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Joaquim A, Vieira C, Ribeiro L, Barros A, Leão I, Alvim C, Pinheiro S, Nogueira M, Morais C. Head and neck cancer patient journey's health literacy: a multidisciplinary team perspective. VOICE study. Support Care Cancer 2024; 32:133. [PMID: 38280025 PMCID: PMC10821956 DOI: 10.1007/s00520-023-08256-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 12/12/2023] [Indexed: 01/29/2024]
Abstract
PURPOSE Health literacy is a current Public Health priority in Portugal. The participation of well-informed patients in their care and shared decision making are essential, especially in chronic aggressive and debilitating pathologies such as recurrent or metastatic (R/M) Head and Neck Squamous Cell Carcinoma (HNSCC). AIMS This study aimed to characterize R/M HNSCC patients' and caregivers' information needs identified by healthcare professionals (HCPs). METHODS Two online Focus Groups, one with only medical doctors and the other with other HCPs involved in the treatment of R/M HNSCC patients, were conducted, using a modified Metaplan, Lean or adapted PDCA methodology. The discussions were audio recorded in full and content analysis was performed using ATLAS.ti qualitative data analysis software. RESULTS Topics addressed were diagnosis, treatment, quality of life, and global evaluation. In general, all experts agreed that only essential information should be cautiously given, according to patients' and caregivers' wishes. It was consensual that patients are given the necessary information to adhere to treatment. Two main barriers were identified: one barrier was associated with verbal communication due to the lack of health literacy of these patients, and the other barrier regarded healthcare access. It was also considered important to remind patients of the daily and social activities that they could and should maintain, as well as providing sufficient social resources and problem-solving training to caregivers. CONCLUSIONS This qualitative study highlights the complexity of R/M HNSCC patients' care. Immediate availability of psychologists and psychiatrists should be implemented in all centers that treat HNSCC patients. The differences found between the physicians' Focus Group and other HCPs' Focus Group in some of the addressed topics emphasize the importance of a multidisciplinary and holistic approach, in a biomedical model integrated with a biopsychosocial model.
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Affiliation(s)
- Ana Joaquim
- Centro Hospitalar Vila Nova de Gaia E Espinho, Vila Nova de Gaia, Portugal
| | | | - Leonor Ribeiro
- Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal
| | - Anabela Barros
- Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal
| | - Inês Leão
- Centro Hospitalar Vila Nova de Gaia E Espinho, Vila Nova de Gaia, Portugal
| | - Cecília Alvim
- Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal
| | - Sara Pinheiro
- Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal
| | - Mafalda Nogueira
- MSD Portugal, R. da Qt. da Fonte 19, 2770-192, Paço de Arcos, Portugal
| | - Catarina Morais
- MSD Portugal, R. da Qt. da Fonte 19, 2770-192, Paço de Arcos, Portugal.
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Esperança-Martins M, Melo-Alvim C, Dâmaso S, Lopes-Brás R, Peniche T, Nogueira-Costa G, Abreu C, Luna Pais H, de Sousa RT, Torres S, Gallego-Paez LM, Martins M, Ribeiro L, Costa L. Breast Sarcomas, Phyllodes Tumors, and Desmoid Tumors: Turning the Magnifying Glass on Rare and Aggressive Entities. Cancers (Basel) 2023; 15:3933. [PMID: 37568749 PMCID: PMC10416994 DOI: 10.3390/cancers15153933] [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: 06/30/2023] [Revised: 07/27/2023] [Accepted: 07/28/2023] [Indexed: 08/13/2023] Open
Abstract
Breast sarcomas (BSs), phyllodes tumors (PTs), and desmoid tumors (DTs) are rare entities that arise from connective tissue. BSs can be classified as either primary or secondary, whether they develop de novo or after radiation exposure or lymphedema. PIK3CA seems to play an important common role in different BS. Malignant PTs show similar behavior to BSs, while DTs are locally aggressive but rarely metastasize. BSs usually present as unilateral, painless, rapidly growing masses with rare nodal involvement. The diagnosis should be based on magnetic resonance imaging and a core needle biopsy. Staging should comprise a chest computed tomography (CT) scan (except for benign PT and DT), while abdominal and pelvic CT scans and bone scans should be added in certain subtypes. The mainstay of treatment for localized BS is surgery, with margin goals that vary according to subtype. Radiotherapy and chemotherapy can be used as neoadjuvant or adjuvant approaches, but their use in these settings is not standard. Advanced BS should be treated with systemic therapy, consistent with recommendations for advanced soft tissue sarcomas of other topographies. Given the rarity and heterogeneity of these entities, multidisciplinary and multi-institutional collaboration and treatment at reference centers are critical.
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Affiliation(s)
- Miguel Esperança-Martins
- Medical Oncology Department, Centro Hospitalar Universitário Lisboa Norte, 1649-028 Lisboa, Portugal; (C.M.-A.); (S.D.); (R.L.-B.); (G.N.-C.); (C.A.); (H.L.P.); (R.T.d.S.); (S.T.); (L.R.)
- Luis Costa Lab, Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina da Universidade de Lisboa, 1649-028 Lisboa, Portugal; (T.P.); (L.M.G.-P.); (M.M.)
| | - Cecília Melo-Alvim
- Medical Oncology Department, Centro Hospitalar Universitário Lisboa Norte, 1649-028 Lisboa, Portugal; (C.M.-A.); (S.D.); (R.L.-B.); (G.N.-C.); (C.A.); (H.L.P.); (R.T.d.S.); (S.T.); (L.R.)
- Faculdade de Medicina da Universidade de Lisboa, 1649-028 Lisboa, Portugal
| | - Sara Dâmaso
- Medical Oncology Department, Centro Hospitalar Universitário Lisboa Norte, 1649-028 Lisboa, Portugal; (C.M.-A.); (S.D.); (R.L.-B.); (G.N.-C.); (C.A.); (H.L.P.); (R.T.d.S.); (S.T.); (L.R.)
| | - Raquel Lopes-Brás
- Medical Oncology Department, Centro Hospitalar Universitário Lisboa Norte, 1649-028 Lisboa, Portugal; (C.M.-A.); (S.D.); (R.L.-B.); (G.N.-C.); (C.A.); (H.L.P.); (R.T.d.S.); (S.T.); (L.R.)
| | - Tânia Peniche
- Luis Costa Lab, Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina da Universidade de Lisboa, 1649-028 Lisboa, Portugal; (T.P.); (L.M.G.-P.); (M.M.)
| | - Gonçalo Nogueira-Costa
- Medical Oncology Department, Centro Hospitalar Universitário Lisboa Norte, 1649-028 Lisboa, Portugal; (C.M.-A.); (S.D.); (R.L.-B.); (G.N.-C.); (C.A.); (H.L.P.); (R.T.d.S.); (S.T.); (L.R.)
- Faculdade de Medicina da Universidade de Lisboa, 1649-028 Lisboa, Portugal
| | - Catarina Abreu
- Medical Oncology Department, Centro Hospitalar Universitário Lisboa Norte, 1649-028 Lisboa, Portugal; (C.M.-A.); (S.D.); (R.L.-B.); (G.N.-C.); (C.A.); (H.L.P.); (R.T.d.S.); (S.T.); (L.R.)
- Faculdade de Medicina da Universidade de Lisboa, 1649-028 Lisboa, Portugal
| | - Helena Luna Pais
- Medical Oncology Department, Centro Hospitalar Universitário Lisboa Norte, 1649-028 Lisboa, Portugal; (C.M.-A.); (S.D.); (R.L.-B.); (G.N.-C.); (C.A.); (H.L.P.); (R.T.d.S.); (S.T.); (L.R.)
- Faculdade de Medicina da Universidade de Lisboa, 1649-028 Lisboa, Portugal
| | - Rita Teixeira de Sousa
- Medical Oncology Department, Centro Hospitalar Universitário Lisboa Norte, 1649-028 Lisboa, Portugal; (C.M.-A.); (S.D.); (R.L.-B.); (G.N.-C.); (C.A.); (H.L.P.); (R.T.d.S.); (S.T.); (L.R.)
- Faculdade de Medicina da Universidade de Lisboa, 1649-028 Lisboa, Portugal
| | - Sofia Torres
- Medical Oncology Department, Centro Hospitalar Universitário Lisboa Norte, 1649-028 Lisboa, Portugal; (C.M.-A.); (S.D.); (R.L.-B.); (G.N.-C.); (C.A.); (H.L.P.); (R.T.d.S.); (S.T.); (L.R.)
| | - Lina Marcela Gallego-Paez
- Luis Costa Lab, Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina da Universidade de Lisboa, 1649-028 Lisboa, Portugal; (T.P.); (L.M.G.-P.); (M.M.)
| | - Marta Martins
- Luis Costa Lab, Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina da Universidade de Lisboa, 1649-028 Lisboa, Portugal; (T.P.); (L.M.G.-P.); (M.M.)
| | - Leonor Ribeiro
- Medical Oncology Department, Centro Hospitalar Universitário Lisboa Norte, 1649-028 Lisboa, Portugal; (C.M.-A.); (S.D.); (R.L.-B.); (G.N.-C.); (C.A.); (H.L.P.); (R.T.d.S.); (S.T.); (L.R.)
- Faculdade de Medicina da Universidade de Lisboa, 1649-028 Lisboa, Portugal
| | - Luís Costa
- Medical Oncology Department, Centro Hospitalar Universitário Lisboa Norte, 1649-028 Lisboa, Portugal; (C.M.-A.); (S.D.); (R.L.-B.); (G.N.-C.); (C.A.); (H.L.P.); (R.T.d.S.); (S.T.); (L.R.)
- Luis Costa Lab, Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina da Universidade de Lisboa, 1649-028 Lisboa, Portugal; (T.P.); (L.M.G.-P.); (M.M.)
- Faculdade de Medicina da Universidade de Lisboa, 1649-028 Lisboa, Portugal
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Carraça EV, Rodrigues B, Franco S, Nobre I, Jerónimo F, Ilharco V, Gabriel F, Ribeiro L, Palmeira AL, Silva MN. Promoting physical activity through supervised vs motivational behavior change interventions in breast cancer survivors on aromatase inhibitors (PAC-WOMAN): protocol for a 3-arm pragmatic randomized controlled trial. BMC Cancer 2023; 23:632. [PMID: 37407950 DOI: 10.1186/s12885-023-11137-1] [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: 06/09/2023] [Accepted: 06/29/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND Aromatase inhibitors (AI) are frequently used to treat hormone-receptor-positive breast cancer, but they have multiple adverse effects (e.g., osteoporosis, arthralgia), resulting in premature therapy discontinuation/switch. Physical activity (PA) can attenuate these negative effects and improve quality of life (QoL). However, most cancer survivors fail to perform/sustain adequate PA levels, especially in the long-term. Theory-based interventions, using evidence-based behavior change techniques, aimed at promoting long-term behavior change in breast cancer survivors are effective, but remain scarce and fail to promote self-regulatory skills and better-quality motivations associated with sustained PA adoption. This paper describes the design of the PAC-WOMAN trial, which will test the long-term effectiveness and cost-effectiveness of two state of the art, group-based interventions encouraging sustained changes in PA, sedentary behavior, and QoL. Additional aims include examining the impact of both interventions on secondary outcomes (e.g., body composition, physical function), and key moderators/mediators of short and long-term changes in primary outcomes. METHODS A 3-arm pragmatic randomized controlled trial, involving a 4-month intervention and a 12-month follow-up, will be implemented, in a real exercise setting, to compare: 1) brief PA counseling/motivational intervention; 2) structured exercise program vs. waiting-list control group. Study recruitment goal is 122 hormone-receptor-positive breast cancer survivors (stage I-III), on AI therapy (post-primary treatment completion) ≥ 1 month, ECOG 0-1. Outcome measures will be obtained at baseline, 4 months (i.e., post-intervention), 10 and 16 months. Process evaluation, analyzing implementation determinants, will also be conducted. DISCUSSION PAC-WOMAN is expected to have a relevant impact on participants PA and QoL and provide insights for the improvement of interventions designed to promote sustained adherence to active lifestyle behaviors, facilitating its translation to community settings. TRIAL REGISTRATION April 20, 2023 - NCT05860621. April 21, 2023 - https://doi.org/10.17605/OSF.IO/ZAQ9N April 27, 2023 - UMIN000050945.
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Affiliation(s)
- Eliana V Carraça
- Centro de Investigação Em Educação Física, Desporto, Saúde e Exercício (CIDEFES), Universidade Lusófona, Campo Grande 376, Lisboa, 1749-024, Portugal.
| | - Bruno Rodrigues
- CIAFEL, Faculdade de Desporto, Universidade do Porto, Porto, Portugal
- Programa Nacional Para a Promoção da Atividade Física, Direção-Geral Saúde, Portugal
| | - Sofia Franco
- Centro de Investigação Em Educação Física, Desporto, Saúde e Exercício (CIDEFES), Universidade Lusófona, Campo Grande 376, Lisboa, 1749-024, Portugal
| | - Inês Nobre
- Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada, Lisboa, Portugal
| | - Flávio Jerónimo
- Centro de Investigação Em Educação Física, Desporto, Saúde e Exercício (CIDEFES), Universidade Lusófona, Campo Grande 376, Lisboa, 1749-024, Portugal
| | - Vítor Ilharco
- Centro de Investigação Em Educação Física, Desporto, Saúde e Exercício (CIDEFES), Universidade Lusófona, Campo Grande 376, Lisboa, 1749-024, Portugal
| | - Fernanda Gabriel
- Centro Hospitalar Universitário Lisboa Norte - Hospital de Santa Maria, Lisboa, Portugal
| | - Leonor Ribeiro
- Centro Hospitalar Universitário Lisboa Norte - Hospital de Santa Maria, Lisboa, Portugal
| | - António L Palmeira
- Centro de Investigação Em Educação Física, Desporto, Saúde e Exercício (CIDEFES), Universidade Lusófona, Campo Grande 376, Lisboa, 1749-024, Portugal
| | - Marlene N Silva
- Centro de Investigação Em Educação Física, Desporto, Saúde e Exercício (CIDEFES), Universidade Lusófona, Campo Grande 376, Lisboa, 1749-024, Portugal
- Programa Nacional Para a Promoção da Atividade Física, Direção-Geral Saúde, Portugal
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Berni M, Mota J, Bressan D, Ribeiro L, Martins G, Pereira J, Ramos I, Nunes-da-Fonseca R, Araujo H. A pro-BMP function exerted by Rhodnius prolixus short gastrulation reveals great diversity in the role of BMP modulators during embryonic patterning. Open Biol 2023; 13:230023. [PMID: 37403495 DOI: 10.1098/rsob.230023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/06/2023] Open
Abstract
Dorsal-ventral (DV) patterning is regulated by the bone morphogenetic pathway (BMP) in Bilateria. In insect DV patterning, the Toll pathway also plays a role, in addition to BMPs. Variations in the relative importance of each pathway for DV patterning have been reported using single species of coleopteran, hymenopteran, hemipteran and orthopteran insects. To investigate if the molecular control of DV patterning is conserved inside an insect order, the emergent model hemiptera species Rhodnius prolixus was studied. We found that R. prolixus BMP pathway controls the entire DV axis, with a broader effect respective to Toll, as shown for the hemiptera Oncopeltus fasciatus. Different from O. fasciatus, the unique R. prolixus short gastrulation (sog) and the twisted gastrulation (tsg) orthologues do not antagonize, but rather favour embryonic BMP signalling. Our results reinforce the hypothesis that hemiptera rely preferentially on BMPs for DV patterning but that, surprisingly, in R. prolixus Sog and Tsg proteins exert only a positive role to establish a dorsal-to-ventral BMP gradient. Since sog has been reported to be lost from orthopteran and hymenopteran genomes, our results indicate that Sog's role to modify BMP activity varies greatly in different insect species.
