IPVZ, Prague 10, Czech Republic
| | - N Volodko
- Department of Oncology and Radiology, Danylo Halytsky Lviv national medical university, Lviv, Ukraine
| | - M E Cruickshank
- Aberdeen Centre for Women's Health Research (ACWHR), University of Aberdeen, UK
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Gama A, Marques MJ, Pedro AR, Hoffmeister LV, Rodrigues F, Ribeiro JS, Dias S. Which effects had the pandemic in migrants’ health and well-being? A mixed-methods approach. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.606] [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
The COVID-19 pandemic affected populations’ health, with a disproportionate impact on those most socially vulnerable such as migrants. The way these populations experienced the pandemic lockdowns and its effects on daily life are yet to be known. This study aimed to understand the effects of the pandemic on health and well-being of migrants in Portugal.
Methods
In a mixed-methods approach, a survey was conducted with a community-based sample of 1126 migrants in the Lisbon Metropolitan Area, assessing sociodemographics, migration-related characteristics and the perceived impact of the pandemic on health. In addition, n = 12 migrants purposively recruited were invited to participate in a photovoice study, sharing photographs about their daily life during the lockdowns. Following semi-structured interviews were conducted. Quantitative data were analysed using multivariable analysis and qualitative data were analysed through content analysis.
Results
A fifth of the participants perceived having worse health condition since the pandemic, which was more likely among women (OR = 1.58, CI95% 1.13-2.20), those >45 years old (OR = 1.78, CI95% 1.02-3.16), with lower education (Basic education: OR = 1.57, CI95% 1.01-2.47) and with lower monthly income (<EUR 650: OR = 1.69, CI95% 1.18-2.44). Two themes emerged from the photovoice: effects of the pandemic lockdowns on daily life (routines, social relations, work) and on health and well-being (eating habits, physical exercise, leisure). Strategies to cope with the adverse effects included social activation and changes in lifestyles.
Conclusions
The pandemic had disproportionate effects on some migrant groups, intensifying social and health inequalities, with consequences for their well-being. Participatory methods can contribute to further understand migrants’ experiences while involving and empowering them for health promotion.
Key messages
• The pandemic had adverse effects on migrants’ health and well-being, disproportionately affecting most socially vulnerable migrant groups.
• Participatory research methods as photovoice are valuable to gain access to individual experiences and perspectives, while involving and empowering participants.
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Affiliation(s)
- A Gama
- NOVA National School of Public Health, PHRC, Universidade NOVA de Lisboa , Lisbon, Portugal
- Comprehensive Health Research Center , Lisbon, Portugal
| | - MJ Marques
- NOVA National School of Public Health, Universidade NOVA de Lisboa , Lisbon, Portugal
- Comprehensive Health Research Center , Lisbon, Portugal
| | - AR Pedro
- NOVA National School of Public Health, PHRC, Universidade NOVA de Lisboa , Lisbon, Portugal
- Comprehensive Health Research Center , Lisbon, Portugal
| | - LV Hoffmeister
- NOVA National School of Public Health, PHRC, Universidade NOVA de Lisboa , Lisbon, Portugal
- Comprehensive Health Research Center , Lisbon, Portugal
| | - F Rodrigues
- NOVA National School of Public Health, Universidade NOVA de Lisboa , Lisbon, Portugal
| | - JS Ribeiro
- NOVA National School of Public Health, Universidade NOVA de Lisboa , Lisbon, Portugal
| | - S Dias
- NOVA National School of Public Health, PHRC, Universidade NOVA de Lisboa , Lisbon, Portugal
- Comprehensive Health Research Center , Lisbon, Portugal
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Marques MJ, Gama A, Pedro AR, Magano R, Tiessen C, Hollanders P, Dias S. Mental health of migrants during the COVID-19 pandemic: additional stressors, increased inequalities. Eur J Public Health 2022. [PMCID: PMC9594497 DOI: 10.1093/eurpub/ckac131.501] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
The COVID-19 pandemic has resulted in an unprecedent range of negative mental health outcomes across populations worldwide. Such effects are increasingly being documented, however an evidence gap persists on the consequences on most vulnerable groups, as certain subgroups of migrants. These populations already suffer from increased psychological burden, and the pandemic effects may potentially exacerbate adverse experiences and outcomes. This study aims to uncover the perceived impact of the COVID-19 pandemic on the mental health of migrants in Portugal and the associated sociodemographic aspects. A survey was conducted with a community-based sample of 1126 adult migrants in Portugal, assessing sociodemographics, migration-related characteristics and the perceived impact of the pandemic on mental health. Association between sociodemographics and mental health indicators was measured through bivariable analysis. In total, 1126 adult migrants were surveyed: 53.4% female, mean age of 35.8 years (range 18-77), 48.9% from African countries, 29.5% from Middle East/Asian countries, 21.6% from Brazil. Most participants (80%) reported feelings of agitation, anxiety or sadness during the pandemic period with 26.4% experiencing these feelings most days. The pandemic had a disproportionate impact on women (86.9% reported negative impact compared to 72.5% of men, p < 0.05), those undocumented (83.3% vs 75.4%, p < 0.05), those whose financial situation got worse since the pandemic (82.8% vs. 77.3%, p < 0.05) and those who had increased food shortages (84.4% vs 79%, p < 0.05). Migrants perceived an elevated deterioration of their mental health during the COVID-19 pandemic. In addition, particular groups such as women and those with a more insecure income or residence status are particularly susceptible to experiencing negative mental health outcomes. Key messages • There is a need to recognize the detrimental mental health impact of the COVID-19 pandemic on particular migrant groups and to develop interventions that target their unique needs. • Investigating sociodemographic and migration aspects could help identifying migrants at a higher risk of experiencing mental health distress.
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Affiliation(s)
- MJ Marques
- NOVA National School of Public Health, Universidade NOVA de Lisboa , Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa , Lisbon, Portugal
| | - A Gama
- NOVA National School of Public Health, Universidade NOVA de Lisboa , Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa , Lisbon, Portugal
| | - AR Pedro
- NOVA National School of Public Health, Universidade NOVA de Lisboa , Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa , Lisbon, Portugal
| | - R Magano
- NOVA National School of Public Health, Universidade NOVA de Lisboa , Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa , Lisbon, Portugal
| | - C Tiessen
- Universiteit Amsterdam Vrije , Amsterdam, Netherlands
| | | | - S Dias
- NOVA National School of Public Health, Universidade NOVA de Lisboa , Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa , Lisbon, Portugal
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Avelar FG, Raposo B, Torres A, Pedro AR. Does Portuguese pharmaceutical market follow an innovative trend? The INFOMED database analysis. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac131.252] [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
Background
Product innovation in the pharmaceutical market is, although not exclusively, a new product with the capacity to generate value. Thus, it must represent an invention through investment in research and development, and not a commercial monopoly. The aim is to identify innovation trends by Marketing Authorization (MA) granted in Portugal.
Methods
Quantitative descriptive study based on data (years 2017 to 2021) from Human Medicinal Products Database (INFOMED), managed by the National Authority of Medicines and Health Products, I.P. The parameters identified and used were MA and medical product subject to medical prescription. List was filtered by Product Group - New Active Substance. To identify innovation, findings were compared with the Anatomical Therapeutic Chemical (ATC) database and scientific literature to find other therapeutic options available.
Results
A total of 2695 records were identified. 1804 (67%) were generic drugs. Regarding new substances, 46 registrations (1.7%) were obtained, with the highest number recorded in 2017 (n = 13 - 2.03%) and the lowest in 2019 (n = 3 - 0.76%). After exclusion of different concentrations with the same therapeutic indication, a total of 26 medicines were observed: 54% had a listed ATC code and those, 64% had more than two linked ATC codes; 12 medicines had no related ATC code and 5 were classified as vaccine and therefore were not considered, thus 7 medicines were classified as major innovation.
Conclusions
Most of the innovation seen in the pharmaceutical market is not major innovation, but rather due to structural changes to chemical compositions. The Portuguese scenario is no different. Generic drugs, although not innovative, are important in the pharmaceutical market from a public health perspective. The identified innovations, although not major innovations, are important from a clinical and market availability perspective, however they should not represent a large portion of the pharmaceutical market.
Key messages
• In Portugal, the innovation trend in the pharmaceutical industry is based essentially on modifications in chemical composition and related therapeutic class.
• The development of major innovation in medicines should be stimulated and new models of financing and sustainability should be improved.
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Affiliation(s)
- FG Avelar
- Public Health Research Centre, National School of Public Health , Lisbon, Portugal
| | - B Raposo
- Public Health Research Centre, National School of Public Health , Lisbon, Portugal
| | - A Torres
- Public Health Research Centre, National School of Public Health , Lisbon, Portugal
| | - AR Pedro
- Public Health Research Centre, National School of Public Health , Lisbon, Portugal
- Comprehensive Health Research Centre , Lisbon, Portugal
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Pedro AR, Rosário R, Monteiro I, Cerqueira M, Roque S, Assunção V, Brandão D, Escoval A, Ferreira PL. Health literacy in higher education students: findings from a Portuguese study. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac130.140] [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: 11/13/2022] Open
Abstract
Abstract
Background
Health literacy (HL) concerns the knowledge and competences of people to meet the complex demands of health in modern society. It is essential for health promotion, disease prevention and healthcare. Young adults can perform a very important role in taking a more active role in managing and protect their health, so this study aimed to identify the HL levels in the population of higher education students, according to the European Health Literacy Survey (HLS-EU-PT) and to evaluate its association with social and academic determinants.
