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Parente H, Pontes Ferreira M, Soares C, Guimarães F, Azevedo S, Santos-Faria D, Tavares-Costa J, Peixoto D, Afonso C, Roriz D, Teixeira F. Lumbosacral pain in a patient with psoriatic arthritis: when the rheumatic disease is innocent. Reumatismo 2023; 75. [PMID: 38115779 DOI: 10.4081/reumatismo.2023.1565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 08/30/2023] [Indexed: 12/21/2023] Open
Abstract
Lumbar pain is a very common symptom that derives from benign musculoskeletal conditions, rheumatic inflammatory diseases, neoplasms, and referred and/or nociplastic pain. A 70-year-old man with psoriatic arthritis presented with early-onset lumbosacral pain without evident red flags. Symptomatic treatment was unhelpful. Radiographic imaging showed subtle signs of a disease that could easily be missed. Magnetic resonance imaging revealed a massive prostatic malignancy with bone (sacral and iliopubic) metastasis. Awareness must be given not to disregard every lumbar pain as part of the preexisting rheumatic inflammatory disease (spondyloarthropathy in this case) or a common muscle/ligament/articular disarrangement. Persistence of pain, albeit not inflam-matory nor sharp in nature, despite adequate treatment might be just as important as an acute red flag and requires proper follow-up.
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Affiliation(s)
- H Parente
- Department of Rheumatology, Unidade Local de Saúde do Alto Minho, Ponte de Lima.
| | - M Pontes Ferreira
- Department of Rheumatology, Unidade Local de Saúde do Alto Minho, Ponte de Lima.
| | - C Soares
- Department of Rheumatology, Unidade Local de Saúde do Alto Minho, Ponte de Lima.
| | - F Guimarães
- Department of Rheumatology, Unidade Local de Saúde do Alto Minho, Ponte de Lima.
| | - S Azevedo
- Department of Rheumatology, Unidade Local de Saúde do Alto Minho, Ponte de Lima.
| | - D Santos-Faria
- Department of Rheumatology, Unidade Local de Saúde do Alto Minho, Ponte de Lima.
| | - J Tavares-Costa
- Department of Rheumatology, Unidade Local de Saúde do Alto Minho, Ponte de Lima.
| | - D Peixoto
- Department of Rheumatology, Unidade Local de Saúde do Alto Minho, Ponte de Lima.
| | - C Afonso
- Department of Rheumatology, Unidade Local de Saúde do Alto Minho, Ponte de Lima.
| | - D Roriz
- Department of Radiology, Unidade Local de Saúde do Alto Minho, Viana do Castelo.
| | - F Teixeira
- Department of Rheumatology, Unidade Local de Saúde do Alto Minho, Ponte de Lima.
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2
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Lin R, Kos A, Lopez JP, Dine J, Fiori LM, Yang J, Ben-Efraim Y, Aouabed Z, Ibrahim P, Mitsuhashi H, Wong TP, Ibrahim EC, Belzung C, Blier P, Farzan F, Frey BN, Lam RW, Milev R, Muller DJ, Parikh SV, Soares C, Uher R, Nagy C, Mechawar N, Foster JA, Kennedy SH, Chen A, Turecki G. SNORD90 induces glutamatergic signaling following treatment with monoaminergic antidepressants. eLife 2023; 12:e85316. [PMID: 37432876 PMCID: PMC10335830 DOI: 10.7554/elife.85316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 06/26/2023] [Indexed: 07/13/2023] Open
Abstract
Pharmacotherapies for the treatment of major depressive disorder were serendipitously discovered almost seven decades ago. From this discovery, scientists pinpointed the monoaminergic system as the primary target associated with symptom alleviation. As a result, most antidepressants have been engineered to act on the monoaminergic system more selectively, primarily on serotonin, in an effort to increase treatment response and reduce unfavorable side effects. However, slow and inconsistent clinical responses continue to be observed with these available treatments. Recent findings point to the glutamatergic system as a target for rapid acting antidepressants. Investigating different cohorts of depressed individuals treated with serotonergic and other monoaminergic antidepressants, we found that the expression of a small nucleolar RNA, SNORD90, was elevated following treatment response. When we increased Snord90 levels in the mouse anterior cingulate cortex (ACC), a brain region regulating mood responses, we observed antidepressive-like behaviors. We identified neuregulin 3 (NRG3) as one of the targets of SNORD90, which we show is regulated through the accumulation of N6-methyladenosine modifications leading to YTHDF2-mediated RNA decay. We further demonstrate that a decrease in NRG3 expression resulted in increased glutamatergic release in the mouse ACC. These findings support a molecular link between monoaminergic antidepressant treatment and glutamatergic neurotransmission.
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Affiliation(s)
- Rixing Lin
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Department of Psychiatry, McGill UniversityMontrealCanada
- Integrated Program in Neuroscience, McGill UniversityMontrealCanada
| | - Aron Kos
- Department of Stress Neurobiology and Neurogenetics, Max Planck Institute of PsychiatryMunichGermany
- Department of Brain Sciences, Weizmann Institute of ScienceRehovotIsrael
- Department of Molecular Neuroscience, Weizmann Institute of ScienceRehovotIsrael
| | - Juan Pablo Lopez
- Department of Stress Neurobiology and Neurogenetics, Max Planck Institute of PsychiatryMunichGermany
- Department of Brain Sciences, Weizmann Institute of ScienceRehovotIsrael
- Department of Molecular Neuroscience, Weizmann Institute of ScienceRehovotIsrael
| | - Julien Dine
- Department of Stress Neurobiology and Neurogenetics, Max Planck Institute of PsychiatryMunichGermany
- Department of Brain Sciences, Weizmann Institute of ScienceRehovotIsrael
- Department of Molecular Neuroscience, Weizmann Institute of ScienceRehovotIsrael
| | - Laura M Fiori
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Department of Psychiatry, McGill UniversityMontrealCanada
| | - Jennie Yang
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Department of Psychiatry, McGill UniversityMontrealCanada
| | - Yair Ben-Efraim
- Department of Stress Neurobiology and Neurogenetics, Max Planck Institute of PsychiatryMunichGermany
- Department of Brain Sciences, Weizmann Institute of ScienceRehovotIsrael
- Department of Molecular Neuroscience, Weizmann Institute of ScienceRehovotIsrael
| | - Zahia Aouabed
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Department of Psychiatry, McGill UniversityMontrealCanada
| | - Pascal Ibrahim
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Department of Psychiatry, McGill UniversityMontrealCanada
- Integrated Program in Neuroscience, McGill UniversityMontrealCanada
| | - Haruka Mitsuhashi
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Department of Psychiatry, McGill UniversityMontrealCanada
- Integrated Program in Neuroscience, McGill UniversityMontrealCanada
| | - Tak Pan Wong
- Neuroscience Division, Douglas Research CentreMontrealCanada
- Department of Psychiatry, McGill UniversityMontrealCanada
| | - El Cherif Ibrahim
- Aix-Marseille Université, CNRS, INT, Institute Neuroscience TimoneMarseilleFrance
| | - Catherine Belzung
- UMR 1253, iBrain, UFR Sciences et Techniques; Parc GrandmontToursFrance
| | - Pierre Blier
- Mood Disorders Research Unit, University of Ottawa Institute of Mental Health ResearchOntarioCanada
| | | | - Benicio N Frey
- Department of Psychiatry and Behavioural Neurosciences, McMaster UniversityHamiltonCanada
- Mood Disorders Program, St. Joseph’s Healthcare HamiltonHamiltonCanada
| | - Raymond W Lam
- Department of Psychiatry, University of British ColumbiaColumbiaCanada
| | - Roumen Milev
- Departments of Psychiatry and Psychology, Queens UniversityOntarioCanada
| | - Daniel J Muller
- Department of Psychiatry, University Health Network, Krembil Research Institute, University of TorontoTorontoCanada
- Centre for Addiction and Mental HealthTorontoCanada
| | - Sagar V Parikh
- Department of Psychiatry, University of MichiganAnn ArborUnited States
| | - Claudio Soares
- Departments of Psychiatry and Psychology, Queens UniversityOntarioCanada
| | - Rudolf Uher
- Nova Scotia Health AuthorityHalifaxCanada
- Department of Psychiatry, Dalhousie UniversityHalifaxCanada
| | - Corina Nagy
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Department of Psychiatry, McGill UniversityMontrealCanada
| | - Naguib Mechawar
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Department of Psychiatry, McGill UniversityMontrealCanada
| | - Jane A Foster
- Department of Psychiatry and Behavioural Neurosciences, McMaster UniversityHamiltonCanada
- Mood Disorders Program, St. Joseph’s Healthcare HamiltonHamiltonCanada
- Department of Psychiatry, University Health Network, Krembil Research Institute, University of TorontoTorontoCanada
| | - Sidney H Kennedy
- Department of Psychiatry, University Health Network, Krembil Research Institute, University of TorontoTorontoCanada
- St Michael’s Hospital, Li Ka Shing Knowledge Institute, Centre for Depression and Suicide StudiesTorontoCanada
| | - Alon Chen
- Department of Stress Neurobiology and Neurogenetics, Max Planck Institute of PsychiatryMunichGermany
- Department of Brain Sciences, Weizmann Institute of ScienceRehovotIsrael
- Department of Molecular Neuroscience, Weizmann Institute of ScienceRehovotIsrael
| | - Gustavo Turecki
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Department of Psychiatry, McGill UniversityMontrealCanada
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Gutierrez G, Stephenson C, Eadie J, Moghimi E, Omrani M, Groll D, Soares C, Milev R, Vazquez G, Yang M, Alavi N. Evaluating the efficacy of Web-Based Cognitive Behavioural Therapy for the treatment of patients with Bipolar II Disorder and residual depressive symptoms: Protocol for a randomized controlled trial. JMIR Res Protoc 2023; 12:e46157. [PMID: 37140460 DOI: 10.2196/46157] [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] [Received: 01/31/2023] [Revised: 04/24/2023] [Accepted: 04/25/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND Bipolar disorder (BD) is a highly prevalent psychiatric condition that can significantly impact every aspect of a person's life if left untreated. A subtype of BD, Bipolar disorder II (BD-II) is characterized by long depressive episodes and residual depression symptoms, with short-lived hypomanic episodes. Medication and psychotherapy, such as cognitive behavioral therapy (CBT), are the main treatment options for BD-II. CBT specific for BD-II involves the recognition of warning signs, potentially triggering stimuli, and the development of coping skills to increase euthymic periods and improve global functioning. However, access to in-person CBT may be limited by several barriers including low availability, high costs and geographical limitations. Thus, online adaptations of CBT (e-CBT) have become a promising solution to address these treatment barriers Nevertheless, e-CBT for the treatment of BD-II remains understudied. OBJECTIVE The proposed study aims to establish the first e-CBT program specific for the treatment of BD-II with residual depressive symptoms. The primary objective of this study will be to determine the effect of e-CBT in managing BD symptomatology. The secondary objective will be to assess the effects of this e-CBT program on quality of life, and resilience. The tertiary objective will involve gathering user feedback using a post-treatment survey to support the continuous improvement and optimization of the proposed program. METHODS Adult participants (n = 170) with a confirmed diagnosis of BD-II experiencing residual depressive symptoms will be randomly assigned to either the e-CBT plus TAU (n = 85) group or the TAU (n = 85) control group. Participants in the control group will be able to participate in the online program after the first 13 weeks. The e-CBT program will consist of 13 weekly online modules designed following a validated CBT framework. Participants will complete module-related homework and receive asynchronous personalized feedback from a therapist. TAU will consist of standard treatment services conducted outside of the current research study. Depression and manic symptoms quality of life and resiliency will be assessed using clinically validated symptomatology questionnaires at baseline, week 6, and week 13. RESULTS The study received ethics approval in March 2020 and participant recruitment is expected to begin in February 2023 through targeted advertisements and physician referrals. Data collection and analysis are expected to conclude by December 2024. Linear and binomial regression (continuous and categorical outcomes respectively) will be conducted along with qualitative interpretive methods. CONCLUSIONS The findings will be the first on the effectiveness of delivering e-CBT for patients with BD-II with residual depressive symptoms. This approach can provide an innovative method to address barriers to in-person psychotherapy by increasing accessibility and decreasing costs. CLINICALTRIAL clinicaltrials.gov (NCT04664257); clinicaltrials.gov/ct2/show/NCT04664257.
