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Arca G, Núñez C, Stephan-Otto C, Arnaez J, Agut T, Cordeiro M, Boronat N, Lubián-López S, Benavente-Fernández I, Valverde E, Garcia-Alix A. Massive Neonatal Arterial Ischemic Stroke. Pediatr Neurol 2023; 144:5-10. [PMID: 37087915 DOI: 10.1016/j.pediatrneurol.2023.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 03/17/2023] [Accepted: 03/19/2023] [Indexed: 04/25/2023]
Abstract
BACKGROUND Massive infarction in adults is a devastating entity characterized by signs of extreme swelling of the brain's parenchyma. We explored whether a similar entity exists in neonates, which we call massive neonatal arterial ischemic stroke (M-NAIS), and assess its potential clinical implications. METHODS Prospective multicenter cohort study comprising 48 neonates with gestational age ≥35 weeks with middle cerebral artery (MCA) NAIS was performed. Diagnosis with magnetic resonance imaging (MRI) was performed within the first three days after symptom onset. The presence of signs of a space-occupying mass, such as brain midline shift and/or ventricular and/or extra-axial space collapse, was recorded. The volume of the infarct and brain midline shift were determined with semiautomatic procedures. Neurodevelopment was assessed at age 24 months. RESULTS Fifteen (31%) neonates presented MRI signs of a space-occupying mass effect and were considered to have an M-NAIS. The relative volume (infarct volume/total brain volume) of the infarct was on average significantly greater in the M-NAIS subgroup (29% vs 4.9%, P < 0.001). Patients with M-NAIS consistently presented lesions involving the M1 arterial territory of the MCA and showed more apneic and tonic seizures, which had an earlier onset and lasted longer. Moderate to severe adverse neurodevelopmental outcomes were present in most M-NAIS cases (79% vs 6%, P < 0.001). CONCLUSIONS M-NAIS appears to be a distinctive subtype of neonatal infarction, defined by characteristic neuroimaging signs. Neonates with M-NAIS frequently present a moderate to severe adverse outcome. Early M-NAIS identification would allow for prompt, specific rehabilitation interventions and would provide more accurate prognostic information to families.
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Affiliation(s)
- Gemma Arca
- Department of Neonatology, Hospital Clínic, IDIBAPS, Barcelona, Spain; Nene Foundation, Madrid, Spain.
| | - Christian Núñez
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Mental Health Research Group, Institut d'Investigació Biomèdica-Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Christian Stephan-Otto
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Pediatric Computational Imaging Group (PeCIC), Hospital Sant Joan de Déu, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Juan Arnaez
- Nene Foundation, Madrid, Spain; Department of Neonatology, Hospital Universitario de Burgos, Burgos, Spain
| | - Thais Agut
- Nene Foundation, Madrid, Spain; Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Department of Neonatology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Malaika Cordeiro
- Department of Neonatology, La Paz University Hospital, Madrid, Spain
| | - Nuria Boronat
- Department of Neonatology, University and Politechnic Hospital La Fe, Health Research Institute La Fe, Valencia, Spain
| | - Simón Lubián-López
- Nene Foundation, Madrid, Spain; Department of Neonatology, Puerta del Mar University Hospital, Cádiz, Spain; Department of Pediatrics, Institute for Research and Innovation in Biomedical Sciences (INiBICA), Cádiz, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras, Madrid, Spain
| | - Isabel Benavente-Fernández
- Nene Foundation, Madrid, Spain; Department of Neonatology, Puerta del Mar University Hospital, Cádiz, Spain; Department of Pediatrics, Institute for Research and Innovation in Biomedical Sciences (INiBICA), Cádiz, Spain
| | - Eva Valverde
- Nene Foundation, Madrid, Spain; Department of Neonatology, La Paz University Hospital, Madrid, Spain
| | - Alfredo Garcia-Alix
- Nene Foundation, Madrid, Spain; Professor in Iberoamerican Society of Neonatology (SIBEN), Buenos Aires, Argentina
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Núñez C, Stephan-Otto C, Arca G, Agut T, Arnaez J, Cordeiro M, Benavente-Fernández I, Boronat N, Lubián-López SP, Valverde E, Hortigüela M, García-Alix A. Neonatal arterial stroke location is associated with outcome at 2 years: a voxel-based lesion-symptom mapping study. Arch Dis Child Fetal Neonatal Ed 2022; 107:45-50. [PMID: 33990386 DOI: 10.1136/archdischild-2020-320400] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 04/13/2021] [Accepted: 04/23/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVE In contrast to motor impairments, the association between lesion location and cognitive or language deficits in patients with neonatal arterial ischaemic stroke remains largely unknown. We conducted a voxel-based lesion-symptom mapping cross-sectional study aiming to reveal neonatal arterial stroke location correlates of language, motor and cognitive outcomes at 2 years of age. DESIGN Prospective observational multicentre study. SETTING Six paediatric university hospitals in Spain. PARTICIPANTS We included 53 patients who had a neonatal arterial ischaemic stroke with neonatal MRI and who were followed up till 2 years of age. MAIN OUTCOME MEASURES We analysed five dichotomous clinical variables: speech therapy (defined as the need for speech therapy as established by therapists), gross motor function impairment, and the language, motor and cognitive Bayley scales. All the analyses were controlled for total lesion volume. RESULTS We found that three of the clinical variables analysed significantly correlated with neonatal stroke location. Speech therapy was associated with lesions located mainly at the left supramarginal gyrus (p=0.007), gross motor function impairment correlated with lesions at the left external capsule (p=0.044) and cognitive impairment was associated with frontal lesions, particularly located at the left inferior and middle frontal gyri (p=0.012). CONCLUSIONS The identification of these susceptible brain areas will allow for more precise prediction of neurological impairments on the basis of neonatal brain MRI.