Methods
A quantitative, observational, and cross-sectional study was carried out based on an online survey disseminated in Portuguese universities. Data were analysed using binary logistic regression, adjusted for age, income, parents’ education, gender, and chronic disease report.
Results
In total, 4801 students were surveyed, 76% female. Of those, 44% revealed a problematic or inadequate level of HL. Those students with higher income levels (OR (95% CI), OR = 4.5 (3.4; 5.9) and whose parents had higher education levels (OR = 1.3(1.1; 1.5) had higher odds of achieving sufficient or excellent levels of HL, even after adjusting for confounders. In what concerns academic determinants, data revealed that HL tends to be sufficient or excellent among those students from health-related courses (OR = 2.0 (1.6; 2.5). In the subgroup of students from non-health-related courses, it was found that HL levels do not differ in 1st year and last year's students. However, in students from health-related courses, data revealed that a last yeaŕs students had higher odds of having sufficient or excellent HL levels compared to a 1st-year student (OR = 1.7 (1.4; 2.2).
Conclusions
This study reveals low HL levels and addresses that socioeconomic and familiar context are determinants of HL in higher education students. Future intervention studies are needed, focused on these determinants so that adequate levels of HL are achieved in higher education students.
Key messages
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Affiliation(s)
- AR Pedro
- Public Health Research Centre, National School of Public Health of NOVA University of Lisbon , Lisbon, Portugal
- Comprehensive Health Research Centre , Lisbon, Portugal
- Rede Académica de Literacia em Saúde , Lisbon, Portugal
| | - R Rosário
- School of Nursing, University of Minho , Braga, Portugal
- Health Sciences Research Unit: Nursing, Nursing School of Coimbra , Coimbra, Portugal
- Rede Académica de Literacia em Saúde , Lisbon, Portugal
| | - I Monteiro
- University of Aveiro , Aveiro, Portugal
- Rede Académica de Literacia em Saúde , Lisbon, Portugal
| | - M Cerqueira
- University of Aveiro , Aveiro, Portugal
- Rede Académica de Literacia em Saúde , Lisbon, Portugal
| | - S Roque
- Escola Superior de Saúde de Portalegre, Instituto Politécnico de Portalegre , Portalegre, Portugal
- Rede Académica de Literacia em Saúde , Lisbon, Portugal
| | - V Assunção
- Faculty of Dental Medicine, University of Lisbon , Lisbon, Portugal
- Rede Académica de Literacia em Saúde , Lisbon, Portugal
| | - D Brandão
- Public Health Research Centre, National School of Public Health of NOVA University of Lisbon , Lisbon, Portugal
- Rede Académica de Literacia em Saúde , Lisbon, Portugal
| | - A Escoval
- Public Health Research Centre, National School of Public Health of NOVA University of Lisbon , Lisbon, Portugal
- Comprehensive Health Research Centre , Lisbon, Portugal
- Rede Académica de Literacia em Saúde , Lisbon, Portugal
| | - PL Ferreira
- Faculty of Economics, University of Coimbra , Coimbra, Portugal
- Centre for Health Studies and Research of the University of Coimbra , Coimbra, Portugal
- Rede Académica de Literacia em Saúde , Lisbon, Portugal
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de Noronha N, Moniz M, Gama A, Laires PA, Goes AR, Pedro AR, Dias S, Soares P, Nunes C. Non-adherence to COVID-19 lockdown: who are they? A cross-sectional study in Portugal. Public Health 2022; 211:5-13. [PMID: 35988506 PMCID: PMC9271418 DOI: 10.1016/j.puhe.2022.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 06/21/2022] [Accepted: 07/04/2022] [Indexed: 11/15/2022]
Abstract
Objectives The SARS-CoV-2 virus has spread worldwide, leading governments to implement mitigation measures. Understanding the reluctance to adhere to non-pharmacological interventions might help promote adherence to these measures. This study aimed to identify factors associated with non-adherence to the first lockdown in Portugal. Study design Cross-sectional study. Methods This study used data from a Portuguese community-based survey entitled ‘COVID-19 Barometer: Social Opinion’. Data were collected on risk perception, health status and social experiences using a snowball sampling technique. The event of interest corresponded to participants who reported not staying home during the lockdown period, serving as a proxy for non-adherence to lockdown. Logistic regression was used to identify factors associated with non-adherence to the first lockdown. Results Responses from 133,601 individual questionnaires that were completed during the first week of the first lockdown in 2020 were analysed. A minority of participants (5.6%) reported non-adherence to lockdown (i.e. leaving home for reasons other than essential situations). Working in the workplace was the factor with the strongest association of non-adherence to the lockdown. Several other factors were also associated with non-adherence to the first lockdown; namely, being a man, being a student, having a low level of education, having a low income, living alone or with a high-infection-risk professional (e.g. doctor, nurse, pharmaceutical, health technician, firefighter, police officer, military, essential services worker), perceiving the risk of getting COVID-19 to be high, not having social support in case of infection, feeling agitated, sad or anxious every day, and considering the preventive measures to be unimportant or inadequate. Conclusions Non-adherence to lockdown was associated with socio-economic, trust and perception factors. Future research should investigate the mechanisms underlying these associations to help identify the population groups who are most at risk of non-adherence.
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Affiliation(s)
- N de Noronha
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal.
| | - M Moniz
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal; Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - A Gama
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal; Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - P A Laires
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal; Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - A R Goes
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal; Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - A R Pedro
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal; Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - S Dias
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal; Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - P Soares
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal; Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - C Nunes
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal; Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal
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Goes AR, Soares P, Moniz M, Gama A, Pedro AR, Laires P, Dias S, Nunes C. Factors associated with motivation to avoid meeting family and friends during the COVID-19 pandemic. Eur J Public Health 2021. [PMCID: PMC8574604 DOI: 10.1093/eurpub/ckab164.850] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background The widespread adherence to behaviours that prevent the transmission of the SARS-CoV-2 virus depends on human will. There is a paucity of research on the factors that influence adherence to social distancing. Available research suggests that it varies with the specific behaviour and that reducing contact with family and friends is the hardest one. This study aims to identify factors associated with motivation to avoid meeting with family and friends during the second lockdown of the COVID-19 pandemic in Portugal. Methods We used data from a community-based survey, “COVID-19 Barometer: Social Opinion”, which includes sociodemographics, psychosocial variables, and subjective health and wellbeing indicators from 20th February to 19th March 2021. We included 1336 participants who answered the question “To what extent is it easy for you to avoid visiting family and friends?”. Logistic regression analysis was used to identify factors associated with difficulty to avoid visiting family and friends. Results Preliminary data shows that 38.4% (513) had difficulties avoiding meeting with family and friends. Those with greater difficulty were the ones who have less education, higher negative emotionality, do not work remotely, have more difficulties to stay home and practice physical distancing and consider the Government's measures inadequate. Contrarily, those who have less difficulty avoiding visiting friends and family are older and have low risk perception of COVID-19 infection. Conclusions This study suggests higher difficulty in avoiding visiting friends and family for those whose routines demand not staying at home, with low agreement with Government measures, and struggle with higher negative emotionality, confirming the personal costs of these behaviours and the importance of habits. Older people had less difficulty, suggesting that these measures may be closer to their usual routines. Interventions should consider the specificities of social interaction. Key messages Social distancing comes at an enormous cost to people's livelihoods and it also depends on people living circumstances. Interventions to improve adherence to social distancing should consider the specificity of social interaction and the potential dissonance created by the overall routines.