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Affiliation(s)
- Gilmar Gutierrez
- Department of Psychiatry, Queen's University, 15 Arch Street, Kingston, CA
| | - Callum Stephenson
- Department of Psychiatry, Queen's University, 15 Arch Street, Kingston, CA
| | - Jazmin Eadie
- Department of Psychiatry, Queen's University, 15 Arch Street, Kingston, CA
- Department of Psychology, Queen's University, Kingston, CA
- Department of Education, Queen's University, Kingston, CA
| | - Elnaz Moghimi
- Department of Psychiatry, Queen's University, 15 Arch Street, Kingston, CA
| | - Mohsen Omrani
- Department of Psychiatry, Queen's University, 15 Arch Street, Kingston, CA
| | - Dianne Groll
- Department of Psychiatry, Queen's University, 15 Arch Street, Kingston, CA
| | - Claudio Soares
- Department of Psychiatry, Queen's University, 15 Arch Street, Kingston, CA
- Centre for Neuroscience Studies, Queen's University, Kingston, CA
| | - Roumen Milev
- Department of Psychiatry, Queen's University, 15 Arch Street, Kingston, CA
- Centre for Neuroscience Studies, Queen's University, Kingston, CA
| | - Gustavo Vazquez
- Department of Psychiatry, Queen's University, 15 Arch Street, Kingston, CA
- Centre for Neuroscience Studies, Queen's University, Kingston, CA
| | - Megan Yang
- Department of Psychiatry, Queen's University, 15 Arch Street, Kingston, CA
| | - Nazanin Alavi
- Department of Psychiatry, Queen's University, 166 Brock street, Kingston, CA
- Centre for Neuroscience Studies, Queen's University, Kingston, CA
- OPTT Inc., Toronto, CA
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4
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Moghimi E, Stephenson C, Gutierrez G, Jagayat J, Layzell G, Patel C, McCart A, Gibney C, Langstaff C, Ayonrinde O, Khalid-Khan S, Milev R, Snelgrove-Clarke E, Soares C, Omrani M, Alavi N. Mental health challenges, treatment experiences, and care needs of post-secondary students: a cross-sectional mixed-methods study. BMC Public Health 2023; 23:655. [PMID: 37020282 PMCID: PMC10076091 DOI: 10.1186/s12889-023-15452-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 03/15/2023] [Indexed: 04/07/2023] Open
Abstract
BACKGROUND Post-secondary students frequently experience high rates of mental health challenges. However, they present meagre rates of treatment-seeking behaviours. This elevated prevalence of mental health problems, particularly after the COVID-19 pandemic, can lead to distress, poor academic performance, and lower job prospects following the completion of education. To address the needs of this population, it is important to understand students' perceptions of mental health and the barriers preventing or limiting their access to care. METHODS A broad-scoping online survey was publicly distributed to post-secondary students, collecting demographic, sociocultural, economic, and educational information while assessing various components of mental health. RESULTS In total, 448 students across post-secondary institutions in Ontario, Canada, responded to the survey. Over a third (n = 170; 38.6%) of respondents reported a formal mental health diagnosis. Depression and generalized anxiety disorder were the most commonly reported diagnoses. Most respondents felt that post-secondary students did not have good mental health (n = 253; 60.5%) and had inadequate coping strategies (n = 261; 62.4%). The most frequently reported barriers to care were financial (n = 214; 50.5%), long wait times (n = 202; 47.6%), insufficient resources (n = 165; 38.9%), time constraints (n = 148; 34.9%), stigma (n = 133; 31.4%), cultural barriers (n = 108; 25.5%), and past negative experiences with mental health care (n = 86; 20.3%). The majority of students felt their post-secondary institution needed to increase awareness (n = 231; 56.5%) and mental health resources (n = 306; 73.2%). Most viewed in-person therapy and online care with a therapist as more helpful than self-guided online care. However, there was uncertainty about the helpfulness and accessibility of different forms of treatment, including online interventions. The qualitative findings highlighted the need for personal strategies, mental health education and awareness, and institutional support and services. CONCLUSIONS Various barriers to care, perceived lack of resources, and low knowledge of available interventions may contribute to compromised mental health in post-secondary students. The survey findings indicate that upstream approaches such as integrating mental health education for students may address the varying needs of this critical population. Therapist-involved online mental health interventions may be a promising solution to address accessibility issues.
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Affiliation(s)
- Elnaz Moghimi
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, 166 Brock Street, Kingston, ON, K7L 5G2, Canada
- Waypoint Research Institute, Waypoint Centre for Mental Health Care, Penetanguishene, Canada
| | - Callum Stephenson
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, 166 Brock Street, Kingston, ON, K7L 5G2, Canada
| | - Gilmar Gutierrez
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, 166 Brock Street, Kingston, ON, K7L 5G2, Canada
| | - Jasleen Jagayat
- Centre for Neuroscience Studies, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
| | - Gina Layzell
- Centre for Neuroscience Studies, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
| | - Charmy Patel
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, 166 Brock Street, Kingston, ON, K7L 5G2, Canada
| | - Amber McCart
- Student Wellness Services, Queen's University, Kingston, ON, Canada
| | - Cynthia Gibney
- Student Wellness Services, Queen's University, Kingston, ON, Canada
| | - Caryn Langstaff
- Wellness, Accessibility & Student Success, St. Lawrence College, Kingston, ON, Canada
| | - Oyedeji Ayonrinde
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, 166 Brock Street, Kingston, ON, K7L 5G2, Canada
| | - Sarosh Khalid-Khan
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, 166 Brock Street, Kingston, ON, K7L 5G2, Canada
| | - Roumen Milev
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, 166 Brock Street, Kingston, ON, K7L 5G2, Canada
- Centre for Neuroscience Studies, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
| | - Erna Snelgrove-Clarke
- School of Nursing, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
| | - Claudio Soares
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, 166 Brock Street, Kingston, ON, K7L 5G2, Canada
| | - Mohsen Omrani
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, 166 Brock Street, Kingston, ON, K7L 5G2, Canada
- OPTT Inc, Toronto, ON, Canada
| | - Nazanin Alavi
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, 166 Brock Street, Kingston, ON, K7L 5G2, Canada.
- Centre for Neuroscience Studies, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada.
- OPTT Inc, Toronto, ON, Canada.
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5
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Temtem M, Mendonca MI, Serrao M, Santos M, Sa D, Soares C, Sousa AC, Henriques E, Rodrigues M, Freitas S, Borges S, Ornelas I, Drumond A, Palma Dos Reis R. Prognostic impact of adding Coronary Calcium Score to European SCORE2 in an asymptomatic Portuguese population. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
The new European SCORE2 estimates the combined risk of fatal and non-fatal cardiovascular (CV) events, in contrast with SCORE's use for CV mortality only. Although controversial, several studies point out that Coronary Artery Calcification (CAC) scoring could improve CV risk stratification in primary prevention.
Purpose
Assess the impact of including CAC score to the new SCORE2 in MACE prediction and CV risk stratification in an asymptomatic Portuguese population.
Methods
The new SCORE2 was calculated in a population-based cohort of 1,014 individuals (mean age 58.6±8.5 years) without known CV disease and diabetes. Population was stratified into three SCORE2 risk categories (low-, moderate- and high-risk). According to the Hoff's nomogram, CAC score was categorized into: low CAC (0≤CAC<100 or P<50); moderate CAC (100≤CAC<400 or P50–75) and high or severe CAC (CAC≥400 or P>75). Kaplan-Meier survival curves were estimated and a multivariate regression analysis predicted the MACE risk for both scores. C-statistic methodology evaluated the ability of CAC when added to the SCORE2 model in MACE prediction.
Results
Kaplan-Meier curves showed that the highest categories of both scores presented a worst survival. Cox regression analysis showed that the highest categories of both CAC and SCORE2 remained in the equation with an increased MACE risk (HR) of 3.69 (p=0.008) and 9.87 (p=0.005), respectively, when compared with the lowest categories. C-statistic demonstrated that the predictive value for MACE increased from 0.668 (SCORE2 model) to 0.787 when CAC was included (p=0.012), showing a better predictive and discriminative capacity for MACE.
Conclusions
Our results highlight the importance of adding CAC score to SCORE2 in primary prevention to improve cardiovascular risk stratification and MACE risk prediction. Larger prospective multicenter cohorts with longer follow-up should reproduce and validate these findings.
Funding Acknowledgement
Type of funding sources: Public hospital(s). Main funding source(s): SESARAM EPERAM
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Affiliation(s)
- M Temtem
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - M I Mendonca
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - M Serrao
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - M Santos
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - D Sa
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - C Soares
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - A C Sousa
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - E Henriques
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - M Rodrigues
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - S Freitas
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - S Borges
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - I Ornelas
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - A Drumond
- Hospital Funchal , Funchal , Portugal
| | - R Palma Dos Reis
- New University of Lisbon, Faculty of Medical Sciences , Lisbon , Portugal
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6
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Temtem M, Palma Dos Reis R, Serrao M, Sa D, Santos M, Soares C, Sousa AC, Rodrigues M, Freitas S, Henriques E, Borges S, Guerra G, Ornelas I, Drumond A, Mendonca MI. Prognostic role of adding a genetic risk score to the new European SCORE2 in a cardiovascular events prediction, in a moderate-risk region. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
The new SCORE2 provides risk estimates for the combined outcome of fatal and non-fatal cardiovascular disease (CVD) events, in contrast with SCORE's use for CVD mortality only. Genetic predisposition to CVD is not considered in SCORE2 for prevention and treatment.
Purpose
Evaluate the impact of adding a Genetic Risk Score (GRS) to the new European SCORE2 in MACE prediction and estimate the additional value in cardiovascular risk stratification in an asymptomatic Portuguese population.
Methods
A prospective study was performed in a population-based cohort of 1,100 individuals without known CVD and diabetes (mean age 53.3±6.9 years). For all included participants, SCORE2 was calculated and three risk categories were considered: low-, moderate- and high-risk. A 33-SNP GRS was constructed and two groups were analyzed: lower and higher than the GRS median. Kaplan-Meier survival curves were created and a Cox regression model was performed with the two scores to assess MACE risk. C-statistic methodology compared the model between SCORE2 solely and SCORE2 plus GRS.
Results
After Kaplan-Meier analysis for MACE occurrence, the high categories of SCORE 2 and GRS showed worst survival when compared to the lower categories (p<0.0001). Cox regression presented an HR of 8.528 (p=0.001) for high-risk SCORE2 and an HR of 4.520 (p<0.0001) for GRS higher than the median. C-statistic demonstrated that the SCORE2 predictive value was 0.678, increasing to 0.792 when GRS was included (p=0.0005).
Conclusions
In this work, combining SCORE2 with multiple genetic loci gathered into a GRS, improved the identification of patients with the worst prognosis. This new tool may be of great utility in risk stratification in primary prevention. Larger prospective multicenter cohorts with longer follow-up should reproduce and validate these findings.
Funding Acknowledgement
Type of funding sources: Public hospital(s). Main funding source(s): SESARAM EPERAM
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Affiliation(s)
- M Temtem
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - R Palma Dos Reis
- New University of Lisbon, Faculty of Medical Sciences , Lisbon , Portugal
| | - M Serrao
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - D Sa
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - M Santos
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - C Soares
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - A C Sousa
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - M Rodrigues
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - S Freitas
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - E Henriques
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - S Borges
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - G Guerra
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - I Ornelas
- Funchal Hospital, Research Unit , Funchal , Portugal
| | - A Drumond
- Hospital Funchal , Funchal , Portugal
| | - M I Mendonca
- Funchal Hospital, Research Unit , Funchal , Portugal
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7
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Deon B, Cotta K, Silva R, Batista C, Justino G, Freitas G, Cordeiro A, Barbosa A, Loução F, Simioni T, Morais A, Medeiros I, Almeida R, Araújo C, Soares C, Padoin N. Digital twin and machine learning for decision support in thermal power plant with combustion engines. Knowl Based Syst 2022. [DOI: 10.1016/j.knosys.2022.109578] [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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8
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Simas J, Delgado A, Guedes R, Silveira C, Soares C. Management of Parkinson’s disease challenged by co-morbid drug abuse. Eur Psychiatry 2022. [PMCID: PMC9566004 DOI: 10.1192/j.eurpsy.2022.1188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Parkinson’s disease (PD) is a neurologic degenerative condition with complex neuropsychiatric manifestations which can be challenging to manage and greatly impact quality of life and prognosis. Objectives The description of this case aims to highlight the complex interaction between PD, drug-abuse and impulse control disorder (ICD). Methods Clinical information was obtained through patient interviewing and medical records consulting. A literature review on the topic was conducted. Results We report the case of a 52-years-old male with PD diagnosed at the age of 45, presenting with rigidity of right limbs and freezing of gait. He had a history of multiple substance-abuse: hashish, heroin and cocaine, with cessation of all substances by the age of 40. The patient responded well to antiparkinsonian medication initially, but needed frequent adjustments and developed ICD secondary to dopamine agonists, presenting pathological gambling and hypersexuality. At 47 he restarted using cocaine stating that it diminished the motor symptoms. Motor symptoms worsened and became partially responsive to medication. Pharmacologic options were limited due to ICD. He developed dopamine dysregulation syndrome, abusing dopaminergic drugs and requesting multiple prescriptions. Deep brain stimulation surgery was proposed, but the patient was deemed unfit for the procedure after two separate psychiatric evaluations, mainly because of behaviour and social problems in relation to sustained cocaine abuse and personality disorder. Attempts to stop drug abuse were unsuccessful despite several interventions by addiction psychiatry. Conclusions Co-occurrence of PD, substance-abuse and personality disorder poses as a therapeutic challenge conditioned by pharmacological iatrogenesis and behavioural disturbances, requiring a multidisciplinary and individualized approach. Disclosure No significant relationships.
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Nogueira M, Melo C, Grangeia A, Magalhães T, Soares C, Dias R, Fonseca J, Sampaio M, Sousa R. PURA syndrome in a child with severe developmental delay: a challenging diagnosis. Rev Neurol 2022; 74:170-173. [PMID: 35211951 DOI: 10.33588/rn.7405.2021068] [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: 11/24/2022]
Abstract
INTRODUCTION PURA syndrome is a rare autosomal dominant condition caused by de novo pathogenic variants in PURA gene and characterized by a multisystemic phenotype that includes global neurodevelopmental delay, early hypotonia, absence of speech, feeding difficulties, hypersomnolence, epilepsy and movement disorders. CASE REPORT We report a 9-year-old girl with hypotonia and feeding difficulties with failure to thrive since the neonatal period. At the age of 3 years motor and intellectual delay were evident, she had a wide-based gait, no speech and an exaggerated acoustic startle response. She developed hand-mouthing stereotypies and epilepsy at 6 years old. The 24 hours continuous electroencephalogram monitoring revealed global slow activity and frequent epileptiform activity in left temporal and centrotemporal areas. The brain MRI revealed delayed myelination. At 6 years old the clinical exome sequencing identified a heterozygous pathogenic variant in the PURA gene, c.153delA p.(Leu54CysfsTer24). CONCLUSION PURA syndrome has clinical features similar to other neurological disorders but the association with some clinical features, not as common in other neurological entities, like never being able to speak but being able to follow simple orders and exaggerated acoustic startle response, should raise the suspicion of PURA syndrome and genetic analysis must be performed to confirm the diagnosis and provide early multidisciplinary intervention.