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Affiliation(s)
- Christian Núñez
- Departament de Psiquiatria, Institut d'Investigació Biomèdica-Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Christian Stephan-Otto
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain .,Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Gemma Arca
- Departament de Neonatologia, Hospital Clínic, IDIBAPS, Barcelona, Spain.,NeNe Foundation, Madrid, Spain
| | - Thais Agut
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain.,NeNe Foundation, Madrid, Spain.,Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Juan Arnaez
- NeNe Foundation, Madrid, Spain.,Departamento de Neonatología, Hospital Universitario de Burgos, Burgos, Spain
| | - Malaika Cordeiro
- Departamento de Neonatología, Hospital Universitario La Paz, Madrid, Spain
| | | | - Nuria Boronat
- Departamento de Neonatología, Hospital Universitario y Politécnico La Fe. Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - Simón Pedro Lubián-López
- NeNe Foundation, Madrid, Spain.,Departamento de Neonatología, Hospital Puerta del Mar, Cádiz, Spain
| | - Eva Valverde
- NeNe Foundation, Madrid, Spain.,Departamento de Neonatología, Hospital Universitario La Paz, Madrid, Spain
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Hill LF, Clements MN, Turner MA, Donà D, Lutsar I, Jacqz-Aigrain E, Heath PT, Roilides E, Rawcliffe L, Alonso-Diaz C, Baraldi E, Dotta A, Ilmoja ML, Mahaveer A, Metsvaht T, Mitsiakos G, Papaevangelou V, Sarafidis K, Walker AS, Sharland M, Clements M, Turner MA, Donà D, Lutsar I, Jacqz-Aigrain E, Heath PT, Roilides E, Rawcliffe L, Bafadal B, Alarcon Allen A, Alonso-Diaz C, Anatolitou F, Baraldi E, Del Vecchio A, Dotta A, Giuffrè M, Ilmoja ML, Karachristou K, Mahaveer A, Manzoni P, Martinelli S, Metsvaht T, Mitsiakos G, Moriarty P, Nika A, Papaevangelou V, Roehr C, Sanchez Alcobendas L, Sarafidis K, Siahanidou T, Tzialla C, Bonadies L, Booth N, Catalina Morales-Betancourt P, Cordeiro M, de Alba Romero C, de la Cruz J, De Luca M, Farina D, Franco C, Gialamprinou D, Hallik M, Ilardi L, Insinga V, Iosifidis E, Kalamees R, Kontou A, Molnar Z, Nikaina E, Petropoulou C, Reyné M, Tataropoulou K, Triantafyllidou P, Vontzalidis A, Walker AS, Sharland M. Optimised versus standard dosing of vancomycin in infants with Gram-positive sepsis (NeoVanc): a multicentre, randomised, open-label, phase 2b, non-inferiority trial. Lancet Child Adolesc Health 2022; 6:49-59. [PMID: 34843669 DOI: 10.1016/s2352-4642(21)00305-9] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 09/15/2021] [Accepted: 09/17/2021] [Indexed: 01/19/2023]
Abstract
BACKGROUND Vancomycin is the most widely used antibiotic for neonatal Gram-positive sepsis, but clinical outcome data of dosing strategies are scarce. The NeoVanc programme comprised extensive preclinical studies to inform a randomised controlled trial to assess optimised vancomycin dosing. We compared the efficacy of an optimised regimen to a standard regimen in infants with late onset sepsis that was known or suspected to be caused by Gram-positive microorganisms. METHODS NeoVanc was an open-label, multicentre, phase 2b, parallel-group, randomised, non-inferiority trial comparing the efficacy and toxicity of an optimised regimen of vancomycin to a standard regimen in infants aged 90 days or younger. Infants with at least three clinical or laboratory sepsis criteria or confirmed Gram-positive sepsis with at least one clinical or laboratory criterion were enrolled from 22 neonatal intensive care units in Greece, Italy, Estonia, Spain, and the UK. Infants were randomly assigned (1:1) to either the optimised regimen (25 mg/kg loading dose, followed by 15 mg/kg every 12 h or 8 h dependent on postmenstrual age, for 5 ± 1 days) or the standard regimen (no loading dose; 15 mg/kg every 24 h, 12 h, or 8 h dependent on postmenstrual age for 10 ± 2 days). Vancomycin was administered intravenously via 60 min infusion. Group allocation was not masked to local investigators or parents. The primary endpoint was success at the test of cure visit (10 ± 1 days after the end of actual vancomycin therapy) in the per-protocol population, where success was defined as the participant being alive at the test of cure visit, having a successful outcome at the end of actual vancomycin therapy, and not having a clinically or microbiologically significant relapse or new infection requiring antistaphylococcal antibiotics for more than 24 h within 10 days of the end of actual vancomycin therapy. The non-inferiority margin was -10%. Safety was assessed in the intention-to-treat population. This trial is registered at ClinicalTrials.gov (NCT02790996). FINDINGS Between March 3, 2017, and July 29, 2019, 242 infants were randomly assigned to the standard regimen group (n=122) or the optimised regimen group (n=120). Primary outcome data in the per-protocol population were available for 90 infants in the optimised group and 92 in the standard group. 64 (71%) of 90 infants in the optimised group and 73 (79%) of 92 in the standard group had success at test of cure visit; non-inferiority was not confirmed (adjusted risk difference -7% [95% CI -15 to 2]). Incomplete resolution of clinical or laboratory signs after 5 ± 1 days of vancomycin therapy was the main factor contributing to clinical failure in the optimised group. Abnormal hearing test results were recorded in 25 (30%) of 84 infants in the optimised group and 12 (15%) of 79 in the standard group (adjusted risk ratio 1·96 [95% CI 1·07 to 3·59], p=0·030). There were six vancomycin-related adverse events in the optimised group (one serious adverse event) and four in the standard group (two serious adverse events). 11 infants in the intention-to-treat population died (six [6%] of 102 infants in the optimised group and five [5%] of 98 in the standard group). INTERPRETATION In the largest neonatal vancomycin efficacy trial yet conducted, no clear clinical impact of a shorter duration of treatment with a loading dose was demonstrated. The use of the optimised regimen cannot be recommended because a potential hearing safety signal was identified; long-term follow-up is being done. These results emphasise the importance of robust clinical safety assessments of novel antibiotic dosing regimens in infants. FUNDING EU Seventh Framework Programme for research, technological development and demonstration.
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Affiliation(s)
- Louise F Hill
- Institute for Infection and Immunity, St George's, University of London, London, UK.
