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Oliveira D, Martins A, Martins F, Rato M, Pinheiro F, Fonseca D, Vaz C, Mariz E, Costa L. Wunderlich syndrome as a rare complication of polyarteritis nodosa: a case report. Reumatismo 2024; 76. [PMID: 38523579 DOI: 10.4081/reumatismo.2024.1669] [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: 10/23/2023] [Accepted: 01/02/2024] [Indexed: 03/26/2024] Open
Abstract
Spontaneous subcapsular and perirenal hemorrhage, known as Wunderlich syndrome (WS), is a rare clinical manifestation of polyarteritis nodosa (PAN). We report a case of a 48-year-old male with a history of recurrent episodes of leg muscle tenderness and dysesthesia, bilateral flank pain, painful nodular skin lesions in the lower limbs, weight loss, and difficult-to-control arterial hypertension. The abdominopelvic computed tomography angiography showed a large left perirenal hematoma, leading to the patient's admission to the intensive care unit. After the exclusion of infectious or neoplastic foci, the patient was diagnosed with PAN and started intravenous methylprednisolone pulses with a good response. Since WS is a rare initial clinical manifestation of PAN, an early diagnosis and aggressive treatment will significantly improve clinical outcomes.
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Affiliation(s)
- D Oliveira
- Rheumatology Department, São João University Hospital Center, Porto; Center for Health Technology and Services Research, Faculty of Medicine, University of Porto.
| | - A Martins
- Rheumatology Department, São João University Hospital Center, Porto.
| | - F Martins
- Rheumatology Department, University Hospital Center of the Algarve, Faro.
| | - M Rato
- Rheumatology Department, São João University Hospital Center, Porto; Department of Medicine, Faculty of Medicine, University of Porto.
| | - F Pinheiro
- Rheumatology Department, São João University Hospital Center, Porto.
| | - D Fonseca
- Rheumatology Department, Vila Nova de Gaia/Espinho Hospital Center, Gaia.
| | - C Vaz
- Rheumatology Department, São João University Hospital Center, Porto; Center for Health Technology and Services Research, Faculty of Medicine, University of Porto; Department of Medicine, Faculty of Medicine, University of Porto.
| | - E Mariz
- Rheumatology Department, São João University Hospital Center, Porto; Department of Medicine, Faculty of Medicine, University of Porto.
| | - L Costa
- Rheumatology Department, São João University Hospital Center, Porto.
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Pereira JO, Oliveira D, Faustino M, Vidigal SSMP, Pereira AM, Ferreira CMH, Oliveira AS, Durão J, Rodríguez-Alcalá LM, Pintado ME, Madureira AR, Carvalho AP. Use of Various Sugarcane Byproducts to Produce Lipid Extracts with Bioactive Properties: Physicochemical and Biological Characterization. Biomolecules 2024; 14:233. [PMID: 38397470 PMCID: PMC10886787 DOI: 10.3390/biom14020233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 01/31/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024] Open
Abstract
Sugarcane, a globally cultivated crop constituting nearly 80% of total sugar production, yields residues from harvesting and sugar production known for their renewable bioactive compounds with health-promoting properties. Despite previous studies, the intricate interplay of extracts from diverse sugarcane byproducts and their biological attributes remains underexplored. This study focused on extracting the lipid fraction from a blend of selected sugarcane byproducts (straw, bagasse, and filter cake) using ethanol. The resulting extract underwent comprehensive characterization, including physicochemical analysis (FT-IR, DSC, particle size distribution, and color) and chemical composition assessment (GC-MS). The biological properties were evaluated through antihypertensive (ACE), anticholesterolemic (HMG-CoA reductase), and antidiabetic (alpha-glucosidase and Dipeptidyl Peptidase-IV) assays, alongside in vitro biocompatibility assessments in Caco-2 and Hep G2 cells. The phytochemicals identified, such as β-sitosterol and 1-octacosanol, likely contribute to the extract's antidiabetic, anticholesterolemic, and antihypertensive potential, given their association with various beneficial bioactivities. The extract exhibited substantial antidiabetic effects, inhibiting α-glucosidase (5-60%) and DPP-IV activity (25-100%), anticholesterolemic potential with HMG-CoA reductase inhibition (11.4-63.2%), and antihypertensive properties through ACE inhibition (24.0-27.3%). These findings lay the groundwork for incorporating these ingredients into the development of food supplements or nutraceuticals, offering potential for preventing and managing metabolic syndrome-associated conditions.
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Affiliation(s)
- Joana Odila Pereira
- CBQF—Centro de Biotecnologia e Química Fina, Laboratório Associado, Escola Superior de Biotecnologia, Universidade Católica Portuguesa, Rua Diogo Botelho 1327, 4169-005 Porto, Portugal; (D.O.); (M.F.); (S.S.M.P.V.); (A.M.P.); (C.M.H.F.); (A.S.O.); (J.D.); (L.M.R.-A.); (M.E.P.); (A.R.M.); (A.P.C.)
- Amyris Bio Products Portugal Unipessoal Lda, 4169-005 Porto, Portugal
| | - Diana Oliveira
- CBQF—Centro de Biotecnologia e Química Fina, Laboratório Associado, Escola Superior de Biotecnologia, Universidade Católica Portuguesa, Rua Diogo Botelho 1327, 4169-005 Porto, Portugal; (D.O.); (M.F.); (S.S.M.P.V.); (A.M.P.); (C.M.H.F.); (A.S.O.); (J.D.); (L.M.R.-A.); (M.E.P.); (A.R.M.); (A.P.C.)
- Amyris Bio Products Portugal Unipessoal Lda, 4169-005 Porto, Portugal
| | - Margarida Faustino
- CBQF—Centro de Biotecnologia e Química Fina, Laboratório Associado, Escola Superior de Biotecnologia, Universidade Católica Portuguesa, Rua Diogo Botelho 1327, 4169-005 Porto, Portugal; (D.O.); (M.F.); (S.S.M.P.V.); (A.M.P.); (C.M.H.F.); (A.S.O.); (J.D.); (L.M.R.-A.); (M.E.P.); (A.R.M.); (A.P.C.)
| | - Susana S. M. P. Vidigal
- CBQF—Centro de Biotecnologia e Química Fina, Laboratório Associado, Escola Superior de Biotecnologia, Universidade Católica Portuguesa, Rua Diogo Botelho 1327, 4169-005 Porto, Portugal; (D.O.); (M.F.); (S.S.M.P.V.); (A.M.P.); (C.M.H.F.); (A.S.O.); (J.D.); (L.M.R.-A.); (M.E.P.); (A.R.M.); (A.P.C.)
| | - Ana Margarida Pereira
- CBQF—Centro de Biotecnologia e Química Fina, Laboratório Associado, Escola Superior de Biotecnologia, Universidade Católica Portuguesa, Rua Diogo Botelho 1327, 4169-005 Porto, Portugal; (D.O.); (M.F.); (S.S.M.P.V.); (A.M.P.); (C.M.H.F.); (A.S.O.); (J.D.); (L.M.R.-A.); (M.E.P.); (A.R.M.); (A.P.C.)
- Amyris Bio Products Portugal Unipessoal Lda, 4169-005 Porto, Portugal
| | - Carlos M. H. Ferreira
- CBQF—Centro de Biotecnologia e Química Fina, Laboratório Associado, Escola Superior de Biotecnologia, Universidade Católica Portuguesa, Rua Diogo Botelho 1327, 4169-005 Porto, Portugal; (D.O.); (M.F.); (S.S.M.P.V.); (A.M.P.); (C.M.H.F.); (A.S.O.); (J.D.); (L.M.R.-A.); (M.E.P.); (A.R.M.); (A.P.C.)
- Amyris Bio Products Portugal Unipessoal Lda, 4169-005 Porto, Portugal
| | - Ana Sofia Oliveira
- CBQF—Centro de Biotecnologia e Química Fina, Laboratório Associado, Escola Superior de Biotecnologia, Universidade Católica Portuguesa, Rua Diogo Botelho 1327, 4169-005 Porto, Portugal; (D.O.); (M.F.); (S.S.M.P.V.); (A.M.P.); (C.M.H.F.); (A.S.O.); (J.D.); (L.M.R.-A.); (M.E.P.); (A.R.M.); (A.P.C.)
| | - Joana Durão
- CBQF—Centro de Biotecnologia e Química Fina, Laboratório Associado, Escola Superior de Biotecnologia, Universidade Católica Portuguesa, Rua Diogo Botelho 1327, 4169-005 Porto, Portugal; (D.O.); (M.F.); (S.S.M.P.V.); (A.M.P.); (C.M.H.F.); (A.S.O.); (J.D.); (L.M.R.-A.); (M.E.P.); (A.R.M.); (A.P.C.)
- Amyris Bio Products Portugal Unipessoal Lda, 4169-005 Porto, Portugal
| | - Luís M. Rodríguez-Alcalá
- CBQF—Centro de Biotecnologia e Química Fina, Laboratório Associado, Escola Superior de Biotecnologia, Universidade Católica Portuguesa, Rua Diogo Botelho 1327, 4169-005 Porto, Portugal; (D.O.); (M.F.); (S.S.M.P.V.); (A.M.P.); (C.M.H.F.); (A.S.O.); (J.D.); (L.M.R.-A.); (M.E.P.); (A.R.M.); (A.P.C.)
| | - Manuela E. Pintado
- CBQF—Centro de Biotecnologia e Química Fina, Laboratório Associado, Escola Superior de Biotecnologia, Universidade Católica Portuguesa, Rua Diogo Botelho 1327, 4169-005 Porto, Portugal; (D.O.); (M.F.); (S.S.M.P.V.); (A.M.P.); (C.M.H.F.); (A.S.O.); (J.D.); (L.M.R.-A.); (M.E.P.); (A.R.M.); (A.P.C.)
| | - Ana Raquel Madureira
- CBQF—Centro de Biotecnologia e Química Fina, Laboratório Associado, Escola Superior de Biotecnologia, Universidade Católica Portuguesa, Rua Diogo Botelho 1327, 4169-005 Porto, Portugal; (D.O.); (M.F.); (S.S.M.P.V.); (A.M.P.); (C.M.H.F.); (A.S.O.); (J.D.); (L.M.R.-A.); (M.E.P.); (A.R.M.); (A.P.C.)
| | - Ana P. Carvalho
- CBQF—Centro de Biotecnologia e Química Fina, Laboratório Associado, Escola Superior de Biotecnologia, Universidade Católica Portuguesa, Rua Diogo Botelho 1327, 4169-005 Porto, Portugal; (D.O.); (M.F.); (S.S.M.P.V.); (A.M.P.); (C.M.H.F.); (A.S.O.); (J.D.); (L.M.R.-A.); (M.E.P.); (A.R.M.); (A.P.C.)
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Oliveira D, Moura D, Azevedo S, Guimarães B, Toste S. Oromandibular Dystonia as a Side Effect of Methotrexate. Cureus 2023; 15:e47248. [PMID: 38022297 PMCID: PMC10656108 DOI: 10.7759/cureus.47248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Abstract
Oromandibular dystonia is a focal dystonia characterized by involuntary movements of the jaw, oropharynx, lips, and tongue. The diagnosis of oromandibular dystonia is clinical and can be complex. For effective treatment, it is essential to understand its underlying etiology. A 70-year-old man was referred to our center with a diagnosis of Meige's syndrome, which had been present for five and a half years, for receiving botulinum toxin-A (BoNT-A) injections. Upon physical examination, he exhibited oromandibular dystonia, with a score of 177 points on the Oromandibular Dystonia Rating Scale (OMDRS). He had a history of taking methotrexate for six years, as he was diagnosed with psoriatic arthritis during that time. The possibility of methotrexate-induced dystonia was considered. A switch from methotrexate to sulfasalazine was initiated. Subsequently, the patient showed progressive improvement in his symptoms, as reflected by an OMDRS score of 103 points. After eight weeks, the medical team decided to supplement the treatment with BoNT-A injections, resulting in an OMDRS score of 75. While there is currently no definitive evidence linking the use of methotrexate to the development of dystonia, it is advisable to consider oromandibular dystonia as a potential side effect of methotrexate until more robust evidence becomes available.