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Affiliation(s)
- AR Goes
- Public Health Research Center, NOVA National School of Public Health, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - P Soares
- Public Health Research Center, NOVA National School of Public Health, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - M Moniz
- Public Health Research Center, NOVA National School of Public Health, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - A Gama
- Public Health Research Center, NOVA National School of Public Health, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - AR Pedro
- Public Health Research Center, NOVA National School of Public Health, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - P Laires
- Public Health Research Center, NOVA National School of Public Health, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - S Dias
- Public Health Research Center, NOVA National School of Public Health, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - C Nunes
- Public Health Research Center, NOVA National School of Public Health, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
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Gama A, Marques MJ, Pedro AR, Mendonça J, Fernandes AC, Dias S. Perceived need of health care and barriers in access to health services among migrants in Portugal. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.612] [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
Health care has been pointed out as a key determinant of migrants' health and social integration, but there is evidence of disparities in its access across subgroups. A deeper understanding of the barriers in access to health care, particularly among vulnerable groups, is needed. Our study aims to examine perceived need of health care, access to health services and barriers among migrants in Portugal. A cross-sectional survey was conducted with 1126 adult migrants (53.4% females), originated from African, Middle East, Asian countries and Brazil, living in Portugal for no longer than 10 years. The collected data included sociodemographic characteristics, perceived need of health care, access to health services and difficulties experienced. Differences between groups were analysed through chi-square tests. Results showed that most of the participants (64.7%) have needed health care in the previous 12 months in Portugal. Of these, 87.8% accessed a health care service. However, even needing health care, 3.3% decided not to seek care and 8.8% were not able to access a health care service. Reporting no access to health care was more frequent among migrants with shorter length of stay in the country (<1 year: 19.4% vs. 1 to 5 years: 7.3% and 6 to 10 years: 4.6%; p = 0.001) and those with non-regular migration status (in regularisation process: 11.5% and undocumented: 9.5% vs. documented: 7.2%; p = 0.040). Most common barriers were lack of the National Health Service user card (38%), financial constraints (15%), undocumented status (11%) and language difficulties (7%). Although efforts have been made over the past decades in Portugal to adopt inclusive policies and promote migrants' access to health care, strategies are needed to improve information on migrants' health rights, especially of those undocumented and recently arrived. Economic and language difficulties should be further addressed in comprehensive interventions to promote equal access to health care.
Key messages
Migrants residing in the country for less than a year and those with non-regular migration status reported more frequently not being able to access health care. Despite the efforts to adopt inclusive policies and promote migrants’ access to health care, strategies are needed to improve information on migrants’ health rights and promote equal access to care.
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Affiliation(s)
- A Gama
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Centre, Lisbon, Portugal
| | - MJ Marques
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Centre, Lisbon, Portugal
| | - AR Pedro
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Centre, Lisbon, Portugal
| | - J Mendonça
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - AC Fernandes
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Centre, Lisbon, Portugal
| | - S Dias
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Centre, Lisbon, Portugal
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9
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Lopes S, Soares P, Gama A, Pedro AR, Moniz M, Laires P, Goes AR, Nunes C, Dias S. Factors associated with avoidance of emergency department visits in Portugal during the pandemic. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.076] [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
Avoiding an emergency department (ED) visit risks irreversible negative consequences for patients' health. EDs are a frequent access point to the Portuguese health system. Previous studies have shown that patients may avoid visiting ED during the pandemic. This study aims to identify factors associated with avoidance of ED visits in Portugal during the COVID-19 pandemic.
Methods
We used data from a community-based survey, “COVID-19 Barometer: Social Opinion”, which includes healthcare utilisation, health status, and risk perception in Portugal from 11th April 2020 to 16th April 2021. We included respondents that reported having needed ED care. Data were collected on sociodemographics, health status (comorbidities, mental health), risk perception (COVID-19 and complications), level of trust in health services and self-assessment of the severity of the reason for ED visit. The outcome of interest was the decision to avoid ED care. We used logistic regression to identify factors associated with the decision to avoid ED.
Results
Preliminary data showed that 914 respondents reported needing ED care (74.8% female; mean age 43 years). From those, 224 (25%) decided to avoid ED care. ED visits avoidance was higher during lockdowns (28%). People reporting specific comorbidities (cardiac, autoimmune, respiratory) avoided ED more than those without them. Perception of no severe reason for ED visit, poor mental health, perception of higher risk of COVID-19 and complications, and low trust in health services response to the pandemic were associated with higher odds of ED visit avoidance.
Conclusions
People avoiding ED visits represented a considerable share. The decision to avoid ED visit was associated with clinical characteristics, but the perception of risk and assessment of the context and health system response also played a role in decision making.
Key messages
The effect of avoided ED visits on health should be a research and policy concern. People with certain comorbidities or perception of high risk of COVID-19 and complications may be closely monitored.
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Affiliation(s)
- S Lopes
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - P Soares
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - A Gama
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - AR Pedro
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - M Moniz
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - P Laires
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - AR Goes
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - C Nunes
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - S Dias
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
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10
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Jornet N, Perez Alija J, Bermejo S, Ventosa N, Pedro A, Gomez de Segura G, Guerra P, Sancho G. PO-1707 Near misses reporting: effective tool for safety culture shift in a Radiation Oncology Department. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)08158-5] [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: 12/01/2022]
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11
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Garrido J, Martins T, Pedro AR, Santos I, Miranda R, Silva D. Medicinal cannabis, a medicine. Characterization of the reality in Portugal. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.1075] [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
Cannabis has been used over the centuries for medicinal purposes. The first evidence dates from the third millennium BC in India and Chinese Empire, due to its analgesic, antiemetic and anticonvulsant properties. Nevertheless, its use is also associated to manufacture industry - hemp - translating a widespread function. However, through time, it is its recreational, additive and illegal purposes are the ones that we most quickly associate with it. This stigmatized its use in society and neglected the benefits. Its only in the XX century with the discover of the of the endocannabinoid system that allowed a new vision on the theme, challenging and revolutionizing the, until then, ingrained classic vision. In fact, its benefits in several pathologies or clinical symptons are well documented today. In light of the current debate on the use of cannabis for medicinal purposes worldwide and recently in Portugal with new legislation, a review of the available literature is required to explain the national reality and its context in the international reality. Due to the clinical and social relevance of the theme, the authors aimed to study, collect and systematize information in order to uptodate the state of art in: innovation, potential indications for its therapeutic use; understand the existing legal framework in Portugal, for cannabinoids and for the previous phases, such as cultivation and production; understand and compare the international reality and that existing in Portugal, namely in Portuguese hospitals; and, understand what are the future perspectives for cannabis as a therapeutic line.
Key messages
Clinical and social relevance of the theme and its legal framework. What are the future perspectives for cannabis as a therapeutic line nd the stigma of using it.
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Affiliation(s)
- J Garrido
- National School of Public Health, Nova University, Lisbon, Lisbon, Portugal
| | - T Martins
- National School of Public Health, Nova University, Lisbon, Lisbon, Portugal
| | - A R Pedro
- National School of Public Health, Nova University, Lisbon, Lisbon, Portugal
| | - I Santos
- National School of Public Health, Nova University, Lisbon, Lisbon, Portugal
| | - R Miranda
- National School of Public Health, Nova University, Lisbon, Lisbon, Portugal
| | - D Silva
- National School of Public Health, Nova University, Lisbon, Lisbon, Portugal
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12
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Redman CWE, Kesic V, Cruickshank ME, Gultekin M, Carcopino X, Castro Sanchez M, Grigore M, Jakobsson M, Kuppers V, Pedro A, Reich O, Leeson S, Tabuica U, Zodzika J, Ciavattini A, Jach R, Katsyuba M, Koiss R, Martin-Hirsch P, Tjalma WA, Nieminen P. European consensus statement on essential colposcopy. Eur J Obstet Gynecol Reprod Biol 2020; 256:57-62. [PMID: 33171418 DOI: 10.1016/j.ejogrb.2020.06.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 04/14/2020] [Revised: 05/24/2020] [Accepted: 06/15/2020] [Indexed: 10/23/2022]
Abstract
This European consensus statement on essential colposcopy provides standards for the general colposcopist seeing women referred for colposcopy with an abnormal cervical screening test (including cytology and HPV tests) or with a clinically suspicious cervix. The article gives guidance regarding the aims and conduct of colposcopy. Recommendations are provided on colposcopy technique, the management of common colposcopy issues, treatment and follow-up of after treatment of CIN or early stage cervical. Colposcopists should make an informed decision on the management of each individual that is referred and organize appropriate follow-up. Cervical cancer is still a major health issue and the quality of care can only improve if there is a structured guidance for women with an abnormal smear or suspicious cervix.
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Affiliation(s)
- C W E Redman
- Past-President European Federation of Colposcopy and University Hospitals of North Midlands, Stoke-on-Trent, UK
| | - V Kesic
- Faculty of Medicine, University of Belgrade, Clinic of Obstetrics and Gynecology, Clinical Center of Serbia, Belgrade, Serbia
| | - M E Cruickshank
- Aberdeen Centre for Women's Health Research, University of Aberdeen, UK.