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Affiliation(s)
- M Berni
- Institute for Biomedical Sciences, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Instituto Nacional de Ciência e Tecnologia em Entomologia Molecular, Brazil (INCT-EM)
| | - J Mota
- Institute for Biomedical Sciences, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Post-graduate Program in Morphological Sciences (PCM), Federal University of Rio de Janeiro
| | - D Bressan
- Institute for Biomedical Sciences, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - L Ribeiro
- Institute of Biodiversity and Sustainability (NUPEM), Federal University of Rio de Janeiro, Campus Macaé, Rio de Janeiro
| | - G Martins
- Institute for Biomedical Sciences, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Post-graduate Program in Morphological Sciences (PCM), Federal University of Rio de Janeiro
| | - J Pereira
- Institute for Medical Biochemistry, Federal University of Rio de Janeiro
| | - I Ramos
- Institute for Medical Biochemistry, Federal University of Rio de Janeiro
- Instituto Nacional de Ciência e Tecnologia em Entomologia Molecular, Brazil (INCT-EM)
| | - R Nunes-da-Fonseca
- Institute of Biodiversity and Sustainability (NUPEM), Federal University of Rio de Janeiro, Campus Macaé, Rio de Janeiro
- Instituto Nacional de Ciência e Tecnologia em Entomologia Molecular, Brazil (INCT-EM)
| | - H Araujo
- Institute for Biomedical Sciences, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Instituto Nacional de Ciência e Tecnologia em Entomologia Molecular, Brazil (INCT-EM)
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Calleris G, Marra G, Massari E, Benfant N, Rajwa P, Ahmed M, Abreu A, Cacciamani G, Ribeiro L, Westhofen T, Tourinho-Barbosa R, Raskin Y, Smith J, Van Der Poel H, Joniau S, Sanchez-Salas R, Kretschmer A, Cathcart P, Gill I, Karnes R, Tilki D, Shariat S, Touijer K, Gontero P. EAU patient selection criteria are predictors of metastasis-free survival in a large contemporary salvage radical prostatectomy patients cohort. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01157-0] [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: 02/12/2023]
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Joaquim A, Nobre AR, Araújo C, Vieira G, Alves P, Carinha P, Ribeiro L. A Collaborative Approach for the Development of a Standardized Set of Patient-Centered Outcomes in Head and Neck Cancers. ACTA MEDICA PORT 2023. [PMID: 36602411 DOI: 10.20344/amp.18180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 08/18/2022] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Head and neck cancers remain a significant health burden worldwide. Standardizing the care provided to these patients through the systematic measurement of established indicators is key to improve their outcomes. The aim of this study was to establish a relevant set of outcome indicators in this condition and identify measurement tools and requirements to do so. MATERIAL AND METHODS One scientific committee and two regional working groups worked in a stepwise manner to narrow down an initial list of potential outcome indicators retrieved from an exhaustive literature review to a smaller set of outcome indicators according to their clinical practice. This was assessed by one representative of a head and neck cancer patient association until a final set of indicators was reached. RESULTS A total of 164 outcome indicators comprising case-mix, outcomes, and adverse events dimensions were retrieved from the literature. These were reduced to a working set of 79 outcome indicators by the Scientific Committee and divided into seven categories including demographics, clinical status, tumor-related parameters, nutritional status, treatment, health and quality of life parameters and survival. Subsequently, these indicators were further reduced to a set of 50 indicators by the regional working groups and to a set of 49 indicators by the final Scientific Committee assessment. Finally, the discussed indicators were appraised by a head and neck cancer patient association, which added the 'rehabilitation' category, a key parameter to these patients. CONCLUSION An initial set of outcome indicators for head and neck cancer was systematically developed aiming to standardize the care provided to these patients across institutions at national level and identify measurement tools and requirements to measure those indicators. This standard set should be continuously improved and consistently adopted in the different clinical and national settings.
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Affiliation(s)
- Ana Joaquim
- Centro Hospitalar de Vila Nova de Gaia/Espinho. Vila Nova de Gaia. *Co-first author. Portugal
| | - Ana Rita Nobre
- Instituto Português de Oncologia de Coimbra Francisco Gentil. Lisboa. *Co-first author. Portugal
| | - Cláudia Araújo
- Instituto Português de Oncologia do Porto Francisco Gentil. Porto. *Co-first author. Portugal
| | - Guy Vieira
- Joaquim Chaves Saúde - Clínica de Radioncologia do Algarve. Faro. *Co-first author. Portugal
| | - Paula Alves
- Instituto Português de Oncologia do Porto Francisco Gentil. Porto. *Co-first author. Portugal
| | - Paulo Carinha
- Centro Hospitalar Universitário de São João. Porto. *Co-first author. Portugal
| | - Leonor Ribeiro
- Centro Hospitalar Universitário Lisboa Norte. Lisboa. *Co-first author. Portugal
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Melo-Alvim C, Neves ME, Santos JL, Abrunhosa-Branquinho AN, Barroso T, Costa L, Ribeiro L. Radiotherapy, Chemotherapy and Immunotherapy-Current Practice and Future Perspectives for Recurrent/Metastatic Oral Cavity Squamous Cell Carcinoma. Diagnostics (Basel) 2022; 13:99. [PMID: 36611391 PMCID: PMC9818309 DOI: 10.3390/diagnostics13010099] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/23/2022] [Accepted: 12/25/2022] [Indexed: 01/01/2023] Open
Abstract
Oral squamous cell carcinoma is the most common malignant epithelial neoplasm affecting the oral cavity. While surgical resection is the cornerstone of a multimodal curative approach, some tumors are deemed recurrent or metastatic (R/M) and often not suitable for curative surgery. This mainly occurs due to the extent of lesions or when surgery is expected to result in poor functional outcomes. Amongst the main non-surgical therapeutic options for oral squamous cell carcinoma are radiotherapy, chemotherapy, molecular targeted agents, and immunotherapy. Depending on the disease setting, these therapeutic approaches can be used isolated or in combination, with distinct efficacy and side effects. All these factors must be considered for treatment decisions within a multidisciplinary approach. The present article reviews the evidence regarding the treatment of patients with R/M oral squamous cell carcinoma. The main goal is to provide an overview of available treatment options and address future therapeutic perspectives.
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Affiliation(s)
- Cecília Melo-Alvim
- Department of Medical Oncology, Centro Hospitalar Universitário Lisboa Norte, 1649-028 Lisboa, Portugal
| | - Maria Eduarda Neves
- Department of Radiotherapy, Centro Hospitalar Universitário Lisboa Norte, 1649-028 Lisboa, Portugal
| | - Jorge Leitão Santos
- Department of Radiotherapy, Centro Hospitalar Universitário Lisboa Norte, 1649-028 Lisboa, Portugal
| | | | - Tiago Barroso
- Department of Medical Oncology, Centro Hospitalar Universitário Lisboa Norte, 1649-028 Lisboa, Portugal
| | - Luís Costa
- Department of Medical Oncology, Centro Hospitalar Universitário Lisboa Norte, 1649-028 Lisboa, Portugal
- Luís Costa Lab, Instituto de Medicina Molecular–João Lobo Antunes, Faculdade de Medicina de Lisboa, 1649-028 Lisboa, Portugal
| | - Leonor Ribeiro
- Department of Medical Oncology, Centro Hospitalar Universitário Lisboa Norte, 1649-028 Lisboa, Portugal
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Fontes-Sousa M, de Sousa L, Ribeiro L, Pinto Torres S, Alpuim Costa D, Gama Pinto C, Mestre L, Borralho P, Raimundo A, Negreiros I. HER2-low versus HER2-0 in Invasive Lobular Breast Carcinoma. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01585-4] [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: 11/21/2022]
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Hubner AM, Canisso IF, Peixoto PM, Coelho WM, Ribeiro L, Aldridge BM, Lima FS. A randomized controlled trial examining the effects of treatment with propylene glycol and injectable cyanocobalamin on naturally occurring disease, milk production, and reproductive outcomes of dairy cows diagnosed with concurrent hyperketonemia and hypoglycemia. J Dairy Sci 2022; 105:9070-9083. [PMID: 36114052 DOI: 10.3168/jds.2021-21328] [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: 09/22/2021] [Accepted: 06/19/2022] [Indexed: 11/19/2022]
Abstract
The objective of this study was to assess the effects of treatment with propylene glycol (PG) and cyanocobalamin (B12) on health, milk production, and reproductive outcomes of cows diagnosed with hyperketonemia (HK), hypoglycemia (HG), or concurrent HKHG. Glucose and β-hydroxybutyric acid (BHBA) concentrations were assessed in whole blood using a handheld device in lactating dairy cows (n = 2,418) between 3 and 9 d postpartum. Cows categorized as HK (n = 232, BHBA ≥1.2 mmol/L), HG (n = 161, glucose ≤2.2 mmol/L), and concurrent HKHG (n = 204, BHBA ≥1.2 mmol/L, and glucose ≤2.2 mmol/L) were randomized to receive treatment or to remain untreated (control). Treatment consisted of a single dose of B12 (10 mg, intramuscularly) and 300 mL of PG orally for 5 d, starting on the day of cow-side testing. Milk production, health, and reproductive outcomes were analyzed according to groups. Statistical analysis was carried out using SAS version 9.4 (SAS/STAT, SAS Institute Inc.). Treatment in HG cows decreased clinical ketosis, increased milk production in the fifth week of lactation for multiparous cows, and tended to increase 305-d mature-equivalent milk yield (305ME) for primiparous cows compared with untreated cows with the same metabolic profile. For cows with HKHG, treatment increased 305ME in multiparous cows and tended to increase 305ME in primiparous cows. No differences were found for treatment among any of the metabolic groups regarding reproductive outcomes, nor were any treatment effects found among HK cows. Glycemic status may help identify metabolically challenged early postpartum dairy cows, which may have differential response to PG and B12 treatment.
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Affiliation(s)
- A M Hubner
- Department of Veterinary Clinical Medicine, University of Illinois, Urbana 61802; Department of Comparative Biosciences, University of Illinois, Urbana 61802
| | - I F Canisso
- Department of Veterinary Clinical Medicine, University of Illinois, Urbana 61802; Department of Comparative Biosciences, University of Illinois, Urbana 61802.
| | - P M Peixoto
- Department of Veterinary Clinical Medicine, University of Illinois, Urbana 61802
| | - W M Coelho
- Department of Veterinary Clinical Medicine, University of Illinois, Urbana 61802
| | - L Ribeiro
- Department of Veterinary Clinical Medicine, University of Illinois, Urbana 61802
| | - B M Aldridge
- Department of Veterinary Clinical Medicine, University of Illinois, Urbana 61802
| | - F S Lima
- Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis 95616.
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Pinto L, Joaquim A, Dinis R, Amarelo A, Amorim A, Dias Â, Brandão D, Godinho J, Ribeiro L, Travado L, Brito M, Luis M, Brice M, Almeida S, Hussong Milagre T, Dionísio M, Domingues M, Rosa P, Santos R, Vieira C. Advanced breast cancer journey: a consensus guidance from a multidisciplinary panel for improving clinical practice in Portugal. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01537-4] [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: 11/19/2022]
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Abdo L, Barros L, Viegas M, Marques L, Ferreira P, Aragão E, Hadju K, Ribeiro L, Chicaybam L, Bonamino M. IMPROVEMENT CAR-T CELL THERAPY WITH ULTRA-FAST PROTOCOL AND IL-15 MEMBRANE BOUND ADDITION. Cytotherapy 2022. [DOI: 10.1016/s1465-3249(22)00844-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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12
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Hubner A, Canisso IF, Peixoto PM, Coelho WM, Ribeiro L, Aldridge BM, Menta P, Machado VS, Lima FS. Characterization of metabolic profile, health, milk production, and reproductive outcomes of dairy cows diagnosed with concurrent hyperketonemia and hypoglycemia. J Dairy Sci 2022; 105:9054-9069. [PMID: 36114055 DOI: 10.3168/jds.2021-21327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 06/19/2022] [Indexed: 11/19/2022]
Abstract
The objective of this prospective cohort study was to characterize the metabolic profile, health, milk production, and reproductive outcomes of cows diagnosed with hyperketonemia (HK; β-hydroxybutyrate ≥1.2 mmol/L), hypoglycemia (HG; glucose ≤2.2 mmol/L), or concurrent HK and HG (HKHG). Glucose and β-hydroxybutyrate concentrations in whole blood were assessed using a handheld device (Precision Xtra, Abbott Laboratories) in lactating dairy cows (n = 2,418) between 3 and 9 d postpartum. Cows were categorized into 4 groups: no HK or HG (healthy; Norm = 1,821), HK only (HK = 232), HG only (HG = 161), and concurrent HK and HG (HKHG = 204). Subsequent milk production, along with health and reproductive outcomes, as recorded by farm personnel, were analyzed according to metabolic category. Serum collected on the day of cow-side diagnosis of hyperketonemia and hypoglycemia was evaluated for total calcium (tCa), magnesium (Mg), nonesterified fatty acids (NEFA), triglycerides (TG), and urea using an automated chemistry analyzer (Randox Daytona; Randox Laboratories Ltd.). Statistical analysis was carried out using SAS version 9.4 (SAS Institute Inc.). Hyperketonemia in multiparous cows was associated with greater incidence of metabolic abnormalities (hypomagnesemia, hypocalcemia, and elevated NEFA and urea). Hyperketonemia in primiparous and multiparous cows led to increased adverse health events (culling rate, retained fetal membranes, puerperal metritis, clinical ketosis, left displaced abomasum) relative to Norm cows. Multiparous cows with HKHG had fewer metabolic disturbances (hypomagnesemia, hypocalcemia, elevated NEFA) than HK cows. Cows with HKHG had an increased incidence of clinical ketosis and left displaced abomasum relative to Norm cows. Cows with HG had similar metabolic profiles to Norm cows and had lower incidence of retained fetal membranes and puerperal metritis than cows with HK. Multiparous cows with HG produced more milk than Norm cows from wk 10 to 20, whereas multiparous cows with HK produced less milk than Norm cows. For primiparous cows, HK did not have a negative effect on milk production compared with Norm cows.