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Affiliation(s)
- M Nogueira
- Centro Hospitalar Universitário de São João, Oporto, Portugal
| | - C Melo
- Centro Hospitalar Universitário de São João, Oporto, Portugal
| | - A Grangeia
- Centro Hospitalar Universitário de São João, Oporto, Portugal
| | - T Magalhães
- Centro Hospitalar Universitário de São João, Oporto, Portugal
| | - C Soares
- Centro Hospitalar Universitário de São João, Oporto, Portugal
| | - R Dias
- Centro Hospitalar Universitário de São João, Oporto, Portugal
| | - J Fonseca
- Centro Hospitalar Universitário de São João, Oporto, Portugal
| | - M Sampaio
- Centro Hospitalar Universitário de São João, Oporto, Portugal
| | - R Sousa
- Centro Hospitalar Universitário de São João, Oporto, Portugal
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Barros T, Soares C, Andrade A, Moreira C, Guedes-Martins L, Braga J. 213 Case report: fetal malformations and 3P22.2P21.2 Deletion. Eur J Obstet Gynecol Reprod Biol 2022. [DOI: 10.1016/j.ejogrb.2021.11.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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11
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Cardoso F, Costa F, Soares C, de Moraes M, D’alva C, Cavalcante DS, Cid A, Ribeiro T, Quidute A. Oral health aspects in sporadic and familial primary hyperparathyroidism. J Clin Exp Dent 2022; 14:e396-e403. [PMID: 35582348 PMCID: PMC9094720 DOI: 10.4317/jced.59527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 03/28/2022] [Indexed: 11/05/2022] Open
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12
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Amado A, Castro B, Torre AP, Graça S, Tavares A, Póvoa A, Soares C, Gonçalves G. Serum TSH as a predictor of malignancy in indeterminate thyroid nodules. Ann R Coll Surg Engl 2021; 104:380-384. [PMID: 34939834 DOI: 10.1308/rcsann.2021.0196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Thyroid nodules are lesions that are radiologically distinct from the thyroid parenchyma. Cervical ultrasound diagnoses 19-67% of nodules and is crucial in identifying those that lack cytological characterisation. Approximately 25% of biopsies reveal an indeterminate cytological result (Bethesda III), in which the risk of malignancy is variable (5-15%). The clinical importance of the diagnostic strategy used for thyroid nodules results from the need to exclude malignancy. The aim of this study was to evaluate the usefulness of serum thyroid-stimulating hormone (TSH) levels as a predictor of malignancy in cytologically indeterminate thyroid nodules. METHODS Our retrospective study included 40 patients with cytologically indeterminate thyroid nodules seen in our hospital between January 2013 and December 2017. Clinical parameters were reviewed, including age, gender, serum TSH levels, family history of thyroid carcinoma, radiation exposure and some sonographic features of the nodules. Statistical analysis was performed using SPSS. Statistical significance was defined as p<0.05. RESULTS Female gender was predominant (85%) and the mean (SD) age was 53.3 (15) years. Thyroid carcinoma was confirmed in 28% of patients. Median TSH levels were higher in patients with malignant (2.73µIU/ml) compared with benign (1.56µIU/ml) nodules (p<0.05). We demonstrated an increased risk of malignancy in patients with TSH levels of 2.68µIU/ml or above (p<0.05). CONCLUSION Higher serum TSH levels are associated with an increased risk of thyroid carcinoma in cytologically indeterminate nodules. TSH can become a fundamental diagnostic tool in stratifying the risk of malignancy and assist in diagnostic and therapeutic approaches to these nodules.
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Affiliation(s)
- A Amado
- Vila Nova de Gaia/Espinho Hospital Center (CHVNG/E), Vila Nova de Gaia, Portugal
| | - B Castro
- Vila Nova de Gaia/Espinho Hospital Center (CHVNG/E), Vila Nova de Gaia, Portugal
| | - A P Torre
- Vila Nova de Gaia/Espinho Hospital Center (CHVNG/E), Vila Nova de Gaia, Portugal
| | - S Graça
- Vila Nova de Gaia/Espinho Hospital Center (CHVNG/E), Vila Nova de Gaia, Portugal
| | - A Tavares
- Vila Nova de Gaia/Espinho Hospital Center (CHVNG/E), Vila Nova de Gaia, Portugal
| | - A Póvoa
- Vila Nova de Gaia/Espinho Hospital Center (CHVNG/E), Vila Nova de Gaia, Portugal
| | - C Soares
- Vila Nova de Gaia/Espinho Hospital Center (CHVNG/E), Vila Nova de Gaia, Portugal
| | - G Gonçalves
- Vila Nova de Gaia/Espinho Hospital Center (CHVNG/E), Vila Nova de Gaia, Portugal
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13
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Temtem M, Mendonca MI, Soares C, Serrao M, Rodrigues R, Santos M, Sousa JA, Mendonca F, Sousa AC, Rodrigues M, Henriques E, Freitas S, Drumond A, Palma Dos Reis R. Does coronary calcium score add value to European SCORE in an asymptomatic population? Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Despite being a controversial subject, multiple guidelines mention the use of Coronary Artery Calcification (CAC) scoring in the cardiovascular risk prediction in the asymptomatic population. Adding CAC score to European SCORE (Systematic Coronary Risk Evaluation) may improve the prediction of MACE (Major Adverse Cardiovascular Events), providing better cardiovascular risk stratification.
Purpose
Our study aims to evaluate the impact of CAC severity in MACE prediction compared with SCORE and estimate the additional value of CAC score in cardiovascular risk stratification in a low- risk region and asymptomatic population.
Methods and results
The study consisted of a prospective registry of 1110 asymptomatic individuals free of known coronary heart disease, enrolled from the GENEMACOR study and referred for computed tomography for the CAC scoring assessment. The mean age was 51.6±8.2 years, and 74.1% were male. This population was followed for a mean of 5.2±3.3 years for the primary endpoint of all-cause of cardiovascular events. The extent of CAC differs significantly between men and women in the same age group. Therefore, the distribution of CAC score by age and gender was done using Hoff's nomogram (a). According to this nomogram, 3 categories were created: low CAC (0≤CAC<100 and P<50); moderate CAC (100≤CAC<400 or P50–75) and high CAC (CAC≥400 or P>75). Through a Cox regression for MACE occurrence, SCORE does not remain in the equation, and the higher severity level of CAC presented a significant risk of MACE occurrence with an HR of 7.943 (95% CI 2.948 – 21.401; p<0.0001). Using the C-index, CAC was superior to SCORE (0.729 vs 0.615; p<0.0001). Adding CAC score to SCORE increased MACE prediction compared to SCORE alone (AUC 0.77 vs 0.615; p=0.003).
Conclusion
Our results point to the importance of the CAC score inclusion in primary prevention to improve cardiovascular risk stratification. CAC score in clinical practice could have a prognostic impact on MACE prediction. Larger prospective multicenter cohorts with longer follow-up should reproduce and validate these findings.
Funding Acknowledgement
Type of funding sources: None. Table 1
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Affiliation(s)
- M Temtem
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - M I Mendonca
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - C Soares
- Hospital Dr. Nelio Mendonca, Funchal, Portugal
| | - M Serrao
- Hospital Dr. Nelio Mendonca, Funchal, Portugal
| | - R Rodrigues
- Hospital Dr. Nelio Mendonca, Funchal, Portugal
| | - M Santos
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - J A Sousa
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - F Mendonca
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - A C Sousa
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - M Rodrigues
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - E Henriques
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - S Freitas
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - A Drumond
- Hospital Dr. Nelio Mendonca, Funchal, Portugal
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Soares C, Temtem M, Mendonca MI, Sousa JA, Santos M, Sousa AC, Rodrigues M, Henriques E, Freitas S, Borges S, Guerra G, Drumond A, Palma Dos Reis R. Comparison between a genetic risk score and the European SCORE in cardiovascular events prediction in a primary prevention population. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The risk for Coronary Artery Disease (CAD) can be estimated using different scores, such as the European SCORE (Systematic Coronary Risk Evaluation) scale or genetic risk score (GRS). The addition of GRS to the European SCORE may increase the precision of predicting MACE (Major Adverse Cardiovascular Events).
Purpose
This study aims to compare the European SCORE and the multiplicative genetic risk score (mGRS) in predicting MACE.
Methods and results
The study included 1110 asymptomatic individuals without known CAD from GENEMACOR prospective registry. We defined the primary endpoint of all-cause cardiovascular events.
The study population had mean age of 51.6 years, 74.1% male and had risk factors of diabetes (11.6%), dyslipidemia (67.5%), hypertension (48.1%) and smoking (22.9%). Using C-index methodology, mGRS score was superior to SCORE in predicting MACE (mGRS = 0.832 Vs SCORE = 0.615; p=0.014).
Conclusions
The mGRS score was superior to SCORE in predicting MACE in an asymptomatic and free of CAD population. Genetic information may improve cardiovascular risk stratification in primary prevention.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- C Soares
- Hospital Dr. Nelio Mendonca, Funchal, Portugal
| | - M Temtem
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - M I Mendonca
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - J A Sousa
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - M Santos
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - A C Sousa
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - M Rodrigues
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - E Henriques
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - S Freitas
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - S Borges
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - G Guerra
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - A Drumond
- Hospital Dr. Nelio Mendonca, Funchal, Portugal
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Soares C, Grazina A, Vaz C, Henriques P, Correia G, Nunes R, Pereira A, Mykhayliv V, Sousa M, Spencer C. IRRADIATED BLOOD PRODUCTS-INSTITUTE PORTUGUESE OF ONCOLOGY – COIMBRA (IPOC) – EXPERIENCE OF BLOOD QUALITY ASSURANCE. Hematol Transfus Cell Ther 2021. [DOI: 10.1016/j.htct.2021.10.680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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16
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Nunes R, Correia G, Soares C, Vaz C, Pereira A, Henriques P, Grazina A, Mykhayliv V, Spencer C. EVALUATION OF BLOOD HEMOLYSIS IN ERYTHROCYTES CONCENTRATE: OUR EXPERIENCE-INSTITUTE OF ONCOLOGY COIMBRA (IPOC). Hematol Transfus Cell Ther 2021. [DOI: 10.1016/j.htct.2021.10.621] [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] Open
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17
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Alavi N, Stephenson C, Miller S, Khalafi P, Sinan I, Kain D, McDougall M, Davies J, Stark D, Tompkins E, Jagayat J, Omrani M, Shirazi A, Groll D, Soares C. Developing and Implementing a Web-Based Psychotherapy Program to Address Mental Health Challenges Among Patients Receiving Oncologic and Palliative Care: Protocol for an Open-Label Randomized Controlled Trial. JMIR Res Protoc 2021; 10:e30735. [PMID: 34259164 PMCID: PMC8319771 DOI: 10.2196/30735] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 05/31/2021] [Indexed: 11/13/2022] Open
Abstract
Background The demand for mental health care, particularly for depression and anxiety, is 3-fold greater among patients receiving oncologic and palliative care than for the general population. This population faces unique barriers, making them more susceptible to mental health challenges. Various forms of psychotherapy have been deemed effective in addressing mental health challenges in this population, including supportive psychotherapy, cognitive behavioral therapy, problem-based therapy, and mindfulness; however, their access to traditional face-to-face psychotherapy resources is limited owing to their immunocompromised status, making frequent hospital visits dangerous. Additionally, patients can face hospital fatigue from numerous appointments and investigations or may live in remote areas, which makes commutes both physically and financially challenging. Web-based psychotherapy is a promising solution to address these accessibility barriers. Moreover, web-based psychotherapy has been proven effective in addressing depression and anxiety in other populations and may be implementable among patients receiving oncologic and palliative care. Objective The study will investigate the feasibility and effectiveness of web-based psychotherapy among patients receiving oncologic and palliative care, who have comorbid depression or anxiety. We hypothesized that this program will be a viable and efficacious treatment modality compared to current treatment modalities in addressing depression and anxiety symptoms in this population. Methods Participants (n=60) with depression or anxiety will be recruited from oncology and palliative care settings in Kingston (Ontario, Canada). Participants will be randomly allocated to receive either 8 weeks of web-based psychotherapy plus treatment as usual (treatment arm) or treatment as usual exclusively (control arm). The web-based psychotherapy program will incorporate cognitive behavioral therapy, mindfulness, and problem-solving skills, and homework assignments with personalized feedback from a therapist. All web-based programs will be delivered through a secure platform specifically designed for web-based psychotherapy delivery. To evaluate treatment efficacy, all participants will complete standardized symptomology questionnaires at baseline, midpoint (week 4), and posttreatment. Results The study received ethics approval in February 2021 and began recruiting participants in April 2021. Participant recruitment has been conducted through social media advertisements, physical advertisements, and physician referrals. To date, 11 participants (treatment, n=5; control, n=4; dropout, n=2) have been recruited. Data collection and analysis are expected to conclude by December 2021 and January 2022, respectively. Linear regression (for continuous outcomes) will be conducted with interpretive qualitative methods. Conclusions Our findings can be incorporated into clinical policy and help develop more accessible mental health treatment options for patients receiving oncologic and palliative care. Asynchronous and web-based psychotherapy delivery is a more accessible, scalable, and financially feasible treatment that could have major implications on the health care system. Trial Registration ClinicalTrials.gov NCT04664270; https://clinicaltrials.gov/ct2/show/NCT04664270 International Registered Report Identifier (IRRID) DERR1-10.2196/30735
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Affiliation(s)
- Nazanin Alavi
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada.,Centre for Neuroscience Studies, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
| | - Callum Stephenson
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada.,Centre for Neuroscience Studies, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
| | - Shadé Miller
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
| | - Payam Khalafi
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
| | - Israa Sinan
- Faculty of Arts and Science, Queen's University, Kingston, ON, Canada
| | - Danielle Kain
- Department of Medicine, Queen's University, Kingston, ON, Canada
| | - Maggie McDougall
- Supportive Care Program, Cancer Centre of Southeastern Ontario, Kingston Health Sciences Centre, Kingston, ON, Canada
| | - Julia Davies
- Supportive Care Program, Cancer Centre of Southeastern Ontario, Kingston Health Sciences Centre, Kingston, ON, Canada
| | - Debora Stark
- Supportive Care Program, Cancer Centre of Southeastern Ontario, Kingston Health Sciences Centre, Kingston, ON, Canada
| | - Erin Tompkins
- Supportive Care Program, Cancer Centre of Southeastern Ontario, Kingston Health Sciences Centre, Kingston, ON, Canada
| | - Jasleen Jagayat
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
| | | | - Amirhossein Shirazi
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada.,Centre for Neuroscience Studies, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada.,OPTT Inc, Toronto, ON, Canada
| | - Dianne Groll
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
| | - Claudio Soares
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
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Raphael MJ, Griffiths R, Peng Y, Gupta S, Siemens DR, Soares C, Booth CM. Mental Health Resource Use Among Patients Undergoing Curative Intent Treatment for Bladder Cancer. J Natl Cancer Inst 2021; 113:1238-1245. [PMID: 33674834 DOI: 10.1093/jnci/djab026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 12/18/2020] [Accepted: 02/22/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Patients with bladder cancer may experience mental health distress. Mental health-care service (MHS) use can quantify the magnitude of the problem. METHODS The Ontario Cancer Registry was used to identify all patients with bladder cancer treated with curative-intent cystectomy or radiotherapy in Ontario, Canada (2004-2013). Population-level databases were used to identify MHS use (visits to general practitioner, psychiatrist, emergency department, or hospitalization). Generalized estimating equations were used to compare rates of MHS use. Baseline, peritreatment, and posttreatment MHS use were defined as visits from 2 years to 3 months before, 3 months before to 3 months after, and from 3 months after to 2 years after start of treatment, respectively. RESULTS From 2004 to 2013, 4296 patients underwent cystectomy (n = 3332) or curative-intent radiotherapy (n = 964). Compared with baseline, the rate of MHS use was higher in the peritreatment (adjusted rate ratio [aRR] = 1.64, 95% confidence interval [CI] = 1.48 to 1.82) and posttreatment periods (aRR = 1.45, 95% CI =1.30 to 1.63). By 2 years posttreatment, 24.6% (95% CI = 23.4% to 25.9%) of all patients had MHS use. Patients with baseline MHS use had substantially higher MHS use in the peritreatment (aRR = 5.77, 95% CI = 4.86 to 6.86) and posttreatment periods (aRR = 4.58, 95% CI = 3.78 to 5.55). Female patients had higher use MHS use overall, but males had a higher incremental increase in the posttreatment period compared with baseline (2-sided Pinteraction = .02). Male patients had a statistically significant increase in MHS use following surgery or radiotherapy, whereas female patients only had an increase following surgery. CONCLUSIONS MHS use is common among patients undergoing treatment for bladder cancer, particularly in the peritreatment period. Screening for mental health concerns in this population is warranted.