| | - M Gultekin
- Department of Obstetrics and Gynecology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - X Carcopino
- Department of Obstetrics and Gynaecology, Hôpital Nord, APHM, Aix-Marseille University (AMU), University Avignon, CNRS, IRD, IMBE UMR 7263, Marseille, France
| | - M Castro Sanchez
- Department of Obstetrics and Gynaecology, University Hospital Puerto De Hierro Majadahonda, Madrid, Spain
| | - M Grigore
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy "Grigore T. Popa" Iasi, Romania
| | - M Jakobsson
- HUS Hyvinkää Hospital, University of Helsinki, Finland
| | - V Kuppers
- Obstetrics and Gynecology Koenigsallee 64, Duesseldorf, Germany
| | - A Pedro
- Department of Obstetrics and Gynaecology, Cuf Sintra Hospital, Sintra, Portugal
| | - O Reich
- Department of Obstetrics and Gynecology, Medical University of Graz, Austria
| | - S Leeson
- Department of Obstetrics and Gynaecology, Ysbyty Gwynedd, Bangor, Wales, UK
| | - U Tabuica
- Department of Obstetrics and Gynecology, State University of Medicine and Pharmacy, Referral Center of Colposcopy, Chisinau, Moldavia
| | - J Zodzika
- Department of Obstetrics and Gynaecology, Riga Stradiņš University, Riga East Clinical University Hospital, Riga, Latvia
| | - A Ciavattini
- Department of Woman's Health Sciences, Gynecologic Section, Polytechnic University of Marche, Ancona, Italy
| | - R Jach
- Clinic of Endocrynologic Gynecology, University Hospital UJ CM, Krakow, Poland
| | - M Katsyuba
- Department of Oncology, Kazan State Medical Academy, Kazan, Russian Federation
| | - R Koiss
- Department of Obstetrics and Gynecologic Oncology, St. Stephan Hospital, Budapest, Hungary
| | - P Martin-Hirsch
- Department of Obstetrics & Gynaecology, Lancashire Teaching Hospitals NHS Foundation Trust, Lancashire & Royal Preston Hospital, Preston, United Kingdom
| | - W A Tjalma
- Department of Obstetrics and Gynecology, Breast Clinic - Unit Gynecologic Oncology, Antwerp University Hospital and University of Antwerp, Belgium
| | - P Nieminen
- Department of Obstetrics and Gynecology, Helsinki University Hospital and Helsinki University, Finland
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13
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Siopa M, Pedro A, Bourbon M. The Influence Of The Lifestyle Factors On The Lipid Profile Of A Portuguese Population. Atherosclerosis 2019. [DOI: 10.1016/j.atherosclerosis.2019.06.573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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14
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Cambra MJ, Moreno F, Sanz X, Anglada L, Mollà M, Reyes V, Arenas M, Pedro A, Ballester R, García V, Casals J, Cusidó M, Jimenez C, Escribà JM, Macià M, Solé JM, Arcusa A, Seguí MA, Gonzalez S, Farrús B, Biete A. Role of boost radiotherapy for local control of pure ductal carcinoma in situ after breast-conserving surgery: a multicenter, retrospective study of 622 patients. Clin Transl Oncol 2019; 22:670-680. [PMID: 31264148 DOI: 10.1007/s12094-019-02168-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 06/19/2019] [Indexed: 12/01/2022]
Abstract
PURPOSE To evaluate the effect of boost radiotherapy on ipsilateral breast tumor recurrence (IBTR) for ductal carcinoma in situ (DCIS) after breast-conserving surgery and whole breast radiotherapy (WBRT) with or without boost. METHODS AND MATERIALS Retrospective, multicentre study of 622 patients (624 tumors) diagnosed with pure DCIS from 1993-2011. RESULTS Most tumors (377/624; 60.4%) received a boost. At a median follow-up of 8.8 years, IBTR occurred in 64 cases (10.3%). A higher percentage of patients with risk factors for IBTR received a boost (p < 0.05). Boost was not associated with lower rates of IBTR than WBRT alone (HR 0.75, 95% CI 0.42-1.35). On the univariate analyses, IBTR was significantly associated with tumor size (11-20 mm, HR 2.32, 95% CI 1.27-4.24; and > 20 mm, HR 2.10, 95% CI 1.14-3.88), re-excision (HR 1.76, 95% CI 1.04-2.96), and tamoxifen (HR 2.03, 95% CI 1.12-3.70). Boost dose > 16 Gy had a protective effect (HR 0.39, 95% CI 0.187-0.824). Multivariate analyses confirmed the independent associations between IBTR and 11-20 mm (p = 0.02) and > 20 mm (p = 0.009) tumours, and re-excision (p = 0.006). On the margin-stratified multivariate analysis, tamoxifen was a poor prognostic factor in the close/positive margin subgroup (HR 4.28 95% CI 1.23-14.88), while the highest boost dose ( > 16 Gy) had a significant positive effect (HR 0.34, 95% CI 0.13-0.86) in the negative margin subgroup. CONCLUSIONS Radiotherapy boost did not improve the risk of IBTR. Boost radiotherapy was more common in patients with high-risk disease. Tumor size and re-excision were significant independent prognostic factors.
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Affiliation(s)
- M J Cambra
- Department of Radiation Oncology, Hospital Universitari General de Catalunya-Grupo Quirónsalud (IOV-HGC-Quironsalud), Carrer Pedro i Pons 1, 08195, Sant Cugat del Vallés, Barcelona, Spain.
| | - F Moreno
- Department of Radiation Oncology, Institut Català d'Oncologia L'Hospitalet, L'Hospitalet de Llobregat, Avda de la Granvia, 199, 08908, Barcelona, Spain
| | - X Sanz
- Department of Radiation Oncology, Parc de Salut MAR, Passeig Marítim 25-29, 08003, Barcelona, Spain
| | - L Anglada
- Department of Radiation Oncology, ICO Girona, Avda de França, s/n, 17007, Girona, Spain
| | - M Mollà
- Department of Radiation Oncology, Hospital Vall d'Hebrón, Pg Vall d'Hebron 119, 129, 08035, Barcelona, Spain.,Department of Radiation Oncology, Hospital Clìnic, Universitat de Barcelona, Villarroel 170, 08036, Barcelona, Spain
| | - V Reyes
- Department of Radiation Oncology, Hospital Vall d'Hebrón, Pg Vall d'Hebron 119, 129, 08035, Barcelona, Spain
| | - M Arenas
- Department of Radiation Oncology, Hospital Universitari Sant Joan Reus, Avda del Dr. Josep Laporte, 2, 43204, Reus, Tarragona, Spain
| | - A Pedro
- Department of Radiation Oncology, Hospital Plató, c/Plató, 21, 08006, Barcelona, Spain
| | - R Ballester
- Department of Radiation Oncology, Institut Català D'Oncologia-Badalona, Carretera del Canyet, s/n, 08916, Badalona, Barcelona, Spain
| | - V García
- Department of Radiation Oncology, Hospital Arnau de Vilanova, Avda Alcalde Rovira Roure, 80, 25198, Lleida, Spain
| | - J Casals
- Department of Radiation Oncology, Hospital Quirón, Plaça Alfonso Comín, 5, 08023, Barcelona, Spain
| | - M Cusidó
- Department of Gynecology and Obstetrics, Hospital Universitari Dexeus-Grupo Quirónsalud, c/Sabino Arana, 5-19, 08028, Barcelona, Spain
| | - C Jimenez
- Biostatistics and Bioinformatic Expert, Olesa de Montserrat, c/Urgell 55 A, 08640, Barcelona, Spain
| | - J M Escribà
- Catalan Cancer Registry, Cancer Planning Directorate, L'Hospitalet de Llobregat, Avda de La Granvia, s/n, 08908, Barcelona, Spain.,Department of Clinical Sciences, University of Barcelona, Barcelona, Spain
| | - M Macià
- Department of Radiation Oncology, Institut Català d'Oncologia L'Hospitalet, L'Hospitalet de Llobregat, Avda de la Granvia, 199, 08908, Barcelona, Spain
| | - J M Solé
- Department of Radiation Oncology, Consorci Sanitari de Terrassa, Ctra. Torrebonica s/n, 08227, Terrassa, Barcelona, Spain
| | - A Arcusa
- Department of Medical Oncology, Ctra. Torrebonica s/n, Consorci Sanitari de Terrassa, 08227, Terrassa, Barcelona, Spain
| | - M A Seguí
- Department of Medical Oncology, Corporació Sanitaria Parc Taulí, Parc Taulí 1, 08208, Sabadell, Barcelona, Spain
| | - S Gonzalez
- Department of Medical Oncology, Hospital Universitari Mútua de Terrassa, Plaça del Doctor Robert, 5, 08221, Terrassa, Barcelona, Spain
| | - B Farrús
- Department of Radiation Oncology, Hospital Clìnic, Universitat de Barcelona, Villarroel 170, 08036, Barcelona, Spain
| | - A Biete
- Department of Radiation Oncology, Hospital Clìnic, Universitat de Barcelona, Villarroel 170, 08036, Barcelona, Spain
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Borras J, Font R, Solà J, Macià M, Arenas M, Verges R, Eraso A, Tuset V, Biete A, Solé J, Farré N, Pedro A, Mira M, Espinàs J. OC-0600 Assessment of non-adherence to external radiotherapy treatment in cancer patients in Catalonia,Spain. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31020-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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16
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van Cleef E, Almeida M, Paschoaloto J, Castro Filho E, Barducci R, Soragni G, Zampieri Neto E, Pedro A, Ezequiel J. PSXV-17 Effects of increasing concentrations of soybean molasses on feed intake, growth performance, carcass and meat traits of feedlot lambs. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.1029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- E van Cleef