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Affiliation(s)
- Diana Oliveira
- Physical Medicine and Rehabilitation, Centro Hospitalar de Entre Douro e Vouga, Santa Maria da Feira, PRT
| | - David Moura
- Physical Medicine and Rehabilitation, Centro Hospitalar de Entre Douro e Vouga, Santa Maria da Feira, PRT
| | - Sofia Azevedo
- Physical Medicine and Rehabilitation, Centro Hospitalar de Entre Douro e Vouga, Santa Maria da Feira, PRT
| | - Bruno Guimarães
- Physical Medicine and Rehabilitation, Centro Hospitalar de Entre Douro e Vouga, Santa Maria da Feira, PRT
| | - Sofia Toste
- Physical Medicine and Rehabilitation, Centro Hospitalar de Entre Douro e Vouga, Santa Maria da Feira, PRT
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Ferreira AI, Silva JE, Melo N, Oliveira D, Silva C, Lume M, Pereira J, Almeida J, Araújo JP, Lourenço P. Prognostic impact of red blood cell distribution width in chronic heart failure patients with left ventricular dysfunction. J Cardiovasc Med (Hagerstown) 2023; 24:746-751. [PMID: 37642949 DOI: 10.2459/jcm.0000000000001543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
AIMS Red blood cell (RBC) distribution width (RDW) measures RBC variations in size. Higher RDW values have been associated with poor outcome in acute heart failure (HF). We aimed to assess the prognostic impact of the RDW in chronic HF. METHODS We retrospectively analysed a cohort of chronic HF patients with left ventricular systolic dysfunction followed in our HF clinic between January 2012 and May 2018. Patients with missing data concerning RDW were excluded. Patients were categorized according to RDW tertiles: ≤13.5%; between 13.5 and 14.7%; and >14.7%. Patients were followed until January 2021; all-cause mortality was the end point analysed. The association of RDW with all-cause mortality was assessed with a Cox-regression analysis. Two multivariate models were built. RESULTS We studied 860 chronic HF patients, 66.4% males, mean age 70 (standard deviation, SD 13) years. Patients were followed for a median of 49 (29-82) months. During this period, 423 (49.2%) patients died. Mortality increased with increasing RDW tertiles. Patients with RDW >14.7% had a HR of mortality of 1.95 (1.47-2.58), p < 0.001 (model 1) and of 1.81 (1.35-2.41), p < 0.001 (model 2) when compared with those with RDW ≤13.5. Patients in the second RDW tertile had an all-cause death HR of 1.47 (1.12-1.93) and of 1.44 (1.09-1.90) in models 1 and 2, respectively. CONCLUSIONS Chronic HF patients with RDW values >14.7% presented an almost 2-fold higher risk of dying in the long term than those with RDW <13.5%. RDW is a widely available and easily measured parameter that can help clinicians in the risk stratification of chronic HF patients.
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Affiliation(s)
| | - João Enes Silva
- Internal Medicine Department, Centro Hospitalar Universitário de São João
| | - Nuno Melo
- Internal Medicine Department, Centro Hospitalar Universitário de São João
| | - Diana Oliveira
- Internal Medicine Department, Centro Hospitalar Universitário de São João
| | - Clara Silva
- Internal Medicine Department, Centro Hospitalar Universitário de São João
| | - Maria Lume
- Internal Medicine Department, Centro Hospitalar Universitário de São João
| | - Joana Pereira
- Internal Medicine Department, Centro Hospitalar Universitário de São João
- Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Jorge Almeida
- Internal Medicine Department, Centro Hospitalar Universitário de São João
| | - José Paulo Araújo
- Internal Medicine Department, Centro Hospitalar Universitário de São João
- Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Patrícia Lourenço
- Internal Medicine Department, Centro Hospitalar Universitário de São João
- Faculdade de Medicina da Universidade do Porto, Porto, Portugal
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Oliveira D, Lopes KF, de Avelar DM, Cota G, Oliveira E. Accuracy of serological tests in diagnosing mucosal leishmaniasis. Parasitol Res 2023; 122:2001-2010. [PMID: 37391643 DOI: 10.1007/s00436-023-07900-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 06/12/2023] [Indexed: 07/02/2023]
Abstract
In this serum panel-based study, we evaluated the accuracy of serological tests originally developed for visceral leishmaniasis (VL), for diagnosis of mucosal leishmaniasis (ML). A total of five tests were evaluated, four of which are registered at the National Agency of Sanitary Surveillance (Agência Nacional de Vigilância Sanitária-ANVISA) (RIDASCREEN® Leishmania Ab from R-Biopharm AG., Leishmania ELISA IgG + IgM from Vircell S.L., IFI Leishmaniose Humana-BioManguinhos, and IT-LEISH® from Bio-Rad Laboratories, Inc.), and the other a direct agglutination test (DAT-LPC) prototype kit developed at Fiocruz. The panel was composed of 40 serum samples from patients with confirmed ML and 20 from patients with mucosal involvement and negative parasitological/molecular tests for leishmaniasis and confirmation of another etiology. All cases were treated from 2009 to 2016 in a referral center for leishmaniasis in Belo Horizonte, Minas Gerais, Brazil (Instituto René Rachou, Fiocruz). Diagnostic accuracy, based on the cut-off point for VL diagnosis, was 86.2% with RIDASCREEN® Leishmania Ab, 73.3% with Leishmania ELISA IgG + IgM, and 66.7% with IFI Leishmaniose Humana, while IT-LEISH® and DAT-LPC had the lowest accuracy (38.3%), despite high specificity (100% and 95%, respectively). New cut-off points defined with sera from ML patients improved accuracy from 86.2 to 89% (p = 0.64) and 73.3 to 88% (p = 0.04) for RIDASCREEN® Leishmania Ab and Leishmania ELISA IgG + IgM, respectively. Moreover, these tests presented greater sensitivity and immunoreactivity in patients with moderate/severe clinical ML forms. The data of this study suggest that ELISA assays can contribute to laboratory diagnosis, especially for patients with moderate or severe mucosal involvement.
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Affiliation(s)
- Diana Oliveira
- Clinical Research and Public Politics in Infectious and Parasitic Diseases, Instituto René Rachou, Oswaldo Cruz Foundation, Belo Horizonte, Minas Gerais, Brazil
| | - Karine Ferreira Lopes
- Clinical Research and Public Politics in Infectious and Parasitic Diseases, Instituto René Rachou, Oswaldo Cruz Foundation, Belo Horizonte, Minas Gerais, Brazil
| | - Daniel Moreira de Avelar
- Clinical Research and Public Politics in Infectious and Parasitic Diseases, Instituto René Rachou, Oswaldo Cruz Foundation, Belo Horizonte, Minas Gerais, Brazil
| | - Gláucia Cota
- Clinical Research and Public Politics in Infectious and Parasitic Diseases, Instituto René Rachou, Oswaldo Cruz Foundation, Belo Horizonte, Minas Gerais, Brazil.
| | - Edward Oliveira
- Clinical Research and Public Politics in Infectious and Parasitic Diseases, Instituto René Rachou, Oswaldo Cruz Foundation, Belo Horizonte, Minas Gerais, Brazil.
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Melo N, Ferreira AI, Silva C, Oliveira D, Enes J, Lume MJ, Pereira J, Araújo JP, Lourenço P. Influence of weight variation on long-term mortality of patients with heart failure. Arch Cardiovasc Dis 2023; 116:403-410. [PMID: 37574401 DOI: 10.1016/j.acvd.2023.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 06/24/2023] [Accepted: 06/27/2023] [Indexed: 08/15/2023]
Abstract
BACKGROUND In heart failure, weight loss predicts dismal prognosis. Weight variations have not been addressed in obese patients with heart failure. AIM To study the impact of weight variation on heart failure mortality according to body mass index strata. METHODS Retrospective study of patients with chronic heart failure with left ventricular ejection fraction<50%. Only patients with ≥1 year of follow-up were included. Patients with missing data for body mass index at the index and 1-year appointments were excluded. Patients were classified into three groups according to weight variation: weight gain>5%; weight loss>5%; and weight stability. Follow-up was set from the 1-year appointment. Cox-regression analysis was used to assess the prognostic impact of weight variation. RESULTS We studied 589 patients: 69.8% male; mean age, 69 years. Over 1 year, 148 patients (25.1%) gained>5% weight, 97 (16.5%) lost>5% weight and the remaining 344 were weight-stable. During 49 months of median follow-up, 248 patients died. Patients who lost>5% of their weight presented a higher death risk than the others (hazard ratio 1.61, 95% confidence interval 1.18-2.19). After multivariable adjustment, the hazard ratio for death for low/normal-weight patients who lost>5% of their weight was 1.81 (95% confidence interval 1.02-3.21; P=0.04) compared with the others. Among the overweight, those who lost>5% of their weight had a hazard ratio of 2.34 (95% confidence interval 1.32-4.12). In the initially obese subgroup, weight loss>5% was not associated with prognosis (hazard ratio 1.08, 95% confidence interval 0.53-2.19). CONCLUSIONS Weight loss predicted mortality in low/normal-weight and overweight patients with heart failure. However, in obese patients, significant weight loss did not predict poorer survival. Weight loss should not be discouraged in obese patients with heart failure.
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Affiliation(s)
- Nuno Melo
- Internal Medicine Department, Centro Hospitalar e Universitário de São João, 4200-319 Porto, Portugal
| | - Ana I Ferreira
- Internal Medicine Department, Centro Hospitalar e Universitário de São João, 4200-319 Porto, Portugal
| | - Clara Silva
- Internal Medicine Department, Centro Hospitalar e Universitário de São João, 4200-319 Porto, Portugal
| | - Diana Oliveira
- Internal Medicine Department, Centro Hospitalar e Universitário de São João, 4200-319 Porto, Portugal
| | - João Enes
- Internal Medicine Department, Centro Hospitalar e Universitário de São João, 4200-319 Porto, Portugal
| | - Maria J Lume
- Internal Medicine Department, Centro Hospitalar e Universitário de São João, 4200-319 Porto, Portugal
| | - Joana Pereira
- Internal Medicine Department, Centro Hospitalar e Universitário de São João, 4200-319 Porto, Portugal; Medicine Department, Faculty of Medicine, Porto University, 4200-319 Porto, Portugal; Heart Failure Clinic of the Internal Medicine Department, Centro Hospitalar e Universitário de São João, 4200-319 Porto, Portugal
| | - José P Araújo
- Medicine Department, Faculty of Medicine, Porto University, 4200-319 Porto, Portugal
| | - Patrícia Lourenço
- Internal Medicine Department, Centro Hospitalar e Universitário de São João, 4200-319 Porto, Portugal; Medicine Department, Faculty of Medicine, Porto University, 4200-319 Porto, Portugal.
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Oliveira M, Oliveira D, Lisboa C, Boechat JL, Delgado L. Clinical Manifestations of Human Exposure to Fungi. J Fungi (Basel) 2023; 9:jof9030381. [PMID: 36983549 PMCID: PMC10052331 DOI: 10.3390/jof9030381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 03/19/2023] [Accepted: 03/20/2023] [Indexed: 03/30/2023] Open
Abstract
Biological particles, along with inorganic gaseous and particulate pollutants, constitute an ever-present component of the atmosphere and surfaces. Among these particles are fungal species colonizing almost all ecosystems, including the human body. Although inoffensive to most people, fungi can be responsible for several health problems, such as allergic fungal diseases and fungal infections. Worldwide fungal disease incidence is increasing, with new emerging fungal diseases appearing yearly. Reasons for this increase are the expansion of life expectancy, the number of immunocompromised patients (immunosuppressive treatments for transplantation, autoimmune diseases, and immunodeficiency diseases), the number of uncontrolled underlying conditions (e.g., diabetes mellitus), and the misusage of medication (e.g., corticosteroids and broad-spectrum antibiotics). Managing fungal diseases is challenging; only four classes of antifungal drugs are available, resistance to these drugs is increasing, and no vaccines have been approved. The present work reviews the implications of fungal particles in human health from allergic diseases (i.e., allergic bronchopulmonary aspergillosis, severe asthma with fungal sensitization, thunderstorm asthma, allergic fungal rhinosinusitis, and occupational lung diseases) to infections (i.e., superficial, subcutaneous, and systemic infections). Topics such as the etiological agent, risk factors, clinical manifestations, diagnosis, and treatment will be revised to improve the knowledge of this growing health concern.