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Affiliation(s)
- Michael J Raphael
- Division of Medical Oncology and Hematology, Department of Medicine, University of Toronto, Toronto, Canada.,Division of Cancer Care and Epidemiology, Queen's University Cancer Research Institute, Kingston, Canada
| | - Rebecca Griffiths
- Division of Cancer Care and Epidemiology, Queen's University Cancer Research Institute, Kingston, Canada.,ICES Queen's, Queen's University, Kingston, Canada
| | - Yingwei Peng
- Division of Cancer Care and Epidemiology, Queen's University Cancer Research Institute, Kingston, Canada.,Department of Public Health Sciences, Queen's University, Kingston, Canada.,Department of Mathematics and Statistics, Queen's University, Kingston, Canada
| | - Sumit Gupta
- ICES Central, University of Toronto, Toronto, Canada.,The Hospital for Sick Children, Toronto, Ontario, Canada
| | | | - Claudio Soares
- Department of Psychiatry, Queen's University, Kingston, Canada
| | - Christopher M Booth
- Division of Cancer Care and Epidemiology, Queen's University Cancer Research Institute, Kingston, Canada.,ICES Queen's, Queen's University, Kingston, Canada.,Department of Public Health Sciences, Queen's University, Kingston, Canada.,Department of Oncology, Queen's University, Kingston, Canada
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Hatcher S, Heisel M, Ayonrinde O, Campbell JK, Colman I, Corsi DJ, Edgar NE, Gillett L, Kennedy SH, Hunt SL, Links P, MacLean S, Mehta V, Mushquash C, Raimundo A, Rizvi SJ, Saskin R, Schaffer A, Sidahmed A, Sinyor M, Soares C, Taljaard M, Testa V, Thavorn K, Thiruganasambandamoorthy V, Vaillancourt C. The BEACON study: protocol for a cohort study as part of an evaluation of the effectiveness of smartphone-assisted problem-solving therapy in men who present with intentional self-harm to emergency departments in Ontario. Trials 2020; 21:925. [PMID: 33187542 PMCID: PMC7663866 DOI: 10.1186/s13063-020-04424-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 05/16/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Patients who present to emergency departments after intentional self-harm are at an increased risk of dying by suicide. This applies particularly to men, who represent nearly two-thirds of those who die by suicide in Ontario. One way of potentially addressing this gap is to offer a course of blended problem-solving therapy, comprised of a brief course of evidence-based psychotherapy for individuals at risk for suicide, facilitated by the use of a patient-facing smartphone application and a clinician-facing "dashboard." This approach has the potential to combine the benefits of face-to-face therapy and technology to create a novel intervention. METHODS This is a cohort study nested within a larger pragmatic multicentre pre- and post-design cluster randomised trial. Suicidal ideation assessed by the Beck Scale for Suicide Ideation is the primary outcome variable. Secondary outcome measures include depression (Patient Health Questionnaire-9), anxiety (Generalized Anxiety Disorder 7-item scale), post-traumatic stress disorder (Primary Care PTSD Screen), health-related quality of life (EuroQol 5-dimension 5-level questionnaire), meaning in life (Experienced Meaning in Life Scale), perceived social supports (Multidimensional Scale of Perceived Social Support), alcohol use (Alcohol Use Disorders Identification Test), drug use (Drug Abuse Screening Test Short Form 10), problem-solving skills (Social Problem-Solving Inventory-Revised Short Form), and self-reported healthcare costs, as well as health service use measured using Ontario administrative health data. A process evaluation will also be conducted following study completion. DISCUSSION The cohort study will test whether better adherence to the intervention results in better outcomes. The value of the cohort study design is that we can examine in more detail certain subgroups or other variables that are not available in the larger cluster randomised trial. This trial will aim to improve standards by informing best practice in management of men who self-harm and present to hospitals in Ontario. TRIAL REGISTRATION ClinicalTrials.gov , NCT03473535 . Registered on March 22, 2018.
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Affiliation(s)
- Simon Hatcher
- Ottawa Hospital Research Institute, Ottawa, Canada.
- University of Ottawa, Ottawa, Canada.
| | - Marnin Heisel
- Lawson Health Research Institute, London, Canada
- Western University, London, Canada
| | - Oyedeji Ayonrinde
- Queen's University, Kingston, Canada
- Kingston Health Sciences Centre, Kingston, Canada
| | | | | | - Daniel J Corsi
- Ottawa Hospital Research Institute, Ottawa, Canada
- University of Ottawa, Ottawa, Canada
| | | | - Lindsay Gillett
- Sioux Lookout Meno Ya Win Health Centre, Sioux Lookout, Canada
| | - Sidney H Kennedy
- St. Michael's Hospital, Toronto, Canada
- University of Toronto, Toronto, Canada
| | | | | | - Sarah MacLean
- Ottawa Hospital Research Institute, Ottawa, Canada
- Carleton University, Ottawa, Canada
| | | | | | - Alicia Raimundo
- Ottawa Hospital Research Institute, Ottawa, Canada
- University of Ottawa, Ottawa, Canada
| | - Sakina J Rizvi
- St. Michael's Hospital, Toronto, Canada
- University of Toronto, Toronto, Canada
| | - Refik Saskin
- Institute for Clinical Evaluative Sciences, Toronto, Canada
| | - Ayal Schaffer
- University of Toronto, Toronto, Canada
- Sunnybrook Research Institute, Toronto, Canada
| | | | - Mark Sinyor
- University of Toronto, Toronto, Canada
- Sunnybrook Research Institute, Toronto, Canada
| | - Claudio Soares
- Queen's University, Kingston, Canada
- Kingston Health Sciences Centre, Kingston, Canada
| | - Monica Taljaard
- Ottawa Hospital Research Institute, Ottawa, Canada
- University of Ottawa, Ottawa, Canada
| | - Valerie Testa
- Ottawa Hospital Research Institute, Ottawa, Canada
- University of Ottawa, Ottawa, Canada
| | - Kednapa Thavorn
- Ottawa Hospital Research Institute, Ottawa, Canada
- University of Ottawa, Ottawa, Canada
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20
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Ferreira V, Almeida Morais L, Sousa L, Fiarresga A, Martins J, Timoteo A, Viveiros Monteiro A, Loureiro P, Soares C, Castelo A, Garcia Bras P, Reis J, Pinto F, Agapito A, Cruz Ferreira R. New onset atrial fibrillation after percutaneous Patent Foramen Ovale closure: how serious is this problem? Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Percutaneous Patent Foramen Ovale (pPFO) closure benefits for secondary prevention after cardio-embolic stroke have recently been proved. With the increasing number of cases and procedures, a concern with new onset atrial fibrillation (NOAF) has been raised.
Purpose
To evaluate long-term outcome regarding NOAF rate and to identify its predictors and clinical impact, in a real population submitted to pPFO closure.
Methods
From 2000 to 2017, consecutive patients (P) submitted to pPFO closure in a tertiary centre were prospectively enrolled. The primary endpoint was NOAF rate and secondary endpoints were all-cause, neurologic and cardiac mortality rates and recurrent ischemic events. Previous and follow-up electrocardiographic, echocardiographic and 24-hour heart rhythm monitoring data were analysed. Follow-up was performed through medical visits, medical charts consultation and a phone call based system, in order to assess clinical status, on-going treatment and events.
Results
496 patients were submitted to pPFO. Immediate success was achieved in 98.8% and 9.1% presented a residual shunt on the 1st year TEE. Mean age was 45.0±11.2 years-old with 50.2% of males. The prevalence of hypertension, hypercholesterolemia and atrial septum aneurysm (ASA) was 25.7%, 45.0% and 46.3%, respectively. Pre-procedural mean left atrial (LA) diameter was 36.0±5.3 mm. FU data was available for 490 (98.6%), for a mean FU time of 7.41±3.51 years. 34 P (6.9%) presented ischemic events recurrence (26 strokes and 8 TIA). The primary endpoint was observed in 21 P (4.3%) during the FU period.
Median time to 1st AF episode since PFO closure was 5.90±5.53 years. 11 P (52.3%) initiated oral anticoagulation. In univariate analysis, age (44.6±11.3 vs 51.8±6.0 years, p=0.005) and hypertension (24.7% vs 47.6%, p=0.019) were predictors of NOAF in this population. In multivariated analysis, only age remained a predictor of NOAF (OR 1.05 (1.007–1.101), p=0.025). LA pre pPFO closure dimensions, ASA, device type or size and the presence of residual shunt in TEE were not determinants of AF occurrence. The incidence of NOAF was associated with the need for hospitalization due to cardiac causes (19% vs 3.2%, p=0.001) and a trend towards higher rate of recurrent stroke (4.9% vs 14.3%, p=0.06).
Conclusion
Despite being a highly successful and safe procedure in most patients, pPFO closure was associated with a non-negligenciable rate of NOAF during long-term follow-up. NOAF predictors were related with classical cardiovascular risk factors, such as age and hypertension. None of the procedure or device features were associated with NOAF. Yet, a clinical impact was attributed to NOAF, with more hospitalizations and a trend towards ischemic events recurrence.
As young patients submitted to pPFO closure grow older, prevention strategies to diagnose and treat NOAF should be endeavoured.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- V Ferreira
- Hospital de Santa Marta, Lisbon, Portugal
| | | | - L Sousa
- Hospital de Santa Marta, Lisbon, Portugal
| | | | | | | | | | - P Loureiro
- Hospital de Santa Marta, Lisbon, Portugal
| | - C Soares
- Hospital de Santa Marta, Lisbon, Portugal
| | - A Castelo
- Hospital de Santa Marta, Lisbon, Portugal
| | | | - J Reis
- Hospital de Santa Marta, Lisbon, Portugal
| | - F Pinto
- Hospital de Santa Marta, Lisbon, Portugal
| | - A Agapito
- Hospital de Santa Marta, Lisbon, Portugal
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21
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Soares C, Ferreira D, Araújo R. Gender analysis of 'man-in-the-barrel' syndrome: is 'person-in-the-barrel' a more adequate term? Eur J Neurol 2020; 28:341-343. [PMID: 32961582 DOI: 10.1111/ene.14551] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 09/15/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND PURPOSE Gender bias is a known issue in healthcare and academia. We analysed the gender of patients reported in the literature with 'man-in-the-barrel' syndrome or equivalent semiological terms. METHODS A search in the PubMed database was conducted using the terms 'man-in-the-barrel', 'person-in-the-barrel', 'woman-in-the-barrel', 'brachial diplegia', 'flail arm' and 'cruciate paralysis'. All articles published between 1969 and 2020 containing a detailed description compatible with the original description of man-in-the-barrel syndrome were included. RESULTS Ninety-five patients with a clinical picture compatible with man-in-the-barrel syndrome were included. Up to 33% of patients were female. Overall, the proportion of female patients with man-in-the-barrel syndrome was 25%. DISCUSSION AND CONCLUSIONS The term man-in-the-barrel may disenfranchise up to a third of women presenting with brachial diplegia with undesirable consequences. We propose a gender-neutral alternative such as 'person-in-the-barrel'.