| | - Michelle N Clements
- Medical Research Council Clinical Trials Unit, University College London, London, UK
| | - Mark A Turner
- Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Daniele Donà
- Division of Pediatric Infectious Diseases, Department of Women's and Children's Health, University of Padova, Padova, Italy; Fondazione Penta, Padua, Italy
| | | | - Evelyne Jacqz-Aigrain
- Department of Pediatric Pharmacology and Pharmacogenetics, Hôpital Robert Debré, Paris, France
| | - Paul T Heath
- Institute for Infection and Immunity, St George's, University of London, London, UK
| | - Emmanuel Roilides
- 3rd Department of Pediatrics, Aristotle University, Thessaloniki, Greece
| | | | | | - Eugenio Baraldi
- Azienda Ospedale-Universita' di Padova, Fondazione Istituto di Ricerca Pediatrica, Padova, Italy
| | | | | | | | | | | | | | | | - A Sarah Walker
- Medical Research Council Clinical Trials Unit, University College London, London, UK
| | - Michael Sharland
- Institute for Infection and Immunity, St George's, University of London, London, UK
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Álvarez P, Ramiro-Cortijo D, Montes MT, Moreno B, Calvo MV, Liu G, Esteban Romero A, Ybarra M, Cordeiro M, Clambor Murube M, Valverde E, Sánchez-Pacheco A, Fontecha J, Gibson R, Saenz de Pipaon M. Randomized controlled trial of early arachidonic acid and docosahexaenoic acid enteral supplementation in very preterm infants. Front Pediatr 2022; 10:947221. [PMID: 36090567 PMCID: PMC9452757 DOI: 10.3389/fped.2022.947221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 07/25/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To evaluate changes in blood long-chain polyunsaturated fatty acid (LCPUFA) and oxylipin concentrations in very preterm infants from birth to 36 weeks' postmenstrual age (WPA) after providing an emulsified arachidonic acid (ARA):docosahexaenoic acid (DHA) supplement at two different concentrations. STUDY DESIGN This prospective, randomized trial assigned infants to receive a supplement (1) 80:40 group (80 mg/kg/day ARA and 40 mg/kg/day DHA, n = 9) or (2) 120:60 group (120 mg/kg/day ARA and 60 mg/kg/day DHA, n = 9). Infants received supplement daily from birth until 36 WPA. At baseline, 21 days of life and 36 WPA, the LCPUFAs were measured in plasma by gas chromatography/mass spectrophotometry. Additionally, LCPUFAs and oxylipins were analyzed in whole blood by ultra-high-performance liquid chromatography-tandem mass spectrometry. Furthermore, a sample of oral mucosa was obtained to analyze single-nucleotide polymorphism located in the FADS1 gene by PCR. RESULTS Gestational age was similar between groups (80:40 = 28+6 [27+3; 30+3] completed weeks+days ; 120:60 = 29+6 [27+3; 30+5] completed weeks+days , p = 0.83). At 36 WPA, the change in plasma ARA was significantly different between groups (80:40 group = 0.15 [-0.67; 0.69] %nmol, 120:60 = 1.68 [1.38; 3.16] %nmol, p = 0.031). In whole blood, the levels of ARA-derived oxylipins (5-, 8-, 9-, 11-, 15-HETE and 8,9-EET) and EPA-derived oxylipins (18-HEPE) significantly increase from baseline to 36 WPA in the 120:60 group than the 80:40 group. CONCLUSION Supplementation at high doses (120:60 mg/kg/day) increased levels of ARA, and EPA- and ARA-derived oxylipins compared to low doses (80:40 mg/kg/day). Differences were detected in EPA metabolites without a significant increase in plasma DHA.
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Affiliation(s)
- Patricia Álvarez
- Department of Neonatology, La Paz University Hospital, Universidad Autónoma de Madrid, Madrid, Spain
| | - David Ramiro-Cortijo
- Department of Physiology, Faculty of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
| | - María Teresa Montes
- Department of Neonatology, La Paz University Hospital, Universidad Autónoma de Madrid, Madrid, Spain
| | - Bárbara Moreno
- Department of Neonatology, La Paz University Hospital, Universidad Autónoma de Madrid, Madrid, Spain
| | - María V Calvo
- Food Lipid Biomarkers and Health Group, Instituto de Investigación en Ciencias de la Alimentación (CIAL, CSIC-UAM), Madrid, Spain
| | - Ge Liu
- South Australian Health and Medical Research Institute, SAHMRI Women and Kids, Adelaide, SA, Australia
| | - Ana Esteban Romero
- Department of Neonatology, La Paz University Hospital, Universidad Autónoma de Madrid, Madrid, Spain
| | - Marta Ybarra
- Department of Neonatology, La Paz University Hospital, Universidad Autónoma de Madrid, Madrid, Spain
| | - Malaika Cordeiro
- Department of Neonatology, La Paz University Hospital, Universidad Autónoma de Madrid, Madrid, Spain
| | - Marina Clambor Murube
- Department of Biochemistry, Instituto de Investigaciones Biomédicas Alberto Sols (CSIC-UAM), Madrid, Spain
| | - Eva Valverde
- Department of Neonatology, La Paz University Hospital, Universidad Autónoma de Madrid, Madrid, Spain
| | - Aurora Sánchez-Pacheco
- Department of Biochemistry, Instituto de Investigaciones Biomédicas Alberto Sols (CSIC-UAM), Madrid, Spain
| | - Javier Fontecha
- Food Lipid Biomarkers and Health Group, Instituto de Investigación en Ciencias de la Alimentación (CIAL, CSIC-UAM), Madrid, Spain
| | - Robert Gibson
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, SA, Australia.,School of Agriculture, Food and Wine, The University of Adelaide, Adelaide, SA, Australia
| | - Miguel Saenz de Pipaon
- Department of Neonatology, La Paz University Hospital, Universidad Autónoma de Madrid, Madrid, Spain
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5
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Cordeiro M, Peinado H, Montes MT, Valverde E. Evaluation of the suitability and clinical applicability of different electrodes for aEEG/cEEG monitoring in the extremely premature infant. An Pediatr (Barc) 2021; 95:423-430. [PMID: 34686476 DOI: 10.1016/j.anpede.2020.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 09/10/2020] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Monitoring of brain function using continuous electroencephalography (aEEG/cEEG) is an essential tool in the standard care of the term infant, and its use is growing in the premature infant as a biomarker of lesion and brain maturity. However, the placing of the electrodes is a great challenge, particularly in the extremely premature infant, which often discourages neuromonitoring. The aim of this study is to assess the different electrodes available, to select the one that best suits the peculiarities of the extremely premature infant, and evaluate its applicability in clinical practice. POPULATION AND METHODS With the aim of designing a neuromonitoring study protocol using aEEG/cEEG in <28 weeks premature infants, an analysis was made of our experience with the type of electrodes available. The electrode that was considered most suitable for this population was chosen by assessing: the need of preparing the scalp, speed in positioning the electrodes, if the application was invasive or not, the possibility of repositioning, risk of skin injuries, sterility of the technique, and durability. The electrode chosen was used for continuous electroencephalographic monitoring started in the first 24 h of life, and maintained until at least 72 h of life. RESULTS The electrodes evaluated were: subdermal needles, silver cups, and 2 types of self-adhesive electrodes (solid hydrogel and wet gel). The wet gel electrodes were chosen. They were used on 41 neonates with a mean gestational age of 25.8 ± 1.1 weeks. Good stable impedance was rapidly obtained, without the need of excessive manipulations, and no skin injuries were observed. The satisfaction of the staff involved in positioning them was very high. CONCLUSION The self-adhesive disposable electrodes with wet gel and integrated cable enabled the electrodes to be positioned rapidly and provided continuous non-invasive and good quality aEEG/cEEG monitoring in the extremely premature infant.