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Affiliation(s)
- Manuela Oliveira
- i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen 208, 4200-135 Porto, Portugal
- Ipatimup-Instituto de Patologia e Imunologia Molecular da Universidade do Porto, Rua Júlio Amaral de Carvalho 45, 4200-135 Porto, Portugal
| | - Diana Oliveira
- CRN-Unidade de Reabilitação AVC, Centro de Reabilitação do Norte, Centro Hospitalar de Vila Nova de Gaia/Espinho, Avenida dos Sanatórios 127, 4405-565 Vila Nova de Gaia, Portugal
| | - Carmen Lisboa
- Serviço de Microbiologia, Departamento de Patologia, Faculdade de Medicina do Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
- Serviço de Dermatologia, Centro Hospitalar Universitário de São João, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
- CINTESIS@RISE-Centro de Investigação em Tecnologias e Serviços de Saúde, Faculdade de Medicina, Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - José Laerte Boechat
- CINTESIS@RISE-Centro de Investigação em Tecnologias e Serviços de Saúde, Faculdade de Medicina, Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
- Serviço de Imunologia Básica e Clínica, Departamento de Patologia, Faculdade de Medicina, Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Luís Delgado
- CINTESIS@RISE-Centro de Investigação em Tecnologias e Serviços de Saúde, Faculdade de Medicina, Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
- Serviço de Imunologia Básica e Clínica, Departamento de Patologia, Faculdade de Medicina, Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
- Laboratório de Imunologia, Serviço de Patologia Clínica, Centro Hospitalar e Universitário de São João, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
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Oliveira D, Assis A, Hora JB, Moreira A, Melo J, Rocha A, Nahas S, Carnevale F. Abstract No. 40 Embolization of the Superior and Middle Rectal Arteries for the Treatment of Symptomatic Hemorrhoidal Disease using the Combination of Metallic Coils and Microspheres. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023] Open
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Nicolau R, Martins A, Oliveira D, Samões B, Martins F, Pinheiro F, Rato M, Bernardes M, Costa L. Impact de l’infection par le SARS-CoV-2 sur l’activité de la maladie des patients atteints de rhumatisme psoriasique sous bDMARD : données réelles. Rev Rhum Ed Fr 2022. [PMCID: PMC9758747 DOI: 10.1016/j.rhum.2022.10.401] [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] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Introduction L’infection par le SARS-CoV-2 peut entraîner une inflammation sévère et il a été suggéré d’induire des poussées de rhumatisme psoriasique (RP). Cependant, l’impact sur l’activité de la maladie et la réponse aux DMARD biologiques modificateurs de la maladie (bDMARD) reste inconnu. Patients et méthodes Nous avons réalisé une analyse rétrospective incluant tous les patients atteints de RP, répondant aux critères CASPAR et sous biothérapie, suivis dans le service de rhumatologie d’un CHU universitaire tertiaire. Les données démographiques et cliniques, y compris la survenue d’une infection par le SARS-CoV-2, ont été collectées à partir de notre base de données nationale (reuma.pt). L’activité de la maladie (CDAI, SDAI, DAS28 4v, BASDAI, ASDAS) et les réponses aux bDMARD (réponses EULAR, ASDAS, ASAS, ACR et PsARC) ont été évaluées avant et après l’infection par le SARS-Cov-2. Résultats Au total, 102 patients atteints de RP ont été inclus. Cinquante-deux étaient des femmes (51 %). L’âge moyen était de 53 ± 11,09 ans et la durée médiane de la maladie était de 15 ans [min 2, max 47]. Au total, 54 (53 %) patients avaient une atteinte axiale prédominante, 26 (26 %) périphérique et 36 (37 %) enthésopathique. Le bDMARD le plus utilisé était l’étanercept (n = 28, 27,5 %) suivi de l’adalimumab (n = 22, 21,6 %) et du sécukinumab (n = 18, 17,6 %). La prévalence de l’infection par le SARS-CoV-2 était de 15,7 % (n = 16). Soixante-trois pour cent ont reçu le vaccin BNT162b2 (Pfizer/BioNtech), 31 % ont reçu l’ARNm-1273 (Moderna), 13 % ont reçu l’AZD1222 (AstraZeneca) et 13 % ont reçu l’AD26.COV2.S (Janssen/Johnson & Johnson). Soixante-trois pour cent étaient infectés avant toute vaccination, 13 % après la première dose et 25 % après la seconde. Les symptômes les plus fréquents étaient l’anosmie (65 %), la dysgueusie (56 %) et la toux (56 %). Tous les patients se sont complètement remis de l’infection, sans nécessiter d’hospitalisation. Quel que soit le score utilisé, la différence entre l’activité moyenne de la maladie après l’infection par le SARS-CoV-2 et celle au départ n’a pas atteint la signification statistique. Au départ et après l’infection, les paramètres moyens de l’activité de la maladie étaient respectivement : CDAI 8,6 ± 5,7 vs 8,6 ± 5,7, p = 0,997 ; SDAI 9,3 ± 6,6 contre 9,2 ± 6,1, p = 0,928 ; DAS 28 4v 2,9 ± 1,2 contre 2,9 ± 1,2, p = 0,818 ; BASDAI 3,6 ± 2,6 contre 3,2 ± 2,7, p = 0,506 ; ASDAS 2,2 ± 1,2 contre 2,2 ± 1, p = 0,721. Le nombre de patients ne répondant pas aux bDMARD (selon EULAR, ASDAS, ASAS, ACR et PsARC) avant l’infection n’était pas différent de celui post-infection. Conclusion Notre étude suggère que l’infection par le SARS-CoV-2 n’a aucun impact négatif sur l’activité de la maladie PSA et les réponses bDMARD. Cependant, d’autres études sont encore nécessaires pour mieux comprendre les effets à long terme de l’infection par le SARS-CoV-2.
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Affiliation(s)
- R. Nicolau
- Rhumatologie, Centro Hospitalar Tondela – Viseu, Epe, Viseu, Portugal,Auteur correspondant
| | - A. Martins
- Rhumatologie, Centro Hospitalar Universitário de São-João, Porto, Portugal
| | - D. Oliveira
- Rhumatologie, Centro Hospitalar Universitário de São-João, Porto, Portugal
| | - B. Samões
- Département de rhumatologie, Centro Hospitalar Vila Nova de Gaia e Espinho, Vila Nova de Gaia
| | - F. Martins
- Rhumatologie, Centro Hospitalar Universitário do Algarve, Algarve, Portugal
| | - F. Pinheiro
- Rhumatologie, Centro Hospitalar e Universitário de São-João, Porto, Portugal
| | - M. Rato
- Rhumatologie, Centro Hospitalar e Universitário de São-João, Porto, Portugal
| | - M. Bernardes
- Rhumatologie, Centro Hospitalar São-João, Porto, Portugal
| | - L. Costa
- Rhumatologie, Centro Hospitalar De São-João, E.P.E., Porto, Portugal
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Neves RP, Oliveira D, Fanasca MA, Vechin FC. Shortening of hip flexor muscles and chronic low-back pain among resistance training practitioners: applications of the modified Thomas test. Sport Sci Health 2022. [DOI: 10.1007/s11332-022-00969-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Hohmann L, Oliveira D, Sigurjónsdóttir K, Bosch A, Borg Å, Vallon-Christersson J, Staaf J. 17P Clinicopathological and transcriptomic characterization of luminal HER2-enriched breast cancer. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.03.032] [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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Staaf J, Oliveira D, Vallon-Christersson J, Ehrencrona H, Kvist A, Borg Å. 150P Molecular characteristics of breast cancer patients subjected to screening for germline predisposition in a population-based observational study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.03.167] [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: 11/01/2022] Open
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Silva JE, Melo N, Ferreira AI, Silva C, Oliveira D, Lume MJ, Pereira J, Araújo JP, Lourenço P. Prognostic impact of neurohormonal modulation in very old patients with chronic heart failure. Age Ageing 2022; 51:6561971. [PMID: 35363254 DOI: 10.1093/ageing/afac076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND A gap in evidence exists concerning the survival-benefit of neurohormonal blockade in older patients with chronic heart failure (HF). The purpose of our study was to investigate the neurohormonal modulation therapy in older HF patients. METHODS We retrospectively analysed data on chronic HF patients with systolic dysfunction from January 2012 to May 2018 at a central tertiary academic hospital in Porto, Portugal. Very old (VO) patients were those ≥80 years. Endpoint under analysis: all-cause mortality; patients were followed until January 2021. The prognostic impact of beta-blockers (BBs) and renin-angiotensin system inhibitors (RASi) use was assessed with a Cox-regression analysis adjusting for confounders. RESULTS We studied 934 patients, 65.5% male; 45.3% had ischemic HF. BBs were used in 92.2% and RASi in 83.5%; 255 (27.3%) were VO patients. VO more often presented co-morbidities, were more symptomatic, presented worse renal function and higher BNP levels. BB prescription was similar in VO and non-VO patients, however RASi were less used in VO: 74.9% versus 86.7%, respectively. During a median follow-up of 47 months, 479 (51.3%) patients died: 71.4% among VO versus 43.7% in non-VO. BBs increased survival both in non-VO and VO-multivariate adjusted HRs of 0.57 (95% CI: 0.38-0.85) and 0.59 (0.36-0.97), respectively. A survival-benefit was also observed with RASi-adjusted HR of 0.71 (0.50-1.01) and 0.59 (0.42-0.83) in non-VO and VO. CONCLUSIONS VO patients with chronic HF with systolic dysfunction have a very ominous outcome. Neurohormonal modulation therapy appears to portend survival-benefit also in this particularly vulnerable subgroup of patients.
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Affiliation(s)
- João Enes Silva
- Internal Medicine Department, Centro Hospitalar de São João, Porto, Portugal
- Heart Failure Clinic of the Internal Medicine Department, Centro Hospitalar de São João, Porto, Portugal
| | - Nuno Melo
- Internal Medicine Department, Centro Hospitalar de São João, Porto, Portugal
- Heart Failure Clinic of the Internal Medicine Department, Centro Hospitalar de São João, Porto, Portugal
| | - Ana Isabel Ferreira
- Internal Medicine Department, Centro Hospitalar de São João, Porto, Portugal
- Heart Failure Clinic of the Internal Medicine Department, Centro Hospitalar de São João, Porto, Portugal
| | - Clara Silva
- Internal Medicine Department, Centro Hospitalar de São João, Porto, Portugal
- Heart Failure Clinic of the Internal Medicine Department, Centro Hospitalar de São João, Porto, Portugal
| | - Diana Oliveira
- Internal Medicine Department, Centro Hospitalar de São João, Porto, Portugal
- Heart Failure Clinic of the Internal Medicine Department, Centro Hospitalar de São João, Porto, Portugal
| | - Maria João Lume
- Internal Medicine Department, Centro Hospitalar de São João, Porto, Portugal
- Heart Failure Clinic of the Internal Medicine Department, Centro Hospitalar de São João, Porto, Portugal
| | - Joana Pereira
- Internal Medicine Department, Centro Hospitalar de São João, Porto, Portugal
- Heart Failure Clinic of the Internal Medicine Department, Centro Hospitalar de São João, Porto, Portugal
| | - José Paulo Araújo
- Internal Medicine Department, Centro Hospitalar de São João, Porto, Portugal
- Heart Failure Clinic of the Internal Medicine Department, Centro Hospitalar de São João, Porto, Portugal
- Porto Cardiovascular I&D Unit (UnIC), Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Patrícia Lourenço
- Internal Medicine Department, Centro Hospitalar de São João, Porto, Portugal
- Heart Failure Clinic of the Internal Medicine Department, Centro Hospitalar de São João, Porto, Portugal
- Porto Cardiovascular I&D Unit (UnIC), Faculdade de Medicina da Universidade do Porto, Porto, Portugal
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Amini S, Pereira P, Roulet J, Oliveira D, Rocha M. Degree of Conversion of Resin-Based Luting Materials Containing Alternative Photoinitiators. Dent Mater 2022. [DOI: 10.1016/j.dental.2021.12.034] [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: 11/03/2022]
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Oliveira D, Rocha M, Zoidis P, Pereira P, Ribeiro A. The effect of different pulp capping methods on the intrapulpal temperature when using light-cured procedures. J Clin Exp Dent 2022; 14:e633-e638. [PMID: 36046163 PMCID: PMC9422968 DOI: 10.4317/jced.59779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 06/26/2022] [Indexed: 11/13/2022] Open
Abstract
Background To evaluate the intra-pulpal temperature during different direct pulp capping methods and light-cured procedures.
Material and Methods Class I preparations 5 mm long, 4 mm wide and 4 mm deep were performed in extracted third molars, leaving 0.5 mm of dentin at the pulpal floor with a 1 mm diameter of pulp exposure. Teeth were placed in a customized oral cavity chamber simulator in which the initial temperature was standardized at 36oC. The overall temperature variations (oC) in the pulp chamber during the light-activation processes were recorded live using an infrared camera (FLIR ONE PRO, FLIR Systems). The liners and bases evaluated were: Dycal (Dentisply), TheraCal LC (Bisco), Biodentin (Septodent), Vitrebond Plus (3M/ESPE), and Fuji IX GP (GC), followed by restoration with a bulk fill composite (EvoCeram Bulk Fill, Ivoclar Vivadent). All light-activation procedures were performed with the VALO Grand (Ultradent) light-curing unit. A power analysis was conducted to determine the sample size to provide a power of at least 0.8 with α=0.05. Statistical analyses were performed using ANOVA and Tukey’s test for multiple comparisons.
Results The intrapulpal temperature increased above a 10oC to 20oC threshold difference for all liners and bases that were light cured. When added as second layers, neither of those could provide thermal insulation following additional light-activated procedures (p=0.25). The higher the number of procedures requiring light-activation, the longer the pulp temperature remained in those increased temperature thresholds.
Conclusions For direct pulp capping procedures, a reduced number light activation procedures should be indicated to reduce the time intra-pulpal temperature rises above a 10oC threshold. Key words:Liner, base, calcium hydroxide, glass ionomer, dental adhesive, bulkfill composite.
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Floriani F, Brandfon B, Sawczuk NJ, Lopes G, Rocha M, Oliveira D. Color difference between the vita classical shade guide and composite veneers using the dual-layer technique. J Clin Exp Dent 2022; 14:e615-e620. [PMID: 36046166 PMCID: PMC9422970 DOI: 10.4317/jced.59759] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 06/06/2022] [Indexed: 11/28/2022] Open
Abstract
Background The purpose of this in vitro study was to evaluate the color difference between the Vita Classical Shade Guide and composite veneers using the dual-layer technique.
Material and Methods Thirty samples were fabricated using a custom-made mold (Easy Layering Shade Guide Kit, 3M) using two resin composites: Filtek Supreme Ultra (3M); and Estelite Omega (Tokuyama) (n=3). The composite veneers were made by layering the different enamel and body or dentin shades from each composite. The color measurements were taken using a spectrophotometer (Vita Easyshade V®, Vita Zahnfabrik). The ΔE00 between the Vita Classical Shade Guide (Vita Zahnfabrik) and the composite veneers were calculated using the CIEDE2000 formula.