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Affiliation(s)
- C Soares
- Department of Neurology, Centro Hospitalar Universitário São João, EPE, Porto, Portugal.,Department of Clinic Neurosciences and Mental Health, Faculty of Medicine of University of Porto, Porto, Portugal
| | - D Ferreira
- Department of Neurology, Centro Hospitalar Universitário São João, EPE, Porto, Portugal.,Department of Clinic Neurosciences and Mental Health, Faculty of Medicine of University of Porto, Porto, Portugal
| | - R Araújo
- Department of Neurology, Centro Hospitalar Universitário São João, EPE, Porto, Portugal.,Department of Clinic Neurosciences and Mental Health, Faculty of Medicine of University of Porto, Porto, Portugal
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22
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Orengo C, Velankar S, Wodak S, Zoete V, Bonvin AMJJ, Elofsson A, Feenstra KA, Gerloff DL, Hamelryck T, Hancock JM, Helmer-Citterich M, Hospital A, Orozco M, Perrakis A, Rarey M, Soares C, Sussman JL, Thornton JM, Tuffery P, Tusnady G, Wierenga R, Salminen T, Schneider B. A community proposal to integrate structural bioinformatics activities in ELIXIR (3D-Bioinfo Community). F1000Res 2020; 9. [PMID: 32566135 PMCID: PMC7284151 DOI: 10.12688/f1000research.20559.1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/05/2020] [Indexed: 12/11/2022] Open
Abstract
Structural bioinformatics provides the scientific methods and tools to analyse, archive, validate, and present the biomolecular structure data generated by the structural biology community. It also provides an important link with the genomics community, as structural bioinformaticians also use the extensive sequence data to predict protein structures and their functional sites. A very broad and active community of structural bioinformaticians exists across Europe, and 3D-Bioinfo will establish formal platforms to address their needs and better integrate their activities and initiatives. Our mission will be to strengthen the ties with the structural biology research communities in Europe covering life sciences, as well as chemistry and physics and to bridge the gap between these researchers in order to fully realize the potential of structural bioinformatics. Our Community will also undertake dedicated educational, training and outreach efforts to facilitate this, bringing new insights and thus facilitating the development of much needed innovative applications e.g. for human health, drug and protein design. Our combined efforts will be of critical importance to keep the European research efforts competitive in this respect. Here we highlight the major European contributions to the field of structural bioinformatics, the most pressing challenges remaining and how Europe-wide interactions, enabled by ELIXIR and its platforms, will help in addressing these challenges and in coordinating structural bioinformatics resources across Europe. In particular, we present recent activities and future plans to consolidate an ELIXIR 3D-Bioinfo Community in structural bioinformatics and propose means to develop better links across the community. These include building new consortia, organising workshops to establish data standards and seeking community agreement on benchmark data sets and strategies. We also highlight existing and planned collaborations with other ELIXIR Communities and other European infrastructures, such as the structural biology community supported by Instruct-ERIC, with whom we have synergies and overlapping common interests.
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Affiliation(s)
- Christine Orengo
- Structural and Molecular Biology Department, University College, London, UK
| | - Sameer Velankar
- Protein Data Bank in Europe, European Molecular Biology Laboratory, European Bioinformatics Institute, Hinxton, CB10 1SD, UK
| | - Shoshana Wodak
- VIB-VUB Center for Structural Biology, Brussels, Belgium
| | - Vincent Zoete
- Department of Oncology, Lausanne University, Swiss Institute of Bioinformatics, Lausanne, Switzerland
| | - Alexandre M J J Bonvin
- Bijvoet Center, Faculty of Science - Chemistry, Utrecht University, Utrecht, 3584CH, The Netherlands
| | - Arne Elofsson
- Science for Life Laboratory, Stockholm University, Solna, S-17121, Sweden
| | - K Anton Feenstra
- Dept. Computer Science, Center for Integrative Bioinformatics VU (IBIVU), Vrije Universiteit, Amsterdam, 1081 HV, The Netherlands
| | - Dietland L Gerloff
- Luxembourg Centre for Systems Biomedicine, University of Luxembourg, Belvaux, L-4367, Luxembourg
| | - Thomas Hamelryck
- Bioinformatics center, Department of Biology, University of Copenhagen, Copenhagen, DK-2200, Denmark
| | | | | | - Adam Hospital
- Institute for Research in Biomedicine, The Barcelona Institute of Science and Technology, Barcelona, 08028, Spain
| | - Modesto Orozco
- Institute for Research in Biomedicine, The Barcelona Institute of Science and Technology, Barcelona, 08028, Spain
| | | | - Matthias Rarey
- ZBH - Center for Bioinformatics, Universität Hamburg, Hamburg, D-20146, Germany
| | - Claudio Soares
- Instituto de Tecnologia Química e Biológica Antonio Xavier, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Joel L Sussman
- Department of Structural Biology, Weizmann Institute of Science, Rehovot, 76100, Israel
| | - Janet M Thornton
- European Molecular Biology Laboratory, European Bioinformatics Institute, Hinxton, CB10 1SD, UK
| | - Pierre Tuffery
- Ressource Parisienne en Bioinformatique Structurale, Université de Paris, Paris, F-75205, France
| | - Gabor Tusnady
- Membrane Bioinformatics Research Group, Institute of Enzymology, Budapest, H-1117, Hungary
| | | | - Tiina Salminen
- Structural Bioinformatics Laboratory, Åbo Akademi University, Turku, FI-20500, Finland
| | - Bohdan Schneider
- Institute of Biotechnology of the Czech Academy of Sciences, Vestec, CZ-25250, Czech Republic
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23
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Soares C, Tenreiro Machado JA, Lopes AM, Vieira E, Delerue-Matos C. Electrochemical impedance spectroscopy characterization of beverages. Food Chem 2020; 302:125345. [PMID: 31445377 DOI: 10.1016/j.foodchem.2019.125345] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 08/07/2019] [Accepted: 08/07/2019] [Indexed: 10/26/2022]
Abstract
This paper compares the results of standard chemical analytical processes and electrochemical impedance spectroscopy (EIS) in the characterization of different beverages, namely ground coffee, soluble coffee, coffee substitutes, barley, cow milk, vegetable drinks, tea, plant infusions and plant mixtures. For the two approaches, the similarities between the experimental data are assessed by means of the Euclidean and Canberra distances. The resulting information is processed by means of the multidimensional scaling (MDS) clustering and visualization algorithm. The results of the chemical analytical processes and EIS reveal identical clusters for the two adopted distances. Furthermore, the robustness of the experimental and computational scheme are assessed by means of the Procrustes technique. The results confirm the effectiveness of combining the EIS and MDS.
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Affiliation(s)
- C Soares
- REQUIMTE/LAQV, Institute of Engineering, Polytechnic of Porto, R. Dr. António Bernardino de Almeida, 431, 4249 - 015 Porto, Portugal.
| | - J A Tenreiro Machado
- Institute of Engineering, Polytechnic of Porto, Dept. of Electrical Engineering, R. Dr. António Bernardino de Almeida, 431, 4249 - 015 Porto, Portugal.
| | - António M Lopes
- UISPA-LAETA/INEGI, Faculty of Engineering, University of Porto, Rua Dr. Roberto Frias, 4200 - 465 Porto, Portugal.
| | - E Vieira
- REQUIMTE/LAQV, Institute of Engineering, Polytechnic of Porto, R. Dr. António Bernardino de Almeida, 431, 4249 - 015 Porto, Portugal.
| | - C Delerue-Matos
- REQUIMTE/LAQV, Institute of Engineering, Polytechnic of Porto, R. Dr. António Bernardino de Almeida, 431, 4249 - 015 Porto, Portugal.
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24
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Soares C, Pacheco A, Zabel F, González-Goberña E, Sequeira C. Baseline assessment of underwater noise in the Ria Formosa. Mar Pollut Bull 2020; 150:110731. [PMID: 31753564 DOI: 10.1016/j.marpolbul.2019.110731] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Revised: 11/06/2019] [Accepted: 11/11/2019] [Indexed: 06/10/2023]
Abstract
The Ria Formosa is a sheltered large coastal lagoon located on the Atlantic South Coast of Portugal, that has been classified as a natural park since 1987. The lagoon hosts a diverse and abundant fish community and other species of commercial importance. Several economical activities are supported by shipping, and as such, vessel traffic within the Ria Formosa lagoon is very intense at some locations during particular seasons of the year, creating high levels of underwater noise. Recently, strong efforts are being made to turn the main inlet of the lagoon, the Faro-Olhão Inlet, a testing site for small scale tidal stream turbines, which will bring an additional source of underwater noise. Underwater noise can be one of a number of factors causing habitat degradation, as it can perturb fish behavior and cause physiological damage. Therefore, in order to comply with underwater noise pollution regulations, tidal energy technology developers are very interested in minimising the introduction of acoustic energy in the environment during the operation of their devices. Under the scope of project SCORE, which involved the deployment and operation of a floating tidal energy converter, this paper presents and discusses the first baseline noise monitoring performed at Ria Formosa. The acoustic data were collected in two occasions over several days, one in the winter and the other in the summer, in 2017. The obtained analysis results highlight the potential impact of the intense boat traffic in Ria Formosa, and the wide range of sound levels introduced in that ecosystem, and the high diurnal and seasonal variability.
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Affiliation(s)
- C Soares
- MarSensing Lda., Centro Empresarial Pavilhão B1, Campus de Gambelas, 8005-139 Faro, Portugal.
| | - A Pacheco
- CIMA, University of Algarve Ed7, Campus de Gambelas, Faro 8005-139, Portugal
| | - F Zabel
- MarSensing Lda., Centro Empresarial Pavilhão B1, Campus de Gambelas, 8005-139 Faro, Portugal
| | - E González-Goberña
- CIMA, University of Algarve Ed7, Campus de Gambelas, Faro 8005-139, Portugal
| | - C Sequeira
- CIMA, University of Algarve Ed7, Campus de Gambelas, Faro 8005-139, Portugal
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25
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Timoteo AT, Gouveia M, Soares C, Ferreira RC. P5243Indirect costs of acute myocardial infarction in Portugal. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Cardiovascular diseases are the main cause of death in Portugal. The high incidence of acute myocardial infarction (AMI) is also a major problem, particularly due to the economic burden caused by productivity losses (indirect costs) associated with temporary absence from work, not yet sufficiently studied in Portugal. Our objective was to quantify the indirect costs of AMI in the first year after admission.
Methods
All consecutive patients admitted in a single center with <66 years (official retirement age) during one year that survived to discharge were included in the present study. Employment status on admission was assessed in every patient. For each employed patient, working at the time of admission, the monthly wage was estimated from market wage rates from national public sources (grossed up by social security contributions) according to gender and age. A day-cost was calculated to assess the cost of temporary absence from work. A half-day absence was considered for Cardiology medical appointments and exams. The duration of temporary absence from work was assessed by a first follow-up contact at 30-day and a second follow-up evaluation up to one-year after admission. The cost of temporary absence from work per episode was calculated in this sample and results were applied to the total number of MI in Portugal during the year 2016 (last available national data) and separately according to ST-elevation AMI (STEAMI) or non-ST-elevation acute coronary syndrome (NSTACS).
Results
We included 219 patients (54±7 years, 83% males), from which, 66.2% were working, 16.4% early-retired, 11.9% unemployed and 5.5% in long-term exit from work due to non-cardiac disease. During the one-year follow-up there were no changes in employment status. In our sample, mean monthly labor cost was 1802 euros (69 euros/day). Median number of days absent from work were 34 days (31 days in men and 52 days in women) and a median of 2 half-days were also obtained for Cardiology appointments / exams. We obtained a total cost of 760.521,55 euros. We used available data from 2016 to estimate indirect costs at a national level. There were 4133 patients with <66 years admitted in Portugal due to AMI that survived to discharge. We performed an analysis, using the proportions of 41% of cases with STEAMI and 59% with NSTACS that came out of the Portuguese Registry on Acute Coronary Syndromes and the working patient's proportions in each group. Costs were higher in patients with STEAMI. We estimate an indirect total cost in Portugal of € 10.12 million in the first year after MI.
Conclusions
In Portugal, the costs to society of disability generated losses of productivity are over ten million euros during the first year after AMI. Strategies to improve time of return to work are very important to lower these costs.
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Affiliation(s)
- A T Timoteo
- Hospital Santa Marta, CHLC, Lisbon, Portugal
| | - M Gouveia
- Hospital Santa Marta, CHLC, Lisbon, Portugal
| | - C Soares
- Hospital Santa Marta, CHLC, Lisbon, Portugal
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Booth CM, Raphael MJ, Wei X, Soares C, Bedard PL, Leveridge M, Siemens DR, Robinson AG. Utilization of mental health services among survivors of testicular cancer: A population-based study. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e16062] [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: 11/20/2022] Open
Abstract
e16062 Background: Testicular cancer survivors may experience long-term psychological distress related to their diagnosis and treatment. Measurement of mental health service use (MHS) is an objective way to quantify the incurred burden of psychological distress. Here we describe patterns of MHS use among survivors of testicular cancer in a single-payer health system. Methods: The Ontario Cancer Registry was linked to electronic treatment records to identify all incident cases of testicular cancer treated with orchiectomy in the Canadian province of Ontario during 2004-2010. Mental health clinical visits were identified from records of hospital admission, emergency room visits and out-patient physician billing records. Results: The study cohort included 1877 patients; mean age was 35 and 61% had pure seminoma. Two thirds of patients (66%, 1230/1877) were initially treated with active surveillance. In the 2-year period prior to orchiectomy, 24% (443/1877) of patients had MHS use. Post-orchiectomy, the prevalence of MHS use was 18% (331/1877), 23% (431/1877) and 30% (572/1877) at 6, 12 and 24 months, respectively. The use of MHS was greatest in the peri-diagnostic/surgical period. Rates of MHS visits, 3 months before, 0-3 months after, 4-6 months after and 2 years after orchiectomy were 11%, 14%, 10%, and 6%, respectively. Post-orchiectomy MHS use was greatest among those with baseline MHS use. The prevalence of MHS use for patients with and without baseline MHS use was 40% (175/443) vs 11% (156/1434, p < 0.001) at 6 months; 51% (225/443) vs 14% (206/1434, p < 0.001) at 12 months; and 61% (271/443) vs 21% (301/1434, p < 0.001) at 24 months post-orchiectomy. Post-orchiectomy MHS use did not vary by initial treatment strategy (active surveillance vs upfront treatment, p = 0.435). Older patients were more likely to have MHS visits at all time periods than younger patients; MHS rates at 6 months were 15% (93/631) vs 18% (112/625) vs 20% (126/621) for ages 16-29, 30-39, and 40+ years respectively (p = 0.035). Conclusions: MHS use among survivors of testicular cancer is common, particularly in the peri-diagnostic and surgical period. The rate of MHS use is highest among those patients with a history of prior MHS use. Clinicians should screen for the presence of psychological distress among survivors of testicular cancer.