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Affiliation(s)
- A Hubner
- Department of Veterinary Clinical Medicine, University of Illinois, Urbana 61802; Department of Comparative Biosciences, University of Illinois, Urbana 61802
| | - I F Canisso
- Department of Veterinary Clinical Medicine, University of Illinois, Urbana 61802; Department of Comparative Biosciences, University of Illinois, Urbana 61802.
| | - P M Peixoto
- Department of Veterinary Clinical Medicine, University of Illinois, Urbana 61802
| | - W M Coelho
- Department of Veterinary Clinical Medicine, University of Illinois, Urbana 61802
| | - L Ribeiro
- Department of Veterinary Clinical Medicine, University of Illinois, Urbana 61802
| | - B M Aldridge
- Department of Veterinary Clinical Medicine, University of Illinois, Urbana 61802
| | - P Menta
- Department of Veterinary Science, College of Agricultural Sciences and Natural Resources, Texas Tech University, Lubbock 79409
| | - V S Machado
- Department of Veterinary Science, College of Agricultural Sciences and Natural Resources, Texas Tech University, Lubbock 79409
| | - F S Lima
- Department of Population Health and Reproduction, University of California, Davis 95616.
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13
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Proietti M, Romiti GF, Vitolo M, Harrison SL, Lane DA, Fauchier L, Marin F, Näbauer M, Potpara TS, Dan GA, Maggioni AP, Cesari M, Boriani G, Lip GYH, Ekmekçiu U, Paparisto V, Tase M, Gjergo H, Dragoti J, Goda A, Ciutea M, Ahadi N, el Husseini Z, Raepers M, Leroy J, Haushan P, Jourdan A, Lepiece C, Desteghe L, Vijgen J, Koopman P, Van Genechten G, Heidbuchel H, Boussy T, De Coninck M, Van Eeckhoutte H, Bouckaert N, Friart A, Boreux J, Arend C, Evrard P, Stefan L, Hoffer E, Herzet J, Massoz M, Celentano C, Sprynger M, Pierard L, Melon P, Van Hauwaert B, Kuppens C, Faes D, Van Lier D, Van Dorpe A, Gerardy A, Deceuninck O, Xhaet O, Dormal F, Ballant E, Blommaert D, Yakova D, Hristov M, Yncheva T, Stancheva N, Tisheva S, Tokmakova M, Nikolov F, Gencheva D, Shalganov T, Kunev B, Stoyanov M, Marchov D, Gelev V, Traykov V, Kisheva A, Tsvyatkov H, Shtereva R, Bakalska-Georgieva S, Slavcheva S, Yotov Y, Kubíčková M, Marni Joensen A, Gammelmark A, Hvilsted Rasmussen L, Dinesen P, Riahi S, Krogh Venø S, Sorensen B, Korsgaard A, Andersen K, Fragtrup Hellum C, Svenningsen A, Nyvad O, Wiggers P, May O, Aarup A, Graversen B, Jensen L, Andersen M, Svejgaard M, Vester S, Hansen S, Lynggaard V, Ciudad M, Vettus R, Muda P, Maestre A, Castaño S, Cheggour S, Poulard J, Mouquet V, Leparrée S, Bouet J, Taieb J, Doucy A, Duquenne H, Furber A, Dupuis J, Rautureau J, Font M, Damiano P, Lacrimini M, Abalea J, Boismal S, Menez T, Mansourati J, Range G, Gorka H, Laure C, Vassalière C, Elbaz N, Lellouche N, Djouadi K, Roubille F, Dietz D, Davy J, Granier M, Winum P, Leperchois-Jacquey C, Kassim H, Marijon E, Le Heuzey J, Fedida J, Maupain C, Himbert C, Gandjbakhch E, Hidden-Lucet F, Duthoit G, Badenco N, Chastre T, Waintraub X, Oudihat M, Lacoste J, Stephan C, Bader H, Delarche N, Giry L, Arnaud D, Lopez C, Boury F, Brunello I, Lefèvre M, Mingam R, Haissaguerre M, Le Bidan M, Pavin D, Le Moal V, Leclercq C, Piot O, Beitar T, Martel I, Schmid A, Sadki N, Romeyer-Bouchard C, Da Costa A, Arnault I, Boyer M, Piat C, Fauchier L, Lozance N, Nastevska S, Doneva A, Fortomaroska Milevska B, Sheshoski B, Petroska K, Taneska N, Bakrecheski N, Lazarovska K, Jovevska S, Ristovski V, Antovski A, Lazarova E, Kotlar I, Taleski J, Poposka L, Kedev S, Zlatanovik N, Jordanova S, Bajraktarova Proseva T, Doncovska S, Maisuradze D, Esakia A, Sagirashvili E, Lartsuliani K, Natelashvili N, Gumberidze N, Gvenetadze R, Etsadashvili K, Gotonelia N, Kuridze N, Papiashvili G, Menabde I, Glöggler S, Napp A, Lebherz C, Romero H, Schmitz K, Berger M, Zink M, Köster S, Sachse J, Vonderhagen E, Soiron G, Mischke K, Reith R, Schneider M, Rieker W, Boscher D, Taschareck A, Beer A, Oster D, Ritter O, Adamczewski J, Walter S, Frommhold A, Luckner E, Richter J, Schellner M, Landgraf S, Bartholome S, Naumann R, Schoeler J, Westermeier D, William F, Wilhelm K, Maerkl M, Oekinghaus R, Denart M, Kriete M, Tebbe U, Scheibner T, Gruber M, Gerlach A, Beckendorf C, Anneken L, Arnold M, Lengerer S, Bal Z, Uecker C, Förtsch H, Fechner S, Mages V, Martens E, Methe H, Schmidt T, Schaeffer B, Hoffmann B, Moser J, Heitmann K, Willems S, Willems S, Klaus C, Lange I, Durak M, Esen E, Mibach F, Mibach H, Utech A, Gabelmann M, Stumm R, Ländle V, Gartner C, Goerg C, Kaul N, Messer S, Burkhardt D, Sander C, Orthen R, Kaes S, Baumer A, Dodos F, Barth A, Schaeffer G, Gaertner J, Winkler J, Fahrig A, Aring J, Wenzel I, Steiner S, Kliesch A, Kratz E, Winter K, Schneider P, Haag A, Mutscher I, Bosch R, Taggeselle J, Meixner S, Schnabel A, Shamalla A, Hötz H, Korinth A, Rheinert C, Mehltretter G, Schön B, Schön N, Starflinger A, Englmann E, Baytok G, Laschinger T, Ritscher G, Gerth A, Dechering D, Eckardt L, Kuhlmann M, Proskynitopoulos N, Brunn J, Foth K, Axthelm C, Hohensee H, Eberhard K, Turbanisch S, Hassler N, Koestler A, Stenzel G, Kschiwan D, Schwefer M, Neiner S, Hettwer S, Haeussler-Schuchardt M, Degenhardt R, Sennhenn S, Steiner S, Brendel M, Stoehr A, Widjaja W, Loehndorf S, Logemann A, Hoskamp J, Grundt J, Block M, Ulrych R, Reithmeier A, Panagopoulos V, Martignani C, Bernucci D, Fantecchi E, Diemberger I, Ziacchi M, Biffi M, Cimaglia P, Frisoni J, Boriani G, Giannini I, Boni S, Fumagalli S, Pupo S, Di Chiara A, Mirone P, Fantecchi E, Boriani G, Pesce F, Zoccali C, Malavasi VL, Mussagaliyeva A, Ahyt B, Salihova Z, Koshum-Bayeva K, Kerimkulova A, Bairamukova A, Mirrakhimov E, Lurina B, Zuzans R, Jegere S, Mintale I, Kupics K, Jubele K, Erglis A, Kalejs O, Vanhear K, Burg M, Cachia M, Abela E, Warwicker S, Tabone T, Xuereb R, Asanovic D, Drakalovic D, Vukmirovic M, Pavlovic N, Music L, Bulatovic N, Boskovic A, Uiterwaal H, Bijsterveld N, De Groot J, Neefs J, van den Berg N, Piersma F, Wilde A, Hagens V, Van Es J, Van Opstal J, Van Rennes B, Verheij H, Breukers W, Tjeerdsma G, Nijmeijer R, Wegink D, Binnema R, Said S, Erküner Ö, Philippens S, van Doorn W, Crijns H, Szili-Torok T, Bhagwandien R, Janse P, Muskens A, van Eck M, Gevers R, van der Ven N, Duygun A, Rahel B, Meeder J, Vold A, Holst Hansen C, Engset I, Atar D, Dyduch-Fejklowicz B, Koba E, Cichocka M, Sokal A, Kubicius A, Pruchniewicz E, Kowalik-Sztylc A, Czapla W, Mróz I, Kozlowski M, Pawlowski T, Tendera M, Winiarska-Filipek A, Fidyk A, Slowikowski A, Haberka M, Lachor-Broda M, Biedron M, Gasior Z, Kołodziej M, Janion M, Gorczyca-Michta I, Wozakowska-Kaplon B, Stasiak M, Jakubowski P, Ciurus T, Drozdz J, Simiera M, Zajac P, Wcislo T, Zycinski P, Kasprzak J, Olejnik A, Harc-Dyl E, Miarka J, Pasieka M, Ziemińska-Łuć M, Bujak W, Śliwiński A, Grech A, Morka J, Petrykowska K, Prasał M, Hordyński G, Feusette P, Lipski P, Wester A, Streb W, Romanek J, Woźniak P, Chlebuś M, Szafarz P, Stanik W, Zakrzewski M, Kaźmierczak J, Przybylska A, Skorek E, Błaszczyk H, Stępień M, Szabowski S, Krysiak W, Szymańska M, Karasiński J, Blicharz J, Skura M, Hałas K, Michalczyk L, Orski Z, Krzyżanowski K, Skrobowski A, Zieliński L, Tomaszewska-Kiecana M, Dłużniewski M, Kiliszek M, Peller M, Budnik M, Balsam P, Opolski G, Tymińska A, Ozierański K, Wancerz A, Borowiec A, Majos E, Dabrowski R, Szwed H, Musialik-Lydka A, Leopold-Jadczyk A, Jedrzejczyk-Patej E, Koziel M, Lenarczyk R, Mazurek M, Kalarus Z, Krzemien-Wolska K, Starosta P, Nowalany-Kozielska E, Orzechowska A, Szpot M, Staszel M, Almeida S, Pereira H, Brandão Alves L, Miranda R, Ribeiro L, Costa F, Morgado F, Carmo P, Galvao Santos P, Bernardo R, Adragão P, Ferreira da Silva G, Peres M, Alves M, Leal M, Cordeiro A, Magalhães P, Fontes P, Leão S, Delgado A, Costa A, Marmelo B, Rodrigues B, Moreira D, Santos J, Santos L, Terchet A, Darabantiu D, Mercea S, Turcin Halka V, Pop Moldovan A, Gabor A, Doka B, Catanescu G, Rus H, Oboroceanu L, Bobescu E, Popescu R, Dan A, Buzea A, Daha I, Dan G, Neuhoff I, Baluta M, Ploesteanu R, Dumitrache N, Vintila M, Daraban A, Japie C, Badila E, Tewelde H, Hostiuc M, Frunza S, Tintea E, Bartos D, Ciobanu A, Popescu I, Toma N, Gherghinescu C, Cretu D, Patrascu N, Stoicescu C, Udroiu C, Bicescu G, Vintila V, Vinereanu D, Cinteza M, Rimbas R, Grecu M, Cozma A, Boros F, Ille M, Tica O, Tor R, Corina A, Jeewooth A, Maria B, Georgiana C, Natalia C, Alin D, Dinu-Andrei D, Livia M, Daniela R, Larisa R, Umaar S, Tamara T, Ioachim Popescu M, Nistor D, Sus I, Coborosanu O, Alina-Ramona N, Dan R, Petrescu L, Ionescu G, Popescu I, Vacarescu C, Goanta E, Mangea M, Ionac A, Mornos C, Cozma D, Pescariu S, Solodovnicova E, Soldatova I, Shutova J, Tjuleneva L, Zubova T, Uskov V, Obukhov D, Rusanova G, Soldatova I, Isakova N, Odinsova S, Arhipova T, Kazakevich E, Serdechnaya E, Zavyalova O, Novikova T, Riabaia I, Zhigalov S, Drozdova E, Luchkina I, Monogarova Y, Hegya D, Rodionova L, Rodionova L, Nevzorova V, Soldatova I, Lusanova O, Arandjelovic A, Toncev D, Milanov M, Sekularac N, Zdravkovic M, Hinic S, Dimkovic S, Acimovic T, Saric J, Polovina M, Potpara T, Vujisic-Tesic B, Nedeljkovic M, Zlatar M, Asanin M, Vasic V, Popovic Z, Djikic D, Sipic M, Peric V, Dejanovic B, Milosevic N, Stevanovic A, Andric A, Pencic B, Pavlovic-Kleut M, Celic V, Pavlovic M, Petrovic M, Vuleta M, Petrovic N, Simovic S, Savovic Z, Milanov S, Davidovic G, Iric-Cupic V, Simonovic D, Stojanovic M, Stojanovic S, Mitic V, Ilic V, Petrovic D, Deljanin Ilic M, Ilic S, Stoickov V, Markovic S, Kovacevic S, García Fernandez A, Perez Cabeza A, Anguita M, Tercedor Sanchez L, Mau E, Loayssa J, Ayarra M, Carpintero M, Roldán Rabadan I, Leal M, Gil Ortega M, Tello Montoliu A, Orenes Piñero E, Manzano Fernández S, Marín F, Romero Aniorte A, Veliz Martínez A, Quintana Giner M, Ballesteros G, Palacio M, Alcalde O, García-Bolao I, Bertomeu Gonzalez V, Otero-Raviña F, García Seara J, Gonzalez Juanatey J, Dayal N, Maziarski P, Gentil-Baron P, Shah D, Koç M, Onrat E, Dural IE, Yilmaz K, Özin B, Tan Kurklu S, Atmaca Y, Canpolat U, Tokgozoglu L, Dolu AK, Demirtas B, Sahin D, Ozcan Celebi O, Diker E, Gagirci G, Turk UO, Ari H, Polat N, Toprak N, Sucu M, Akin Serdar O, Taha Alper A, Kepez A, Yuksel Y, Uzunselvi A, Yuksel S, Sahin M, Kayapinar O, Ozcan T, Kaya H, Yilmaz MB, Kutlu M, Demir M, Gibbs C, Kaminskiene S, Bryce M, Skinner A, Belcher G, Hunt J, Stancombe L, Holbrook B, Peters C, Tettersell S, Shantsila A, Lane D, Senoo K, Proietti M, Russell K, Domingos P, Hussain S, Partridge J, Haynes R, Bahadur S, Brown R, McMahon S, Y H Lip G, McDonald J, Balachandran K, Singh R, Garg S, Desai H, Davies K, Goddard W, Galasko G, Rahman I, Chua Y, Payne O, Preston S, Brennan O, Pedley L, Whiteside C, Dickinson C, Brown J, Jones K, Benham L, Brady R, Buchanan L, Ashton A, Crowther H, Fairlamb H, Thornthwaite S, Relph C, McSkeane A, Poultney U, Kelsall N, Rice P, Wilson T, Wrigley M, Kaba R, Patel T, Young E, Law J, Runnett C, Thomas H, McKie H, Fuller J, Pick S, Sharp A, Hunt A, Thorpe K, Hardman C, Cusack E, Adams L, Hough M, Keenan S, Bowring A, Watts J, Zaman J, Goffin K, Nutt H, Beerachee Y, Featherstone J, Mills C, Pearson J, Stephenson L, Grant S, Wilson A, Hawksworth C, Alam I, Robinson M, Ryan S, Egdell R, Gibson E, Holland M, Leonard D, Mishra B, Ahmad S, Randall H, Hill J, Reid L, George M, McKinley S, Brockway L, Milligan W, Sobolewska J, Muir J, Tuckis L, Winstanley L, Jacob P, Kaye S, Morby L, Jan A, Sewell T, Boos C, Wadams B, Cope C, Jefferey P, Andrews N, Getty A, Suttling A, Turner C, Hudson K, Austin R, Howe S, Iqbal R, Gandhi N, Brophy K, Mirza P, Willard E, Collins S, Ndlovu N, Subkovas E, Karthikeyan V, Waggett L, Wood A, Bolger A, Stockport J, Evans L, Harman E, Starling J, Williams L, Saul V, Sinha M, Bell L, Tudgay S, Kemp S, Brown J, Frost L, Ingram T, Loughlin A, Adams C, Adams M, Hurford F, Owen C, Miller C, Donaldson D, Tivenan H, Button H, Nasser A, Jhagra O, Stidolph B, Brown C, Livingstone C, Duffy M, Madgwick P, Roberts P, Greenwood E, Fletcher L, Beveridge M, Earles S, McKenzie D, Beacock D, Dayer M, Seddon M, Greenwell D, Luxton F, Venn F, Mills H, Rewbury J, James K, Roberts K, Tonks L, Felmeden D, Taggu W, Summerhayes A, Hughes D, Sutton J, Felmeden L, Khan M, Walker E, Norris L, O’Donohoe L, Mozid A, Dymond H, Lloyd-Jones H, Saunders G, Simmons D, Coles D, Cotterill D, Beech S, Kidd S, Wrigley B, Petkar S, Smallwood A, Jones R, Radford E, Milgate S, Metherell S, Cottam V, Buckley C, Broadley A, Wood D, Allison J, Rennie K, Balian L, Howard L, Pippard L, Board S, Pitt-Kerby T. Epidemiology and impact of frailty in patients with atrial fibrillation in Europe. Age Ageing 2022; 51:6670566. [PMID: 35997262 DOI: 10.1093/ageing/afac192] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [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: 03/17/2022] [Revised: 06/08/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Frailty is a medical syndrome characterised by reduced physiological reserve and increased vulnerability to stressors. Data regarding the relationship between frailty and atrial fibrillation (AF) are still inconsistent. OBJECTIVES We aim to perform a comprehensive evaluation of frailty in a large European cohort of AF patients. METHODS A 40-item frailty index (FI) was built according to the accumulation of deficits model in the AF patients enrolled in the ESC-EHRA EORP-AF General Long-Term Registry. Association of baseline characteristics, clinical management, quality of life, healthcare resources use and risk of outcomes with frailty was examined. RESULTS Among 10,177 patients [mean age (standard deviation) 69.0 (11.4) years, 4,103 (40.3%) females], 6,066 (59.6%) were pre-frail and 2,172 (21.3%) were frail, whereas only 1,939 (19.1%) were considered robust. Baseline thromboembolic and bleeding risks were independently associated with increasing FI. Frail patients with AF were less likely to be treated with oral anticoagulants (OACs) (odds ratio 0.70, 95% confidence interval 0.55-0.89), especially with non-vitamin K antagonist OACs and managed with a rhythm control strategy, compared with robust patients. Increasing frailty was associated with a higher risk for all outcomes examined, with a non-linear exponential relationship. The use of OAC was associated with a lower risk of outcomes, except in patients with very/extremely high frailty. CONCLUSIONS In this large cohort of AF patients, there was a high burden of frailty, influencing clinical management and risk of adverse outcomes. The clinical benefit of OAC is maintained in patients with high frailty, but not in very high/extremely frail ones.