- Federal University of Triangulo Mineiro,Uberaba, Brazil
| | - M Almeida
- Sao Paulo State University,Sao Paulo, Brazil
| | | | | | - R Barducci
- Sao Paulo State University,Jaboticabal, Brazil
| | - G Soragni
- Sao Paulo State University,Jaboticabal, Brazil
| | | | - A Pedro
- Sao Paulo State University,Jaboticabal, Brazil
| | - J Ezequiel
- Sao Paulo State University,Jaboticabal, Brazil
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17
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Almeida M, van Cleef E, Paschoaloto J, Castro Filho E, Barducci R, Soragni G, Zampieri Neto E, Pedro A, Ezequiel J. PSXV-32 Effects of increasing inclusion of soybean molasses on rumen fermentation of feedlot sheep. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.1040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M Almeida
- Sao Paulo State University,Sao Paulo, Brazil
| | - E van Cleef
- Federal University of Triangulo Mineiro,Uberaba, Brazil
| | | | | | - R Barducci
- Sao Paulo State University,Jaboticabal, Brazil
| | - G Soragni
- Sao Paulo State University,Jaboticabal, Brazil
| | | | - A Pedro
- Sao Paulo State University,Jaboticabal, Brazil
| | - J Ezequiel
- Sao Paulo State University,Jaboticabal, Brazil
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18
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Miranda D, Barbosa P, Sakellarides C, Escoval A, Pedro AR, Salavisa M. Lessons learned from developing and applying health literacy tools in Portugal. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- D Miranda
- Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Lisbon, Portugal
| | - P Barbosa
- Ministry of Health, Lisbon, Portugal
| | - C Sakellarides
- Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Lisbon, Portugal
| | - A Escoval
- Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Lisbon, Portugal
| | - AR Pedro
- Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Lisbon, Portugal
| | - M Salavisa
- Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Lisbon, Portugal
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Bonet M, Arenas M, Farré N, García V, Algara M, Farrús B, Fernández J, Reyes V, Eraso A, Alvarez A, Cambra M, Pedro A, Vayreda J, Montero A, Poortmans P. EP-1297: RT for bone-only oligometastases in breast cancer patients: a survey of current clinical practice. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31607-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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20
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Cambra M, Farrús B, Moreno F, Anglada L, Arenas M, Ballester R, Casals J, Cusidó M, García V, Gutiérrez C, Mollà M, Pedro A, Reyes V, Sanz X. Management of breast ductal carcinoma in situ in Catalonia, Spain: Results from the Grup Oncologic Calalà-Occità-Catalonia survey with 9-year follow up. Breast 2017; 35:196-202. [DOI: 10.1016/j.breast.2017.08.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Revised: 07/31/2017] [Accepted: 08/07/2017] [Indexed: 12/25/2022] Open
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Borras J, Prades J, Algara M, Espinàs J, Farrús B, Arenas M, Reyes V, Garcia-Reglero V, Cambra M, Rubio Calatayud E, Anglada L, Eraso A, Pedro A, Fuentes-Raspall M, Tuset V. EP-1173: Understanding variations in the use of hypofractionated radiotherapy for breast cáncer. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31609-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Vila A, Perez de Olaguer J, Gallego P, Carrera G, Pedro A. EP-1142: EORTC QLQ C-30 scores evolution in stage I-III breast cancer patients during sequential treatment. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31578-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Zapatero A, Guerrero A, Maldonado J, Alvarez A, Gonzalez San Segundo C, Cabeza Rodriguez M, Macias V, Pedro A, Casas F, Boladeras A, Martin de Vidales C, Vazquez de la Torre M, Calvo F. Androgen Deprivation and High-Dose Radiation Therapy in Prostate Cancer: Report on Late Toxicity from DART 01/05 Randomized Phase III Trial. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Gallego P, Pérez-Alija J, Olivares S, Loscos S, Ambroa E, Pedro A. EP-1733: Deep inspiration breath-hold technique using an Arduino. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32984-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Perez-Alija J, Gallego P, Pedro A. PV-0087: Non-publication of Phase-3 clinical trials in radiotherapy. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)31336-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Pérez-Alija J, Franco P, Ambroa E, Olivares S, Loscos S, Pedro A. EP-1778: On the feasibility of performing a 3D-scan with your own smartphone. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)33029-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Cambra MJ, Moreno F, Sanz X, Anglada L, Moià M, Reyes V, Arenas M, Pedro A, Ballester R, García V, Sanjosé S, Cusidó M, Jimenez C, Macià M, Solé JM, Farrus B. Abstract P5-17-08: Study of boost radiotherapy's influence on local control in 646 pure ductal carcinoma in situ breast cancer with long-term follow-up. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p5-17-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
BACKGROUND: Boost radiotherapy (B-RT) improves outcome in patients (pts) with invasive breast cancer. It's use in patients with pure ductal carcinoma in situ (DCIS) is unclear. There are two ongoing randomize trials, results are expected in ten years. Twelve retrospective observational studies have been published since 2006, the recent meta-analysis, support boost in the presence of positive margins.
PATIENTS and METHODS: We analyse a retrospective women's cohort of 646 pure DCIS patients (pts) treated mainly in two Hospitals (n=518) from 1993 to 2014. The other ten Hospitals included 128 pts all 2005 long. Proportions were compared by boost status, using the chi-square tests. The impact of boost radiation on the development of local recurrence (LR) was determined using survival analyses. In the comparison of Kaplan-Meier (K-M) was used log-rank test.
RESULTS: B-RT subgroup is 394 pts (61%), noB-RT 252 (39%). Median follow-up (FU) is 8.8 years. High risk factors: young age, size, margin status and tamoxifen (TMX) show differences among B-RT (p<0.05). 46% were Estrogen Receptor positive (ER+), 30% B-RT and 16% noB-RT. 22% RE+ in B-RT take TMX vs 9.4 % RE+ noB-RT. Total LR 65 (10%). In situ LR 30 pts (4,6%) and Invasive (Inv) 35 (5,4%). By subgroup, LR in B-RT 47 (12%) vs. 18 (7%) in noB-RT. By subtype, In situ LR in B-RT 20 (5.1%) vs. noB-RT 10 (4%). Inv LR in B-RT 27 (6.9%) vs. noB-RT 8 (3.2%). In uni & multivariate analysis, tumour size, Re-Excision, and TMX, are significant LR risk factors (p<0.05). Boost total doses >16 Gy in the B-RT subgroup is a LR significant risk factor related to 10-16 Gy (p∼0.05). TMX and Dose Boost are related (p<0.001). When Dose is introduced in multivariate analysis model, TMX lost signification. Contralateral local recurrence (CLR) in 29 pts (7%). Second tumours 9 pts (NSD between subgroups). Global disease free survival (DFS) is 80.5%, 77% in B-RT vs. 85% in noB-RT. Four pts have a LR combined with CLR; 2 pts have a LR and a second tumor; 1 pt with CLR and second tumour; 1 pt a Inv regional recurrence; 1 pt mixosarcoma in ipsilateral breast and lung metastases. Deaths: 3 pts (0.5%) after an Inv LR; 3 pts (0.5%) after Inv CR; 20 pts other causes; 10 pts lost their FU. Median FU in B-RT subgroup was 9y vs. 8.3y in noB-RT. The maximum FU according LR in B-RT is 20.6y vs. 17.4y in noB-RT. RL is not significant according to Boost (K-M p=0.398). Median LR in situ or inv depending of B-RT vs. noB-RT shows NSD (p=0.663).
CONCLUSIONS: In this large cohort retrospective study with long-term follow-up B-RT was associated with similar LR as noB-RT despite being used more frequently with higher risk disease. Dose boost >16 Gy has a protective effect. Tamoxifen and boost dose are related variables. Further evidence, based on ongoing randomized trials results is essential.
Citation Format: Cambra MJ, Moreno F, Sanz X, Anglada L, Moià M, Reyes V, Arenas M, Pedro A, Ballester R, García V, Sanjosé S, Cusidó M, Jimenez C, Macià M, Solé JM, Farrus B. Study of boost radiotherapy's influence on local control in 646 pure ductal carcinoma in situ breast cancer with long-term follow-up. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P5-17-08.