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Affiliation(s)
| | | | - Xuejiao Wei
- Division of Cancer Care and Epidemiology, Cancer Research Institute, Queen's University, Kingston, ON, Canada
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Melo M, Rocha Júnior V, Pimentel P, Caldeira L, Ruas J, Chamone J, Silva FVE, Lanna D, Soares C. Composição de ácidos graxos do queijo e leite de vacas alimentadas com casca de banana. ARQ BRAS MED VET ZOO 2018. [DOI: 10.1590/1678-4162-9476] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO Objetivou-se avaliar os níveis de casca de banana seca ao sol na dieta de vacas F1 Holandês x Zebu sobre o perfil de ácidos graxos do leite e do queijo minas frescal. Os tratamentos foram constituídos de 0, 15, 30, 45 e 60% de substituição da silagem de sorgo pela casca de banana. O delineamento experimental foi em dois quadrados latinos 5 x 5 simultâneos. As amostras de leite e queijo foram analisadas quanto ao perfil de ácidos graxos por cromatografia gasosa. Observou-se efeito quadrático para o somatório de ácidos graxos poli-insaturados do leite, com valor máximo no nível de 23,54% de substituição. Houve efeito linear decrescente para os ácidos graxos C15:0 iso e C16:0 iso. Os ácidos graxos heneicosanoico, linoleico, linoleico conjugado e araquidônico apresentaram efeito quadrático. Não houve efeito das dietas sobre os ácidos graxos no queijo. A substituição de até 60% da silagem de sorgo por casca de banana na dieta de vacas em lactação pode ser alternativa para produção e processamento do leite, quando se considera a melhora no valor nutricional da fração lipídica do leite e o aumento dos teores de ácido linoleico conjugado.
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Affiliation(s)
- M.T.P. Melo
- Universidade Estadual de Montes Claros, Brazil
| | | | | | | | - J.R.M. Ruas
- Universidade Estadual de Montes Claros, Brazil
| | | | | | | | - C. Soares
- Universidade Estadual de Montes Claros, Brazil
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Almeida Morais L, Pereira-Da-Silva T, Ramos R, Fiarresga A, Sousa L, Carvalho R, Bernardes L, Patricio L, Aguiar-Rosa S, Soares C, Cacela D, Cruz-Ferreira R. P5358Long-term prognostic impact of diabetes mellitus in a real world population following percutaneous coronary intervention with a second-generation drug-eluting stent. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5358] [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: 11/14/2022] Open
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Guerreiro R, Ruano C, Soares C, Santos F, Portugal G, Gomes L, Bento A, Costa M, Fernandes R, Cacao R, Ramos R, Ferreira R, Goncalves L, Aguiar J. P871Validation of pre-test probability model of coronary artery disease in the Portuguese population. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p871] [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: 11/14/2022] Open
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30
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Piletti R, Bugiereck A, Pereira A, Gussati E, Dal Magro J, Mello J, Dalcanton F, Ternus R, Soares C, Riella H, Fiori M. Microencapsulation of eugenol molecules by β-cyclodextrine as a thermal protection method of antibacterial action. Materials Science and Engineering: C 2017; 75:259-271. [DOI: 10.1016/j.msec.2017.02.075] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 11/30/2016] [Accepted: 02/14/2017] [Indexed: 10/20/2022]
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Silove DM, Tay AK, Steel Z, Tam N, Soares Z, Soares C, Dos Reis N, Alves A, Rees S. Symptoms of post-traumatic stress disorder, severe psychological distress, explosive anger and grief amongst partners of survivors of high levels of trauma in post-conflict Timor-Leste. Psychol Med 2017; 47:149-159. [PMID: 27682000 DOI: 10.1017/s0033291716002233] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Little is known about the mental health of partners of survivors of high levels of trauma in post-conflict countries. METHOD We studied 677 spouse dyads (n = 1354) drawn from a community survey (response 82.4%) in post-conflict Timor-Leste. We used culturally adapted measures of post-traumatic stress disorder (PTSD), psychological distress, explosive anger and grief. RESULTS Latent class analysis identified three classes of couples: class 1, comprising women with higher trauma events (TEs), men with intermediate TEs (19%); class 2, including men with higher TEs, women with lower TEs (23%); and class 3, comprising couples in which men and women had lower TE exposure (58%) (the reference group). Men and women partners of survivors of higher TE exposure (classes 1 and 2) had increased symptoms of explosive anger and grief compared with the reference class (class 3). Women partners of survivors of higher TE exposure (class 2) had a 20-fold increased rate of PTSD symptoms compared with the reference class, a pattern that was not evident for men living with women exposed to higher levels of trauma (class 1). CONCLUSIONS Men and women living with survivors of higher levels of trauma showed an increase in symptoms of grief and explosive anger. The manifold higher rate of PTSD symptoms amongst women living with men exposed to high levels of trauma requires replication. It is important to assess the mental health of partners when treating survivors of high levels of trauma in post-conflict settings.
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Affiliation(s)
- D M Silove
- Academic Mental Health Unit and Ingham Institute,University of New South Wales and South Western Sydney Local Health District,Level 2, Mental Health Centre,Liverpool Hospital,Sydney, NSW 2170,Australia
| | - A K Tay
- Academic Mental Health Unit and Ingham Institute,University of New South Wales and South Western Sydney Local Health District,Level 2, Mental Health Centre,Liverpool Hospital,Sydney, NSW 2170,Australia
| | - Z Steel
- St John of God Richmond Hospital,School of Psychiatry,University of New South Wales,North Richmond,NSW 2754,Australia
| | - N Tam
- Academic Mental Health Unit and Ingham Institute,University of New South Wales and South Western Sydney Local Health District,Level 2, Mental Health Centre,Liverpool Hospital,Sydney, NSW 2170,Australia
| | - Z Soares
- Alola Foundation,Dili, Timor-Leste
| | - C Soares
- Alola Foundation,Dili, Timor-Leste
| | | | - A Alves
- Alola Foundation,Dili, Timor-Leste
| | - S Rees
- Academic Mental Health Unit and Ingham Institute,University of New South Wales and South Western Sydney Local Health District,Level 2, Mental Health Centre,Liverpool Hospital,Sydney, NSW 2170,Australia
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Silove DM, Tay AK, Tol WA, Tam N, Dos Reis N, da Costa Z, Soares C, Rees S. Patterns of separation anxiety symptoms amongst pregnant women in conflict-affected Timor-Leste: Associations with traumatic loss, family conflict, and intimate partner violence. J Affect Disord 2016; 205:292-300. [PMID: 27552593 DOI: 10.1016/j.jad.2016.07.052] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Revised: 06/19/2016] [Accepted: 07/09/2016] [Indexed: 02/05/2023]
Abstract
BACKGROUND Adult separation anxiety (ASA) symptoms are prevalent amongst young women in low and middle-income countries and symptoms may be common in pregnancy. No studies have focused on defining distinctive patterns of ASA symptoms amongst pregnant women in these settings or possible associations with trauma exposure and ongoing stressors. METHODS In a consecutive sample of 1672 women attending antenatal clinics in Dili, Timor-Leste (96% response), we assessed traumatic events of conflict, ongoing adversity, intimate partner violence (IPV), ASA, post-traumatic stress disorder (PTSD) and severe psychological distress. Latent Class Analysis was used to identify classes of women based on their distinctive profiles of ASA symptoms, comparisons then being made with key covariates including trauma domains of conflict, intimate partner violence (IPV) and ongoing stressors. RESULTS LCA yielded three classes, comprising a core ASA (4%), a limited ASA (25%) and a low symptom class (61%). The core ASA class reported exposure to multiple traumatic losses and IPV and showed a pattern of comorbidity with PTSD; the limited ASA class predominantly reported exposure to ongoing stressors and was comorbid with severe psychological distress; the low symptom class reported relatively low levels of exposure to trauma and stressors. LIMITATIONS The study is cross-sectional, cautioning against inferring causal inferences. CONCLUSIONS The core ASA group may be in need of immediate intervention given the high rate of exposure to IPV amongst this class. A larger number of women experiencing a limited array of non-specific ASA symptoms may need assistance to address the immediate stressors of pregnancy.
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Affiliation(s)
- D M Silove
- Psychiatry Research and Teaching Unit, University of New South Wales, Academic Mental Health Unit, Level 2, Mental Health Centre, Liverpool Hospital, Sydney, New South Wales 2170, Australia
| | - A K Tay
- Psychiatry Research and Teaching Unit, University of New South Wales, Academic Mental Health Unit, Level 2, Mental Health Centre, Liverpool Hospital, Sydney, New South Wales 2170, Australia
| | - W A Tol
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA
| | - N Tam
- Psychiatry Research and Teaching Unit, University of New South Wales, Academic Mental Health Unit, Level 2, Mental Health Centre, Liverpool Hospital, Sydney, New South Wales 2170, Australia
| | | | | | - C Soares
- Alola Women's Foundation, Timor-Leste
| | - S Rees
- Psychiatry Research and Teaching Unit, University of New South Wales, Academic Mental Health Unit, Level 2, Mental Health Centre, Liverpool Hospital, Sydney, New South Wales 2170, Australia.
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Soares C, Morales H, Faria J, Figueiredo A, Pedro L, Venâncio A. Inhibitory effect of essential oils on growth and on aflatoxins production by Aspergillus parasiticus. WORLD MYCOTOXIN J 2016. [DOI: 10.3920/wmj2015.1987] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The aim of this work was to assess the inhibitory effect of essential oils on the growth and aflatoxin production of Aspergillus parasiticus, as well as to correlate it with the chemical composition of the essential oils. Essential oils from six aromatic species (Cymbopogon citratus, Eucalyptus globulus, Origanum vulgare, Ruta graveolens, Salvia officinalis, Satureja montana) were characterised by gas chromatography and tested for their inhibitory effect against A. parasiticus strain MUM 92.02. Furthermore, the in vitro inhibitory effects of these essential oils on the production of aflatoxins were evaluated by HPLC. Results showed that all essential oils retarded the time for visible growth. Growth rate was affected differently depending on the essential oil. S. montana essential oil prevented growth in all cases. The essential oil of R. graveolens inhibited most of the aflatoxin production even though growth inhibition was low, while with C. citratus essential oil trace levels of aflatoxins were detected. Essential oils containing carvacrol and/or thymol (S. montana and O. vulgare) have the highest activity against fungal growth, while an essential oil (R. graveolens) containing 2-undecanone and 8-phenyl-2-octanone inhibited the synthesis of aflatoxins. Although the main component of this essential oil was 2-undecanone (91%), when pure 2-undecanone was tested, it did not inhibit aflatoxin production. Inhibition activity is probably due to the recently identified minor compound or to a synergistic effect. Essential oils seem to be a good alternative to fungicides not only because of environmental issues but also because they do not seem to enhance mycotoxin production as it has been reported for some fungicides.
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Affiliation(s)
- C. Soares
- CEB-Centre of Biological Engineering, University of Minho, 4710-057 Braga, Portugal
| | - H. Morales
- CEB-Centre of Biological Engineering, University of Minho, 4710-057 Braga, Portugal
| | - J. Faria
- Centro de Estudos do Ambiente e do Mar Lisboa, Faculdade de Ciências, Universidade de Lisboa, CBV, DBV, 1749-016 Lisboa, Portugal
| | - A.C. Figueiredo
- Centro de Estudos do Ambiente e do Mar Lisboa, Faculdade de Ciências, Universidade de Lisboa, CBV, DBV, 1749-016 Lisboa, Portugal
| | - L.G. Pedro
- Centro de Estudos do Ambiente e do Mar Lisboa, Faculdade de Ciências, Universidade de Lisboa, CBV, DBV, 1749-016 Lisboa, Portugal
| | - A. Venâncio
- CEB-Centre of Biological Engineering, University of Minho, 4710-057 Braga, Portugal
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Viveiros Monteiro A, Ramos R, Fiarresga A, de Sousa L, Cacela D, Patrício L, Bernardes L, Soares C, Cruz Ferreira R. Timing and long-term prognosis of recurrent MI after primary angioplasty : Stent thrombosis vs. non-stent-related reinfarction. Herz 2016; 42:186-193. [PMID: 27363417 DOI: 10.1007/s00059-016-4446-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 01/16/2016] [Revised: 04/30/2016] [Accepted: 05/13/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND In patients recovering from an ST-segment elevation myocardial infarction (STEMI), it is not clear whether the negative impact of stent thrombosis (ST) is different from a non-stent-related recurrent myocardial infarction (NSRMI). This study sought to assess the long-term incidence and prognostic impact of recurrent myocardial infarction (MI) after percutaneous coronary intervention (PCI) for STEMI by comparing outcomes of ST versus NSRMI. PATIENTS AND METHODS From 2001 to 2007, 1025 patients undergoing PCI for STEMI were prospectively followed up. Patients with ST, with NSRMI, and those free from recurrent MI were compared regarding mortality and major adverse cardiac and cerebrovascular events (MACCE). RESULTS Recurrent MI decreased from 37 events per 1000 person/months in the first month to 3.3 events per 1000 person/months after the first year. The cumulative 5‑year incidence of ST and NSRMI was 5.27 % and 13.2 %, respectively. MACCE at 60 months after recurrence were not significantly different for patients with reinfarction but were significantly higher than for patients free from any recurrent MI (both log-rank p < 0.001). However, the cumulative all-cause death rate did not differ between the three groups (27.8 vs. 26.7 vs. 23.0 %). Compared with ST occurring in the first 30 days after PCI for STEMI, early NSRMI was associated with a significantly reduced risk for all-cause death (HR, 0.21; 95 % CI, 0.33-3.30) but this association did not persist for recurrent MIs occurring in the late (HR, 1.05; 95 % CI, 0.33-3.30) or very late follow-up periods. CONCLUSION Although ST was associated with a significant increase in adverse events in the early recovery period, in the long term, MACCE and all-cause mortality rates were comparable to those for NSRMI.