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Affiliation(s)
- Marco Proietti
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
| | - Giulio Francesco Romiti
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Department of Translational and Precision Medicine, Sapienza - University of Rome, Italy
| | - Marco Vitolo
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy.,Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Stephanie L Harrison
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK
| | - Deirdre A Lane
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Laurent Fauchier
- Service de Cardiologie, Centre Hospitalier Universitaire Trousseau, Tours, France
| | - Francisco Marin
- Department of Cardiology, Hospital Universitario Virgen de la Arrixaca, IMIB-Arrixaca, University of Murcia, CIBER-CV, Murcia, Spain
| | - Michael Näbauer
- Department of Cardiology, Ludwig-Maximilians-University, Munich, Germany
| | - Tatjana S Potpara
- School of Medicine, University of Belgrade, Belgrade, Serbia.,Clinical Center of Serbia, Belgrade, Serbia
| | - Gheorghe-Andrei Dan
- University of Medicine, 'Carol Davila', Colentina University Hospital, Bucharest, Romania
| | - Aldo P Maggioni
- ANMCO Research Center, Heart Care Foundation, Florence, Italy
| | - Matteo Cesari
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
| | - Giuseppe Boriani
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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Barbosa P, Remelhe M, Venâncio Â, Ribeiro L. Clozapine and myopathic dysfunction: is creatinine kinase an important parameter to measure? Eur Psychiatry 2022. [PMCID: PMC9567851 DOI: 10.1192/j.eurpsy.2022.2292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction
There have been reports of myopathic dysfunction with creatinine kinase (CK) elevation associated with neuroleptics, particularly, in clozapine-treated patients. The patients in these reports did not have any other clinical symptoms or signs indicative of neuropleptic malignant syndrome. Myopathic dysfunction was supported by the presence of CK elevations and either proximal limb weakness or fatigue, characteristic electrophysiologic abnormalities, or both. It has also been reported that CK elevation is neither dose nor treatment-duration dependent. The underlying mechanism is still unknown although it has been postulated that it is associated with cytochrome P450 interactions and/or calmodulin antagonism.
Objectives
To report a case of elevation of CK during treatment with clozapine.
Methods
The authors report a case of elevation of CK during treatment with clozapine. A non-systematic review was conducted by searching the PubMed database, using the terms “clozapine”, “myotoxicity”.
Results
A 36-year-old man was admitted after abandoning treatment with clozapine. During the titration of the medication, he developed complaints of muscle fatigue in conjunction with an elevation of CK. CK levels normalized after intravenous hydration and with dose reduction. Furthermore, CK levels would increase with clozapine re-titration.
Conclusions
Clozapine has numerous side effects. Myopathic dysfunction with CK elevation is a possible side effect which could have serious consequences such as renal impairment. In such cases, appropriate treatment should be implemented. Therefore, clinicians should be aware of this potential side effect.
Disclosure
No significant relationships.
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Rodrigues J, Nombora O, Ribeiro L. Therapeutic potential of serotoninergic psychedelic substances in the treatment of Obsessive Compulsive Disorder. Eur Psychiatry 2022. [PMCID: PMC9567436 DOI: 10.1192/j.eurpsy.2022.1659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Obsessive Compulsive Disorder (OCD) is a psychiatric disorder associated with suffering and disability. The serotoninergic system is implicated in the neurobiological processes of OCD and serotonin reuptake inhibitors (SRIs) are the first-line treatment. However, clinical improvement after starting SRIs can take long and patients may not fully recover. Meanwhile, recent data suggests that activation of 5-HT receptors may exert a therapeutic action in obsessional symptoms. Some psychedelics are strong 5-HT2 receptor agonists and there is a growing research interest as they can be a promising therapeutic approach to OCD. Objectives We aim to provide an overview on the current evidence on the therapeutic potential of serotoninergic psychoactive substances in the treatment of OCD. Methods Non-systematic review. Literature search in the PubMed database using the terms psychedelics and obsessive-compulsive disorder. Results Although research is currently limited to a few small studies, the ones conducted so far showed clinically meaningful acute reduction of OCD symptoms after treatment with serotoninergic psychoactive drugs, as well as possible longer-lasting benefits, particularly with psilocybin and lysergic acid diethylamide (LSD). Furthermore, substance-assisted psychotherapy with psychedelics has been showing promising results, being suitable for OCD treatment. It is important to add that, to date, studies have indicated relatively good tolerability to these drugs. Conclusions These promising early findings highlight the role of psychedelics in OCD treatment and the need for further research into efficacy, therapeutic mechanisms and safety, in order to determine whether these drugs may be worthy options for OCD treatment in the future. Disclosure No significant relationships.
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Hubner A, Canisso I, Peixoto P, Coelho W, Cunha L, Ribeiro L, Crump S, Lima F. Effect of nerve growth factor-β administered at insemination for lactating Holstein dairy cows bred after timed-artificial insemination protocol. J Dairy Sci 2022; 105:6353-6363. [DOI: 10.3168/jds.2022-21874] [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] [Received: 01/26/2022] [Accepted: 03/24/2022] [Indexed: 11/19/2022]
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Monteiro M, Perdiguero P, Couto A, Serra CR, Pereiro P, Novoa B, Figueras A, Ribeiro L, Pousão-Ferreira P, Tafalla C, Oliva-Teles A, Enes P, Secombes CJ, Díaz-Rosales P. Comprehensive transcriptome profiling and functional analysis of the meagre (Argyrosomus regius) immune system. Fish Shellfish Immunol 2022; 123:506-520. [PMID: 35351613 DOI: 10.1016/j.fsi.2022.03.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 03/21/2022] [Accepted: 03/22/2022] [Indexed: 06/14/2023]
Abstract
Meagre (Argyrosomus regius) belongs to the family Sciaenidae and is a promising candidate for Mediterranean aquaculture diversification. As a relatively recent species in aquaculture, the physiological consequences of the immune system activation in meagre are understudied. Spleen, as a primary lymphoid organ has an essential role in meagre immune and inflammatory responses. In this study, we have evaluated the in vivo effects of lipopolysaccharide (LPS) on the spleen transcriptome of meagre by RNA-seq analysis at 4 and 24 h after injection.
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Affiliation(s)
- M Monteiro
- Centro Interdisciplinar de Investigação Marinha e Ambiental (CIIMAR), Universidade do Porto, Terminal de Cruzeiros do Porto de Leixões, Av. General Norton de Matos s/n, 4450-208, Matosinhos, Portugal; Departamento de Biologia, Faculdade de Ciências, Universidade do Porto, Rua do Campo Alegre, Edifício FC4, 4169-007, Porto, Portugal.
| | - P Perdiguero
- Inmunología y Patología de Peces, Centro de Investigación en Sanidad Animal (CISA, INIA-CSIC), Carretera de Algete a El Casar s/n, 28130 Valdeolmos-Alalpardo, Madrid, Spain; Departamento de Genética, Fisiología y Microbiología. Universidad Complutense de Madrid, Ciudad universitaria s/n, 28040, Madrid, Spain
| | - A Couto
- Centro Interdisciplinar de Investigação Marinha e Ambiental (CIIMAR), Universidade do Porto, Terminal de Cruzeiros do Porto de Leixões, Av. General Norton de Matos s/n, 4450-208, Matosinhos, Portugal; Departamento de Biologia, Faculdade de Ciências, Universidade do Porto, Rua do Campo Alegre, Edifício FC4, 4169-007, Porto, Portugal
| | - C R Serra
- Centro Interdisciplinar de Investigação Marinha e Ambiental (CIIMAR), Universidade do Porto, Terminal de Cruzeiros do Porto de Leixões, Av. General Norton de Matos s/n, 4450-208, Matosinhos, Portugal; Departamento de Biologia, Faculdade de Ciências, Universidade do Porto, Rua do Campo Alegre, Edifício FC4, 4169-007, Porto, Portugal
| | - P Pereiro
- Inmunología y Genómica, Instituto de Investigaciones Marinas (IIM), Consejo Superior de Investigaciones Científicas (CSIC), Eduardo Cabello, 6, 36208, Vigo, Spain
| | - B Novoa
- Inmunología y Genómica, Instituto de Investigaciones Marinas (IIM), Consejo Superior de Investigaciones Científicas (CSIC), Eduardo Cabello, 6, 36208, Vigo, Spain
| | - A Figueras
- Inmunología y Genómica, Instituto de Investigaciones Marinas (IIM), Consejo Superior de Investigaciones Científicas (CSIC), Eduardo Cabello, 6, 36208, Vigo, Spain
| | - L Ribeiro
- IPMA - Portuguese Institute for Sea and Atmosphere / EPPO - Aquaculture Research Station, Av. Parque Natural da Ria Formosa, s/n 8700-194 Olhão, Portugal
| | - P Pousão-Ferreira
- IPMA - Portuguese Institute for Sea and Atmosphere / EPPO - Aquaculture Research Station, Av. Parque Natural da Ria Formosa, s/n 8700-194 Olhão, Portugal
| | - C Tafalla
- Inmunología y Patología de Peces, Centro de Investigación en Sanidad Animal (CISA, INIA-CSIC), Carretera de Algete a El Casar s/n, 28130 Valdeolmos-Alalpardo, Madrid, Spain
| | - A Oliva-Teles
- Centro Interdisciplinar de Investigação Marinha e Ambiental (CIIMAR), Universidade do Porto, Terminal de Cruzeiros do Porto de Leixões, Av. General Norton de Matos s/n, 4450-208, Matosinhos, Portugal; Departamento de Biologia, Faculdade de Ciências, Universidade do Porto, Rua do Campo Alegre, Edifício FC4, 4169-007, Porto, Portugal
| | - P Enes
- Centro Interdisciplinar de Investigação Marinha e Ambiental (CIIMAR), Universidade do Porto, Terminal de Cruzeiros do Porto de Leixões, Av. General Norton de Matos s/n, 4450-208, Matosinhos, Portugal; Departamento de Biologia, Faculdade de Ciências, Universidade do Porto, Rua do Campo Alegre, Edifício FC4, 4169-007, Porto, Portugal
| | - C J Secombes
- Scottish Fish Immunology Research Centre, University of Aberdeen, Zoology Building, Tillydrone Avenue, AB24 2TZ Aberdeen, UK
| | - P Díaz-Rosales
- Centro Interdisciplinar de Investigação Marinha e Ambiental (CIIMAR), Universidade do Porto, Terminal de Cruzeiros do Porto de Leixões, Av. General Norton de Matos s/n, 4450-208, Matosinhos, Portugal; Inmunología y Patología de Peces, Centro de Investigación en Sanidad Animal (CISA, INIA-CSIC), Carretera de Algete a El Casar s/n, 28130 Valdeolmos-Alalpardo, Madrid, Spain.