Results For the composite veneers using Filtek Supreme Ultra, the best match for A1 Vita shade was achieved layering either EA1 with DA2 or DA3; EA2 with DA1 or DA2 (ΔE00= 1.53 ~ 1.96 ± 0.4). For A2 Vita shade the best match would be EA3 with DA3 or EA3 with DA2 (ΔE00= 1.40 ~ 1.85 ± 0.1); or for A3 Vita shade the best match would be EA3 with DA2 2.50±(0.6). For the composite veneers using Estelite Omega, the were no best match for neither A1, A2 or A3 Vita shade (ΔE00> 2.5).
Conclusions The combination of enamel and dentin shades from Filtek Supreme Ultra provided acceptable color match for A1, A2 and A3 shades from the Vita Shade Guide, while Estelite Omega did not provide acceptable color match for any of the Vita Shade Guide standard shades tested. Key words:Color, color matching, optical properties, resin composite, layering.
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Rocha M, Ottenga M, Zoidis P, Pontes S, Reis A, Oliveira D. Effect of dental headlights spectrum on the polymerization and working time of light-cured resin composites. J Clin Exp Dent 2022; 14:e492-e498. [PMID: 35765356 PMCID: PMC9233914 DOI: 10.4317/jced.59628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Accepted: 05/23/2022] [Indexed: 11/17/2022] Open
Abstract
Background The use of dental headlights is a common practice to better illuminate the operatory field and achieve excellence in restorative dentistry. However, visible light-cured dental materials can have reduced working time under headlight illumination. The aim of this study was to evaluate the influence of the spectral irradiance power of two dental headlights on the degree of polymerization and working time of light-curable dental composites.
Material and Methods Two headlights, StarLight Nano 3 (StarMed) (SN) and Zeon Endevour XL (Orascoptic) (ZE) were characterized using a spectrophotometer coupled to an integrating sphere (MARC® Light Collector, BlueLight Analytics). The degree of conversion of the two composites, Filtek Supreme (3M) and Tetric Prime (Ivoclar Vivadent), was evaluated using an FTIR spectroscope (NicoletTM iS20, Thermo Fisher).
Results Both headlights emitted a significant amount of blue light. The Zeon headlamp without filter emitted a broader spectrum with lower blue intensity and higher CRI than the White LED of the Nano 3. The Zeon headlamp with the blue blocking filter emitted a broader spectrum than the Orange LED of the Nano 3. There were no differences in the degree of conversion and working time of the Filtek Supreme and Tetric Prime composites when illuminated by the different headlamps. Both Zeon and the White LED of the Nano 3 were capable to cure the composites within only 5-10 minutes of irradiation. There were no changes in the degree of conversion of the composites when the Orange LED of the Nano 3 or the blue blocking filter of the Zeon were used.
Conclusions Both headlights reduced the working time of light-cured materials. The use of orange filters prevented the composite polymerization and maintained the working time. Key words:Surgical Headlight, degree of conversion, working time, light-curing.
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Rodrigues M, Teles P, Pirraco R, Oliveira D, Costa P. Evaluation of fractionation schemes in breast cancer radiotherapy and dosimetric study of the main organs at risk. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00396-9] [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: 11/15/2022] Open
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Cidade-Rodrigues C, Cunha FM, Elias C, Oliveira D, Bettencourt P, Lourenço P. The prognostic impact of uric acid in acute heart failure according to coexistence of diabetes mellitus. Nutr Metab Cardiovasc Dis 2021; 31:3377-3383. [PMID: 34625362 DOI: 10.1016/j.numecd.2021.07.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 07/20/2021] [Accepted: 07/27/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIMS Increased uric acid levels predict higher mortality in heart failure (HF) patients. Patients with diabetes mellitus (DM) appear to have increased xanthine oxidase activity. We aimed to study if the association between uric acid and mortality in acute HF was different according to the coexistence of DM. METHODS AND RESULTS We studied a cohort of patients hospitalized due to acute HF in 2009-2010. Patients with no uric acid measurement upon admission were excluded from the analysis. FOLLOW-UP 2 years; endpoint: all-cause mortality. Patients with elevated uric acid (>80.0 mg/L) were compared with those with lower values. We used a multivariate Cox-regression analysis to assess the prognostic impact of uric acid (both continuous and categorical variable: cut-off 80.0 mg/L). The analysis was stratified according to coexistence of DM. We studied 569 acute HF patients, 44.6%male, mean age 76 years, 290 were diabetic. Median admission uric acid: 81.2 mg/L and 52.2%had uric acid >80.0 mg/L. Elevated uric acid predicted all-cause mortality in acute HF only in patients with DM. The multivariate-adjusted HR of 2-year mortality was 1.68 (95 % CI: 1.15-2.46) for diabetic HF patients with uric acid>80.0 mg/L compared to those with lower levels (p = 0.008) and 1.10 (95 % CI: 1.03-1.18) per each 10 mg/L increase in uric acid (p = 0.007). In non-diabetic HF patients, uric acid was not associated with mortality. CONCLUSIONS Increased uric acid predicts ominous outcome in acute HF patients with diabetes, however, it is not prognostic associated in non-diabetics. Uric acid may play a different role in acute HF depending on DM status.
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Affiliation(s)
| | - Filipe M Cunha
- Endocrinology Department, Centro Hospitalar do Tâmega e Sousa, Portugal
| | - Catarina Elias
- Internal Medicine Department, Centro Hospitalar e Universitário de São João, Portugal
| | - Diana Oliveira
- Internal Medicine Department, Centro Hospitalar e Universitário de São João, Portugal
| | - Paulo Bettencourt
- Medicine Faculty, Porto University, Portugal; Internal Medicine Department, Hospital CUF Porto, Portugal; Cardiovascular R&D Unit (UnIC), Portugal
| | - Patrícia Lourenço
- Internal Medicine Department, Centro Hospitalar e Universitário de São João, Portugal; Medicine Faculty, Porto University, Portugal; Cardiovascular R&D Unit (UnIC), Portugal; Heart Failure Clinic of the Internal Medicine Department, Centro Hospitalar e Universitário de São João, Portugal
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Cunha FM, Cidade-Rodrigues C, Elias C, Oliveira D, Bettencourt P, Lourenço P. Glucose variability predicts 6-month mortality in patients hospitalized with acute heart failure. Intern Emerg Med 2021; 16:2121-2128. [PMID: 33818704 DOI: 10.1007/s11739-021-02719-7] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 03/17/2021] [Indexed: 12/29/2022]
Abstract
In diabetes mellitus (DM), glycaemic fluctuations associate with higher oxidative stress than sustained chronic hyperglycaemia and glucose variability increases the risk of chronic diabetic complications. Our hypothesis was that higher glucose variability would associate with mortality after an acute heart failure (HF) episode. We retrospectively analysed patients with DM hospitalized with acute HF between 2009 and 2010. Patients with < 2 point-of-care glucose values/day were excluded. Glucose coefficient of variation (GCV) was defined as (glucose standard deviation/mean glucose) × 100. Patients were categorized according GCV ≤ 30.0 and > 30.0%. Follow-up: 6-months. Endpoint: all-cause mortality. A Cox-regression analysis was used to study the association of glucose variability with 6-month mortality. We studied 214 diabetic patients with acute HF, 49.1% male, mean age 76 years. Mean glycaemia during hospitalization was 187 ± 50 mg/dL, hypoglycaemia (< 70 mg/dL) was reported in 21 patients and mean GCV was 28.3 ± 7.6%. Patients with GCV > 30.0% had higher mean glycaemia, more hypoglycaemic episodes and higher HbA1c; they were also more often treated with insulin. Patients were similar concerning age, gender, comorbidities, left ventricular systolic dysfunction and ischemic heart disease. During the 6-month follow-up, 38 (17.8%) patients died. Patients with GCV > 30.0% had a HR of 6-month mortality of 2.21 (95% CI: 1.16-4.21), p = 0.02. This association with more than twofold higher short-term mortality was independent of main confounders. Elevated glycaemic variability in acute HF admissions of patients with DM predicts short-term mortality. Patients with GCV > 30.0% have an independent more than twofold higher risk of 6-month death after an acute HF hospitalization.
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Affiliation(s)
- Filipe M Cunha
- Endocrinology Department, Centro Hospitalar do Tâmega e Sousa, Avenida Do Hospital Padre Américo 210, Guilhufe, 4564-007, Penafiel, Portugal.
| | - Catarina Cidade-Rodrigues
- Endocrinology Department, Centro Hospitalar do Tâmega e Sousa, Avenida Do Hospital Padre Américo 210, Guilhufe, 4564-007, Penafiel, Portugal
| | - Catarina Elias
- Internal Medicine Department, Centro Hospitalar e Universitário de São João, Porto, Portugal
| | - Diana Oliveira
- Internal Medicine Department, Centro Hospitalar e Universitário de São João, Porto, Portugal
| | - Paulo Bettencourt
- Medicine Faculty, Porto University, Porto, Portugal
- Internal Medicine Department, Hospital CUF Porto, Porto, Portugal
| | - Patrícia Lourenço
- Internal Medicine Department, Centro Hospitalar e Universitário de São João, Porto, Portugal
- Medicine Faculty, Porto University, Porto, Portugal
- Heart Failure Clinic of the Internal Medicine Department, Centro Hospitalar e Universitário de São João, Porto, Portugal
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Elias C, Oliveira D, Soares-Carreira M, Amorim M, Araújo JP, Bettencourt P, Lourenço P. The ratio of furosemide dosage to urinary sodium concentration predicts mortality in patients with chronic stable heart failure. Pol Arch Intern Med 2021; 131. [PMID: 34632751 DOI: 10.20452/pamw.16083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
INTRODUCTION The urinary sodium (UNa) concentration is associated with outcomes in patients with acute heart failure (HF). Its impact in individuals with chronic HF is unknown. OBJECTIVES This study examined the combined effect of diuretic dosage and UNa concentration in chronic HF. PATIENTS AND METHODS The research sample for this retrospective cohort study consisted of ambulatory patients receiving optimized therapy and followed in an HF clinic. The patients were recruited between 2009 and 2012. The exclusion criteria were therapeutic adjustments or hospital admissions in the previous 2 months and renalreplacement therapy. The patients were followed for 5 years; the endpoint was all‑cause mortality. The association between the ratio of furosemide dosage to UNa concentration and 5‑year mortality was studied using a receiver operating characteristic (ROC) curve. The patients were cross‑classified according to daily furosemide dosage (with the cutoff set at 80 mg) and UNa concentration (80 mEq/l). Multivariable Cox regression analysis was used to assess the prognostic impact of the ratio. RESULTS We analyzed 283 patients with chronic HF (70.3% male; mean age, 69 years). During follow‑up, 134 patients died. The median furosemide dosage was 80 mg/day and the mean UNa concentration was 85 mEq/l. Based on the ROC curve, the best cutoff for the ratio of daily furosemide dosage to UNa concentration was 0.8. Patients with a ratio of 0.8 or higher had an adjusted hazard ratio for 5‑year mortality of 2.85 (95% CI, 1.78-4.58). Patients with a UNa excretion rate of less than 80 mEq/l who wereadministered 80 mg or more of furosemide per day were found to have a worse prognosis (HR, 4.15; 95% CI, 2.31-7.45) when compared with those with a UNa excretion rate of 80 mEq/l or more and less than 80 mg furosemide per day. CONCLUSIONS Combining the diuretic dosage and measurement of UNa excretion can be used to refine risk stratification in chronic HF. The furosemide‑to‑UNa ratio can be a surrogate marker for diuretic resistance and has a prognostic impact in chronic HF.