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Affiliation(s)
- A Viveiros Monteiro
- Cardiology Department, Hospital of Santa Marta, Rua de Santa Marta, 1169-1024, Lisbon, Portugal.
| | - R Ramos
- Cardiology Department, Hospital of Santa Marta, Rua de Santa Marta, 1169-1024, Lisbon, Portugal
| | - A Fiarresga
- Cardiology Department, Hospital of Santa Marta, Rua de Santa Marta, 1169-1024, Lisbon, Portugal
| | - L de Sousa
- Cardiology Department, Hospital of Santa Marta, Rua de Santa Marta, 1169-1024, Lisbon, Portugal
| | - D Cacela
- Cardiology Department, Hospital of Santa Marta, Rua de Santa Marta, 1169-1024, Lisbon, Portugal
| | - L Patrício
- Cardiology Department, Hospital of Santa Marta, Rua de Santa Marta, 1169-1024, Lisbon, Portugal
| | - L Bernardes
- Cardiology Department, Hospital of Santa Marta, Rua de Santa Marta, 1169-1024, Lisbon, Portugal
| | - C Soares
- Cardiology Department, Hospital of Santa Marta, Rua de Santa Marta, 1169-1024, Lisbon, Portugal
| | - R Cruz Ferreira
- Cardiology Department, Hospital of Santa Marta, Rua de Santa Marta, 1169-1024, Lisbon, Portugal
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Hansen J, Culberson W, Soares C, DeWerd L. WE-DE-201-05: Evaluation of a Windowless Extrapolation Chamber Design and Monte Carlo Based Corrections for the Calibration of Ophthalmic Applicators. Med Phys 2016. [DOI: 10.1118/1.4957810] [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: 11/07/2022] Open
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Tay AK, Rees S, Steel Z, Tam N, Soares Z, Soares C, Silove DM. Six-year trajectories of post-traumatic stress and severe psychological distress symptoms and associations with timing of trauma exposure, ongoing adversity and sense of injustice: a latent transition analysis of a community cohort in conflict-affected Timor-Leste. BMJ Open 2016; 6:e010205. [PMID: 26908525 PMCID: PMC4769389 DOI: 10.1136/bmjopen-2015-010205] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To identify the 6-year trajectories of post-traumatic stress symptoms (PTSS) and psychological distress symptoms, and examine for associations with timing of trauma exposure, ongoing adversity and with the sense of injustice in conflict-affected Timor-Leste. SETTING A whole-of-household survey was conducted in 2004 and 2010 in Dili, the capital of Timor-Leste. PARTICIPANTS 1022 adults were followed up over 6 years (retention rate 84.5%). Interviews were conducted by field workers applying measures of traumatic events (TEs), ongoing adversity, a sense of injustice, PTS symptoms and psychological distress. RESULTS Latent transition analysis supported a 3-class longitudinal model (psychological distress, comorbid symptoms and low symptoms). We derived 4 composite trajectories comprising recovery (20.8%), a persisting morbidity trajectory (7.2%), an incident trajectory (37.2%) and a low-symptom trajectory (34.7%). Compared with the low-symptom trajectory, the persistent and incident trajectories reported greater stress arising from poverty and family conflict, higher TE exposure for 2 historical periods, and a sense of injustice for 2 historical periods. The persistent trajectory was unique in reporting greater TE exposure in the Indonesian occupation, whereas the incident trajectory reported greater TE exposure during the later internal conflict that occurred between baseline and follow-up. Compared with the low-symptom trajectory, the incident trajectory reported a greater sense of injustice relating to the periods of the Indonesian occupation and independence. The persistent trajectory was characterised by a sense of injustice relating to the internal conflict and contemporary times. The recovery trajectory was characterised by the absence of these risk factors, the only difference from the low-symptom trajectory being that the former reported a sense of injustice for the period surrounding independence. CONCLUSIONS Our findings suggest that the timing of both TE exposure and the focus of a sense of injustice may differentiate those with persisting and new-onset mental health morbidity in settings of recurrent conflict.
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Affiliation(s)
- AK Tay
- Psychiatry Research and Teaching Unit, University of New South Wales, Sydney, New South Wales, Australia
- Academic Mental Health Unit, Mental Health Centre, Liverpool Hospital, Sydney, New South Wales, Australia
| | - S Rees
- Psychiatry Research and Teaching Unit, University of New South Wales, Sydney, New South Wales, Australia
- Academic Mental Health Unit, Mental Health Centre, Liverpool Hospital, Sydney, New South Wales, Australia
| | - Z Steel
- St John of God Richmond Hospital, School of Psychiatry, University of New South Wales
| | - N Tam
- Psychiatry Research and Teaching Unit, University of New South Wales, Sydney, New South Wales, Australia
- Academic Mental Health Unit, Mental Health Centre, Liverpool Hospital, Sydney, New South Wales, Australia
| | - Z Soares
- Alola Foundation, Dili, Timor-Leste
| | - C Soares
- Alola Foundation, Dili, Timor-Leste
| | - DM Silove
- Psychiatry Research and Teaching Unit, University of New South Wales, Sydney, New South Wales, Australia
- Academic Mental Health Unit, Mental Health Centre, Liverpool Hospital, Sydney, New South Wales, Australia
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Rees SJ, Tol W, Mohammad M, Tay AK, Tam N, dos Reis N, da Costa E, Soares C, Silove DM, Silove DM. A high-risk group of pregnant women with elevated levels of conflict-related trauma, intimate partner violence, symptoms of depression and other forms of mental distress in post-conflict Timor-Leste. Transl Psychiatry 2016; 6:e725. [PMID: 26836413 PMCID: PMC4872420 DOI: 10.1038/tp.2015.212] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 11/01/2015] [Accepted: 11/05/2015] [Indexed: 11/18/2022] Open
Abstract
Women in low-income, post-conflict (LI-PC) [Corrected] countries are at risk of exposure to the traumatic events (TEs) of war and intimate partner violence (IPV), forms of stress that are known to lead to depression and other adverse mental health outcomes. We aimed to assess an index of exposure to these two forms of trauma to identify pregnant women attending antenatal clinics in conflict-affected Timor-Leste at high risk of depression and other forms of stress. A large, cross-sectional study of women in the second trimester of pregnancy was conducted in the four main government antenatal clinics in Dili district of Timor-Leste, between May 2014, and January 2015. The sample consisted of 1672 consecutive women, 3 to 6 months pregnant, with a response rate of 96%. We applied the Edinburgh Postnatal Depression Scale, the Kessler-10 psychological distress scale and the Harvard Trauma Questionnaire. IPV was assessed by the World Health Organisation measure. Composite categories of conflict-related TEs and severity of IPV showed a dose-response relationship with depressive symptoms: for exposure to four or more conflict-related TEs and severe psychological IPV, the adjusted odds ratio (AOR) was 3.95 (95% confidence interval (CI) 2.10-7.40); for four or more TEs and physical abuse, AOR 8.16 (95% CI 3.53-18.85); and for four or more TEs and severe psychological and physical abuse, AOR 9.78 (95% CI 5.31-18.02). For any mental distress, the AOR for four or more TEs and severe psychological abuse was 3.60 (95% CI 2.08-6.23); for four or more TEs and physical abuse 7.03 (95% CI 3.23-15.29); and for four or more TEs and severe psychological and physical abuse the AOR was 10.45 (95% CI 6.06-18.01). Of 184 women (11% of the sample) who reported ⩾ 4 TEs and either physical abuse alone or in combination with severe psychological abuse, 78 (42%) reached threshold for depressive symptoms and 93 (51%) for any mental distress, a 10-fold increase in depressive and other mental health symptoms. Priority should be directed to providing urgent mental health and social interventions for this group of women. Our findings offer a framework for a tiered approach to detection, guiding prevention and intervention strategies for IPV and associated mental health problems in low-income post-conflict countries.
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Affiliation(s)
- S J Rees
- Psychiatry Research and Teaching Unit, University of New South Wales and Academic Mental Health Unit, Mental Health Centre, Liverpool Hospital, Sydney, NSW, Australia,Psychiatry Research and Teaching Unit, University of New South Wales and Academic Mental Health Unit, Mental Health Centre, Liverpool Hospital, Sydney, NSW 2170, Australia. E-mail:
| | - W Tol
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - M Mohammad
- Psychiatry Research and Teaching Unit, University of New South Wales and Academic Mental Health Unit, Mental Health Centre, Liverpool Hospital, Sydney, NSW, Australia
| | - A K Tay
- Psychiatry Research and Teaching Unit, University of New South Wales and Academic Mental Health Unit, Mental Health Centre, Liverpool Hospital, Sydney, NSW, Australia
| | - N Tam
- Psychiatry Research and Teaching Unit, University of New South Wales and Academic Mental Health Unit, Mental Health Centre, Liverpool Hospital, Sydney, NSW, Australia
| | - N dos Reis
- Psychiatry Research and Teaching Unit, University of New South Wales and Academic Mental Health Unit, Mental Health Centre, Liverpool Hospital, Sydney, NSW, Australia,Child and Maternal Health, Alola Women's Foundation, Dili, Timor-Leste
| | - E da Costa
- Psychiatry Research and Teaching Unit, University of New South Wales and Academic Mental Health Unit, Mental Health Centre, Liverpool Hospital, Sydney, NSW, Australia,Child and Maternal Health, Alola Women's Foundation, Dili, Timor-Leste
| | - C Soares
- Psychiatry Research and Teaching Unit, University of New South Wales and Academic Mental Health Unit, Mental Health Centre, Liverpool Hospital, Sydney, NSW, Australia,Child and Maternal Health, Alola Women's Foundation, Dili, Timor-Leste
| | - D M Silove
- Psychiatry Research and Teaching Unit, University of New South Wales and Academic Mental Health Unit, Mental Health Centre, Liverpool Hospital, Sydney, NSW, Australia
| | - D M Silove
- Psychiatry Research and Teaching Unit, University of New South Wales and Academic Mental Health Unit, Mental Health Centre, Liverpool Hospital, Sydney, NSW, Australia
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Yacubian E, Manreza M, Dussan Ordoñe J, Nariño Gonzalez D, Ruiz-Sandoval J, Viana K, Vieira C, Moraes-Santos F, Lamarao F, Tobler J, Soares C, Valverde A. Refractory epilepsy in Latin America: sociodemographic, clinical characteristics and healthcare resources– the Latin America observational study on epilepsy patients (live). J Neurol Sci 2015. [DOI: 10.1016/j.jns.2015.08.536] [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: 11/30/2022]
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Yacubian E, Manreza M, Dussan Ordoñe J, Nariño Gonzalez D, Ruiz-Sandoval J, Viana K, Vieira C, Moraes-Santos F, Lamarao F, Tobler J, Soares C, Valverde A. Recently diagnosed epilepsy in Latin America: sociodemographic, clinical characteristics and healthcare resources– Latin America observational study on epilepsy patients (live). J Neurol Sci 2015. [DOI: 10.1016/j.jns.2015.08.535] [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: 11/25/2022]
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Abstract
Gastrointestinal duplications are rare congenital malformations seldom diagnosed in adulthood. They may vary greatly in size and location, with the small intestine being their major focus. Their clinical presentation is widely variable and unspecific, mimicking more common pathologies, thus making preoperative diagnosis very difficult. The intraoperative surgeon's experience and knowledge are crucial in recognising these lesions so that they can be correctly managed. In this report, the authors present a case of a 36-year-old man with an acute intestinal obstruction as the first presentation of ileal duplication.
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Affiliation(s)
- L Barbosa
- Department of General Surgery, Centro Hospitalar de Vila Nova de Gaia/Espinho, Porto, Portugal
| | - C Soares
- Department of General Surgery, Centro Hospitalar de Vila Nova de Gaia/Espinho, Porto, Portugal
| | - A A Póvoa
- Department of General Surgery, Centro Hospitalar de Vila Nova de Gaia/Espinho, Porto, Portugal
| | - J P Maciel
- Department of General Surgery, Centro Hospitalar de Vila Nova de Gaia/Espinho, Porto, Portugal
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Oliveira LB, Lopes TS, Soares C, Maluf R, Goes BT, Sá KN, Baptista AF. Transcranial direct current stimulation and exercises for treatment of chronic temporomandibular disorders: a blind randomised-controlled trial. J Oral Rehabil 2015; 42:723-32. [PMID: 25891021 DOI: 10.1111/joor.12300] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2015] [Indexed: 11/28/2022]
Abstract
To evaluate the effect of adding transcranial direct current stimulation (tDCS) to exercises for chronic pain, dysfunction and quality of life in subjects with temporomandibular disorders (TMD). Participants were selected based on the RDC/TMD criteria and assessed for pain intensity, pressure pain threshold over temporomandibular joint and cervical muscles and quality of life. After initial assessment, all individuals underwent a 4-week protocol of exercises and manual therapy, together with active or sham primary motor cortex tDCS. Stimulation was delivered through sponge electrodes, with 2 mA amplitude, for 20 min daily, over the first 5 days of the trial. A total of 32 subjects (mean age 24.7 ± 6.8 years) participated in the evaluations and treatment protocol. Mean pain intensity pre-treatment was 5.5 ± 1.4 for active tDCS group, and 6.3 ± 1.2 for sham tDCS. Both groups showed a decrease in pain intensity scores during the trial period (time factor--F(4.5,137.5) = 28.7, P < 0.001; group factor--F(1.0,30.0 = 7.7), P < 0.05). However, there were no differences between the groups regarding change in pain intensity (time*group interaction--F(4.5,137.5) = 1.5, P = 0.137). This result remained the same after 5 months (t-test t = 0.29, P > 0.05). Pressure pain thresholds decrease and improvement in quality of life were also noticeable in both groups, but again without significant differences between them. Absolute benefit increase was 37.5% (CI 95%: -15.9% to 90.9%), and number needed to treat was 2.66. This study suggests that there is no additional benefit in adding tDCS to exercises for the treatment of chronic TMD in young adults.