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Affiliation(s)
- Malaika Cordeiro
- Servicio de Neonatología, Hospital Universitario La Paz, Madrid, Spain; Fundación NeNe, Madrid, Spain.
| | - Helena Peinado
- Servicio de Neonatología, Hospital Universitario La Paz, Madrid, Spain
| | - María Teresa Montes
- Servicio de Neonatología, Hospital Universitario La Paz, Madrid, Spain; Fundación NeNe, Madrid, Spain
| | - Eva Valverde
- Servicio de Neonatología, Hospital Universitario La Paz, Madrid, Spain; Fundación NeNe, Madrid, Spain
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Cordeiro M, Peinado H, Montes MT, Valverde E. [Evaluation of the suitability and clinical applicability of different electrodes for aEEG/cEEG monitoring in the extremely premature infant]. An Pediatr (Barc) 2020; 95:S1695-4033(20)30425-2. [PMID: 33127340 DOI: 10.1016/j.anpedi.2020.09.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 09/10/2020] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Monitoring of brain function using continuous electroencephalography (aEEG/cEEG) is an essential tool in the standard care of the term infant, and its use is growing in the premature infant as a biomarker of lesion and brain maturity. However, the placing of the electrodes is a great challenge, particularly in the extremely premature infant, which often discourages neuromonitoring. The aim of this study is to assess the different electrodes available, to select the one that best suits the peculiarities of the extremely premature infant, and evaluate its applicability in clinical practice. POPULATION AND METHODS With the aim of designing a neuromonitoring study protocol using aEEG/cEEG in<28 weeks premature infants, an analysis was made of our experience with the type of electrodes available. The electrode that was considered most suitable for this population was chosen by assessing: the need of preparing the scalp, speed in positioning the electrodes, if the application was invasive or not, the possibility of repositioning, risk of skin injuries, sterility of the technique, and durability. The electrode chosen was used for continuous electroencephalographic monitoring started in the first 24h of life, and maintained until at least 72h of life. RESULTS The electrodes evaluated were: subdermal needles, silver cups, and 2 types of self-adhesive electrodes (solid hydrogel and wet gel). The wet gel electrodes were chosen. They were used on 41 neonates with a mean gestational age of 25.8±1.1 weeks. Good stable impedance was rapidly obtained, without the need of excessive manipulations, and no skin injuries were observed. The satisfaction of the staff involved in positioning them was very high. CONCLUSION The self-adhesive disposable electrodes with wet gel and integrated cable enabled the electrodes to be positioned rapidly and provided continuous non-invasive and good quality aEEG/cEEG monitoring in the extremely premature infant.
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Affiliation(s)
- Malaika Cordeiro
- Servicio de Neonatología, Hospital Universitario La Paz, Madrid, España; Fundación NeNe, Madrid, España.
| | - Helena Peinado
- Servicio de Neonatología, Hospital Universitario La Paz, Madrid, España
| | - María Teresa Montes
- Servicio de Neonatología, Hospital Universitario La Paz, Madrid, España; Fundación NeNe, Madrid, España
| | - Eva Valverde
- Servicio de Neonatología, Hospital Universitario La Paz, Madrid, España; Fundación NeNe, Madrid, España
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Cordeiro M, Santos D, Magalhães F, Martins G, Barbosa J, Riquieri M, Silva M, Andrade M, Ferreira B, Lima R. Carnival in Brazil as production of health care: narratives from a samba school community. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.1239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Carnival is a popular festival that was introduced in Brazil from the European heritage. However, it was the enslaved African people who saw forms and processes of resistance for the construction of identity during this festive period. The reframing and resistance that blacks establish with carnival is the result of a cultural need to stay alive both as a subject and as a collective. This is how samba schools emerge in the urban peripheries of Rio de Janeiro as a form of artistic, cultural and leisure production. Associations acquire for themselves the role of the State in providing access to rights that many are denied, neglected or scrapped. In these schools, it is possible to observe a relationship of belonging and donation (”principle of gift”) on the part of their so-called community, they are passions and meanings that produce relationships of self-care reaffirmation of intersubjectivity.
Objective
This work aims to identify the carnival as a space for the production of projects, resistances and protagonisms and to analyze the meanings of the subjective processes of health, disease, care and carnival, through the narratives of a samba school community.
Methodology
This is an exploratory analysis of a qualitative approach in public health. A samba school was chosen from the special group of the capixaba carnival, which is located in a peripheral region. We will use it to define snowball technical sampling. The data will be collected through semi-structured interviews and on-site observations by the researcher. The data analysis methodology used will be discourse analysis.
Expected Results
It is expected to understand the different practices and processes of health, disease, care and carnival, among a peripheral community that is part of a samba school.
Key messages
This work aims to analyze health care about a cultural aspect of marginalized populations and how health policies are related to carnival. Impact on the production of knowledge about popular culture and health.
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Affiliation(s)
- M Cordeiro
- Postgraduate Program in Collective Health, Federal University of Espirito Santo, Vitória, Brazil
| | - D Santos
- Postgraduate Program in Collective Health, Federal University of Espirito Santo, Vitória, Brazil
| | - F Magalhães
- Postgraduate Program in Collective Health, Federal University of Espirito Santo, Vitória, Brazil
| | - G Martins
- Postgraduate Program in Collective Health, Federal University of Espirito Santo, Vitória, Brazil
| | - J Barbosa
- Postgraduate Program in Collective Health, Federal University of Espirito Santo, Vitória, Brazil
| | - M Riquieri
- Postgraduate Program in Collective Health, Federal University of Espirito Santo, Vitória, Brazil
| | - M Silva
- Postgraduate Program in Collective Health, Federal University of Espirito Santo, Vitória, Brazil
| | - M Andrade
- Postgraduate Program in Collective Health, Federal University of Espirito Santo, Vitória, Brazil
| | - B Ferreira
- Postgraduate Program in Collective Health, Federal University of Espirito Santo, Vitória, Brazil
| | - R Lima
- Postgraduate Program in Collective Health, Federal University of Espirito Santo, Vitória, Brazil
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Barbosa J, Ferreira B, Santos D, Magalhães F, Martins G, Riquieri M, Cordeiro M, Silva M, Lima R, Andrade M. Care for women in a situation of violence: an institutionalist look. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.776] [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
Objective
To know the dynamic processes that involve the production of care for women in situations of violence.
Methods
Study of qualitative approach and cartographic inspiration based on the theoretical reference of Institutionalism that had as scenario a reference center for women in domestic violence located in Espírito Santo, Brazil. Six professionals who worked directly in the care of women participated in the research. Interventions were carried out, through seven workshops, using storytelling. The material production tools were narratives, the researcher's field diary and the collective field diary, which was built from the record and observation of all the participants in the study. The workshops were held at the center according to the availability of participants and lasted an average of 60 minutes. The meetings were recorded and later transcribed together with the notes of the field diaries, seeking, through a cartography, to give meaning to the experiences lived by the participants. Through the analysis of implication, it was possible to give visibility to the various relationships that constitute a certain reality, in which the researcher is involved.
Results
The study pointed out that violence crosses all women influencing the production of care offered by professionals at the reference center. The narratives multiplied senses contributing to the problematization of the care offered, providing the qualification of other ways of thinking/acting in health.