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Ribeiro L, Silva O, Duarte F, Jesus V. Investigation of Tritrichomonas foetus in cryopreserved bovine semen by culture and polymerase chain reaction. ARQ BRAS MED VET ZOO 2021. [DOI: 10.1590/1678-4162-12370] [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: 11/21/2022] Open
Abstract
ABSTRACT Bovine Trichomoniasis (BT) is an infectious disease caused by Tritrichomonas foetus that can be transmitted either sexually or by fomites. In males, the disease is asymptomatic and permanent. T. foetus has been detected in semen samples where it is able to remain viable even when frozen. The objective of this study was to investigate the presence of T. foetus in 27 samples of commercial frozen bovine semen by culture and Polymerase Chain Reaction (PCR). Samples were thawed in water at 37°C. Part of the samples was inoculated in a test tube containing Diamond’s medium and incubated at 35°C. Growth was evaluated every 24 hours via direct examination under a microscope. The other part was placed in an Eppendorf tube and frozen for later molecular analysis. After 10 days of culture, all samples were negative for T. foetus. The Quick-DNA Miniprep Kit (Zymo Research) without proteinase K was used for DNA extraction. The primers used in PCR were TRF3 and TRF4. PCR results were negative for all samples. In conclusion, bovine semen samples were negative for T. foetus in both diagnostic methods, according to the adopted methodology.
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Affiliation(s)
- L. Ribeiro
- Universidade Federal Rural do Rio de Janeiro, Brazil
| | - O.R. Silva
- Universidade Federal Rural do Rio de Janeiro, Brazil
| | | | - V.L.T. Jesus
- Universidade Federal Rural do Rio de Janeiro, Brazil
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O'Shaughnessy J, Sousa S, Cruz J, Fallowfield L, Auvinen P, Pulido C, Cvetanovic A, Wilks S, Ribeiro L, Burotto M, Klingbiel D, Messeri D, Alexandrou A, Trask P, Fredriksson J, Machackova Z, Stamatovic L. Preference for the fixed-dose combination of pertuzumab and trastuzumab for subcutaneous injection in patients with HER2-positive early breast cancer (PHranceSCa): A randomised, open-label phase II study. Eur J Cancer 2021; 152:223-232. [PMID: 34147014 DOI: 10.1016/j.ejca.2021.03.047] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 03/04/2021] [Accepted: 03/16/2021] [Indexed: 10/21/2022]
Abstract
AIM The aim of the study was to assess patient preference for the fixed-dose combination of pertuzumab and trastuzumab for subcutaneous injection (PH FDC SC) in patients with HER2-positive early breast cancer in PHranceSCa (NCT03674112). MATERIALS AND METHODS Patients who completed neoadjuvant P + H + chemotherapy + surgery were randomised 1:1 to three intravenous (IV) P + H cycles followed by three cycles of PH FDC SC or vice versa (crossover) and then chose subcutaneous (SC) injection or IV infusion to continue up to 18 cycles (continuation). Assessments were via patient and healthcare professional (HCP) questionnaires. RESULTS One hundred and sixty patients were randomised (cut-off: 24 February 2020); 136 (85.0%, 95% confidence interval: 78.5-90.2%) preferred SC; 22 (13.8%) preferred IV; 2 (1.3%) had no preference. The main reasons for SC preference were reduced clinic time (n = 119) and comfort during administration (n = 73). One hundred and forty-one patients (88.1%) were very satisfied/satisfied with SC injection versus 108 (67.5%) with IV infusion; 86.9% chose PH FDC SC continuation. HCP perceptions of median patient treatment room time ranged from 33.0-50.0 min with SC and 130.0-300.0 min with IV. Most adverse events (AEs) were grade 1/2 (no 4/5s); serious AE rates were low. AE rates before and after switching were similar (cycles 1-3 IV → cycles 4-6 SC: 77.5% → 72.5%; cycles 1-3 SC → cycles 4-6 IV: 77.5% → 63.8%). CONCLUSION Most patients strongly preferred PH FDC SC over P + H IV. PH FDC SC was generally well tolerated, with no new safety signals (even when switching), and offers a quicker alternative to IV infusion.
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Affiliation(s)
- Joyce O'Shaughnessy
- Baylor University Medical Center, Texas Oncology, US Oncology, 3410 Worth Street, Suite 400, Dallas, TX 75246, USA.
| | - Susana Sousa
- Department of Medical Oncology, Portuguese Oncology Institute of Porto, Porto, Portugal.
| | - Josefina Cruz
- Department of Medical Oncology, Hospital Universitario de Canarias, La Laguna, S/C Tenerife, Spain.
| | - Lesley Fallowfield
- Sussex Health Outcomes Research & Education in Cancer (SHORE-C), Brighton & Sussex Medical School, University of Sussex, Falmer, Brighton, BN1 9RR, UK.
| | - Päivi Auvinen
- Cancer Center, Kuopio University Hospital, Kuopio, Finland.
| | - Catarina Pulido
- Hospital da Luz Lisboa, Avenida Lusíada, 100, 1500-650, Lisbon, Portugal.
| | - Ana Cvetanovic
- Department of Medical Oncology, Medical Faculty Nis and Clinical Centre Nis, Bul.dr Zorana Djindjica 48, 18000, Nis, Serbia.
| | - Sharon Wilks
- Texas Oncology SA, Hematology/Medical Oncology, 2130 NE Loop 410 Suite 100, San Antonio, TX 78217, USA.
| | - Leonor Ribeiro
- Centro Hospitalar Universitário Lisboa Norte, Av. Prof. Egas Moniz, 1649-028, Lisbon, Portugal.
| | | | - Dirk Klingbiel
- Pharma Development Biometrics, Biostatistics, F. Hoffmann-La Roche Ltd, Hochstrasse 16, CH-4053 Basel, Switzerland.
| | - Dimitri Messeri
- PDG Clinical Operations Oncology, F. Hoffmann-La Roche Ltd, Hochstrasse 16, CH-4053 Basel, Switzerland.
| | - Ari Alexandrou
- Portfolio Clinical Safety, Product Development Safety, Roche Products Limited, Hexagon Place, 6 Falcon Way, Shire Park, Welwyn Garden City, AL7 1TW, UK.
| | - Peter Trask
- Patient Centered Outcomes Research, Oncology, Genentech, Inc., 1 DNA Way, South San Francisco, CA 94080, USA.
| | - Judy Fredriksson
- Global Product Development/Medical Affairs Oncology, F. Hoffmann-La Roche Ltd, Grenzacherstrasse 124, 4070 Basel, Switzerland.
| | - Zuzana Machackova
- Global Product Development/Medical Affairs Oncology, F. Hoffmann-La Roche Ltd, Grenzacherstrasse 124, 4070 Basel, Switzerland.
| | - Ljiljana Stamatovic
- Clinic for Medical Oncology, Institute for Oncology and Radiology of Serbia, Pasterova 14, 11000, Belgrade, Serbia.
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Ribeiro L, Bezerra A, Gervais C, Bernard S, Machado R, Motz G. The influence of pyrolysis temperature on the oxidation resistance of carbon-rich SiCN ceramics derived from reaction of silazanes with acrylonitrile. Ann Ital Chir 2021. [DOI: 10.1016/j.jeurceramsoc.2021.01.042] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Dias de Castro E, Barbosa J, Mesquita AM, Caires A, Ribeiro L, R Cernadas J, Baiardini I. Drug Hypersensitivity Quality of Life Questionnaire: validation procedures and first results of the Portuguese version. Health Qual Life Outcomes 2021; 19:143. [PMID: 33971887 PMCID: PMC8108344 DOI: 10.1186/s12955-021-01749-1] [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: 11/26/2020] [Accepted: 03/17/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hypersensitivity reactions to drugs are unpredictable and can be very complex and severe, even life threatening. Assess its impact on patient's health related quality of life (HRQoL) is crucial. The Drug Hypersensitivity Quality of Life Questionnaire (DrHy-Q) is the only validated disease-specific HRQoL questionnaire. We aimed to translate and cross-cultural validate the DrHy-Q to the Portuguese population. It was also our purpose to determine the impact of drug hypersensitivity on patients' HRQoL. METHODS The translation and cross-cultural adaptation of the DrHy-Q to Portuguese was performed according to standards. Reliability of the DrHy-Q Portuguese version was assessed in terms of internal consistency and test-retest reliability. Structural validity, divergent validity (with a generic health related QoLQ-PGWBI) and discriminant validity were also evaluated. Forty patients accepted to participate in the validation phase. The Portuguese version of the DrHy-Q was applied to 260 consecutively adult patients, studied in our Department for suspected drug hypersensitivity. RESULTS The Portuguese DrHy-Q showed adequate internal consistency (Cronbach's ɑ = 0.938), good test-retest reliability [ICC = 0.713 (95% CI 0.488-0.850] and one-dimensional structure. No significant correlation was found between the DrHy-Q and the PGWBI total scores (r = - 0.010, p = 0.957). Two hundred of patients completed the study: 78.5% female; mean age = 44 ± 15 years. Mean DrHy-Q score was 36.8 ± 12.6. Two clinical factors significantly predict DrHy-Q total score: clinical manifestations and number of suspected drugs. Patients with anaphylaxis (β = 11.005; 95% CI 5.523; 16.487), urticaria/angioedema (β = 7.770; 95% CI 2.600; 12.940) and other manifestations (β = 7.948; 95% CI 1.933; 13.962) are more likely to have higher DrHy-Q total score than patients with maculopapular exanthema. Patients with ≥ 2 suspected drugs are also more likely to have worse QoL (β = 7.927; 95% CI 3.687; 12.166). CONCLUSION The Portuguese version of DrHy-Q revealed adequate validity and reliability, indicating that it is appropriate to assess the impact of drug hypersensitivity on patients' HRQoL, providing data for a better comprehension and management of our patients. Moreover, our results highlight that the severity of the drug hypersensitivity reaction and the number of suspected drugs have impact on patient's DrHy-QoL.
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Affiliation(s)
- E Dias de Castro
- Allergy and Clinical Immunology Department, Centro Hospitalar Universitário de S. João EPE, Porto, Portugal. .,MedInUP- Center for Drug Discover and Innovative Medicines, Faculty of Medicine, University of Porto, Porto, Portugal.
| | - J Barbosa
- Public Health and Forensic Sciences and Medical Education Department, Faculty of Medicine, University of Porto, Porto, Portugal.,UNIC- Cardiovascular Research and Development Unit, University of Porto, Porto, Portugal
| | - A M Mesquita
- Allergy and Clinical Immunology Department, Centro Hospitalar Universitário de S. João EPE, Porto, Portugal
| | - A Caires
- Allergy and Clinical Immunology Department, Centro Hospitalar Universitário de S. João EPE, Porto, Portugal
| | - L Ribeiro
- Public Health and Forensic Sciences and Medical Education Department, Faculty of Medicine, University of Porto, Porto, Portugal.,Biomedicine Department, Faculty of Medicine, University of Porto, Porto, Portugal.,I3S- Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal
| | - J R Cernadas
- Allergy and Clinical Immunology Department, Centro Hospitalar Universitário de S. João EPE, Porto, Portugal
| | - I Baiardini
- Allergy and Respiratory Diseases Clinic - DIMI, University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy
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Barbosa P, Nombora O, Monteiro J, Ribeiro L. Valproate induced encephalopathy: Paradigm of normal ammonia levels. Eur Psychiatry 2021. [PMCID: PMC9480248 DOI: 10.1192/j.eurpsy.2021.1642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Valproic Acid (VPA) is one of the most commonly used mood stabilizer drugs. Although uncommon, serious adverse effects have been reported. One particularly relevant side effect is the induced encephalopathy, usually secondary to Hyperammonemia. However, some descriptions have shown an altered mental state with normal serum levels of ammonia. Objectives We aim to present a case of VPA induced-encephalopathy without hyperammonemia and emphasize its suspicion when patients taking VPA present altered mental states. Methods We present a clinical case of VPA induced-encephalopathy without Hyperammonemia and a qualitative review of this topic using the Pubmed database. Results A 66-year-old woman, with an history of Major Depressive Disorder, previously medicated with Venlafaxine 75mg/day and Mirtazapine 30mg/day, was admitted in our acute psychiatric inpatient unit due to a first manic episode. During the stay, her antidepressants were interrupted, and she was started on VPA, then optimized to 750mg/day. After that, she presented an altered mental state with confusion and prostration. Analytical results were normal including normal ammonia levels and no imagiological abnormalities. Despite these results, we decided to stop VPA empirically. The patient clinical status resolved the day after. Conclusions Studies have shown that only a few patients have developed encephalopathy with normal serum levels of ammonia. Although the pathogenesis behind this remains unknown, a few mechanisms have been proposed. Therefore, it is important to remind that even without abnormal analytical status, VPA is a possible cause of encephalopathy. We also emphasize the need for further studies on the mechanisms behind this phenomenon. Disclosure No significant relationships.
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Barbosa P, Nombora O, Monteiro J, Ribeiro L. Terbinafine and antidepressants: Potential risk of medication induced mania. Eur Psychiatry 2021. [PMCID: PMC9471882 DOI: 10.1192/j.eurpsy.2021.528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction
Mood destabilization and induced manic episodes are well-known phenomenon under antidepressant medications. However, even with a cautious introduction of antidepressants, it’s important to be aware of possible pharmacological interactions. Terbinafine is a known inhibitor of CYP2D6, a major hepatic metabolizer of a full list of antidepressant medications, and so capable of raising their serum levels and potentiating their side effects. Objectives With this case report we aim to emphasize the importance of cautious usage of Terbinafine when combined with antidepressant medications. Methods We present a clinical case of an induced first manic episode after the introduction of Terbinafine in a patient under antidepressant medication and a qualitative review on the topic, using PubMed database. Results A 66-year-old woman, with an history of Major Depressive Disorder, previously medicated with Venlafaxine 75mg/day and Mirtazapine 30mg/day, was brought to the emergency department because of psychomotor agitation. She also had an history of seasonal fluctuating mood, although never fulfilling the criteria for Bipolar Disorder. At admission, her clinical status was compatible with a manic episode. This episode followed two months after the initiation of Terbinafine for onychomycosis. Conclusions
There are few studies that have shown antidepressant toxicity mediated by an interaction with Terbinafine. As far as we know this is the first case of induced mania after the introduction of Terbinafine. Therefore, it is important to remind that Terbinafine is a potential interacting agent when combined with psychotropic medications.