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Affiliation(s)
- MJ Cambra
- Institut Oncològic del Vallés-IDC-HGC, Sant Cugat del Vallés, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet de Llobregat, Barcelona, Spain; Hospital de la Esperança. Parc de Salut Mar, Barcelona, Spain; Institut Català d'Oncologia, Girona, Spain; Hospital Universitari de la Vall de Hebrón, Barcelona, Spain; Hospital Universitari Sant Joan, Reus, Tarragona, Spain; Hospital Plató, Barcelona, Spain; Institut Català d'Oncologia, Badalona, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Hospital Quirón, Barcelona, Spain; Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain; Hospital Clìnic i Provincial, Barcelona, Spain
| | - F Moreno
- Institut Oncològic del Vallés-IDC-HGC, Sant Cugat del Vallés, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet de Llobregat, Barcelona, Spain; Hospital de la Esperança. Parc de Salut Mar, Barcelona, Spain; Institut Català d'Oncologia, Girona, Spain; Hospital Universitari de la Vall de Hebrón, Barcelona, Spain; Hospital Universitari Sant Joan, Reus, Tarragona, Spain; Hospital Plató, Barcelona, Spain; Institut Català d'Oncologia, Badalona, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Hospital Quirón, Barcelona, Spain; Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain; Hospital Clìnic i Provincial, Barcelona, Spain
| | - X Sanz
- Institut Oncològic del Vallés-IDC-HGC, Sant Cugat del Vallés, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet de Llobregat, Barcelona, Spain; Hospital de la Esperança. Parc de Salut Mar, Barcelona, Spain; Institut Català d'Oncologia, Girona, Spain; Hospital Universitari de la Vall de Hebrón, Barcelona, Spain; Hospital Universitari Sant Joan, Reus, Tarragona, Spain; Hospital Plató, Barcelona, Spain; Institut Català d'Oncologia, Badalona, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Hospital Quirón, Barcelona, Spain; Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain; Hospital Clìnic i Provincial, Barcelona, Spain
| | - L Anglada
- Institut Oncològic del Vallés-IDC-HGC, Sant Cugat del Vallés, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet de Llobregat, Barcelona, Spain; Hospital de la Esperança. Parc de Salut Mar, Barcelona, Spain; Institut Català d'Oncologia, Girona, Spain; Hospital Universitari de la Vall de Hebrón, Barcelona, Spain; Hospital Universitari Sant Joan, Reus, Tarragona, Spain; Hospital Plató, Barcelona, Spain; Institut Català d'Oncologia, Badalona, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Hospital Quirón, Barcelona, Spain; Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain; Hospital Clìnic i Provincial, Barcelona, Spain
| | - M Moià
- Institut Oncològic del Vallés-IDC-HGC, Sant Cugat del Vallés, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet de Llobregat, Barcelona, Spain; Hospital de la Esperança. Parc de Salut Mar, Barcelona, Spain; Institut Català d'Oncologia, Girona, Spain; Hospital Universitari de la Vall de Hebrón, Barcelona, Spain; Hospital Universitari Sant Joan, Reus, Tarragona, Spain; Hospital Plató, Barcelona, Spain; Institut Català d'Oncologia, Badalona, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Hospital Quirón, Barcelona, Spain; Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain; Hospital Clìnic i Provincial, Barcelona, Spain
| | - V Reyes
- Institut Oncològic del Vallés-IDC-HGC, Sant Cugat del Vallés, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet de Llobregat, Barcelona, Spain; Hospital de la Esperança. Parc de Salut Mar, Barcelona, Spain; Institut Català d'Oncologia, Girona, Spain; Hospital Universitari de la Vall de Hebrón, Barcelona, Spain; Hospital Universitari Sant Joan, Reus, Tarragona, Spain; Hospital Plató, Barcelona, Spain; Institut Català d'Oncologia, Badalona, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Hospital Quirón, Barcelona, Spain; Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain; Hospital Clìnic i Provincial, Barcelona, Spain
| | - M Arenas
- Institut Oncològic del Vallés-IDC-HGC, Sant Cugat del Vallés, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet de Llobregat, Barcelona, Spain; Hospital de la Esperança. Parc de Salut Mar, Barcelona, Spain; Institut Català d'Oncologia, Girona, Spain; Hospital Universitari de la Vall de Hebrón, Barcelona, Spain; Hospital Universitari Sant Joan, Reus, Tarragona, Spain; Hospital Plató, Barcelona, Spain; Institut Català d'Oncologia, Badalona, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Hospital Quirón, Barcelona, Spain; Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain; Hospital Clìnic i Provincial, Barcelona, Spain
| | - A Pedro
- Institut Oncològic del Vallés-IDC-HGC, Sant Cugat del Vallés, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet de Llobregat, Barcelona, Spain; Hospital de la Esperança. Parc de Salut Mar, Barcelona, Spain; Institut Català d'Oncologia, Girona, Spain; Hospital Universitari de la Vall de Hebrón, Barcelona, Spain; Hospital Universitari Sant Joan, Reus, Tarragona, Spain; Hospital Plató, Barcelona, Spain; Institut Català d'Oncologia, Badalona, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Hospital Quirón, Barcelona, Spain; Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain; Hospital Clìnic i Provincial, Barcelona, Spain
| | - R Ballester
- Institut Oncològic del Vallés-IDC-HGC, Sant Cugat del Vallés, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet de Llobregat, Barcelona, Spain; Hospital de la Esperança. Parc de Salut Mar, Barcelona, Spain; Institut Català d'Oncologia, Girona, Spain; Hospital Universitari de la Vall de Hebrón, Barcelona, Spain; Hospital Universitari Sant Joan, Reus, Tarragona, Spain; Hospital Plató, Barcelona, Spain; Institut Català d'Oncologia, Badalona, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Hospital Quirón, Barcelona, Spain; Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain; Hospital Clìnic i Provincial, Barcelona, Spain
| | - V García
- Institut Oncològic del Vallés-IDC-HGC, Sant Cugat del Vallés, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet de Llobregat, Barcelona, Spain; Hospital de la Esperança. Parc de Salut Mar, Barcelona, Spain; Institut Català d'Oncologia, Girona, Spain; Hospital Universitari de la Vall de Hebrón, Barcelona, Spain; Hospital Universitari Sant Joan, Reus, Tarragona, Spain; Hospital Plató, Barcelona, Spain; Institut Català d'Oncologia, Badalona, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Hospital Quirón, Barcelona, Spain; Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain; Hospital Clìnic i Provincial, Barcelona, Spain
| | - S Sanjosé
- Institut Oncològic del Vallés-IDC-HGC, Sant Cugat del Vallés, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet de Llobregat, Barcelona, Spain; Hospital de la Esperança. Parc de Salut Mar, Barcelona, Spain; Institut Català d'Oncologia, Girona, Spain; Hospital Universitari de la Vall de Hebrón, Barcelona, Spain; Hospital Universitari Sant Joan, Reus, Tarragona, Spain; Hospital Plató, Barcelona, Spain; Institut Català d'Oncologia, Badalona, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Hospital Quirón, Barcelona, Spain; Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain; Hospital Clìnic i Provincial, Barcelona, Spain
| | - M Cusidó
- Institut Oncològic del Vallés-IDC-HGC, Sant Cugat del Vallés, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet de Llobregat, Barcelona, Spain; Hospital de la Esperança. Parc de Salut Mar, Barcelona, Spain; Institut Català d'Oncologia, Girona, Spain; Hospital Universitari de la Vall de Hebrón, Barcelona, Spain; Hospital Universitari Sant Joan, Reus, Tarragona, Spain; Hospital Plató, Barcelona, Spain; Institut Català d'Oncologia, Badalona, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Hospital Quirón, Barcelona, Spain; Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain; Hospital Clìnic i Provincial, Barcelona, Spain
| | - C Jimenez
- Institut Oncològic del Vallés-IDC-HGC, Sant Cugat del Vallés, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet de Llobregat, Barcelona, Spain; Hospital de la Esperança. Parc de Salut Mar, Barcelona, Spain; Institut Català d'Oncologia, Girona, Spain; Hospital Universitari de la Vall de Hebrón, Barcelona, Spain; Hospital Universitari Sant Joan, Reus, Tarragona, Spain; Hospital Plató, Barcelona, Spain; Institut Català d'Oncologia, Badalona, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Hospital Quirón, Barcelona, Spain; Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain; Hospital Clìnic i Provincial, Barcelona, Spain
| | - M Macià
- Institut Oncològic del Vallés-IDC-HGC, Sant Cugat del Vallés, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet de Llobregat, Barcelona, Spain; Hospital de la Esperança. Parc de Salut Mar, Barcelona, Spain; Institut Català d'Oncologia, Girona, Spain; Hospital Universitari de la Vall de Hebrón, Barcelona, Spain; Hospital Universitari Sant Joan, Reus, Tarragona, Spain; Hospital Plató, Barcelona, Spain; Institut Català d'Oncologia, Badalona, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Hospital Quirón, Barcelona, Spain; Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain; Hospital Clìnic i Provincial, Barcelona, Spain
| | - JM Solé
- Institut Oncològic del Vallés-IDC-HGC, Sant Cugat del Vallés, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet de Llobregat, Barcelona, Spain; Hospital de la Esperança. Parc de Salut Mar, Barcelona, Spain; Institut Català d'Oncologia, Girona, Spain; Hospital Universitari de la Vall de Hebrón, Barcelona, Spain; Hospital Universitari Sant Joan, Reus, Tarragona, Spain; Hospital Plató, Barcelona, Spain; Institut Català d'Oncologia, Badalona, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Hospital Quirón, Barcelona, Spain; Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain; Hospital Clìnic i Provincial, Barcelona, Spain
| | - B Farrus
- Institut Oncològic del Vallés-IDC-HGC, Sant Cugat del Vallés, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet de Llobregat, Barcelona, Spain; Hospital de la Esperança. Parc de Salut Mar, Barcelona, Spain; Institut Català d'Oncologia, Girona, Spain; Hospital Universitari de la Vall de Hebrón, Barcelona, Spain; Hospital Universitari Sant Joan, Reus, Tarragona, Spain; Hospital Plató, Barcelona, Spain; Institut Català d'Oncologia, Badalona, Spain; Hospital Universitari Arnau de Vilanova, Lleida, Spain; Hospital Quirón, Barcelona, Spain; Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain; Hospital Clìnic i Provincial, Barcelona, Spain