Conclusions
From an ethical-aesthetic-political paradigm it is possible to produce reflections that broaden the view of care for women in violent situations beyond biological issues, contributing with desirable productive processes in the prevention of violence and the promotion of health.
Key messages
It gives visibility to micropolitical processes and contributes to the construction of policies for women's health capable of welcoming differences and singularities. It shows innovation for the field of qualitative health research, broadening the view on the care of women in situations of violence beyond biological issues.
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Affiliation(s)
- J Barbosa
- Programa de Pós-graduação em Saúde Coletiva do CCS, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
| | - B Ferreira
- Programa de Pós-graduação em Saúde Coletiva do CCS, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
| | - D Santos
- Programa de Pós-graduação em Saúde Coletiva do CCS, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
| | - F Magalhães
- Programa de Pós-graduação em Saúde Coletiva do CCS, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
| | - G Martins
- Programa de Pós-graduação em Saúde Coletiva do CCS, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
| | - M Riquieri
- Programa de Pós-graduação em Saúde Coletiva do CCS, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
| | - M Cordeiro
- Programa de Pós-graduação em Saúde Coletiva do CCS, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
| | - M Silva
- Programa de Pós-graduação em Saúde Coletiva do CCS, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
| | - R Lima
- Programa de Pós-graduação em Saúde Coletiva do CCS, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
| | - M Andrade
- Programa de Pós-graduação em Saúde Coletiva do CCS, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
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Magalhaes F, Santos D, Martins G, Barbosa J, Riquieri M, Cordeiro M, Silva M, Lima R, Sarti T, Andrade M. The access to complementary and integrative health practices in public health system in Brazil. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
A qualitative and exploratory study that analyzed the perspective of access to Integrative and Complementary Practices in Health (PICS) by listening users from a selected service of primary care of a municipality.
Objective
Analyze the access to PICS in a health public service of a municipality in a state of Brazil, from the perspective of users, as well as aimed at understand the needs and desires of health care these users in the search process and use of PICS, identifying facilitators and barriers in this trajectory.
Methods
The theoretical reference from Frenk on access was used, which systematizes the flow of events at the moment when the health need is perceived until the effectiveness of the care, besides the demand and entrance in the health services and the continuity of the treatment. The data collection was done by participant observation and semi-structured interview with 29 users of the service. The narratives were worked through the analysis of thematic content.
Results
The results indicated two groups of PICS: complex medical systems and therapeutic resources. There were differences in the organization of the offer with consequent influence on the different forms of access. It was registered the interest for the use of health care in a non-biomedical logic and a re-signification of the health-disease process in PICS users, contributing to the continuity of health production.
Conclusions
It was concluded that the current models of access analysis do not contemplate the diversities of access to the PICS, and the various possibilities of encounters with these practices allow the identification of the marginality of this care in all cases analyzed.
Key messages
Integrative and Complementary Health Practices gain national relevance as they contribute to the development of health promoting activities, focus on the individual, prevention and comprehensive care. However, considered a controversial topic in a hegemonically biomedical scenario, the incorporation of these new knowledge and practices in the health field occurs in a marginal way.
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Affiliation(s)
- F Magalhaes
- Programa de Pós Graduação em Saúde Coletiva, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - D Santos
- Programa de Pós Graduação em Saúde Coletiva, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - G Martins
- Programa de Pós Graduação em Saúde Coletiva, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - J Barbosa
- Programa de Pós Graduação em Saúde Coletiva, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - M Riquieri
- Programa de Pós Graduação em Saúde Coletiva, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - M Cordeiro
- Programa de Pós Graduação em Saúde Coletiva, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - M Silva
- Programa de Pós Graduação em Saúde Coletiva, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - R Lima
- Programa de Pós Graduação em Saúde Coletiva, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - T Sarti
- Programa de Pós Graduação em Saúde Coletiva, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - M Andrade
- Programa de Pós Graduação em Saúde Coletiva, Universidade Federal do Espírito Santo, Vitória, Brazil
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Cordeiro M, Caskey S, Frank C, Martin S, Srivastava A, Atkinson T. Hybrid triad provides fracture plane stability in a computational model of a Pauwels Type III hip fracture. Comput Methods Biomech Biomed Engin 2020; 23:476-483. [PMID: 32160804 DOI: 10.1080/10255842.2020.1738404] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The study utilized finite element method to determine displacements and stresses in a set of Pauwels Type III femoral neck fractures repaired using 3 techniques (cannulated screws (Triad), sliding hip screw (SHS), and a Hybrid (SHS + cannulated screws). The research found that shear displacement doubled between the 65° and 75° fracture angles regardless of fixation construct. The SHS alone was the least stable construct, with highest construct stresses and shear displacement along the fracture plane. The stability of the Hybrid and Triad constructs were similar, but stress in the Hybrid was lower suggesting it would provide a higher load to failure than the Triad.
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Affiliation(s)
- M Cordeiro
- Orthopaedic Surgery, McLaren-Flint, Flint, MI, USA
| | - S Caskey
- Orthopaedic Surgery, McLaren-Flint, Flint, MI, USA
| | - C Frank
- Orthopaedic Surgery, McLaren-Flint, Flint, MI, USA
| | - S Martin
- Orthopaedic Surgery, McLaren-Flint, Flint, MI, USA
| | - A Srivastava
- Orthopaedic Surgery, McLaren-Flint, Flint, MI, USA
| | - T Atkinson
- Orthopaedic Surgery, McLaren-Flint, Flint, MI, USA.,Department of Mechanical Engineering, Kettering University, Flint, MI, USA
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Fonseca J, Oliveira K, Cordeiro M, Real M. Síndrome de encefalopatía posterior reversible: a propósito de un caso clínico. Neurologia 2019; 34:135-137. [DOI: 10.1016/j.nrl.2016.07.011] [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: 05/10/2016] [Revised: 07/21/2016] [Accepted: 07/25/2016] [Indexed: 10/20/2022] Open
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12
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Plomgaard AM, Alderliesten T, van Bel F, Benders M, Claris O, Cordeiro M, Dempsey E, Fumagalli M, Gluud C, Hyttel-Sorensen S, Lemmers P, Pellicer A, Pichler G, Greisen G. No neurodevelopmental benefit of cerebral oximetry in the first randomised trial (SafeBoosC II) in preterm infants during the first days of life. Acta Paediatr 2019; 108:275-281. [PMID: 29908039 PMCID: PMC6585779 DOI: 10.1111/apa.14463] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 04/20/2018] [Accepted: 06/13/2018] [Indexed: 11/30/2022]
Abstract
AIM Cerebral hypoxia has been associated with neurodevelopmental impairment. We studied whether reducing cerebral hypoxia in extremely preterm infants during the first 72 hours of life affected neurological outcomes at two years of corrected age. METHODS In 2012-2013, the phase II randomised Safeguarding the Brains of our smallest Children trial compared visible cerebral near-infrared spectroscopy (NIRS) monitoring in an intervention group and blinded NIRS monitoring in a control group. Cerebral hypoxia was significantly reduced in the intervention group. We followed up 115 survivors from eight European centres at two years of corrected age, by conducting a medical examination and assessing their neurodevelopment with the Bayley Scales of Infant and Toddler Development, Second or Third Edition, and the parental Ages and Stages Questionnaire (ASQ). RESULTS There were no differences between the intervention (n = 65) and control (n = 50) groups with regard to the mean mental developmental index (89.6 ± 19.5 versus 88.4 ± 14.7, p = 0.77), ASQ score (215 ± 58 versus 213 ± 58, p = 0.88) and the number of children with moderate-to-severe neurodevelopmental impairment (10 versus six, p = 0.58). CONCLUSION Cerebral NIRS monitoring was not associated with long-term benefits or harm with regard to neurodevelopmental outcome at two years of corrected age.