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Soares R, Santos-Carvalho A, Santos-Carvalho A, Cravo-Roxo I, Ribeiro L, Marques R, Alarico S, Ferreira S. Infection control through education: HIV prevention. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.850] [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: 10/22/2022] Open
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Johann A, Lima J, Ribeiro L, Wan-Dall B, Nocera V, Menezes A. LLA-B, PHILADELPHIA+ RECIDIVADO PÓS TRANSPLANTE DE MEDULA ÓSSEA, COM RESPOSTA AO PONATINIBE: RELATO DE CASO. Hematol Transfus Cell Ther 2020. [DOI: 10.1016/j.htct.2020.10.281] [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] Open
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Mota D, Moreira de Sousa A, Ribeiro L. The emotional impact of medical error on Portuguese medical residents - An exploratory study. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.1065] [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: 11/15/2022] Open
Abstract
Abstract
Background
The consequences of the medical error on patients are unquestionable. However, the emotional impact on the health professional that made the error is usually devastating and usually neglected. The present study aimed to study the perception and experiences in a sample of medical residents regarding the emotional impact of the medical error in a clinician.
Methods
A cross-sectional and exploratory study analyzed a sample of 264 Portuguese residents. A survey with multiple-choice questions was created, taking into account the available scientific literature on this topic. The survey was then shared online within the mailing lists and social groups of Portuguese medical residents. The responses were collected between 14th-29th February 2020. Descriptive and logistic regression analyses were carried out using R 3.6.1 and Rstudio 1.2.5033.
Results
48,1% of the residents mentioned that at a certain point in their careers, they made a medical error. 98,4% of them had indirect contact (e.g., discussions with colleagues) with scenarios where a medical error could or was made. The residents that made a medical error had mainly feelings of guilt (85,8%), anxiety (73,2%), and frustration (64.6%). 93,7% of the clinicians that made a medical error reported more caution and the implementation of preventive measures in their future practice. 16,5% of them thought about leaving the medical profession. The odds for a medical error are 2,44 higher (95% CI 1,49-4,02) in the later phase of medical residency.
Conclusions
Although international literature describes the impact of medical error on the clinician, there is no published research on this theme in Portugal. The results allowed us to explore the emotional impact of these events and underline the unmet need for psychological support for the health professional. This exploratory study may serve as support for other research studies on this matter with a more robust methodology and a bigger sample size.
Key messages
Medical error is frequent and has an emotional impact on medical residents. Need for further research in Portugal and the creation of programs for psychological support.
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Affiliation(s)
- D Mota
- Department of Psychiatric and Mental Health, Hospital Center V.N.Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - A Moreira de Sousa
- ACES Alto Tâmega and Barroso - Public Health Unit, Portuguese Northern Region Health Administration, Chaves, Portugal
| | - L Ribeiro
- Department of Psychiatric and Mental Health, Hospital Center V.N.Gaia/Espinho, Vila Nova de Gaia, Portugal
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O'Shaughnessy J, Sousa S, Cruz J, Fallowfield L, Auvinen P, Pulido C, Cvetanovic A, Wilks S, Ribeiro L, Burotto M, Klingbiel D, Messeri D, Alexandrou A, Trask P, Fredriksson J, Machackova Z, Stamatovic L. 165MO Patient (pt) preference for the pertuzumab-trastuzumab fixed-dose combination for subcutaneous use (PH FDC SC) in HER2-positive early breast cancer (EBC): Primary analysis of the open-label, randomised crossover PHranceSCa study. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.287] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Cubas-Rolim E, Yung FR, Gripp MR, Oliveira CLA, Marques LA, Fagundes MC, Souza BV, Ribeiro L, Faria-Tostes E, Santana F. Knowledge at palm of hand: supported self-management and audiovisual content School of Patients DF. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The region of practice of the School of Patients DF is vulnerable at health literacy and income. Audiovisual information is strategic in primary care for its great power of reach and information retention.
Objectives
Since 2016 videos of health education have been produced, initially technical on the Planification for hypertension and diabetes. After the focus switched to popular health education, aiming at improving communication between health professionals and patients on chronic diseases and health promotion, including testimonials. The is potential for video exhibition in qualified waiting rooms and forwarding in social network.
Results
There are videos from diabetes, hypertension, obesity to dengue, pre-natal care and other APS themes, which follow printed orientation with pertinent links. There are graduate and post-graduate studies in course for optimizing audio-visual content for support and capacitation of the family caregivers, especially regarding the facilitated visual model of prescription (“Illustrated Prescription”). Data until 2020-January: YOUTUBE 3146 views, 118,6 hours of exhibition, 50 videos. FACEBOOK page with a reach of 369.248 views. INSTAGRAM 10.119 followers, 193 posts, 37.800 likes and 1003 commentaries.
Conclusions
Modifications in lifestyle and adherence to medication are fundamental for treatment, and videos are promising for health promotion and selfcare capacitation. There is potential for reducing the hierarchy barriers (testimonials). The shared construction of knowledge and its dissemination makes the patient active part in community diffusion of information.
Key messages
Health professionals have a vital role as educators, including for social online networks. Patients have a protagonist role in their treatment, as well as multipliers of knowledge at their community.
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Affiliation(s)
- E Cubas-Rolim
- Secretaria De Saude - Distrito Federal, Brasilia, Brazil
- Universidade De Brasilia, Brasilia, Brazil
- Universidade Euro-Americana, Brasilia, Brazil
| | - F R Yung
- Universidade De Brasilia, Brasilia, Brazil
| | - M R Gripp
- Universidade De Brasilia, Brasilia, Brazil
| | | | | | | | - B V Souza
- Universidade De Brasilia, Brasilia, Brazil
| | - L Ribeiro
- Universidade De Brasilia, Brasilia, Brazil
| | | | - F Santana
- Secretaria De Saude - Distrito Federal, Brasilia, Brazil
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Cubas-Rolim E, Yung FR, Marques LA, Souza BV, Gripp MR, Ribeiro L, Oliveira CLA, Gasperi C, Fagundes MC, Mendonça DL. Illustrated Prescription – History of evolution at the School of Patients DF. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.1088] [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
Issue
There are challenges in PHC associated with low functional literacy in health. The Illustrated Prescription was developed aiming to reduce drug error and increase access to self-care, allowing better understanding and adherence to treatment; facilitate the safe use of medications; strengthen the support network.
Description of the Problem
In April 2016, systematization and preparation of pictorial prescriptions began in the service of origin, one of the researches with the highest participation of multiprofessional residents of pharmacy and medical interns. Optimization and complement of recipe was performed. Several models were systematized in the orientation of users in face-to-face care of prescription reviews. The proposed model has (1) written component, schedule of medicines and strategy organizing medicines according to time of administration and (2) strategy for organizing primary packaging of medicinal products using coloured elastic bands.
Results
The evolution of Illustrated Prescription components resulted in the progressive organization and understanding in the indication of schedules and drugs. There was development, improvement and validation of it as a self-care tool, especially for patients with CNDs. There was a social impact with media dissemination (6 TV stations and 2 radio stations) and national and international congresses; totaling 5 show-forums and 4 congress with participation of the service. Cash prizes were invested in the infrastructure of the FHS workplaces.
Lessons
The evolution of Illustrated Prescription allowed progressive gain of organization and clarity for patients with difficulty reading, which directed efforts to avoid drug errors, especially prescription.
Key messages
Illustrated Prescription allowed us to invest more time guiding the patient in accessible and understandable language. Illustrated Prescription is useful for empowering and training it in self-care, promoting, mainly, autonomy and citizenship.
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Affiliation(s)
- E Cubas-Rolim
- Secretaria De Saude - Distrito Federal, Brasilia, Brazil
- Universidade De Brasilia, Brasilia, Brazil
- Universidade Euro-Americana, Brasilia, Brazil
| | - F R Yung
- Universidade De Brasilia, Brasilia, Brazil
| | | | - B V Souza
- Universidade De Brasilia, Brasilia, Brazil
| | - M R Gripp
- Universidade De Brasilia, Brasilia, Brazil
| | - L Ribeiro
- Universidade De Brasilia, Brasilia, Brazil
| | | | - C Gasperi
- Universidade De Brasilia, Brasilia, Brazil
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Cubas-Rolim E, Yung FR, Gripp MR, Oliveira CLA, Marques LA, Fagundes MC, Souza BV, Ribeiro L, Tostes-Faria E, Santana F. Each reading is a seed – prescribing books and links at the School of Patients DF. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Issue
The fragile reading habit is a common feature in Brazil, having wide negative impacts in Health and Education areas. Itapoã-DF presents important social vulnerabilities with challenges about the reading habit. Stimulating individual reading from early childhood to elderly, associated with positive reinforcement during doctor appointments, is a way to provide health education.
Description of the problem
In October of 2016, the “Prescreva um Livro” (prescribe a book) project began from childcare doctor appointments, by encouraging children with books and the borrowing of material, in addition to positive reinforcement in consultations. In 2019, book references for adults were incorporated into the chapters of the School of Patients DF - especially for prenatal care and chronic conditions such as hypertension. It highlights the potencial of primary care as point of encouragement for reading and community support, reading coordinator.
Results
The Reading stimulus brought, since 2016, a change in the relationship of young people with the service, making it a space of curiosity and fun instead of “fear of needles”. The importance of primary care in constructive stimuli to reading is reinforced even more considering the difficulties of education in Brazil.
Lessons
Initially focused on children and adolescents, the practice was incorporated into the health education strategy of the School of Patients, grouping prevalent comorbidities and printed guidelines delivered at each consultation. The participating children reported the stories they had read at subsequent visits. This feedback reinforces the influence that the primary care environment can have in several areas of the user's life, including reading
Key messages
Waiting rooms and home visits are opportunities to exchange information also of a literary nature. The stimulus to reading is vital for the full exercise of citizenship, and health services can be a reference for reading.
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Affiliation(s)
- E Cubas-Rolim
- Secretaria de Saude - Distrito Federal, Brasilia, Brazil
- Universidade de Brasilia, Brasilia, Brazil
- Universidade Euro-Americana, Brasilia, Brazil
| | - F R Yung
- Universidade de Brasilia, Brasilia, Brazil
| | - M R Gripp
- Universidade de Brasilia, Brasilia, Brazil
| | | | | | | | - B V Souza
- Universidade de Brasilia, Brasilia, Brazil
| | - L Ribeiro
- Universidade de Brasilia, Brasilia, Brazil
| | | | - F Santana
- Secretaria de Saude - Distrito Federal, Brasilia, Brazil
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Cubas-Rolim E, Yung FR, Gripp MR, Oliveira CLA, Marques LA, Fagundes MC, Souza BV, Ribeiro L, Faria-Tostes E, Santana F. Case simulations for permanent education in Primary Care – School of Patients DF. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
In scenarios of vulnerability that include triple charge of diseases, permanent education in Primary Care and university is fundamental to allow greater access, efficiency and safety for users and health teams.
Objectives
The School of Patients DF was created as a tool for popular and technical health education, including case simulations for practice. It consists of standard technical content (Chapters), categorized by conditions and diseases, shared by Google Drive and used primarily in selected primary care units of Brazil's capital city.
Results
Technical simulations are performed in pairs, 1 participant acts as “patient” with script in hand (topics of the training) while the other acts as “health professional” as if in a regular visit. Simulations are timed for 10 minutes for consultation and 5 for feedback, boosting learning. Contents are based on guidelines and protocols from the Ministry of Health, Secretary of Health and Brazilian Community and Family Medicine Society. Since 2016 there have been realized over 1400 simulations, including weekly classes for last term medical students at the capital city federal university.
Conclusions
Simulations optimize the time necessary for permanent education (15 minutes blocks), avoiding limiting access for triage and consults, allowing smaller groups to train with greater focus and independent of computers or projectors.
Key messages
Standardizing training and practice bring benefit to patient care and safety. Simulations with structured physical examination are important both for professional as well as students.
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Affiliation(s)
- E Cubas-Rolim
- Secretaria De Saude - Distrito Federal, Brasilia, Brazil
- Universidade De Brasilia, Brasilia, Brazil
- Universidade Euro-Americana, Brasilia, Brazil
| | - F R Yung
- Universidade De Brasilia, Brasilia, Brazil
| | - M R Gripp
- Universidade De Brasilia, Brasilia, Brazil
| | | | | | | | - B V Souza
- Universidade De Brasilia, Brasilia, Brazil
| | - L Ribeiro
- Universidade De Brasilia, Brasilia, Brazil
| | | | - F Santana
- Secretaria De Saude - Distrito Federal, Brasilia, Brazil
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Cubas-Rolim E, Yung FR, Marques LA, Souza BV, Gripp MR, Ribeiro L, Oliveira CLA, Gasperi C, Fagundes MC, Mendonça DL. Primary care professional validation of visual model of prescription – Illustrated prescription. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.1089] [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
Issue
Chronic diseases such as hypertension and diabetes have great global impact on morbidity, mortality and costs. Incorrect use of medicines is especially worrisome for vulnerable populations with low health literacy, and visual models of prescription can bring benefit. The objective of this study was to validate the visual model of prescription Illustrated Prescription to obtain an adapted prescription with greater clarity, correction and cost-efficiency especially for risk users in a vulnerable peripheral region of the capital of Brazil served free of charge by the Unified Health System.
Description of the Problem
We conducted a content validation by primary health care nurses, pharmacists and physicians (PHC) by Delphi technique, applied in two phases from November to December 2018, through a questionnaire that evaluated clarity, relevance and feasibility of performing Illustrated Prescription, with field for comments. We used a 4-point Likert scale, Cronbach Alpha for reliability and Content Validation Index (CVI) with agreement above 0.8 indicating validation. Project approved by the Ethics Committee - FEPECS.
Results
Round-1: 29 out of 32 items were validated, with Cronbach's alpha .9812. Round-2: Included 4 new items, guidelines for indicating whole tablet, adjustment of the font size and color column size of elastic alloys, all items being validated and Cronbach's alpha of 0.9876.
Lessons
Validation ensures clarity and correction of the Illustrated Prescription, being extremely important for dissemination of the visual model for prescribing. It allows future evaluation of increased drug adherence and risk reduction related to incorrect use of medications especially for illiterate or visually impaired users.