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Cambra Serés M, Frarrús B, Moreno F, Anglada L, Arenas M, Ballester R, Casals J, Cusido M, García V, Gutierrez C, Pedro A, Reyes V, Sanz X. Best oral presentation: Comparative management of breast ductal carcinoma in situ: Goco-Praccis-Catalunya (2004-0001) Praccis–France. Rep Pract Oncol Radiother 2013. [DOI: 10.1016/j.rpor.2013.03.716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Oliveira M, Pinto-Neto A, Pedro A, Costa-Paiva L, Valadares A. THE PRESS AND WOMEN'S HEALTH: THE APPROACH TAKEN BY BRAZILIAN WEEKLY MAGAZINES. Maturitas 2009. [DOI: 10.1016/s0378-5122(09)70531-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Silva R, Costa-Paiva L, Pinto-Neto A, Pedro A, Antunes A, Valadares A. FALLS PREVALENCE AND THE RELATIONSHIP OF INTRINSIC FALL RISK FACTORS IN POSTMENOPAUSAL WOMEN WITH AND WITHOUT OSTEOPOROSIS. Maturitas 2009. [DOI: 10.1016/s0378-5122(09)70369-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Valadares A, Pinto-Neto A, Osis M, Sousa M, Costa-Paiva L, Pedro A, Conde D. SOCIOCULTURAL ADAPTATION AND VALIDATION OF THE SHORT PERSONAL EXPERIENCES QUESTIONNAIRE (SPEQ) INTO THE PORTUGUESE LANGUAGE. Maturitas 2009. [DOI: 10.1016/s0378-5122(09)70428-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Silveira C, Santos F, Barbosa F, Pedro A, Palha A, Marques-Teixeira J. A Preliminary Study of P200 in First-episode Patients, their Relatives and Healthy Controls: Search of New Endophenotypes. Eur Psychiatry 2009. [DOI: 10.1016/s0924-9338(09)70586-3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Background/Objective:Despite the well established genetic basis of schizophrenia, the relationship between genes and the disorder itself is still elusive. Individual endophenotypes, which reduce the complexity of genetic analyses, allow statistical approaches with quantitative trait methodologies. P200 abnormalities of event-related potentials have been reported in schizophrenia with conflicting results. The present study aims to characterize the P200 in first-episode patients and to compare it with that of first-degree relatives and controls.Methods:ERPs were recorded at 19 sites with an auditory oddball for 21 first-episode patients with schizophrenia (mean age=25.14; SD=6.20), 41 of their first degree relatives (mean age=47.65; SD=15.53) and 19 healthy controls (mean age=26.32; SD=7.16). Potentials were averaged for frequent stimuli and P200 amplitude and latency measures were obtained.Results:Analysis of midline electrodes revealed significant group effects for P200 peak amplitudes (F(2, 78)=3.315, p=.042), but not for peak latencies. Post-hoc analyses revealed that patients with schizophrenia present significantly lower P200 amplitudes (M=2.466; SD=1.564) than controls (M=5.037; SD=2.500) at Pz (T(38)=3.851, p=.003). No other significant differences were found.Conclusion:The results obtained do not straight-forwardly support the P200 peak amplitude nor peak latency as an endophenotype of schizophrenia. However, the trends of our results may suggest that the P200 amplitudes of relatives may present intermediate values between healthy controls (with higher amplitudes) and patients (with lower amplitudes). Further statistical analyses will be required in order to disentangle the effects of possible confounding variables.
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Mavale-Manuel S, Joaquim O, Nunes E, Pedro A, Bandeira S, Eduardo E, Macome C, Almeida L, Cossa A, Malichocho J, Maciel L, Constance E, Marques S, Tembe A, de Blic J, Annesi-Maesano I. Prevalence of asthma-like symptoms by ISAAC video questionnaire in Mozambican schoolchildren. Monaldi Arch Chest Dis 2007; 65:189-95. [PMID: 17393663 DOI: 10.4081/monaldi.2006.548] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The International Study of Asthma and Allergies in Childhood (ISAAC) video questionnaire was developed to overcome the language and cultural differences in the assessment of asthma-like symptoms. METHODS 27 schools were included in the Maputo Asthma and Allergies in childhood Study (MAPAAS) using ISAAC methods, and a video questionnaire (VQ) was administered to 1614 adolescents 13-14 years old of 20 schools located in urban, suburban and semi-rural areas of Maputo (Mozambique). Simultaneously, they also replied to the ISAAC written questionnaire (WQ). RESULTS According to the video questionnaire, the prevalence of current asthma was 11.9% (compared with 13.3% using the written questionnaire). Wheezing after exercise in the last year was reported by about 21%. Females reported more frequent wheezing after exercise than males (p < .001). The prevalence of nocturnal cough in the last year was 24.7%, and was more frequent in the suburban area (p < .001). "Severe attacks of asthma" was reported by 11.9% of the individuals. Teenagers instructed in the suburban schools reported more severe asthma-like symptoms than others (p < .05). There was a poor correlation between the WQ and the AVQ3.0 (kappa coefficients varied from 0.09 to 0.24). The lowest agreement was observed for the question regarding severe attacks of asthma. Agreement was better in terms of specificity than in terms of sensitivity. CONCLUSIONS In spite of the poor agreement between the written and the video questionnaires, the prevalence of asthma symptoms estimated using the video questionnaire confirms that asthma is an important public health problem in Maputo.
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Affiliation(s)
- S Mavale-Manuel
- Maputo Central Hospital--Department of Paediatrics, Mozambique
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Mavale-Manuel S, Joaquim O, Macome C, Almeida L, Nunes E, Daniel A, Malichocho J, Pedro A, Bandeira S, Eduardo E, Maciel L, Constance E, Marques S, Tembe A, de Blic J, Annesi-Maesano I. Asthma and allergies in schoolchildren of Maputo. Allergy 2007; 62:265-71. [PMID: 17298343 DOI: 10.1111/j.1398-9995.2006.01251.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM The study aimed to determine prevalence and severity of asthma, rhinitis and eczema in Maputo, Mozambique. METHODS The International Study of Asthma and Allergies (ISAAC) protocol was applied in 27 schools in urban, suburban and semi-rural areas. RESULTS A total of 2630 completed questionnaires were obtained from students aged 13-14 years, and 2383 from schoolchildren aged 6-7 years. The prevalence of current asthma was 13.3% in the two groups, the prevalence of rhinoconjuctivitis and eczema was 23% and 10% in teenagers and 8.8% and 8.5% respectively in children 6-7 years old. Overall, 35% of the adolescents and 23.8% of children were found to have at least one atopic condition or asthma in the last year. In symptomatic adolescents, the conditions were: rhinoconjuctivitis (41.3%), asthma (20%) and eczema (12.4%). In symptomatic children, asthma was the principal condition (36.2%), followed by eczema (20.3%) and rhinoconjunctivitis (19.1%). In adolescents, asthma was more frequently associated with rhinoconjuctivitis (28%). About 4% of all surveyed children had three atopic conditions associated. In adolescents, past year rhinitis was more frequent and severe in the urban area. Hay fever was commoner in the semi-urban area. Eczema was significantly more recurrent in suburban and semi-rural area. Exercise-induced wheeze, nocturnal cough and ever asthma were more reported in children of suburban area. CONCLUSION Asthma and allergic diseases are important public health problems in Maputo and improvement in prevention and management plans are required.
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Affiliation(s)
- S Mavale-Manuel
- Department of Paediatrics, Maputo Central Hospital, Mozambique
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Vila A, Sanchez-Reyes A, Pedro A, Carabante D, Lainez C, Fernandez J, Moya L, Sanchiz F. Our experience in head and neck IMRT. Radiother Oncol 2007. [DOI: 10.1016/s0167-8140(07)80186-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Gaston B, Gustavo P, Mario C, Pedro A, Julio C, Gerardo F, Carlos Q. Prehospital and emergency room assistance during collective accident situations. Burns 2007. [DOI: 10.1016/j.burns.2006.10.290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Silva G, Pedro A, Costa F, Neves N, Coutinho O, Reis R. Soluble starch and composite starch Bioactive Glass 45S5 particles: Synthesis, bioactivity, and interaction with rat bone marrow cells. Materials Science and Engineering: C 2005. [DOI: 10.1016/j.msec.2005.01.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Sousa L, Soares RM, Abreu J, Branco L, Agapito AF, Pedro A, Roquette J, Antunes AM. [Biological prostheses in the tricuspid position. The immediate and follow-up results]. Rev Port Cardiol 1998; 17:697-702. [PMID: 9834640] [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] [Indexed: 02/09/2023] Open
Abstract
The results of bioprostheses in the tricuspid position were analysed in 42 patients. 79% were in NYHA class III-IV and 43% had previous cardiac surgery. Concomitant surgical procedures were performed in 86% of the cases. Surgical mortality was 14.3%. Mean follow-up was 54 +/- 31 months. Eight patients were reoperated (5.1%/patient/year), but only 3 for the tricuspid prosthesis. Four patients, with left-sided mechanical prostheses, had systemic thromboembolic events (3.8%/patient/year) and 3 on oral anticoagulation had major haemorrhage (2.8%/patient/year). Primary tricuspid valve dysfunction occurred in two patients (1.2%/patient/year). There were no cases of tricuspid valve thrombosis. For hospital survivors, 5 and 8 years survival was 91.4 +/- 10.3% and 76.2 +/- 10.4%, respectively. The only preoperative predictor of decreased survival was pulmonary artery systolic pressure > or = 50 mmHg. Tricuspid valve replacement with a bioprosthesis was usually performed in the set of multiple-valve operation, with previous cardiac surgery in a high percentage of patients, carrying a significant surgical mortality. However, the long-term survival and the low rate of events related to the tricuspid bioprosthesis favours its use, when conservative surgery is not feasible.