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Affiliation(s)
- Anne M. Plomgaard
- Department of Neonatology; Rigshospitalet; Copenhagen University Hospital; Copenhagen Denmark
| | - Thomas Alderliesten
- Wilhelmina Children's Hospital; University Medical Center Utrecht; Utrecht The Netherlands
| | - Frank van Bel
- Wilhelmina Children's Hospital; University Medical Center Utrecht; Utrecht The Netherlands
| | - Manon Benders
- Wilhelmina Children's Hospital; University Medical Center Utrecht; Utrecht The Netherlands
| | - Olivier Claris
- Department of Neonatology; Hospices Civils de Lyon; Claude Bernard University; Lyon France
| | - Malaika Cordeiro
- Department of Neonatology; La Paz University Hospital; Madrid Spain
| | | | - Monica Fumagalli
- NICU; Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico; Università degli Studi di Milano; Milan Italy
| | - Christian Gluud
- Copenhagen Trial Unit; Centre for Clinical Intervention Research; Rigshospitalet; Copenhagen University Hospital; Copenhagen Denmark
| | - Simon Hyttel-Sorensen
- Department of Neonatology; Rigshospitalet; Copenhagen University Hospital; Copenhagen Denmark
| | - Petra Lemmers
- Wilhelmina Children's Hospital; University Medical Center Utrecht; Utrecht The Netherlands
| | - Adelina Pellicer
- Department of Neonatology; La Paz University Hospital; Madrid Spain
| | - Gerhard Pichler
- Department of Pediatrics; Research Unit for Neonatal Micro- and Macrocirculation; Medical University of Graz; Graz Austria
| | - Gorm Greisen
- Department of Neonatology; Rigshospitalet; Copenhagen University Hospital; Copenhagen Denmark
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13
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Nuñez-Ramiro A, Benavente-Fernández I, Valverde E, Cordeiro M, Blanco D, Boix H, Cabañas F, Chaffanel M, Fernández-Colomer B, Fernández-Lorenzo JR, Kuligowski J, Loureiro B, Moral-Pumarega MT, Pavón A, Sánchez-Illana A, Tofé I, Hervás D, García-Robles A, Parra-Llorca A, Cernada M, Martinez-Rodilla J, Lorente-Pozo S, Llorens R, Marqués R, Vento M. Topiramate plus Cooling for Hypoxic-Ischemic Encephalopathy: A Randomized, Controlled, Multicenter, Double-Blinded Trial. Neonatology 2019; 116:76-84. [PMID: 31091527 DOI: 10.1159/000499084] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 02/22/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND OBJECTIVES Therapeutic interventions to improve the efficacy of whole-body cooling for hypoxic-ischemic encephalopathy (HIE) are desirable. Topiramate has been effective in reducing brain damage in experimental studies. However, in the clinical setting information is limited to a small number of feasibility trials. We launched a randomized controlled double-blinded topiramate/placebo multicenter trial with the primary objective being to reduce the antiepileptic activity in cooled neonates with HIE and assess if brain damage would be reduced as a consequence. STUDY DESIGN Neonates were randomly assigned to topiramate or placebo at the initiation of hypothermia. Topiramate was administered via a nasogastric tube. Brain electric activity was continuously monitored. Topiramate pharmacokinetics, energy-related and Krebs' cycle intermediates, and lipid peroxidation biomarkers were determined using liquid chromatography-mass spectrometry and MRI for assessing brain damage. RESULTS Out of 180 eligible patients 110 were randomized, 57 (51.8%) to topiramate and 53 (48.2%) to placebo. No differences in the perinatal or postnatal variables were found. The topiramate group exhibited less seizure burden in the first 24 h of hypothermia (topiramate, n = 14 [25.9%] vs. placebo, n = 22 [42%]); needed less additional medication, and had lower mortality (topiramate, n = 5 [9.2%] vs. placebo, n = 10 [19.2%]); however, these results did not achieve statistical significance. Topiramate achieved a therapeutic range in 37.5 and 75.5% of the patients at 24 and 48 h, respectively. A significant association between serum topiramate levels and seizure activity (p < 0.016) was established. No differences for oxidative stress, energy-related metabolites, or MRI were found. CONCLUSIONS Topiramate reduced seizures in patients achieving therapeutic levels in the first hours after treatment initiation; however, they represented only a part of the study population. Our results warrant further studies with higher loading and maintenance dosing of topiramate.