Key messages
Illustrated Prescription is a validated tool that opens up the possibility of greater safety and efficient use of chronic medications, especially for vulnerable users with chronic diseases. Validation ensures clarity and correction of the Illustrated Prescription, being extremely important for dissemination of the visual model for prescribing.
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Affiliation(s)
- E Cubas-Rolim
- Secretaria De Saude - Distrito Federal, Brasilia, Brazil
- Universidade De Brasilia, Brasilia, Brazil
- Universidade Euro-Americana, Brasilia, Brazil
| | - F R Yung
- Universidade De Brasilia, Brasilia, Brazil
| | | | - B V Souza
- Universidade De Brasilia, Brasilia, Brazil
| | - M R Gripp
- Universidade De Brasilia, Brasilia, Brazil
| | - L Ribeiro
- Universidade De Brasilia, Brasilia, Brazil
| | | | - C Gasperi
- Universidade De Brasilia, Brasilia, Brazil
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Dias de Castro E, Carolino F, Carneiro-Leão L, Barbosa J, Ribeiro L, Cernadas J. Allergy to beta-lactam antibiotics in children: Risk factors for a positive diagnostic work-up. Allergol Immunopathol (Madr) 2020; 48:417-423. [PMID: 32460994 DOI: 10.1016/j.aller.2020.01.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 01/06/2020] [Accepted: 01/29/2020] [Indexed: 01/02/2023]
Abstract
BACKGROUND Allergy to beta-lactam (βL) antibiotics is highly reported in children, but rarely confirmed. Risk factors for a positive diagnostic work-up are scarce. The primary aim was to characterize the cases of children with confirmed βL allergy, investigating potential risk factors. Secondary aims were to assess the prevalence of allergy to βL in this population and to confirm the safety of less extensive diagnostic protocols for milder reactions. METHODS We reviewed the clinical data from all children evaluated in our Department for suspected βL allergy, over a six-year period. RESULTS Two hundred and twenty children (53% females) with a mean age of 6.5±4.2 years were evaluated. Cutaneous manifestations were the most frequently reported (96.9%), mainly maculopapular exanthema (MPE). The reactions were non-immediate in 59.5% of the cases. Only 23 children (10.5%) were diagnosed with allergy to βL. The likelihood of βL allergy was significantly higher in children with a family history of drug allergy (p<0.001) and in those with a smaller time period between the reaction and the study (p=0.046). The probability of not confirming βL allergy is greater in children reporting less severe reactions (p<0.001) and MPE (p<0.001). We found the less extensive diagnostic protocol in milder reactions safe, since only 4.2% of the children presented a positive provocation test (similar reaction as the index reaction). CONCLUSION This study highlights family history of drug allergy as a risk factor for a positive diagnostic work-up. Larger series are required, particularly genetic studies to accurately determine future risk for βL allergy in children.
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Melo-Alvim C, Miguel-Semedo P, Paiva RS, Lobo-Martins S, Luna-Pais H, Costa AL, Santos AR, Florindo A, Vasconcelos AL, Abrunhosa-Branquinho AN, Palmela P, Fernandes L, Presa DL, Costa L, Ribeiro L. Pretreatment hemoglobin level as a prognostic factor in patients with locally advanced head and neck squamous cell carcinoma. Rep Pract Oncol Radiother 2020; 25:768-774. [PMID: 32802001 DOI: 10.1016/j.rpor.2020.07.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 05/30/2020] [Accepted: 07/24/2020] [Indexed: 02/06/2023] Open
Abstract
Aim Evaluate pretreatment hemoglobin values as a prognostic factor in patients with locally advanced head and neck squamous cell carcinoma treated with concurrent chemoradiotherapy. Background Anemia is one of the most prevalent laboratory abnormalities in oncological disease. It leads to a decrease in cellular oxygen supply, altering radiosensitivity of tumor cells and compromising therapeutic outcomes. Materials and Methods Retrospective evaluation of patients with HNSCC treated with cCRT. Primary and secondary endpoint was to evaluate the correlation of Hb levels (≥12.5 g/dL or <12.5 g/dL) at the beginning of cCRT with overall survival (OS) and progression-free survival (PFS), respectively. Results A total of 108 patients were identified. With a median follow-up of 16.10 months median OS was 59.70 months for Hb ≥12.5 g/dL vs. 14.13 months for Hb <12.5 g/dL (p = 0.004). PFS was 12.29 months for Hb ≥12.5 g/dL and 1.68 months for Hb <12.5 g/dL (p = 0.016). Conclusions In this analysis, Hb ≥12.5 g/dL correlated with significantly better OS and PFS. Further studies are needed to validate these findings.
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Affiliation(s)
- Cecília Melo-Alvim
- Medical Oncology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon 1649-035, Portugal
| | - Patrícia Miguel-Semedo
- Medical Oncology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon 1649-035, Portugal
| | - Rita Silva Paiva
- Medical Oncology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon 1649-035, Portugal
| | - Soraia Lobo-Martins
- Medical Oncology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon 1649-035, Portugal
| | - Helena Luna-Pais
- Medical Oncology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon 1649-035, Portugal
| | - Ana Lúcia Costa
- Medical Oncology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon 1649-035, Portugal
| | - Ana Rita Santos
- Otorhinolaryngology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon 1649-035, Portugal
| | - André Florindo
- Radiology Oncology, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon 1649-035, Portugal
| | - Ana Luísa Vasconcelos
- Radiology Oncology, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon 1649-035, Portugal
| | - André N Abrunhosa-Branquinho
- Radiology Oncology, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon 1649-035, Portugal
| | - Paulo Palmela
- Stomatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon 1649-035, Portugal
| | - Leonor Fernandes
- Imaging Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon 1649-035, Portugal
| | - Dolores Lopez Presa
- Pathology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon 1649-035, Portugal
| | - Luís Costa
- Medical Oncology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon 1649-035, Portugal.,Luís Costa Lab, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal
| | - Leonor Ribeiro
- Medical Oncology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon 1649-035, Portugal
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Pais HL, Mansinho A, Branco F, Alvim C, Lobo-Martins S, Fernandes G, Fernandes L, Matos A, Paiva R, Dâmaso S, Brás R, Pinho I, Donato A, Semedo P, Albuquerque J, Ribeiro L. P-65 Locally advanced/metastatic gastric cancer: Real-world data on first-line treatment with oxaliplatin and cisplatin-based doublets. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.147] [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] Open
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Lobo-Martins S, Martins M, Semedo P, Alvim C, Pais HL, Paiva R, Pinto C, Ribeiro L, Fernandes I, Macedo D, Mansinho A, Vendrell I, Sousa RTD, Costa L. P-151 The impact of adjuvant chemotherapy regimens in stage II colon cancer (CC) patients. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Kumar R, George B, Campbell MR, Verma N, Paul AM, Melo-Alvim C, Ribeiro L, Pillai MR, da Costa LM, Moasser MM. HER family in cancer progression: From discovery to 2020 and beyond. Adv Cancer Res 2020; 147:109-160. [PMID: 32593399 DOI: 10.1016/bs.acr.2020.04.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The human epidermal growth factor receptor (HER) family of receptor tyrosine kinases (RTKs) are among the first layer of molecules that receive, interpret, and transduce signals leading to distinct cancer cell phenotypes. Since the discovery of the tooth-lid factor-later characterized as the epidermal growth factor (EGF)-and its high-affinity binding EGF receptor, HER kinases have emerged as one of the commonly upregulated or hyperactivated or mutated kinases in epithelial tumors, thus allowing HER1-3 family members to regulate several hallmarks of cancer development and progression. Each member of the HER family exhibits shared and unique structural features to engage multiple receptor activation modes, leading to a range of overlapping and distinct phenotypes. EGFR, the founding HER family member, provided the roadmap for the development of the cell surface RTK-directed targeted cancer therapy by serving as a prototype/precursor for the currently used HER-directed cancer drugs. We herein provide a brief account of the discoveries, defining moments, and historical context of the HER family and guidepost advances in basic, translational, and clinical research that solidified a prominent position of the HER family in cancer research and treatment. We also discuss the significance of HER3 pseudokinase in cancer biology; its unique structural features that drive transregulation among HER1-3, leading to a superior proximal signaling response; and potential role of HER3 as a shared effector of acquired therapeutic resistance against diverse oncology drugs. Finally, we also narrate some of the current drawbacks of HER-directed therapies and provide insights into postulated advances in HER biology with extensive implications of these therapies in cancer research and treatment.
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Affiliation(s)
- Rakesh Kumar
- Cancer Research Program, Rajiv Gandhi Centre for Biotechnology, Trivandrum, Kerala, India; Department of Medicine, Division of Hematology & Oncology, Rutgers New Jersey Medical School, Newark, NJ, United States; Department of Human and Molecular Genetics, Virginia Commonwealth University, School of Medicine, Richmond, VA, United States.
| | - Bijesh George
- Cancer Research Program, Rajiv Gandhi Centre for Biotechnology, Trivandrum, Kerala, India
| | - Marcia R Campbell
- Department of Medicine, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, United States
| | - Nandini Verma
- Advanced Centre for Treatment, Research and Education in Cancer, Mumbai, India
| | - Aswathy Mary Paul
- Cancer Research Program, Rajiv Gandhi Centre for Biotechnology, Trivandrum, Kerala, India
| | - Cecília Melo-Alvim
- Medical Oncology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - Leonor Ribeiro
- Medical Oncology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - M Radhakrishna Pillai
- Cancer Research Program, Rajiv Gandhi Centre for Biotechnology, Trivandrum, Kerala, India
| | - Luis Marques da Costa
- Medical Oncology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal; Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Mark M Moasser
- Department of Medicine, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, United States.
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O'Shaughnessy J, Sousa S, Cruz J, Fallowfield L, Auvinen P, Pulido C, Cvetanovic A, Wilks S, Ribeiro L, Burotto M, Klingbiel D, Messeri D, Alexandrou A, Trask P, Fredriksson J, Stamatovic L. 80O Patient (pt) preference and satisfaction with the subcutaneous fixed-dose combination of pertuzumab (P) and trastuzumab (H) in pts with HER2-positive early breast cancer (HER2+ eBC): Interim analysis of the open-label, randomised cross-over PHranceSCa study. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.03.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Vieira L, Ribeiro L, Guimarães D, Sousa J, Varanda A. Lisbon Burn Centre experience with intentional burn injuries. Ann Burns Fire Disasters 2020; 33:14-19. [PMID: 32523490 PMCID: PMC7263718] [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] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Accepted: 02/01/2020] [Indexed: 06/11/2023]
Abstract
Burn injury as a form of hetero or auto-aggression accounts for a significant amount of admissions to a Burn Care Unit, with epidemiologic and clinical specificities. To investigate the differences in risk factors, psychiatric comorbidities, injury severity and mortality among adult patients with accidental or intentional burns, we analyzed routinely collected data from a Central Hospital Burn Unit over a period of 6 years (January 1st, 2010 to December 31st, 2015). We identified 22 intentional burn patients (5%) among all the admissions to our Burn Unit. When compared to the accidental burns, the intentional burn patients are significantly younger (45.7±14.7 vs. 54.9±19.9), have a bigger percentage of body surface area burned (35% vs. 14%), have a higher incidence of inhalation burn (50% vs. 22.8%) and higher mortality (18.2% vs. 6.1%). Fifty-five percent of cases of intentional burns were self-inflicted. Self-inflicted burns have a worse prognosis than hetero-aggressions (inhospital mortality 25% vs. 10%). Psychiatric comorbidities were largely more prevalent in the intentional burn patients (59% vs. 6.6%), namely mood disorders. Compared to patients with accidental burns, intentional burn patients have worse clinical condition and prognosis. A multidisciplinary preventive approach, looking at the specificities of the violent nature of the lesions and identifying risk groups may reduce the incidence and severity of this type of burns.
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Affiliation(s)
- L. Vieira
- Luís Vieira, MD
Plastic and Reconstructive Surgery Department, Centro Hospitalar Lisboa CentralRua José António Serrano - 1150-199 LisbonPortugal+351 918055441
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Duarte B, Vieira L, Pessoa E Costa T, Ribeiro L, João A, Cabete J, Varanda A. Predicting incomplete basal cell carcinoma excisions - a large multidisciplinary retrospective analysis in a tertiary center. J DERMATOL TREAT 2020; 31:583-588. [PMID: 31689139 DOI: 10.1080/09546634.2019.1687815] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Introduction: Surgical treatment of basal cell carcinomas is often performed by physicians with different surgical backgrounds. Collecting data from different surgical departments would better reflect their real-life surgical management.Objectives: To identify the rate, recurrence risk, and predictive factors accordingly to their relative contribution for an incomplete basal cell carcinoma excision in a large multidisciplinary real-life settingMethods: Retrospective cohort study of 2305 surgically treated lesions in different departments of a tertiary center.Results: There was a rate of incomplete excisions (15%) and a recurrence rate (35.5% vs. 6.8% in incomplete vs. complete excisions (p < .001)). A third of incompletely excised basal cell carcinoma (BCC) will recur over time. Stratified by relevancy, high-risk histological subtypes (micronodular (OR 5.10 - p < .001) and morpheaform (OR 5.42 - p < .001), smaller specimen sizes ( <0.5 cm or 0.5-1 cm, OR 3.99 and 2.49, respectively, p < .001) high-risk locations (OR 3.06 on the nose, OR 2.77 on the eyelids, p < .001), and recurrent BCCs (OR 1.72, p < .001). are the best predictors of an incomplete excision.Conclusions: Acknowledging the rate, recurrence risk and predictive factors for incomplete excisions may be beneficial for optimal preoperative planning and to prevent unwarranted re-interventions, morbidity, and healthcare costs.