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Affiliation(s)
- Catarina Elias
- Department of Internal Medicine, University Hospital Center of São João, Porto, Portugal; Heart Failure Clinic, Medicina Interna, Porto, Portugal.
| | - Diana Oliveira
- Department of Internal Medicine, University Hospital Center of São João, Porto, Portugal
- Heart Failure Clinic, Medicina Interna, Porto, Portugal
| | - Marta Soares-Carreira
- Department of Internal Medicine, University Hospital Center of São João, Porto, Portugal
- Heart Failure Clinic, Medicina Interna, Porto, Portugal
| | - Marta Amorim
- Department of Internal Medicine, University Hospital Center of São João, Porto, Portugal
- Heart Failure Clinic, Medicina Interna, Porto, Portugal
| | - José Paulo Araújo
- Department of Internal Medicine, University Hospital Center of São João, Porto, Portugal
- Heart Failure Clinic, Medicina Interna, Porto, Portugal
- Faculty of Medicine, University of Porto, Porto, Portugal
- Cardiovascular Research and Development Unit, Cardiovascular Research Center, Porto, Portugal
| | - Paulo Bettencourt
- Heart Failure Clinic, Medicina Interna, Porto, Portugal
- Faculty of Medicine, University of Porto, Porto, Portugal
- Cardiovascular Research and Development Unit, Cardiovascular Research Center, Porto, Portugal
- Department of Internal Medicine, Hospital CUF Porto, Porto, Portugal
| | - Patrícia Lourenço
- Department of Internal Medicine, University Hospital Center of São João, Porto, Portugal
- Heart Failure Clinic, Medicina Interna, Porto, Portugal
- Faculty of Medicine, University of Porto, Porto, Portugal
- Cardiovascular Research and Development Unit, Cardiovascular Research Center, Porto, Portugal
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22
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Oliveira D, Reis J, Ferreira P. [Endocarditis by Abiotrophia defectiva]. Med Clin (Barc) 2021; 157:e273-e274. [PMID: 32843218 DOI: 10.1016/j.medcli.2020.06.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 06/20/2020] [Accepted: 06/24/2020] [Indexed: 11/19/2022]
Affiliation(s)
- Diana Oliveira
- Internal Medicine Resident at Centro Hospitalar São João, Department of Internal Medicine, Portugal.
| | - Joana Reis
- Medical Oncoloy Resident at Centro Hospital São João, Department of Medical Oncology, Portugal
| | - Pestana Ferreira
- Internal Medicine Assistant at Centro Hospitalar São Joao, Department of Internal Medicine, Portugal
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Afonso AC, Oliveira D, Saavedra MJ, Borges A, Simões M. Biofilms in Diabetic Foot Ulcers: Impact, Risk Factors and Control Strategies. Int J Mol Sci 2021; 22:8278. [PMID: 34361044 PMCID: PMC8347492 DOI: 10.3390/ijms22158278] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [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: 06/14/2021] [Revised: 07/28/2021] [Accepted: 07/29/2021] [Indexed: 12/13/2022] Open
Abstract
Diabetic foot ulcers (DFUs) are a serious complication from diabetes mellitus, with a huge economic, social and psychological impact on the patients' life. One of the main reasons why DFUs are so difficult to heal is related to the presence of biofilms. Biofilms promote wound inflammation and a remarkable lack of response to host defences/treatment options, which can lead to disease progression and chronicity. In fact, appropriate treatment for the elimination of these microbial communities can prevent the disease evolution and, in some cases, even avoid more serious outcomes, such as amputation or death. However, the detection of biofilm-associated DFUs is difficult due to the lack of methods for diagnostics in clinical settings. In this review, the current knowledge on the involvement of biofilms in DFUs is discussed, as well as how the surrounding environment influences biofilm formation and regulation, along with its clinical implications. A special focus is also given to biofilm-associated DFU diagnosis and therapeutic strategies. An overview on promising alternative therapeutics is provided and an algorithm considering biofilm detection and treatment is proposed.
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Affiliation(s)
- Ana C. Afonso
- LEPABE—Laboratory for Process Engineering, Environment, Biotechnology and Energy, Faculty of Engineering, University of Porto, Rua Dr. Roberto Frias, s/n, 4200-465 Porto, Portugal; (A.C.A.); (D.O.); (A.B.)
- CITAB—Centre for the Research and Technology for Agro-Environment and Biological Sciences, University of Trás-os-Montes e Alto Douro, 5001-801 Vila Real, Portugal;
- CEB—Centre of Biological Engineering, Campus de Gualtar, University of Minho, 4710-057 Braga, Portugal
| | - Diana Oliveira
- LEPABE—Laboratory for Process Engineering, Environment, Biotechnology and Energy, Faculty of Engineering, University of Porto, Rua Dr. Roberto Frias, s/n, 4200-465 Porto, Portugal; (A.C.A.); (D.O.); (A.B.)
- CIQUP, Department of Chemistry and Biochemistry, Faculty of Sciences, University of Porto, Rua do Campo Alegre, s/n, 4169-007 Porto, Portugal
| | - Maria José Saavedra
- CITAB—Centre for the Research and Technology for Agro-Environment and Biological Sciences, University of Trás-os-Montes e Alto Douro, 5001-801 Vila Real, Portugal;
- Department of Veterinary Sciences, School of Agrarian and Veterinary Sciences, University of Trás-os-Montes e Alto Douro, 5001-801 Vila Real, Portugal
| | - Anabela Borges
- LEPABE—Laboratory for Process Engineering, Environment, Biotechnology and Energy, Faculty of Engineering, University of Porto, Rua Dr. Roberto Frias, s/n, 4200-465 Porto, Portugal; (A.C.A.); (D.O.); (A.B.)
| | - Manuel Simões
- LEPABE—Laboratory for Process Engineering, Environment, Biotechnology and Energy, Faculty of Engineering, University of Porto, Rua Dr. Roberto Frias, s/n, 4200-465 Porto, Portugal; (A.C.A.); (D.O.); (A.B.)
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24
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Cansian RL, Staudt A, Bernardi JL, Puton BMS, Oliveira D, de Oliveira JV, Gomes ACC, Andrade BCOP, Leal ICR, Simas NK, Zeni J, Jungues A, Dallago RM, Backes GT, Paroul N. Toxicity and larvicidal activity on Aedes aegypti of citronella essential oil submitted to enzymatic esterification. BRAZ J BIOL 2021; 83:e244647. [PMID: 34190758 DOI: 10.1590/1519-6984.244647] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 03/10/2021] [Indexed: 11/22/2022] Open
Abstract
The essential oil of citronella (Cymbopogon winterianus) has several biological activities, among them the insect repellent action. Some studies showed that cinnamic acid esters can be applied as natural pesticides, insecticides and fungicides. In this context, the objective of the present work was to evaluate the production of esters from citronella essential oil with cinnamic acid via enzymatic esterification. Besides, the essential oil toxicity before and after esterification against Artemia salina and larvicidal action on Aedes aegypti was investigated. Esters were produced using cinnamic acid as the acylating agent and citronella essential oil (3:1) in heptane and 15 wt% NS 88011 enzyme as biocatalysts, at 70 °C and 150 rpm. Conversion rates of citronellyl and geranyl cinnamates were 58.7 and 69.0% for NS 88011, respectively. For the toxicity to Artemia salina LC50 results of 5.29 μg mL-1 were obtained for the essential oil and 4.36 μg mL-1 for the esterified oils obtained with NS 88011. In the insecticidal activity against Aedes aegypti larvae, was obtained LC50 of 111.84 μg mL-1 for the essential oil of citronella and 86.30 μg mL-1 for the esterified oils obtained with the enzyme NS 88011, indicating high toxicity of the esters. The results demonstrated that the evaluated samples present potential of application as bioinsecticide.
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Affiliation(s)
- R L Cansian
- Programa de Pós-Graduação em Engenharia de Alimentos, Universidade Regional Integrada do Alto Uruguai e das Missões - URI Erechim, Erechim, RS, Brasil
| | - A Staudt
- Programa de Pós-Graduação em Engenharia de Alimentos, Universidade Regional Integrada do Alto Uruguai e das Missões - URI Erechim, Erechim, RS, Brasil.,Laboratório de Produtos Naturais e Ensaios Biológicos - LaProNEB, Departamento de Alimentos e Produtos Naturais, Faculdade de Farmácia, Centro de Ciências da Saúde - CCS, Universidade Federal do Rio de Janeiro - UFRJ, Rio de Janeiro, RJ, Brasil
| | - J L Bernardi
- Programa de Pós-Graduação em Engenharia de Alimentos, Universidade Regional Integrada do Alto Uruguai e das Missões - URI Erechim, Erechim, RS, Brasil
| | - B M S Puton
- Programa de Pós-Graduação em Engenharia de Alimentos, Universidade Regional Integrada do Alto Uruguai e das Missões - URI Erechim, Erechim, RS, Brasil
| | - D Oliveira
- Departamento de Engenharia Química e de Alimentos, Universidade Federal de Santa Catarina - UFSC, Florianópolis, SC, Brasil
| | - J V de Oliveira
- Departamento de Engenharia Química e de Alimentos, Universidade Federal de Santa Catarina - UFSC, Florianópolis, SC, Brasil
| | - A C C Gomes
- Laboratório de Produtos Naturais e Ensaios Biológicos - LaProNEB, Departamento de Alimentos e Produtos Naturais, Faculdade de Farmácia, Centro de Ciências da Saúde - CCS, Universidade Federal do Rio de Janeiro - UFRJ, Rio de Janeiro, RJ, Brasil
| | - B C O P Andrade
- Laboratório de Produtos Naturais e Ensaios Biológicos - LaProNEB, Departamento de Alimentos e Produtos Naturais, Faculdade de Farmácia, Centro de Ciências da Saúde - CCS, Universidade Federal do Rio de Janeiro - UFRJ, Rio de Janeiro, RJ, Brasil
| | - I C R Leal
- Laboratório de Produtos Naturais e Ensaios Biológicos - LaProNEB, Departamento de Alimentos e Produtos Naturais, Faculdade de Farmácia, Centro de Ciências da Saúde - CCS, Universidade Federal do Rio de Janeiro - UFRJ, Rio de Janeiro, RJ, Brasil
| | - N K Simas
- Laboratório de Produtos Naturais e Ensaios Biológicos - LaProNEB, Departamento de Alimentos e Produtos Naturais, Faculdade de Farmácia, Centro de Ciências da Saúde - CCS, Universidade Federal do Rio de Janeiro - UFRJ, Rio de Janeiro, RJ, Brasil
| | - J Zeni
- Programa de Pós-Graduação em Engenharia de Alimentos, Universidade Regional Integrada do Alto Uruguai e das Missões - URI Erechim, Erechim, RS, Brasil
| | - A Jungues
- Programa de Pós-Graduação em Engenharia de Alimentos, Universidade Regional Integrada do Alto Uruguai e das Missões - URI Erechim, Erechim, RS, Brasil
| | - R M Dallago
- Programa de Pós-Graduação em Engenharia de Alimentos, Universidade Regional Integrada do Alto Uruguai e das Missões - URI Erechim, Erechim, RS, Brasil
| | - G T Backes
- Programa de Pós-Graduação em Engenharia de Alimentos, Universidade Regional Integrada do Alto Uruguai e das Missões - URI Erechim, Erechim, RS, Brasil
| | - N Paroul
- Programa de Pós-Graduação em Engenharia de Alimentos, Universidade Regional Integrada do Alto Uruguai e das Missões - URI Erechim, Erechim, RS, Brasil
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Oliveira D, Salazar D, Oliveira J. Pseudo thrombotic microangiopathy secondary to vitamin B12 deficiency. Med Clin (Barc) 2021; 158:291-292. [PMID: 34059356 DOI: 10.1016/j.medcli.2021.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 04/10/2021] [Accepted: 05/03/2021] [Indexed: 11/16/2022]
Affiliation(s)
- Diana Oliveira
- Internal Medicine Resident in Centro Hospitalar e Universitário São João, Portugal.
| | - Daniela Salazar
- Endocrinology Resident in Centro Hospitalar e Universitário São João, Portugal
| | - Jorge Oliveira
- Internal Medicine Graduated Assistant in Centro Hospitalar e Universitário São João, Portugal
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26
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Preto K, Neto D, Tjioe K, Oliveira D. Relevance of Cone-beam computed tomography on diagnosis and surgical planning of the cementoblastoma. J Clin Exp Dent 2021; 13:e1271-e1274. [PMID: 34987720 PMCID: PMC8715555 DOI: 10.4317/jced.58869] [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: 08/15/2021] [Accepted: 10/11/2021] [Indexed: 11/05/2022] Open
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Guiomar V, Oliveira D. Pioderma gangrenoso: una causa rara de una úlcera orbitaria. Gal Clin 2021. [DOI: 10.22546/60/2073] [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: 11/22/2022] Open
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28
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Ferretti R, Mustafa J, Oliveira E, Oliveira D. Association between hyperglycemia and inflammation in critically ill patients. Clin Nutr ESPEN 2020. [DOI: 10.1016/j.clnesp.2020.09.686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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29
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D'Souza M, Oliveira D. Corporate Psychopaths: implications for organizational health and well-being. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Studies on Psychopathy in corporate settings and its toxic effects at the workplace are of the utmost importance. Corporate psychopaths reach upper echelon positions, and demonstrate egocentrism, lack of guilt or remorse; they influence those who are around them to achieve their own goals. In this regard, this study aims to discuss the implications of leaders named corporate psychopaths for the organizational health and well-being.
For this purpose, the study adopted an empirical-theoretical approach, a quantitative evaluation and a survey as the method of data collection, by applying a questionnaire made up by the Self Report Psychopathy (SRP) scale (Paulhus, Neumann, & Hare, 2014), in order to illuminate the non-pathological traits of Psychopathy; the Well-being at work Scale (Paschoal & Tamayo, 2008); and the Perception of Organizational Health Scale by Gomide Jr., Moura, Cunha, & Sousa (1999). The questionnaire was applied to 100 employees from the administrative area of an open capital Brazilian company in the educational area.
The results showed that employees who identified psychopathy traits in their immediate leaders externalized preoccupation, irritation, depression, anxiety, frustration, nervousness, tension and rage, demonstrating uneasiness at the workplace. They also reported that there is a dishonest competition to achieve higher hierarchical positions, no respect between colleagues, and people do not trust each other, demonstrating therefore aspects that reveal a compromised organizational health.