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Affiliation(s)
- Antonio Nuñez-Ramiro
- Division of Neonatology, University and Polytechnic Hospital La Fe, Valencia, Spain
| | | | - Eva Valverde
- Division of Neonatology, University Hospital La Paz, Madrid, Spain
| | - Malaika Cordeiro
- Division of Neonatology, University Hospital La Paz, Madrid, Spain
| | - Dorotea Blanco
- Division of Neonatology, University Hospital Gregorio Marañón, Madrid, Spain
| | - Hector Boix
- Department of Neonatology, University Hospital Vall d'Hebrón, Barcelona, Spain
| | - Fernando Cabañas
- Division of Neonatology, University Hospital Quirónsalud Madrid, Madrid, Spain
| | - Mercedes Chaffanel
- Division of Neonatology, Regional University Hospital Málaga, Málaga, Spain
| | | | | | | | - Begoña Loureiro
- Division of Neonatology, University Hospital Cruces, Bilbao, Spain
| | | | - Antonio Pavón
- Division of Neonatology, University Hospital Virgen del Rocío, Sevilla, Spain
| | | | - Inés Tofé
- Division of Neonatology, University Hospital Reina Sofía, Córdoba, Spain
| | - David Hervás
- Department of Biostatistics, Health Research Institute La Fe, Valencia, Spain
| | - Ana García-Robles
- Division of Neonatology, University Hospital Complex of Vigo, Vigo, Spain
| | - Anna Parra-Llorca
- Division of Neonatology, University and Polytechnic Hospital La Fe, Valencia, Spain
| | - Maria Cernada
- Division of Neonatology, University and Polytechnic Hospital La Fe, Valencia, Spain
| | | | | | - Roberto Llorens
- Department of Radiology, University and Polytechnic Hospital La Fe, Valencia, Spain
| | - Remedios Marqués
- Departament of Pharmacy, University and Polytechnic Hospital La Fe, Valencia, Spain
| | - Máximo Vento
- Division of Neonatology, University and Polytechnic Hospital La Fe, Valencia, Spain, .,Health Research Institute La Fe, Valencia, Spain,
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Carrasco Garcia I, Hindi N, Peinado J, Rincon I, Cordeiro M, Jimenez F, Falcon Gonzalez A, Lasso de la Vega R, Noguer Mediavilla M, Sancho Marquez P, Martin-Broto J. Trabectedin and radiotherapy in advanced sarcoma: Experience of a reference center. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy299.024] [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: 11/12/2022] Open
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15
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Cordeiro M, Garraffoni ARS, Lourenço AP. Rapid assessment of the orchid bee fauna (Hymenoptera: Apidae: Euglossini) in the vicinity of an urban Atlantic Forest remnant in São Paulo, Brazil. BRAZ J BIOL 2018; 79:149-151. [PMID: 29641636 DOI: 10.1590/1519-6984.171286] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 04/08/2017] [Indexed: 11/22/2022] Open
Affiliation(s)
- M Cordeiro
- Departamento de Ciências Biológicas, Universidade Federal dos Vales do Jequitinhonha e Mucuri - UFVJM, Campus JK, Rodovia MGT 367, Km 583, 5000, Bairro Alto da Jacuba, CEP 39100-000, Diamantina, MG, Brasil
| | - A R S Garraffoni
- Departamento de Biologia Animal, Instituto de Biologia, Universidade Estadual de Campinas - UNICAMP, Rua Monteiro Lobato, 255, Cidade Universitária, CEP 13083-862, Campinas, SP, Brasil
| | - A P Lourenço
- Departamento de Ciências Biológicas, Universidade Federal dos Vales do Jequitinhonha e Mucuri - UFVJM, Campus JK, Rodovia MGT 367, Km 583, 5000, Bairro Alto da Jacuba, CEP 39100-000, Diamantina, MG, Brasil
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16
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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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17
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Cruz-Monteagudo M, Medina-Franco J, Perera-Sardiña Y, Borges F, Tejera E, Paz-y-Miño C, Pérez-Castillo Y, Sánchez-Rodríguez A, Contreras- Posada Z, Cordeiro M. Probing the Hypothesis of SAR Continuity Restoration by the Removal of Activity Cliffs Generators in QSAR. Curr Pharm Des 2016; 22:5043-5056. [DOI: 10.2174/1381612822666160509124337] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 05/06/2016] [Indexed: 11/22/2022]
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18
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Mattos C, Rodrigues M, Cordeiro M, Nunes R, Teixeira H, Lima V, Koester L. Nanoemulsions containing a synthetic chalcone: Photodegradation, in vitro release, and interaction studies. J Photochem Photobiol A Chem 2016. [DOI: 10.1016/j.jphotochem.2016.05.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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19
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Cordeiro M, Giestas L, Lima JC, Baptista PMV. BioCode gold-nanobeacon for the detection of fusion transcripts causing chronic myeloid leukemia. J Nanobiotechnology 2016; 14:38. [PMID: 27185032 PMCID: PMC4869199 DOI: 10.1186/s12951-016-0192-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 05/06/2016] [Indexed: 12/24/2022] Open
Abstract
Background Gold-nanobeacons (Au-nanobeacons) have proven to be versatile systems for molecular diagnostics and therapeutic actuators. Here, we present the development and characterization of two gold nanobeacons combined with Förster resonance energy transfer (FRET) based spectral codification for dual mode sequence discrimination. This is the combination of two powerful technologies onto a single nanosystem. Results We proved this concept to detect the most common fusion sequences associated with the development of chronic myeloid leukemia, e13a2 and e14a2. The detection is based on spectral shift of the donor signal to the acceptor, which allows for corroboration of the hybridization event. The Au-nanobeacon acts as scaffold for detection of the target in a homogenous format whose output capability (i.e. additional layer of information) is potentiated via the spectral codification strategy. Conclusions The spectral coded Au-nanobeacons permit the detection of each of the pathogenic fusion sequences, with high specificity towards partial complementary sequences. The proposed BioCode Au-nanobeacon concept provides for a nanoplatform for molecular recognition suitable for cancer diagnostics. Electronic supplementary material The online version of this article (doi:10.1186/s12951-016-0192-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- M Cordeiro
- LAQV, REQUIMTE, Departamento de Química, Faculdade de Ciências e Tecnologia, Universidade Nova de Lisboa, Campus de Caparica, 2829-516, Caparica, Portugal.,CIGMH, UCIBIO, Departamento de Ciências da Vida, Faculdade de Ciências e Tecnologia, Universidade Nova de Lisboa, Campus de Caparica, 2829-516, Caparica, Portugal
| | - L Giestas
- LAQV, REQUIMTE, Departamento de Química, Faculdade de Ciências e Tecnologia, Universidade Nova de Lisboa, Campus de Caparica, 2829-516, Caparica, Portugal.,CIGMH, UCIBIO, Departamento de Ciências da Vida, Faculdade de Ciências e Tecnologia, Universidade Nova de Lisboa, Campus de Caparica, 2829-516, Caparica, Portugal
| | - J C Lima
- LAQV, REQUIMTE, Departamento de Química, Faculdade de Ciências e Tecnologia, Universidade Nova de Lisboa, Campus de Caparica, 2829-516, Caparica, Portugal
| | - P M V Baptista
- CIGMH, UCIBIO, Departamento de Ciências da Vida, Faculdade de Ciências e Tecnologia, Universidade Nova de Lisboa, Campus de Caparica, 2829-516, Caparica, Portugal.