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Affiliation(s)
- L B Oliveira
- Bahian School of Medicine and Human Health, Salvador, Brazil.,Adventist College of Bahia, Cachoeira, Brazil
| | - T S Lopes
- Adventist College of Bahia, Cachoeira, Brazil
| | - C Soares
- Adventist College of Bahia, Cachoeira, Brazil
| | - R Maluf
- Adventist College of Bahia, Cachoeira, Brazil
| | - B T Goes
- Bahian School of Medicine and Human Health, Salvador, Brazil
| | - K N Sá
- Bahian School of Medicine and Human Health, Salvador, Brazil.,Functional Electrostimulation Laboratory, Health Sciences Institute, Federal University of Bahia, Salvador, Brazil
| | - A F Baptista
- Bahian School of Medicine and Human Health, Salvador, Brazil.,Functional Electrostimulation Laboratory, Health Sciences Institute, Federal University of Bahia, Salvador, Brazil
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Nabais Sá MJ, Storey H, Flinter F, Nagel M, Sampaio S, Castro R, Araújo JA, Gaspar MA, Soares C, Oliveira A, Henriques AC, da Costa AG, Abreu CP, Ponce P, Alves R, Pinho L, Silva SE, de Moura CP, Mendonça L, Carvalho F, Pestana M, Alves S, Carvalho F, Oliveira JP. Collagen type IV-related nephropathies in Portugal: pathogenic COL4A3 and COL4A4 mutations and clinical characterization of 25 families. Clin Genet 2014; 88:456-61. [PMID: 25307543 DOI: 10.1111/cge.12521] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2014] [Revised: 10/04/2014] [Accepted: 10/06/2014] [Indexed: 12/22/2022]
Abstract
Pathogenic mutations in genes COL4A3/COL4A4 are responsible for autosomal Alport syndrome (AS) and thin basement membrane nephropathy (TBMN). We used Sanger sequencing to analyze all exons and splice site regions of COL4A3/COL4A4, in 40 unrelated Portuguese probands with clinical suspicion of AS/TBMN. To assess genotype-phenotype correlations, we compared clinically relevant phenotypes/outcomes between homozygous/compound heterozygous and apparently heterozygous patients. Seventeen novel and four reportedly pathogenic COL4A3/COL4A4 mutations were identified in 62.5% (25/40) of the probands. Regardless of the mutated gene, all patients with ARAS manifested chronic renal failure (CRF) and hearing loss, whereas a minority of the apparently heterozygous patients had CRF or extrarenal symptoms. CRF was diagnosed at a significantly younger age in patients with ARAS. In our families, the occurrence of COL4A3/COL4A4 mutations was higher, while the prevalence of XLAS was lower than expected. Overall, a pathogenic COL4A3/COL4A4/COL4A5 mutation was identified in >50% of patients with fewer than three of the standard diagnostic criteria of AS. With such a population background, simultaneous next-generation sequencing of all three genes may be recommended as the most expedite approach to diagnose collagen IV-related glomerular basement membrane nephropathies.
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Affiliation(s)
- M J Nabais Sá
- Department of Genetics, Faculty of Medicine, Porto, Portugal.,Unit of Research and Development of Nephrology (FCT-725), Faculty of Medicine, University of Porto, Porto, Portugal
| | - H Storey
- Molecular Genetics Laboratory, Viapath, UK
| | - F Flinter
- Genetics Centre, Guy's and St. Thomas' Hospital National Health Service Foundation Trust, London, UK
| | - M Nagel
- Center for Nephrology and Metabolic Diseases, Weisswasser, Germany
| | - S Sampaio
- Unit of Research and Development of Nephrology (FCT-725), Faculty of Medicine, University of Porto, Porto, Portugal.,Department of Nephrology, Hospital de São João, Porto, Portugal
| | - R Castro
- Department of Nephrology, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - J A Araújo
- Department of Nephrology, Hospital dos Marmeleiros, Funchal, Portugal
| | - M A Gaspar
- Dialysis Clinic, NephroCare Restelo, Fresenius Medical Care, Lisboa, Portugal
| | - C Soares
- Department of Nephrology, Hospital de Braga, Braga, Portugal
| | - A Oliveira
- Dialysis Clinic Paredes, Diaverum, Paredes, Portugal
| | - A C Henriques
- Dialysis Clinic, NephroCare Braga, Fresenius Medical Care, Braga, Portugal
| | - A G da Costa
- Department of Nephrology, Hospital de Santa Maria, Lisboa, Portugal
| | - C P Abreu
- Dialysis Clinic Lumiar, Diaverum, Lisboa, Portugal
| | - P Ponce
- Dialysis Clinic, NephroCare Lumiar, Fresenius Medical Care, Lisboa, Portugal
| | - R Alves
- Dialysis Clinic, NephroCare Viseu, Fresenius Medical Care, Viseu, Portugal
| | - L Pinho
- Dialysis Clinic Paredes, Diaverum, Paredes, Portugal
| | - S E Silva
- Department of Ophthalmology, Porto, Portugal
| | - C P de Moura
- Department of Otolaryngology, Porto, Portugal.,Medical Genetics Outpatient Clinic, Hospital de São João, Porto, Portugal
| | - L Mendonça
- Department of Ophthalmology, Hospital de Braga, Braga, Portugal
| | - F Carvalho
- Unit of Renal Morphology, Department of Nephrology, Hospital Curry Cabral, Lisboa, Portugal
| | - M Pestana
- Unit of Research and Development of Nephrology (FCT-725), Faculty of Medicine, University of Porto, Porto, Portugal.,Department of Nephrology, Hospital de São João, Porto, Portugal
| | - S Alves
- Department of Genetics, Faculty of Medicine, Porto, Portugal
| | - F Carvalho
- Department of Genetics, Faculty of Medicine, Porto, Portugal
| | - J P Oliveira
- Department of Genetics, Faculty of Medicine, Porto, Portugal.,Unit of Research and Development of Nephrology (FCT-725), Faculty of Medicine, University of Porto, Porto, Portugal.,Medical Genetics Outpatient Clinic, Hospital de São João, Porto, Portugal
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Nabais Sá MJ, Sampaio S, Oliveira A, Alves S, Moura CP, Silva SE, Castro R, Araújo JA, Rodrigues M, Neves F, Seabra J, Soares C, Gaspar MA, Tavares I, Freitas L, Sousa TC, Henriques AC, Costa FT, Morgado E, Sousa FT, Sousa JP, da Costa AG, Filipe R, Garrido J, Montalban J, Ponce P, Alves R, Faria B, Carvalho MF, Pestana M, Carvalho F, Oliveira JP. Collagen type IV-related nephropathies in Portugal: pathogenic COL4A5 mutations and clinical characterization of 22 families. Clin Genet 2014; 88:462-7. [PMID: 25307721 DOI: 10.1111/cge.12522] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Revised: 10/08/2014] [Accepted: 10/08/2014] [Indexed: 11/28/2022]
Abstract
Alport syndrome (AS) is caused by pathogenic mutations in the genes encoding α3, α4 or α5 chains of collagen IV (COL4A3/COL4A4/COL4A5), resulting in hematuria, chronic renal failure (CRF), sensorineural hearing loss (SNHL) and ocular abnormalities. Mutations in the X-linked COL4A5 gene have been identified in 85% of the families (XLAS). In this study, 22 of 60 probands (37%) of unrelated Portuguese families, with clinical diagnosis of AS and no evidence of autosomal inheritance, had pathogenic COL4A5 mutations detected by Sanger sequencing and/or multiplex-ligation probe amplification, of which 12 (57%) are novel. Males had more severe and earlier renal and extrarenal complications, but microscopic hematuria was a constant finding irrespective of gender. Nonsense and splice site mutations, as well as small and large deletions, were associated with younger age of onset of SNHL in males, and with higher risk of CRF and SNHL in females. Pathogenic COL4A3 or COL4A4 mutations were subsequently identified in more than half of the families without a pathogenic mutation in COL4A5. The lower than expected prevalence of XLAS in Portuguese families warrants the use of next-generation sequencing for simultaneous COL4A3/COL4A4/COL4A5 analysis, as first-tier approach to the genetic diagnosis of collagen type IV-related nephropathies.
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Affiliation(s)
- M J Nabais Sá
- Department of Genetics, Faculty of Medicine, Porto, Portugal.,Unit of Research and Development of Nephrology (FCT-725), Faculty of Medicine, University of Porto, Porto, Portugal
| | - S Sampaio
- Unit of Research and Development of Nephrology (FCT-725), Faculty of Medicine, University of Porto, Porto, Portugal.,Department of Nephrology, Porto, Portugal
| | - A Oliveira
- Department of Nephrology, Porto, Portugal
| | - S Alves
- Department of Genetics, Faculty of Medicine, Porto, Portugal
| | - C P Moura
- Department of Otolaryngology, Porto, Portugal.,Medical Genetics Outpatient Clinic, Porto, Portugal
| | - S E Silva
- Department of Ophthalmology, Hospital de São João, Porto, Portugal
| | - R Castro
- Department of Nephrology, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - J A Araújo
- Department of Nephrology, Hospital dos Marmeleiros, Funchal, Portugal
| | - M Rodrigues
- Department of Medical Genetics, Hospital Dona Estefânia, Lisboa, Portugal
| | - F Neves
- Dialysis Clinic of Santarém, NephroCare-Portugal, Santarém, Portugal
| | - J Seabra
- Department of Nephrology, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - C Soares
- Department of Nephrology, Hospital de Braga, Braga, Portugal
| | - M A Gaspar
- Dialysis Clinic of Restelo, NephroCare-Portugal, Lisboa, Portugal
| | - I Tavares
- Unit of Research and Development of Nephrology (FCT-725), Faculty of Medicine, University of Porto, Porto, Portugal.,Dialysis Clinic of Santo Tirso, Uninefro, Santo Tirso, Portugal
| | - L Freitas
- Department of Nephrology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - T C Sousa
- Department of Nephrology, Hospital de São Teotónio, Viseu, Portugal.,Dialysis Clinic of Guarda, NephroCare-Portugal, Guarda, Portugal
| | - A C Henriques
- Dialysis Clinic of Braga, NephroCare-Portugal, Braga, Portugal
| | - F T Costa
- Department of Nephrology, Hospital Garcia de Orta, Almada, Portugal
| | - E Morgado
- Department of Nephrology, Hospital de Faro, Faro, Portugal
| | - F T Sousa
- Dialysis Clinic of Montijo, NephroCare-Portugal, Montijo, Portugal
| | - J P Sousa
- Department of Nephrology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.,Dialysis Clinic of Coimbra, NephroCare-Portugal, Coimbra, Portugal
| | - A G da Costa
- Department of Nephrology, Hospital de Santa Maria, Lisboa, Portugal
| | - R Filipe
- Department of Nephrology, Hospital Amato Lusitano, Castelo Branco, Portugal
| | - J Garrido
- Department of Nephrology, Hospital de São Teotónio, Viseu, Portugal
| | - J Montalban
- Dialysis Clinic of Covilhã, NephroCare-Portugal, Covilhã, Portugal
| | - P Ponce
- Dialysis Clinic of Lumiar, NephroCare-Portugal, Lisboa, Portugal
| | - R Alves
- Dialysis Clinic of Viseu, NephroCare-Portugal, Viseu, Portugal
| | - B Faria
- Dialysis Clinic of Guarda, NephroCare-Portugal, Guarda, Portugal
| | - M F Carvalho
- Unit of Renal Morphology, Department of Nephrology, Hospital Curry Cabral, Lisboa, Portugal
| | - M Pestana
- Unit of Research and Development of Nephrology (FCT-725), Faculty of Medicine, University of Porto, Porto, Portugal.,Department of Nephrology, Porto, Portugal
| | - F Carvalho
- Department of Genetics, Faculty of Medicine, Porto, Portugal
| | - J P Oliveira
- Department of Genetics, Faculty of Medicine, Porto, Portugal.,Unit of Research and Development of Nephrology (FCT-725), Faculty of Medicine, University of Porto, Porto, Portugal.,Medical Genetics Outpatient Clinic, Porto, Portugal
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Gomes E, Soares C, Pinto L, Melo RB. 333. Health-related quality of life of patients with hepatocellular carcinoma submitted to multiple therapy modalities. Eur J Surg Oncol 2014. [DOI: 10.1016/j.ejso.2014.08.323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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45
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Skoronski E, Padoin N, Soares C, Furigo Jr. A. Stability of immobilized Rhizomucor miehei lipase for the synthesis of pentyl octanoate in a continuous packed bed bioreactor. Braz J Chem Eng 2014. [DOI: 10.1590/0104-6632.20140313s00002978] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- E. Skoronski
- Universidade do Estado de Santa Catarina, Brasil
| | - N. Padoin
- Universidade Federal de Santa Catarina, Brasil
| | - C. Soares
- Universidade Federal de Santa Catarina, Brasil
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Riley A, Soares C, Micka J, Culberson W, DeWerd L. WE-A-17A-01: Absorbed Dose Rate-To-Water at the Surface of a Beta-Emitting Planar Ophthalmic Applicator with a Planar, Windowless Extrapolation Chamber. Med Phys 2014. [DOI: 10.1118/1.4889371] [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: 11/07/2022] Open
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47
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Gomes F, Gonçalves D, Gonçalves M, Nascimento M, Novo R, Soares C. EPA-1732 – Gender transition: biological and psychosocial features of adjusting to sex reassignment - crossing literature with psychometric data from a clinical sexology unit in lisbon. Eur Psychiatry 2014. [DOI: 10.1016/s0924-9338(14)78866-2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Monteiro A, Ramos R, Labandeiro J, Fiarresga A, Sousa L, Cacela D, Patricio L, Bernardes L, Soares C, Cruz Ferreira R. Stent thrombosis after primary angioplasty - incidence, timing and long term prognostic: 5 year follow-up registry. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p4889] [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: 11/13/2022] Open
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Massillon-jl G, Minniti R, O' Brien M, Soares C. SU-E-T-86: An Investigation of the Energy Dependence of LiF:Mg,Ti Thermoluminescent Dosimeters in Photon Beams. Med Phys 2013. [DOI: 10.1118/1.4814521] [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: 11/07/2022] Open
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50
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Rosen B, Soares C, Minniti R, DeWerd L. WE-E-141-03: Comparative Study of Novel Versus Conventional Scanning Modalities for Radiochromic Film Dosimetry. Med Phys 2013. [DOI: 10.1118/1.4815594] [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: 11/07/2022] Open
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