The study will make a contribution by providing insights into how companies can recognize and avoid the selection and recruitment of employees who exhibit psychopathy traits, especially due to the potential of these employess becoming leaders and compromising organizational health and well-being. The issue deserves especial attention and more studies should be carried out regarding the consequences of psychopathic leaders' actions for corporate and public health.
Key messages
Provide insights into how companies can recognize and avoid the selection and recruitment of employees who exhibit psychopathy traits and compromising organizational health and welbeing. The issue deserves especial attention and more studies should be carried out regarding the consequences of psychopathatic leaders’ actions for corporate and public health.
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Affiliation(s)
- M D'Souza
- Management and Education, University Estacio of Bahia, Salvador, Brazil
- Accounting, Bahia State University, Camaçari, Brazil
| | - D Oliveira
- Law School, University Estacio of Bahia, Salvador, Brazil
- Management and Education, University Estacio of Bahia, Salvador, Brazil
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30
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Guiomar VB, Tavares S, Oliveira D, Gomes C, Rodrigues P, Correia C, Pereira E. Three-years follow-up of a case of non-articular Felty Syndrome treated solely with corticosteroids. Gazz Med Ital - Arch Sci Med 2020. [DOI: 10.23736/s0393-3660.19.04183-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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31
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Oliveira D, Srinivasan J, Espino D, Buchan K, Dawson D, Shepherd D. Geometric description for the anatomy of the mitral valve: A review. J Anat 2020; 237:209-224. [PMID: 32242929 DOI: 10.1111/joa.13196] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [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: 11/28/2019] [Revised: 03/06/2020] [Accepted: 03/09/2020] [Indexed: 12/16/2022] Open
Abstract
The mitral valve is a complex anatomical structure whose physiological functioning relies on the biomechanical properties and structural integrity of its components. Their compromise can lead to mitral valve dysfunction, associated with morbidity and mortality. Therefore, a review on the morphometry of the mitral valve is crucial, more specifically on the importance of valve dimensions and shape for its function. This review initially provides a brief background on the anatomy and physiology of the mitral valve, followed by an analysis of the morphological information available. A characterisation of mathematical descriptions of several parts of the valve is performed and the impact of different dimensions and shape changes in disease is then outlined. Finally, a section regarding future directions and recommendations for the use of morphometric information in clinical analysis of the mitral valve is presented.
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Affiliation(s)
- Diana Oliveira
- Department of Mechanical Engineering, University of Birmingham, Birmingham, UK
| | | | - Daniel Espino
- Department of Mechanical Engineering, University of Birmingham, Birmingham, UK
| | - Keith Buchan
- Department of Cardiothoracic Surgery, Aberdeen Royal Infirmary, Aberdeen, UK
| | - Dana Dawson
- Cardiology Research Facility, University of Aberdeen and Aberdeen Royal Infirmary, Aberdeen, UK
| | - Duncan Shepherd
- Department of Mechanical Engineering, University of Birmingham, Birmingham, UK
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Guiomar V, Pinto MJ, Gomes C, Correia C, Tavares S, Chaves V, Oliveira D. Whipple's Disease as the First Manifestation of Chronic Lymphocytic Leukaemia. Eur J Case Rep Intern Med 2020; 6:001270. [PMID: 31934577 PMCID: PMC6953428 DOI: 10.12890/2019_001270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Accepted: 09/10/2019] [Indexed: 11/05/2022] Open
Abstract
Whipple’s disease is a rare multisystemic infectious disease that can mimic lymphoproliferative disorders and must be considered in the differential diagnosis of febrile syndromes. The authors describe the case of a 55-year-old man who presented to the Emergency Department with dyspnoea and abdominal pain. He had a 2-month history of fever, night sweats, asthenia and unintentional weight loss. Upon clinical examination he had bilateral inguinal lymphadenopathy. Blood tests showed iron-deficit anaemia and high C-reactive protein. Abdominal ultrasound showed mesenteric and iliac adenopathies and hepatosplenomegaly. The patient was admitted to the Internal Medicine department for additional testing. Flow cytometry analysis of peripheral blood showed CD5-positive monoclonal B-cell expansion. Excisional biopsy of a retroperitoneal adenopathy guided by computed tomography showed periodic acid–Schiff-positive bacilli inside the macrophages, further identified as Tropheryma whipplei through polymerase chain reaction. Bone marrow biopsy showed a scarce positive CD5 lymphoid population and haematopoietic alterations related to infection. The patient started treatment for T. whipplei with complete symptom resolution. This is the first case describing the simultaneous diagnosis of Whipple’s disease and chronic lymphocytic leukaemia in a patient with constitutional symptoms, fever and lymphadenopathies.
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Affiliation(s)
- Verónica Guiomar
- Internal Medicine Department, Centro Hospitalar de São João, Porto, Portugal
| | - Maria João Pinto
- Internal Medicine Department, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - Clara Gomes
- Internal Medicine Department, Centro Hospitalar de São João, Porto, Portugal
| | - Cristina Correia
- Internal Medicine Department, Centro Hospitalar de São João, Porto, Portugal
| | - Sofia Tavares
- Internal Medicine Department, Centro Hospitalar de São João, Porto, Portugal
| | - Vanessa Chaves
- Internal Medicine Department, Centro Hospitalar de São João, Porto, Portugal
| | - Diana Oliveira
- Internal Medicine Department, Centro Hospitalar de São João, Porto, Portugal
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Santiago L, Oliveira D, Cardoso JC, Figueired A. Human Orf: An Under-recognized Entity. Acta Dermatovenerol Croat 2019; 27:280-281. [PMID: 31969245] [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] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Dear Editor, Orf, also called contagious ecthyma, contagious pustular dermatitis, sore mouth, or scabby mouth, is a highly contagious zoonotic disease which is caused by a double-stranded DNA virus, ORFV (Parapoxvirus genus of the family Poxviridae) (1). The infection is endemic to sheep and goats, and humans are infected either through direct transmission from active lesions on infected animals or through contact with fomites (2). Orf is an occupational hazard and the population at risk includes shepherds, butchers, farmers, wool shearers, and veterinarians (2,3). Professionals rarely seek medical attention as they are aware of its benign nature (4). A 59-year-old woman presented with two painful plaques involving the dorsal aspect of her right thumb and the first interdigital space of the left hand. On examination, targetoid appearance with a central umbilication surrounded by a violaceous bullous halo was observed (Figure 1). The patient had been raising goats on her farm that recently presented udder and perioral crusted lesions. She did not wear gloves while performing this task. A skin biopsy was performed and showed elongation of the rete ridges, edematous papillary dermis, and eosinophilic intracytoplasmic inclusions in vacuolated cells (Figure 2). A diagnosis of human orf was established and the patient was started on a topical antiseptic solution to prevent secondary infection. The lesions healed without scarring after 6 weeks. Orf is characterized by one or multiple nodules on the hands and fingers, but also on the feet, legs, neck, and face. After an incubation period of 3-7 days, the lesions evolve through six clinical stages (2-4): (1) maculopapular stage (days 1-7), with erythematous macules or papules; (2) target stage (days 7-14), with necrotic center and red outer halo; (3) acute stage (days 14-21), in which the nodule begins to weep; (4) regenerative stage (days 21-28), in which the nodule becomes dry; (5) papilloma stage (days 28-35), where the lesion become papilloma-like and forms a dry crust; (6) regression stage (after 35 days). The lesions may be accompanied by lymphangitis, lymphadenopathy, malaise, fever, erysipelas, and occasionally erythema multiforme and bullous pemphigoid (3). Orf is usually a clinical diagnosis (2-4). The characteristic clinical appearance and location of the lesions along with the history of contact with infected animals is sufficient to establish a diagnosis. The differential diagnosis includes milker's nodule, cutaneous anthrax, neutrophilic dermatosis, atypical mycobacterial infection, cutaneous leishmaniasis, pyogenic granuloma, keratoacanthoma, and fungal infection (4,5). Further investigations are performed only when the diagnosis is in doubt and include electron microscopy, virology, enzyme-linked immunosorbent assay, or PCR-based approaches (4). The histological findings depend on the stage of the lesion and include eosinophilic inclusion bodies, epidermal necrosis, vacuolated keratinocytes, a dense mixed dermal infiltrate, and delicate finger-like projections in the epidermis (6).There is no specific treatment since the disease resolves spontaneously within 6-8 weeks, but successful application of cryotherapy, topical imiquimod, and cidofovir has been reported without supporting evidence (4). Surgical debridement should be avoided because it prolonged the recovery period (5). For prevention, wearing nonporous gloves, washing after handling, and isolation of infected animals is effective (2,4). In the present case, the diagnosis of orf was established in a straightforward manner after a good clinical examination and occupational history, allowing us to reassure the patient on its benign nature. The knowledge of this diagnosis prevents multiple complementary investigations (blood tests, histopathology, skin cultures, PCR detection, and electron microscopy) and unnecessary overtreatment. Although a rare entity, the predominant hand involvement in professionals can have significant morbidity that reflects on their productivity and quality of life. This reinforces the need for using appropriate measures to prevent animal-to-human transmission.
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Affiliation(s)
- Luis Santiago
- Luis Santiago, MD, Dermatology Department Centro Hospitalar e Universitário de Coimbra, Praceta Prof. Mota Pinto, 3000-075 Coimbra, Portugal;
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Abstract
Abstract Objective: To evaluate the rates of success and failure of ultrasound-guided percutaneous biopsy of lesions in hollow abdominal organs, as well as the influence of contrast enhancement on those rates. Materials and Methods: This was a retrospective, single-center study evaluating patients submitted to ultrasound-guided percutaneous biopsy of abdominal lesions in hollow organs between January 2017 and June 2018. Patient records were reviewed using a standardized data collection form. Results: We included 49 procedures performed in 48 patients, of whom 18 (38%) had a prior diagnosis of cancer. Malignancy was suspected in 44 cases (90%). Among those 44 cases, the suspicion was of a new neoplasm in 28 (64%), of relapse in 11 (25%), and of a metastatic lesion in 5 (11%). The histopathological findings were sufficient to make the diagnosis in all 44 of those cases, 33 (75%) of which were found to be malignant. The diagnosis was consistent with the clinical suspicion in 33 (75%) of the cases in which there was a definitive histological result. There were no complications resulting from the procedure. Conclusion: Ultrasound-guided percutaneous biopsy is a safe procedure that demonstrates high efficacy in providing a sufficient sample for the diagnosis. The main reason to perform such a biopsy is suspicion of a new neoplasm, followed by suspicion of a metastatic lesion. The histopathological results were concordant with the suspicion in the majority of the cases evaluated here.
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Affiliation(s)
| | | | - Carla Serra
- Interventional Ultrasound Unit, St. Orsola-Malpighi Hospital, Italy
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Guiomar V, Oliveira D, Correia C, Pereira E. Efficacy of Rituximab in Refractory Inflammatory Myopathy Associated With Coexistence of Behçet's Disease and Antiphospholipid Syndrome. Eur J Case Rep Intern Med 2019; 6:001294. [PMID: 31890711 PMCID: PMC6886631 DOI: 10.12890/2019_001294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 10/15/2019] [Indexed: 11/06/2022] Open
Abstract
A 43-year-old Caucasian male initiated myalgias and loss of muscle strength in the upper and lower limbs, but especially at the shoulder and pelvic girdle. Creatinine phosphokinase was elevated seven-fold above the normal reference value and aldolase was slightly elevated. He had a previous diagnosis of Behçet’s disease, antiphospholipid syndrome and hypertriglyceridaemia. At this time, he was on azathioprine 150 mg daily, colchicine 1 mg daily, warfarin and fenofibrate 200 mg daily. Fenofibrate was stopped and creatinine phosphokinase re-evaluated 2 months later, but it was higher, with persistent myalgias. By this time, prednisolone was restarted and the azathioprine dose reduced until it was discontinued. Nevertheless, 2 months after stopping azathioprine, the patient remained symptomatic and creatinine phosphokinase was persistently elevated. At this point, the authors requested myositis antibody testing to exclude overlap with a third autoimmune disorder, and Ro52 antibody was positive. Electromyography was normal. Magnetic resonance imaging of lower limb muscles was compatible with polymyositis. Muscular biopsy of the medial gastrocnemius revealed inflammatory myopathy. The authors proposed treatment with rituximab and after 3 months, the patient had clinically and analytically improved, with reduction of creatinine phosphokinase, without adverse reactions. As we can see in this case, rituximab could be a secure treatment for patients with idiopathic inflammatory myopathy without improvement on glucocorticoids plus another immunosuppressive agent. This patient has a rare overlap syndrome, since this is the first case of an association between inflammatory myopathy, Behçet’s disease and antiphospholipid syndrome described in the literature.