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Affiliation(s)
- B Duarte
- Dermatology Department, Hospital de Santo António dos Capuchos Centro Hospitalar de Lisboa Central, Lisboa, Portugal
| | - L Vieira
- Plastic and Reconstrutive Surgery Department, Hospital de São José Centro Hospitalar de Lisboa Central, Lisboa, Portugal
| | - T Pessoa E Costa
- Dermatology Department, Hospital de Santo António dos Capuchos Centro Hospitalar de Lisboa Central, Lisboa, Portugal
| | - L Ribeiro
- Plastic and Reconstrutive Surgery Department, Hospital de São José Centro Hospitalar de Lisboa Central, Lisboa, Portugal
| | - A João
- Dermatology Department, Hospital de Santo António dos Capuchos Centro Hospitalar de Lisboa Central, Lisboa, Portugal
| | - J Cabete
- Dermatology Department, Hospital de Santo António dos Capuchos Centro Hospitalar de Lisboa Central, Lisboa, Portugal
| | - A Varanda
- Plastic and Reconstrutive Surgery Department, Hospital de São José Centro Hospitalar de Lisboa Central, Lisboa, Portugal
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Rego A, Vitória A, Ribeiro T, Ribeiro L, Lourenço-Gil R, Leal S, Cunha MPE. Attitudes and HRM decisions toward older workers in Africa: exploring contradictions through an empirical study. The International Journal of Human Resource Management 2020. [DOI: 10.1080/09585192.2019.1710720] [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] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Arménio Rego
- Católica Porto Business School, Universidade Católica Portuguesa, Porto, Portugal
- Business Research Unit, Instituto Universitário de Lisboa (ISCTE-IUL), Lisboa, Portugal
| | - Andreia Vitória
- Departamento de Economia Gestao e Engenharia Industrial, and Turismo, Universidade de Aveiro, Aveiro, Portugal
- GOVCOPP - Research Unit on Governance, Competitiveness and Public Policies, Aveiro, Portugal
| | | | - Leonor Ribeiro
- GOVCOPP - Research Unit on Governance, Competitiveness and Public Policies, Aveiro, Portugal
| | - Rui Lourenço-Gil
- Católica Porto Business School, Universidade Católica Portuguesa, Porto, Portugal
| | - Susana Leal
- Escola Superior de Gestão e Tecnologia, Instituto Politécnico de Santarém, Instituto Politécnico de Santarém, Santarém, Portugal
- Centro de Investigação em Qualidade de Vida, Santarém, Portugal
| | - Miguel Pina e Cunha
- Nova School of Business and Ecomomics, Universidade Nova de Lisboa, Lisboa, Portugal
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Macedo F, Monteiro A, Coelho D, Luis D, Guilherme R, Gomes M, Ribeiro L. MIPI as a superior prognostic tool in mantle cell lymphoma compared to monocyte-lymphocyte, neutrophil-lymphocyte and platelet-lymphocyte ratios. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz251.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Abstract
BACKGROUND Knowledge of human immunodeficiency virus (HIV) status is essential to effectively manage both tuberculosis (TB) and HIV infection. This is why the World Health Organization (WHO) recommends routine HIV testing in all TB patients. OBJECTIVE To determine the number of TB patients with unknown HIV status in Portugal and to identify the factors associated with unknown HIV status. METHODS A retrospective study of all TB notifications from 2008 to 2014 in Portugal was conducted. A multiple logistic regression model was used to evaluate the association of sociodemographic and clinical factors with unknown HIV status. RESULTS We examined the records of 18 445 patients with TB notification, 2402 of whom (13%) had unknown HIV status. Unknown HIV status was positively associated with age 65 years (adjusted odds ratio [aOR] 1.208, 95%CI 1.037-1.408) and extra-pulmonary TB (aOR 1.381, 95%CI 1.252-1.523), but negatively associated with unemployment (aOR 0.755, 95%CI 0.637-0.895), alcohol dependence (aOR 0.809, 95%CI 0.682-0.959) and drug dependence (aOR 0.566, 95%CI 0.449-0.713). CONCLUSION Risk perception is the most important barrier to complete knowledge of HIV status in TB patients in Portugal. Given the importance of HIV screening in TB patients, every effort should be made to ensure that all TB patients undergo HIV screening.
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Affiliation(s)
- L Ribeiro
- Pulmonology Department, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real
| | - M Gomes
- Occupational Health, Centro Hospitalar de Vila Nova de Gaia/Espinho Entidade Pública Empresarial (EPE), Vila Nova de Gaia, EPIUnit, Instituto De Saúde Pública Da Universidade Do Porto, Universidade do Porto, Porto
| | - R Gaio
- Faculty of Sciences, University of Porto, Porto, Centre of Mathematics, University of Porto, Porto
| | - R Duarte
- EPIUnit, Instituto De Saúde Pública Da Universidade Do Porto, Universidade do Porto, Porto, Chest Disease Centre, Vila Nova de Gaia, Pulmonology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho EPE, Department of Clinical Epidemiology, Predictive Medicine and Public Health University of Porto Medical School, Porto, Portugal
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Afonso C, Roque A, Nascimento T, Sarmento A, Geraldes C, Paiva A, Ribeiro L. PS1413 INCIDENCE OF NEGATIVE MINIMAL RESIDUAL DISEASE IN MULTIPLE MYELOMA PATIENTS AFTER AUTOLOGOUS STEM CELL TRANSPLANT. Hemasphere 2019. [DOI: 10.1097/01.hs9.0000563928.27154.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Moreira CMA, Semedo P, Paiva R, Martins SL, Pais H, Costa A, Ribeiro L, Costa L. PO-070 Prognostic value of hyponatremia on metastatic or recurrent head and neck squamous cell carcinoma. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30236-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Abstract
BACKGROUND Choroidopathy is a rare manifestation of systemic lupus erythematosus (SLE). This entity is associated with active phases of severe SLE and it is frequently accompanied by acute kidney failure, central nervous system involvement and coagulopathy. PURPOSE To evaluate the choroid thickness of patients with lupus nephritis (LN) without choroidopathy, and to compare this with that of age-matched SLE patients without LN and healthy control subjects. STUDY DESIGN Cross-sectional case control study. MATERIAL AND METHODS Fifteen women with LN in remission phase (study group), 15 women with SLE in remission without LN (SLE control group), and 15 healthy women (healthy control group), without ocular diseases or significant refractive error, were recruited. Full ophthalmological examination and a macular optical coherence tomography in enhanced depth imaging mode were performed. The choroid thickness was measured at nine macular points and six lines of mean choroidal thickness were determined. A comparative analysis between the three groups was performed using the one-way ANOVA test and the paired t-test. The choroid thickness of patients under corticotherapy was also compared to that of patients without corticotherapy. Additionally, the correlation between choroid thickness and disease duration was evaluated using the Pearson analysis. RESULTS The mean macular choroidal thickness was 295.73 ± 67.62 μm in the study group, 233.34 ± 41.01 µm in the SLE control group, and 240.98 ± 37.93 μm in the control group ( p = 0.00006 and p = 0.0003, respectively). Additionally, the choroid thickness was significantly thicker than in the SLE and healthy control groups at the foveal ( p = 0.004 and p < 0.000), nasal ( p < 0.000 and p = 0.001), superior ( p = 0.002 and p < 0.000) and inferior ( p < 0.000 and p = 0.001) mean lines. The choroidal thickness in this group was not associated with the duration of the disease. The subgroup of patients with LN under corticotherapy did not reveal a significantly different choroidal thickness. CONCLUSION This study suggests a relationship between LN and choroidal changes, which may represent an increased risk for choroidopathy in these patients. Choroid thickening was not related with the duration of the disease. This thickening may be correlated with histopathological changes similar to those occurring in kidney glomeruli.
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Affiliation(s)
- J Braga
- 1 Centro Hospitalar de Vila Nova de Gaia Espinho, Vila Nova de Gaia, Portugal
| | - R Rothwell
- 2 Centro Hospitalar do Tâmega e Sousa, Penafiel, Portugal
| | - M Oliveira
- 1 Centro Hospitalar de Vila Nova de Gaia Espinho, Vila Nova de Gaia, Portugal
| | - D Rodrigues
- 1 Centro Hospitalar de Vila Nova de Gaia Espinho, Vila Nova de Gaia, Portugal
| | - S Fonseca
- 1 Centro Hospitalar de Vila Nova de Gaia Espinho, Vila Nova de Gaia, Portugal
| | - R Varandas
- 1 Centro Hospitalar de Vila Nova de Gaia Espinho, Vila Nova de Gaia, Portugal
| | - L Ribeiro
- 1 Centro Hospitalar de Vila Nova de Gaia Espinho, Vila Nova de Gaia, Portugal
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Pessoa R, do Carmo M, Alves L, Costa C, Pereira K, Neves M, Melo S, Bartolomeu C, Ribeiro L. PSXI-27 Excretion of purine derivatives and rumen microbial protein synthesis in buffaloes fed sugarcane. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- R Pessoa
- Federal Rural University of Pernambuco,Recife, Brazil
| | - M do Carmo
- Federal Rural University of Pernambuco,Recife, Brazil
| | - L Alves
- Federal Rural University of Pernambuco,Recife, Brazil
| | - C Costa
- Federal Institute of Pernambuco,Recife, Brazil
| | - K Pereira
- Federal University of Alagoas, Maceió,Brazil
| | - M Neves
- Federal Rural University of Pernambuco,Recife, Brazil
| | - S Melo
- Federal Rural University of Pernambuco,Recife, Brazil
| | - C Bartolomeu
- Federal Rural University of Pernambuco,Recife, Brazil
| | - L Ribeiro
- Federal Rural University of Pernambuco,Recife, Brazil
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Ribeiro L, Puchala R, Gipson T, Merkel R, Goetsch A. PSXV-31 Effects of Gestation Nutritional Plane and Diet Nutritive Value During Lactation on Feed Intake and Digestion in Lactating Alpine Goats. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.1039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- L Ribeiro
- American Institute for Goat Research, Langston University; Department of Animal Science, Oklahoma State University,Langston, OK, United States
| | - R Puchala
- American Institute for Goat Research Langston University,Langston, OK, United States
| | - T Gipson
- American Institute for Goat Research Langston University,Langston, OK, United States
| | - R Merkel
- American Institute for Goat Research Langston University,Langston, OK, United States
| | - A Goetsch
- American Institute for Goat Research Langston University,Langston, OK, United States
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Nunes O, Bernardo M, Ribeiro L, Cabeças A, Ferrito F, Carneiro C, Nogueira R, Vale P. Tumores de Células Germinativas Testiculares: Casuística do Hospital CUF Infante Santo. Gaz Med 2018. [DOI: 10.29315/gm.v4i4.83] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
INTRODUÇÃO: Os tumores de células germinativas são tumores raros, constituindo 1% a 2% do total das neoplasias malignas e cerca de 5% do total dos tumores malignos urológicos. Originam-se no testículo em mais de 90% dos casos.MÉTODOS: Os autores reveem os casos de tumores de células germinativas, incluindo o diagnóstico, tratamento e follow-up, ocorridos no Hospital CUF Infante Santo num período de mais de 15 anos, compreendido entre agosto de 1999 e novembro de 2014.RESULTADOS: A série compreende 33 doentes, todos submetidos inicialmente a orquidectomia radical, diagnóstica e terapêutica, estando o maior número de doentes, 21 (63,6%) em estádio I. Destes, 14 (66% dos estádios I), vieram a fazer tratamento pós-orquidectomia. Todos os doentes em estádios mais avançados efetuaram tratamento pós-cirúrgico. Verificaram-se apenas quatro recidivas (12,1%), ocorridas em mediana 20 meses pós-diagnóstico e todas salvas por posterior tratamento.CONCLUSÃO: A toxicidade parece-nos aceitável, não tendo ocorrido nenhuma morte relacionada com qualquer modalidade de tratamento. Com uma mediana de follow-up de 59 meses à data da conclusão da revisão, a sobrevivência livre de doença foi de 100%.
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Abuhaiba SI, Cordeiro M, Amorim A, Cruz Â, Quendera B, Ferreira C, Ribeiro L, Bernardes R, Castelo-Branco M. Occipital blood-brain barrier permeability is an independent predictor of visual outcome in type 2 diabetes, irrespective of the retinal barrier: A longitudinal study. J Neuroendocrinol 2018; 30. [PMID: 29247551 DOI: 10.1111/jne.12566] [Citation(s) in RCA: 4] [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: 08/05/2017] [Revised: 11/13/2017] [Accepted: 12/11/2017] [Indexed: 01/01/2023]
Abstract
Blood-brain barrier (BBB) permeability in type 2 diabetic patients has been previously shown to be altered in certain brain regions such as the basal ganglia and the hippocampus. Because of the histological and functional similarities between the BBB) and the blood-retinal barrier (BRB), we aimed to investigate how the permeability of both barriers predicts visual outcome. We included 2 control groups (acute unilateral stroke patients, n = 9; type 2 diabetics without BRB leakage n = 10) and a case study group of type 2 diabetics with established BRB leakage (n = 17). We evaluated sex, age, disease duration, metabolic impairment, retinopathy grade and BBB permeability as predictors of visual acuity at baseline, 12 and 24 months in the type 2 diabetics without BRB leakage group and the case study group. We have also explored differences in BBB permeability in the occipital lobe and frontal lobe in the 3 different groups. Ktrans (volume transfer coefficient) and Vp (fractional plasma volume) were estimated. The BBB permeability parameter Vp was higher in the case study group compared to the unaffected hemisphere of the stroke patient control group, suggesting vascular dynamics were changed in the occipital lobe of type 2 diabetics with established BRB leakage. These patients showed a significant correlation between glycated hemoglobin (HbA1C) levels and occipital and frontal Ktrans . We report for the first time that occipital BBB permeability is an independent predictor of visual acuity at baseline, as well as at 12 and 24 months, in type 2 diabetics with established BRB leakage. Our results suggest that occipital BBB permeability might be an independent biomarker for visual impairment in patients with established BRB leakage.
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Affiliation(s)
- S I Abuhaiba
- CIBIT, Institute for Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
- CNC.IBILI, University of Coimbra, Coimbra, Portugal
- PhD Programme in Experimental Biology and Biomedicine (PDBEB), CNC - Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal
- Institute for Interdisciplinary Research (IIIUC), University of Coimbra, Coimbra, Portugal
| | - M Cordeiro
- CNC.IBILI, University of Coimbra, Coimbra, Portugal
- Coimbra University and Hospital Centre (CHUC), Coimbra, Portugal
| | - A Amorim
- CIBIT, Institute for Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
- Siemens Healthcare, Amadora, Portugal
- Faculty of Medicine, Visual Neuroscience Laboratory, Institute for Biomedical Imaging and Life Sciences (IBILI), University of Coimbra, Coimbra, Portugal
| | - Â Cruz
- CIBIT, Institute for Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
| | - B Quendera
- Faculty of Medicine, Visual Neuroscience Laboratory, Institute for Biomedical Imaging and Life Sciences (IBILI), University of Coimbra, Coimbra, Portugal
| | - C Ferreira
- CIBIT, Institute for Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
- Faculty of Medicine, Visual Neuroscience Laboratory, Institute for Biomedical Imaging and Life Sciences (IBILI), University of Coimbra, Coimbra, Portugal
| | - L Ribeiro
- Coimbra Coordinating Centre for Clinical Research, AIBILI-Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
| | - R Bernardes
- CIBIT, Institute for Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
- Faculty of Medicine, Visual Neuroscience Laboratory, Institute for Biomedical Imaging and Life Sciences (IBILI), University of Coimbra, Coimbra, Portugal
| | - M Castelo-Branco
- CIBIT, Institute for Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
- Faculty of Medicine, Visual Neuroscience Laboratory, Institute for Biomedical Imaging and Life Sciences (IBILI), University of Coimbra, Coimbra, Portugal
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