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Affiliation(s)
- L Sousa
- Serviço de Cardiologia, Hospital de Santa Marta, Lisboa
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Sousa L, Branco L, Pitta ML, Agapito AF, Abreu J, Pedro A, Banazol N, Antunes AM. [Clinical manifestations and therapeutic of isolated infective endocarditis of the tricuspid valve]. Rev Port Cardiol 1998; 17:439-44. [PMID: 9656766] [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] [Indexed: 02/08/2023] Open
Abstract
We reviewed the records of patients admitted to our centre with the diagnosis of isolated tricuspid valve infective endocarditis and analysed the clinical presentation, etiopathogenic agent, echocardiographic features and therapeutic approach, namely the indication for cardiac surgery. Between 1988 and 1996, 11 cases of confirmed tricuspid valve endocarditis were identified, corresponding to 5% of the cases of endocarditis admitted to our centre in the same period. A predisposing factor was found in ten of the patients, half of them intravenous drug addicts and Staphylococcus aureus was the most frequent agent isolated. Fever and pleuro-pulmonary manifestations were predominant clinical features. Transthoracic echocardiography had a crucial role in the diagnosis and transesophageal echocardiography was important to characterize vegetations. Four patients underwent cardiac surgery, for persistent infection. In two cases, excision of the vegetations and ring annuloplasty was performed. In two patients not addicted to drugs, the tricuspid valve was replaced with a bioprosthesis, since the extension of the damage to the valve did not allow repair. One patient, with early endocarditis of a tricuspid bioprosthesis died before surgery was attempted.
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Affiliation(s)
- L Sousa
- Serviço de Cardiologia, Hospital de Santa Marta, Lisboa
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Farthing D, Sica D, Fakhry I, Pedro A, Gehr TW. Simple high-performance liquid chromatographic method for determination of losartan and E-3174 metabolite in human plasma, urine and dialysate. J Chromatogr B Biomed Sci Appl 1997; 704:374-8. [PMID: 9518174 DOI: 10.1016/s0378-4347(97)00489-1] [Citation(s) in RCA: 51] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
A simple high-performance liquid chromatographic (HPLC) method was developed for the determination of losartan and its E-3174 metabolite in human plasma, urine and dialysate. For plasma, a gradient mobile phase consisting of 25 mM potassium phosphate and acetonitrile pH 2.2 was used with a phenyl analytical column and fluorescence detection. For urine and dialysate, an isocratic mobile phase consisting of 25 mM potassium phosphate and acetonitrile (60:40, v/v) pH 2.2 was used. The method demonstrated linearity from 10 to 1000 ng/ml with a detection limit of 1 ng/ml for losartan and E-3174 using 10 microl of prepared plasma, urine or dialysate. The method was utilized in a study evaluating the pharmacokinetic and pharmacodynamic effects of losartan in patients with kidney failure undergoing continuous ambulatory peritoneal dialysis (CAPD).
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Affiliation(s)
- D Farthing
- Division of Clinical Pharmacology, Medical College of Virginia, Virginia Commonwealth University, Richmond 23298-0160, USA
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Ornelas C, Rosado L, Bicho C, Pedro A. Human Papillomavirus DNA in invasive cervical carcinoma detected by Polimerase Chain Reaction. Journal of Microbiological Methods 1997. [DOI: 10.1016/s0167-7012(97)90343-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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42
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Sanchiz F, Millá A, Artola N, Julià JC, Moya LM, Pedro A, Vila A. Prevention of radioinduced cystitis by orgotein: a randomized study. Anticancer Res 1996; 16:2025-8. [PMID: 8712737] [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] [Indexed: 02/01/2023]
Abstract
On the basis of previous experiences indicating that the anti-oxidant agent Cu/Zn superoxide dismutase (SOD) is an effective drug in reducing acute and late radiation-induced tissue injury, in the Center of Radiotherapy and Oncology of Catalonia, Barcelona, Spain in 1990 we implemented a randomized prospective study to analyze the incidence and grade of side effects in a group of bladder cancer patients. After surgery patients were randomly allocated to receive either: Option A: Radiotherapy or Option B: Radiotherapy + SOD 8 mgr/IM/day, after each radiotherapeutic application. Between January 1990 and January 1995 a total of 448 patients were included (226 A/ 222 B). Apart from cutaneous side effects, a highly significant incidence of radioinduced acute cystitis and rectitis was detected in patients not treated by SOD. Which was similar to the delayed side effects. From our data we can conclude that SOD is effective in decreasing acute radioinduced damage, and also in preventing the appearance of more delayed disorders.
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Affiliation(s)
- F Sanchiz
- Center of Radiotherapy and Oncology of Catalonia, Clinica Platón, Barcelona, Spain
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Sanchiz F, Millá A, Pedro A, Vila A, Artola N, Torner J. 229Value of the timing for radiotherapy and chemotherapy for the SCLC limited stage. Radiother Oncol 1996. [DOI: 10.1016/s0167-8140(96)80238-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Affiliation(s)
- D Roig-Vilaseca
- Servei de Reumatologia, Hospital de Malalties Reumàtiques, Barcelona, Spain
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45
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Verger E, Conill C, Pedro A, Chicote S, Salamero M, de Azpiazu P, Gil E, Biete A. [Palliative care in cancer patients. Frequency and priority of symptoms]. Med Clin (Barc) 1992; 99:565-7. [PMID: 1281248] [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] [Indexed: 12/26/2022]
Abstract
BACKGROUND The presence of multiple symptoms is very frequent in patients with advanced cancer disease. In this situation in which cure is not a realistic aim, the goal is to achieve symptom control and to give support to the patient and family. This study was designed to identify the most common and priority symptoms in patients with advanced cancer. METHODS Patients were given a questionnaire with a list of symptoms and were asked to underline those they presented, and also number those they considered most distressful from 1-3. Physicians and nurse independently answered the same questionnaire. RESULTS Asthenia was the most frequent symptom (patient evaluation 84%, nurse 82% and doctor 93%). Psychopathological disturbances showed a high prevalence. Regarding patient evaluation, dry mouth was the third symptom in frequency (73%), but it was detected by nurses in 39% and by physicians in 16%. Priority symptoms for the three groups were pain, asthenia, anorexia and anxiety. Pain was controlled in 19/22 patients (86%), while psychopathological symptoms were only controlled in 7/19 patients (27%). CONCLUSIONS In order to optimize treatment patient participation is mandatory. An interdisciplinary team (physicians, nurses, social workers, and psychologists) is necessary to take care of these patients.
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Affiliation(s)
- E Verger
- Servicio de Oncología Radioterápica, Hospital Clínic i Provincial, Barcelona
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Hacksell U, Tolf BR, Dahlbom R, Pedro A, Lehmann F. Björn Ringdahl: A remembrance. Chirality 1991. [DOI: 10.1002/chir.530030214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Heredia C, Pedro A, Ribalta T, Mercader JM, Graus F. [Spinal cord metastasis of carcinoma of the lung: evaluation of magnetic resonance and computed tomography in its diagnosis]. Neurologia 1990; 5:133-5. [PMID: 2361052] [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] [Indexed: 12/31/2022] Open
Abstract
A patient with lung adenocarcinoma had progressive myelopathy. Computed tomography of spinal cord with intravenous contrast and magnetic resonance scan were negative. At autopsy, a spinal cord metastasis was found. In patients with cancer and clinical suspicion of spinal cord metastasis, palliative treatment with radiotherapy is indicated in spite of negative radiological investigations, so as to prevent the progression of myelopathy.
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Affiliation(s)
- C Heredia
- Servicios de Neurología, Hospital Clínic i Provincial, Barcelona
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López MJ, Llombart-Boch A, Uris J, Pedro A, Colomer J. [Congenital multiple fibromatosis. Clinical, histological and ultrastructural study]. An Esp Pediatr 1982; 17:321-31. [PMID: 7158881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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