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Affiliation(s)
- Verónica Guiomar
- Internal Medicine Department, Centro Hospitalar de São João, Porto, Portugal
| | - Diana Oliveira
- Internal Medicine Department, Centro Hospitalar de São João, Porto, Portugal
| | - Cristina Correia
- Internal Medicine Department, Centro Hospitalar de São João, Porto, Portugal
| | - Edite Pereira
- Internal Medicine Department, Centro Hospitalar de São João, Porto, Portugal
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Gibran L, Fava M, Ribeiro C, Oliveira F, Oliveira D, Podgaec S, Gebrim L. PIH15 CURRENT PANORAMA OF THE SURGICAL TREATMENT OF ENDOMETRIOSIS BY THE BRAZILIAN PUBLIC SYSTEM. Value Health Reg Issues 2019. [DOI: 10.1016/j.vhri.2019.08.221] [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: 10/25/2022]
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Oliveira F, Oliveira D, Cohen R, Andrade P, Nishikawa A, Junqueira Junior S. PDB13 ESTIMATION OF PATIENTS WITH INDICATION OF METABOLIC SURGERY IN THE PUBLIC AND PRIVATE SECTORS IN BRAZIL. Value Health Reg Issues 2019. [DOI: 10.1016/j.vhri.2019.08.164] [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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Klein G, Oliveira D, Santiago-Junior J, Mendes G, Ribeiro P. Photoelastic Analysis of the Use of a Single Plate for the Treatment of Mandibular Angle Fractures. J Oral Maxillofac Surg 2019. [DOI: 10.1016/j.joms.2019.06.155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Louro P, Durães J, Oliveira D, Paiva S, Ramos L, Macário MC. Woodhouse–Sakati Syndrome: First report of a Portuguese case. Am J Med Genet A 2019; 179:2237-2240. [DOI: 10.1002/ajmg.a.61303] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 06/27/2019] [Accepted: 07/09/2019] [Indexed: 11/11/2022]
Affiliation(s)
- Pedro Louro
- Centro Hospitalar e Universitário de Coimbra Coimbra Portugal
- Familial Risk ClinicInstituto Português de Oncologia de Lisboa Francisco Gentil Lisboa Portugal
- Faculty of Health SciencesUniversidade da Beira Interior Covilhã Portugal
| | - João Durães
- Centro Hospitalar e Universitário de Coimbra Coimbra Portugal
| | - Diana Oliveira
- Centro Hospitalar e Universitário de Coimbra Coimbra Portugal
| | - Sandra Paiva
- Centro Hospitalar e Universitário de Coimbra Coimbra Portugal
| | - Lina Ramos
- Centro Hospitalar e Universitário de Coimbra Coimbra Portugal
- Faculty of Health SciencesUniversidade da Beira Interior Covilhã Portugal
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Giesen K, Oliveira D, Spahn I, Neumaier B. Production of a 52Mn-labeled PSMA-selective bimodal PET/MR probe. Nucl Med Biol 2019. [DOI: 10.1016/s0969-8051(19)30224-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Lages AS, Frade JG, Oliveira D, Paiva I, Oliveira P, Rebelo-Marques A, Carrilho F. Late-Night Salivary Cortisol: Cut-Off Definition and Diagnostic Accuracy for Cushing's Syndrome in a Portuguese Population. ACTA MEDICA PORT 2019; 32:381-387. [PMID: 31166899 DOI: 10.20344/amp.11265] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 01/10/2019] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Diagnosis of Cushing's syndrome remains a challenge in clinical endocrinology. Even though late-night salivary cortisol is used as screening tool, individualized cut-off levels for each population must be defined. MATERIAL AND METHODS Three groups of subjects were studied: normal subjects, suspected and proven Cushing's syndrome. Salivary cortisol was measured using an automated electrochemiluminescence assay. The functional sensitivity of the assay is 0.018 μg/dL. The diagnostic cut-off level was defined by Receiver Operating Characteristic curve and Youden's J index. RESULTS We studied 127 subjects: 57 healthy volunteers, 39 patients with suspected and 31 with proven Cushing's syndrome. 2.5th - 97.5th percentile of the late-night salivary cortisol concentrations in normal subjects was 0.054 to 0.1827 μg/dL. Receiver Operating Characteristic curve analysis showed an area under the curve of 0.9881 (p < 0.0001). A cut-off point of 0.1 μg/dL provided a sensitivity of 96.77% (95% CI 83.3 - 99.92%) and specificity of 91.23% (95% CI 80.7 - 97.09%). There was a significant correlation between latenight salivary cortisol and late-night serum cortisol (R = 0.6977; p < 0.0001) and urinary free cortisol (R = 0.5404; p = 0.0025) in proven Cushing's syndrome group. DISCUSSION The mean ± SD late-night salivary cortisol concentration in patients with proven Cushing's syndrome (0.6798 ± 0.52 μg/ dL) was significantly higher (p < 0.0001). In our population, the late-night salivary cortisol cut-off was 0.1 μg/dL with high sensitivity and specificity. CONCLUSION Late-night salivary cortisol has excellent diagnostic accuracy, making it a highly reliable, noninvasive, screening tool for outpatient assessment. Given its convenience and diagnostic accuracy, late-night salivary cortisol may be added to other traditional screening tests on hypercortisolism.
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Affiliation(s)
- Adriana Sousa Lages
- Endocrinology, Diabetes and Metabolism Department. Coimbra Hospital and University Center. Coimbra. Portugal
| | - João Gonçalo Frade
- Clinical Pathology Department. Coimbra Hospital and University Center. Coimbra. School of Health Sciences. Polytechnic Institute of Leiria. Leiria. Portugal
| | - Diana Oliveira
- Endocrinology, Diabetes and Metabolism Department. Coimbra Hospital and University Center. Coimbra. Portugal
| | - Isabel Paiva
- Endocrinology, Diabetes and Metabolism Department. Coimbra Hospital and University Center. Coimbra. Portugal
| | - Patrícia Oliveira
- Endocrinology, Diabetes and Metabolism Department. Coimbra Hospital and University Center. Coimbra. Portugal
| | - Alexandre Rebelo-Marques
- Family Health Unit from Condeixa. Agrupamento de Centros de Saúde do Baixo Mondego, Administração Regional de Saúde do Centro. Condeixa-A-Nova. Faculty of Medicine. University of Coimbra. Coimbra. Portugal
| | - Francisco Carrilho
- Endocrinology, Diabetes and Metabolism Department. Coimbra Hospital and University Center. Coimbra. Portugal
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Oliveira D, Rosa SA, Tiago J, Ferreira RC, Agapito AF, Sequeira A. Bicuspid aortic valve aortopathies: An hemodynamics characterization in dilated aortas. Comput Methods Biomech Biomed Engin 2019; 22:815-826. [PMID: 30957542 DOI: 10.1080/10255842.2019.1597860] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Bicuspid aortic valve (BAV) aortopathy remains of difficult clinical management due to its heterogeneity and further assessment of related aortic hemodynamics is necessary. The aim of this study was to assess systolic hemodynamic indexes and wall stresses in patients with diverse BAV phenotypes and dilated ascending aortas. The aortic geometry was reconstructed from patient-specific images while the aortic valve was generated based on patient-specific measurements. Physiologic material properties and boundary conditions were applied and fully coupled fluid-structure interaction (FSI) analysis were conducted. Our dilated aortic models were characterized by the presence of abnormal hemodynamics with elevated degrees of flow skewness and eccentricity, regardless of BAV morphotype. Retrograde flow was also present. Both features, predicted by flow angle and flow reversal ratios, were consistently higher than those reported for non-dilated aortas. Right-handed helical flow was present, as well as elevated wall shear stress (WSS) on the outer ascending aortic wall. Our results suggest that the abnormal flow associated with BAV may play a role in aortic enlargement and progress it further on already dilated aortas.
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Affiliation(s)
- Diana Oliveira
- a Department of Mathematics and CEMAT , Instituto Superior Técnico, University of Lisbon , Lisbon , Portugal
| | - Sílvia Aguiar Rosa
- b Cardiology Department , Hospital de Santa Marta (CHLC) , Lisboa , Portugal
| | - Jorge Tiago
- a Department of Mathematics and CEMAT , Instituto Superior Técnico, University of Lisbon , Lisbon , Portugal
| | - Rui Cruz Ferreira
- b Cardiology Department , Hospital de Santa Marta (CHLC) , Lisboa , Portugal
| | | | - Adélia Sequeira
- a Department of Mathematics and CEMAT , Instituto Superior Técnico, University of Lisbon , Lisbon , Portugal
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Martins JD, Zachariah J, Selamet Tierney ES, Truong U, Morris SA, Kutty S, de Ferranti SD, Guarino M, Thomas B, Oliveira D, Marinho A, António M, Gauvreau K, Jalles N, Geva T, Carmo MM, Prakash A. Impact of Treatment Modality on Vascular Function in Coarctation of the Aorta: The LOVE - COARCT Study. J Am Heart Assoc 2019; 8:e011536. [PMID: 30929556 PMCID: PMC6509735 DOI: 10.1161/jaha.118.011536] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Accepted: 01/31/2019] [Indexed: 01/04/2023]
Abstract
Background Optimally treated patients with coarctation of the aorta remain at risk for late vascular dysfunction. The effect of treatment modality on vascular function is unknown. The LOVE-COARCT (Long-term Outcomes and Vascular Evaluation After Successful Coarctation of the Aorta Treatment) study was done to compare vascular function in patients with coarctation of the aorta treated with surgery, balloon dilation (BD), or stent implantation. Methods and Results In treated coarctation of the aorta patients without residual coarctation, we prospectively compared aortic stiffness by applanation tonometry and cardiac magnetic resonance; endothelial function by endothelial pulse amplitude testing; blood pressure ( BP ) phenotype by office BP , ambulatory BP monitoring, and BP response to exercise; left ventricular mass by cardiac magnetic resonance; and blood biomarkers of endothelial function, inflammation, vascular wall function, and extracellular matrix. Participants included 75 patients treated with surgery (n=28), BD (n=23), or stent (n=24). Groups had similar age at enrollment, coarctation of the aorta severity, residual gradient, and metabolic profile, but differed by age at treatment. Prevalence of systemic hypertension, aortic stiffness, endothelial function, and left ventricular mass were similar among treatment groups. However, BD patients had more-distensible ascending aortas, lower peak systolic BP during exercise, less impairment in diurnal BP variation, and lower inflammatory biomarkers. Results were unchanged after adjustment for potential confounders, including age at treatment. Conclusions In our cohort of patients without residual coarctation, treatment modality was not associated with major vascular outcomes, even though there were some favorable vascular characteristics in the BD patients. Although this suggests that choice of treatment modality should continue to be driven by likelihood of achieving a good anatomical result, more long-term studies are required to assess the clinical significance of the more-optimal results of secondary markers of vascular function in BD patients. Clinical Trial Registration URL : http://www.clinicaltrials.gov . Unique identifier: NCT 03262753.
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Affiliation(s)
- José D. Martins
- Department of Pediatric CardiologyHospital de Santa MartaCentro Hospitalar de Lisboa CentralLisbonPortugal
| | - Justin Zachariah
- Division of Pediatric CardiologyDepartment of PediatricsTexas Children's Hospital and Baylor College of MedicineHoustonTX
| | - Elif Seda Selamet Tierney
- Division of Pediatric CardiologyDepartment of PediatricsLucile Packard Children's Hospital and Stanford UniversityPalo AltoCA
| | - Uyen Truong
- Division of Pediatric CardiologyChildren's Hospital ColoradoDenverCO
| | - Shaine A. Morris
- Division of Pediatric CardiologyDepartment of PediatricsTexas Children's Hospital and Baylor College of MedicineHoustonTX
| | - Shelby Kutty
- Division of Pediatric CardiologyChildren's Hospital and Medical CenterOmahaNE
- University of Nebraska College of MedicineOmahaNE
| | - Sarah D. de Ferranti
- Department of CardiologyBoston Children's Hospital and Harvard Medical SchoolBostonMA
| | - Maria Guarino
- CEDOC Chronic DiseasesNova Medical SchoolLisbonPortugal
| | - Boban Thomas
- Ressonância Magnética CaselasS.A. LisbonPortugal
| | - Diana Oliveira
- Biomedical Engineering DepartmentInstituto Superior TécnicoLisbonPortugal
| | - António Marinho
- Pediatric Cardiology DepartmentHospital Pediátrico de CoimbraCoimbraPortugal
| | - Marta António
- Department of Pediatric CardiologyHospital de Santa MartaCentro Hospitalar de Lisboa CentralLisbonPortugal
| | - Kimberlee Gauvreau
- Department of CardiologyBoston Children's Hospital and Harvard Medical SchoolBostonMA
| | - Nuno Jalles
- Ressonância Magnética CaselasS.A. LisbonPortugal
| | - Tal Geva
- Department of CardiologyBoston Children's Hospital and Harvard Medical SchoolBostonMA
| | | | - Ashwin Prakash
- Department of CardiologyBoston Children's Hospital and Harvard Medical SchoolBostonMA
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Ventura M, Gomes L, Rosmaninho-Salgado J, Barros L, Paiva I, Melo M, Oliveira D, Carrilho F. Bifocal germinoma in a patient with 16p11.2 microdeletion syndrome. Endocrinol Diabetes Metab Case Rep 2019; 2019:EDM180149. [PMID: 30738016 PMCID: PMC6373620 DOI: 10.1530/edm-18-0149] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 01/18/2019] [Indexed: 12/12/2022] Open
Abstract
Intracranial germinomas are rare tumors affecting mostly patients at young age. Therefore, molecular data on its etiopathogenesis are scarce. We present a clinical case of a male patient of 25 years with an intracranial germinoma and a 16p11.2 microdeletion. His initial complaints were related to obesity, loss of facial hair and polydipsia. He also had a history of social-interaction difficulties during childhood. His blood tests were consistent with hypogonadotropic hypogonadism and secondary adrenal insufficiency, and he had been previously diagnosed with hypothyroidism. He also presented with polyuria and polydipsia and the water deprivation test confirmed the diagnosis of diabetes insipidus. His sellar magnetic resonance imaging (MRI) showed two lesions: one located in the pineal gland and other in the suprasellar region, both with characteristics suggestive of germinoma. Chromosomal microarray analysis was performed due to the association of obesity with social disability, and the result identified a 604 kb 16p11.2 microdeletion. The surgical biopsy confirmed the histological diagnosis of a germinoma. Pharmacological treatment with testosterone, hydrocortisone and desmopressin was started, and the patient underwent radiotherapy (40 Gy divided in 25 fractions). Three months after radiotherapy, a significant decrease in suprasellar and pineal lesions without improvement in pituitary hormonal deficiencies was observed. The patient is currently under follow-up. To the best of our knowledge, we describe the first germinoma in a patient with a 16p11.2 deletion syndrome, raising the question about the impact of this genetic alteration on tumorigenesis and highlighting the need of molecular analysis of germ cell tumors as only little is known about their genetic background. Learning points: Central nervous system germ cell tumors (CNSGTs) are rare intracranial tumors that affect mainly young male patients. They are typically located in the pineal and suprasellar regions and patients frequently present with symptoms of hypopituitarism. The molecular pathology of CNSGTs is unknown, but it has been associated with gain of function of the KIT gene, isochromosome 12p amplification and a low DNA methylation. Germinoma is a radiosensitive tumor whose diagnosis depends on imaging, tumor marker detection, surgical biopsy and cerebrospinal fluid cytology. 16p11.2 microdeletion syndrome is phenotypically characterized by developmental delay, intellectual disability and autism spectrum disorders. Seminoma, cholesteatoma, desmoid tumor, leiomyoma and Wilms tumor have been described in a few patients with 16p11.2 deletion. Bifocal germinoma was identified in this patient with a 16p11.2 microdeletion syndrome, which represents a putative new association not previously reported in the literature.
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Affiliation(s)
- Mara Ventura
- Department of Endocrinology, Diabetes and Metabolism
| | - Leonor Gomes
- Department of Endocrinology, Diabetes and Metabolism
| | - Joana Rosmaninho-Salgado
- Department of Medical Genetics, Pediatric Unit, Coimbra Hospital and Universitary Center, Coimbra, Portugal
| | - Luísa Barros
- Department of Endocrinology, Diabetes and Metabolism
| | - Isabel Paiva
- Department of Endocrinology, Diabetes and Metabolism
| | - Miguel Melo
- Department of Endocrinology, Diabetes and Metabolism
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Teixeira AIP, Silva DM, Vital T, Nitz N, de Carvalho BC, Hecht M, Oliveira D, Oliveira E, Rabello A, Romero GAS. Improving the reference standard for the diagnosis of canine visceral leishmaniasis: a challenge for current and future tests. Mem Inst Oswaldo Cruz 2019; 114:e180452. [PMID: 30726343 PMCID: PMC6358009 DOI: 10.1590/0074-02760180452] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 01/04/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Studies aimed at validating canine visceral leishmaniasis diagnostic tests present heterogeneous results regarding test accuracy, partly due to divergences in reference standards used and different infection evolution periods in animals. OBJECTIVE This study aimed to evaluate the accuracy of the rapid test-dual path platform (TR-DPP) (Biomanguinhos®), EIE-Leishmaniose-Visceral-Canina-Biomanguinhos (EIE-LVC) (Biomanguinhos®), enzyme-linked immunosorbent assay (ELISA) rK39 (in-house), and the direct agglutination test (DAT-Canis) against a reference standard comprising parasitological and molecular techniques. METHODS A phase II/III validation study was carried out in sample sera from 123 predominantly asymptomatic dogs living in an area endemic for visceral leishmaniasis. FINDINGS Sixty-nine (56.1%) animals were considered infected according to the reference standard. For each test, the sensitivity and specificity, respectively, were as follows: TR-DPP, 21.74% [confidence interval (CI)95% 13.64% to 32.82%] and 92.59% (CI95% 82.45% to 97.08%); EIE-LVC, 11.59% (CI95% 5.9% to 21.25%) and 90.74% (CI95% 80.09% to 95.98%); ELISA rK39, 37.68% (CI95% 27.18% to 49.48%) and 83.33% (CI95% 71.26% to 90.98%); and DAT-Canis, 18.84% (CI95% 11.35% to 29.61%) and 96.30% (CI95% 87.46% to 98.98%). CONCLUSION We concluded that improving the sensitivity of serum testing for diagnosing asymptomatic dogs must constitute a priority in the process of developing new diagnostic tests to be used in the visceral leishmaniasis control program in Brazil.
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Affiliation(s)
| | | | - Tamires Vital
- Universidade de Brasília, Núcleo de Medicina Tropical, Brasília, DF, Brasil.,Universidade de Brasília, Faculdade de Medicina, Laboratório Interdisciplinar de Biociências, Brasília, DF, Brasil
| | - Nadjar Nitz
- Universidade de Brasília, Faculdade de Medicina, Laboratório Interdisciplinar de Biociências, Brasília, DF, Brasil
| | | | - Mariana Hecht
- Universidade de Brasília, Faculdade de Medicina, Laboratório Interdisciplinar de Biociências, Brasília, DF, Brasil
| | - Diana Oliveira
- Grupo de Pesquisas Clínicas e Políticas Públicas em Doenças Infecciosas e Parasitárias, Belo Horizonte, MG, Brasil
| | - Edward Oliveira
- Grupo de Pesquisas Clínicas e Políticas Públicas em Doenças Infecciosas e Parasitárias, Belo Horizonte, MG, Brasil
| | - Ana Rabello
- Grupo de Pesquisas Clínicas e Políticas Públicas em Doenças Infecciosas e Parasitárias, Belo Horizonte, MG, Brasil
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Oliveira D, Puri R, Fenelon MA, O'Mahony JA. Delactosed permeate as a dairy processing co‐product with major potential value: a review. Int J Food Sci Technol 2018. [DOI: 10.1111/ijfs.14064] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Diana Oliveira
- School of Food and Nutritional Sciences University College Cork Room 234, Food Science Building Cork Ireland
- Dairy Processing Technology Centre University College Cork Room 234, Food Science Building Cork Ireland
| | - Ritika Puri
- School of Food and Nutritional Sciences University College Cork Room 234, Food Science Building Cork Ireland
- Dairy Processing Technology Centre University College Cork Room 234, Food Science Building Cork Ireland
| | - Mark A. Fenelon
- Food Chemistry and Technology Department Teagasc Food Research Centre Moorepark, Fermoy, Co. Cork P61 C996 Ireland
| | - James A. O'Mahony
- School of Food and Nutritional Sciences University College Cork Room 234, Food Science Building Cork Ireland
- Dairy Processing Technology Centre University College Cork Room 234, Food Science Building Cork Ireland
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Oliveira D, Correia A, Cavalcanti M, Oliveira D, Miranda V. PO302 Quality of Life in the Elderly: Women Have Worse Results. Glob Heart 2018. [DOI: 10.1016/j.gheart.2018.09.243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Oliveira D, Ventura M, Melo M, Paiva S, Carrilho F. Addison's disease in antiphospholipid syndrome: a rare complication. Endocrinol Diabetes Metab Case Rep 2018; 2018:EDM180118. [PMID: 30481151 PMCID: PMC6280132 DOI: 10.1530/edm-18-0118] [Citation(s) in RCA: 3] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 10/30/2018] [Indexed: 11/24/2022] Open
Abstract
Addison’s disease (AD) is the most common endocrine manifestation of antiphospholipid syndrome (APS), but it remains a very rare complication of the syndrome. It is caused by adrenal venous thrombosis and consequent hemorrhagic infarction or by spontaneous (without thrombosis) adrenal hemorrhage, usually occurring after surgery or anticoagulant therapy. We present a clinical case of a 36-year-old female patient with a previous diagnosis of APS. She presented with multiple thrombotic events, including spontaneous abortions. During evaluation by the third episode of abortion, a CT imaging revealed an adrenal hematoma, but the patient was discharged without further investigation. A few weeks later, she presented in the emergency department with manifestations suggestive of adrenal insufficiency. Based on that assumption, she started therapy with glucocorticoids, with significant clinical improvement. After stabilization, additional investigation confirmed AD and excluded other etiologies; she also started mineralocorticoid replacement. This case illustrates a rare complication of APS that, if misdiagnosed, may be life threatening. A high index of suspicion is necessary for its diagnosis, and prompt treatment is crucial to reduce the morbidity and mortality potentially associated.
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Affiliation(s)
- Diana Oliveira
- Endocrinology, Diabetes and Metabolism Department, Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, Portugal
| | - Mara Ventura
- Endocrinology, Diabetes and Metabolism Department, Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, Portugal
| | - Miguel Melo
- Endocrinology, Diabetes and Metabolism Department, Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, Portugal
| | - Sandra Paiva
- Endocrinology, Diabetes and Metabolism Department, Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, Portugal
| | - Francisco Carrilho
- Endocrinology, Diabetes and Metabolism Department, Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, Portugal
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Dias C, Borges A, Oliveira D, Martinez-Murcia A, Saavedra MJ, Simões M. Biofilms and antibiotic susceptibility of multidrug-resistant bacteria from wild animals. PeerJ 2018; 6:e4974. [PMID: 29910986 PMCID: PMC6003395 DOI: 10.7717/peerj.4974] [Citation(s) in RCA: 15] [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] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 05/24/2018] [Indexed: 12/12/2022] Open
Abstract
Background The "One Health" concept recognizes that human health and animal health are interdependent and bound to the health of the ecosystem in which they (co)exist. This interconnection favors the transmission of bacteria and other infectious agents as well as the flow of genetic elements containing antibiotic resistance genes. This problem is worsened when pathogenic bacteria have the ability to establish as biofilms. Therefore, it is important to understand the characteristics and behaviour of microorganisms in both planktonic and biofilms states from the most diverse environmental niches to mitigate the emergence and dissemination of resistance. Methods The purpose of this work was to assess the antibiotic susceptibility of four bacteria (Acinetobacter spp., Klebsiella pneumoniae, Pseudomonas fluorescens and Shewanella putrefaciens) isolated from wild animals and their ability to form biofilms. The effect of two antibiotics, imipenem (IPM) and ciprofloxacin (CIP), on biofilm removal was also assessed. Screening of resistance genetic determinants was performed by PCR. Biofilm tests were performed by a modified microtiter plate method. Bacterial surface hydrophobicity was determined by sessile drop contact angles. Results The susceptibility profile classified the bacteria as multidrug-resistant. Three genes coding for β-lactamases were detected in K. pneumoniae (TEM, SHV, OXA-aer) and one in P. fluorescens (OXA-aer). K. pneumoniae was the microorganism that carried more β-lactamase genes and it was the most proficient biofilm producer, while P. fluorescens demonstrated the highest adhesion ability. Antibiotics at their MIC, 5 × MIC and 10 × MIC were ineffective in total biofilm removal. The highest biomass reductions were found with IPM (54% at 10 × MIC) against K. pneumoniae biofilms and with CIP (40% at 10 × MIC) against P. fluorescens biofilms. Discussion The results highlight wildlife as important host reservoirs and vectors for the spread of multidrug-resistant bacteria and genetic determinants of resistance. The ability of these bacteria to form biofilms should increase their persistence.
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Affiliation(s)
- Carla Dias
- LEPABE-Department of Chemical Engineering, Faculty of Engineering-University of Porto, Portugal.,CITAB, Centre for the Research and Technology of Agro-Environment and Biological Sciences, Universidade de Tras-os-Montes e Alto Douro, Portugal.,CECAV, Veterinary and Animal Science Research Center, Universidade de Tras-os-Montes e Alto Douro, Portugal
| | - Anabela Borges
- LEPABE-Department of Chemical Engineering, Faculty of Engineering-University of Porto, Portugal.,CECAV, Veterinary and Animal Science Research Center, Universidade de Tras-os-Montes e Alto Douro, Portugal.,CIQUP, Department of Chemistry and Biochemistry, Faculty of Sciences, University of Porto, Portugal
| | - Diana Oliveira
- LEPABE-Department of Chemical Engineering, Faculty of Engineering-University of Porto, Portugal
| | | | - Maria José Saavedra
- CITAB, Centre for the Research and Technology of Agro-Environment and Biological Sciences, Universidade de Tras-os-Montes e Alto Douro, Portugal.,CECAV, Veterinary and Animal Science Research Center, Universidade de Tras-os-Montes e Alto Douro, Portugal
| | - Manuel Simões
- LEPABE-Department of Chemical Engineering, Faculty of Engineering-University of Porto, Portugal
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