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Kleandrova V, Luan F, Speck-Planche A, Cordeiro M. In Silico Assessment of the Acute Toxicity of Chemicals: Recent Advances and New Model for Multitasking Prediction of Toxic Effect. Mini Rev Med Chem 2015; 15:677-86. [DOI: 10.2174/1389557515666150219143604] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Revised: 11/03/2014] [Accepted: 02/14/2015] [Indexed: 11/22/2022]
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21
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Speck-Planche A, Cordeiro M. Editorial (Thematic Issue: Multi-Target Drug Discovery in Medicinal Chemistry: Current Status and Future Perspectives). Mini Rev Med Chem 2015; 15:606-7. [DOI: 10.2174/1389557515666150219121119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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22
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Tenorio-Borroto E, Ramirez F, Speck-Planche A, Cordeiro M, Luan F, Gonzalez-Diaz H. QSPR and Flow Cytometry Analysis (QSPR-FCA): Review and New Findings on Parallel Study of Multiple Interactions of Chemical Compounds with Immune Cellular and Molecular Targets. Curr Drug Metab 2014; 15:414-28. [DOI: 10.2174/1389200215666140908101152] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2013] [Revised: 01/27/2014] [Accepted: 02/07/2014] [Indexed: 11/22/2022]
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Glass HC, Wusthoff CJ, Shellhaas RA, Tsuchida TN, Bonifacio SL, Cordeiro M, Sullivan J, Abend NS, Chang T. Risk factors for EEG seizures in neonates treated with hypothermia: a multicenter cohort study. Neurology 2014; 82:1239-44. [PMID: 24610326 DOI: 10.1212/wnl.0000000000000282] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [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
OBJECTIVE To assess the risk factors for electrographic seizures among neonates treated with therapeutic hypothermia for hypoxic-ischemic encephalopathy (HIE). METHODS Three-center observational cohort study of 90 term neonates treated with hypothermia, monitored with continuous video-EEG (cEEG) within the first day of life (median age at onset of recording 9.5 hours, interquartile range 6.3-14.5), and continued for >24 hours (total recording 93.3 hours, interquartile range 80.1-112.8 among survivors). A pediatric electroencephalographer at each site reviewed cEEGs for electrographic seizures and initial EEG background category. RESULTS A total of 43 (48%) had electrographic seizures, including 9 (10%) with electrographic status epilepticus. Abnormal initial EEG background classification (excessively discontinuous, depressed and undifferentiated, burst suppression, or extremely low voltage), but not clinical variables (including pH <6.8, base excess ≤-20, or 10-minute Apgar ≤ 3), was strongly associated with seizures. CONCLUSIONS Electrographic seizures are common among neonates with HIE undergoing hypothermia and are difficult to predict based on clinical features. These results justify the recommendation for cEEG monitoring in neonates treated with hypothermia.
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Affiliation(s)
- Hannah C Glass
- From the Departments of Neurology (H.C.G., J.S.) and Pediatrics (H.C.G., S.L.B., J.S.), University of California, San Francisco; Division of Child Neurology (C.J.W.), Stanford University School of Medicine, California; the Departments of Neurology and Pediatrics (N.S.A.), The Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania; the Department of Pediatrics & Communicable Diseases (Division of Pediatric Neurology) (R.A.S.), University of Michigan, Ann Arbor; and the Division of Neurophysiology, Epilepsy & Critical Care (T.N.T., M.C., T.C.), Children's National Medical Center, Washington, DC
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Bravo MC, Cordeiro M, Deiros L, Pérez-Rodríguez J. Lethal pulmonary hypertension associated with ibuprofen treatment in a very low birth weight infant. J Paediatr Child Health 2014; 50:85-6. [PMID: 24397458 DOI: 10.1111/jpc.12445] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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25
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del Cerro MJ, Sabaté Rotés A, Cartón A, Deiros L, Bret M, Cordeiro M, Verdú C, Barrios MI, Albajara L, Gutierrez-Larraya F. Pulmonary hypertension in bronchopulmonary dysplasia: clinical findings, cardiovascular anomalies and outcomes. Pediatr Pulmonol 2014; 49:49-59. [PMID: 23788443 DOI: 10.1002/ppul.22797] [Citation(s) in RCA: 130] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Accepted: 02/10/2013] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Pulmonary hypertension (PH) worsens the prognosis of bronchopulmonary dysplasia (BPD). The following items have not been fully established for PH in BPD: clinical characterization, incidence of cardiovascular anomalies (CVAs), response to PH treatment, and outcome. STUDY DESIGN A review of clinical records, computed tomography (CT) images and catheterization data of 36 patients with PH-BPD referred to our PH Unit (March 2006 to December 2011) was performed. Twenty-nine patients without major congenital heart defects and with complete follow-up data were included. RESULTS The diagnosis of PH was made at a median age of 4.5 months (IQR 2.4-7.8), with an echocardiography estimated median right ventricular pressure/systemic pressure ratio of 70% (IQR 60-80%). CT scanning was performed in 21 patients and catheterization in 14 patients. CVAs were found in 19 patients (65.5%): aortopulmonary collaterals (n = 9), pulmonary vein stenosis (n = 7), ASD (n = 4), and PDA (n = 9). Hemodynamic data: PVRI 4.3 UW m(2) (2.7-7); PVRI/SVRI 0.44 (0.32-0.8); and transpulmonary gradient 28 mmHg (19-40). At a median follow-up of 35 months (IQR 21-91), 6 patients had undergone shunts closure, 22 received specific PH drugs, 3 spontaneously improved of their PH, and 8 (26%) had died. CONCLUSION PH in BPD is not always a transient condition; it can be diagnosed at later stages and can have a protracted course. The incidence of associated CVAs is high. Prompt diagnosis, detection, and treatment of CVAs, and specific drug therapy can improve the outcome in these patients, although the mortality rate remains high.
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Speck-Planche A, Kleandrova V, Scotti M, Cordeiro M. 3D-QSAR Methodologies and Molecular Modeling in Bioinformatics for the Search of Novel Anti-HIV Therapies: Rational Design of Entry Inhibitors. Curr Bioinform 2013. [DOI: 10.2174/1574893611308040007] [Citation(s) in RCA: 11] [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: 11/22/2022]
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Speck-Planche A, Cordeiro M. Simultaneous Modeling of Antimycobacterial Activities and ADMET Profiles: A Chemoinformatic Approach to Medicinal Chemistry. Curr Top Med Chem 2013; 13:1656-65. [DOI: 10.2174/15680266113139990116] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Accepted: 06/30/2013] [Indexed: 11/22/2022]
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28
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Fernandes A, Bernardes P, Cordeiro M, Castro MDCÉ, Velho I, Ratilal B. Examination Portability. Neuroradiol J 2011; 24:554-9. [DOI: 10.1177/197140091102400410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2010] [Accepted: 01/03/2011] [Indexed: 11/17/2022] Open
Abstract
Truly global radiology would exist if patients could visit any European physician without their CDs or films. It would be possible for patients to go to a hospital or a clinic in any European country and have their examinations done in a different country, analyzed and eventually compared with the examination done at that hospital. This paper analyzes two national projects that should be documented and analyzed: Scotland with a national archive with radiology images and Finland which is implementing a system that will create an online personal health record of the citizen with all health-related information. This possibility would improve quality in European radiology and create a true network of images and knowledge that can be the seed to improve efficiency by reducing costs and exposure to radiation and increasing knowledge sharing among European radiologists/neuroradiologists. We present here the idea of a network between three centers in three different countries that can be the start for a global project.
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Affiliation(s)
| | | | - M. Cordeiro
- Coimbra University Hospital; Coimbra, Portugal
| | | | | | - B. Ratilal
- S24 Group; Lisbon, Portugal
- Central Lisbon Hospital; Lisbon, Portugal
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Guo L, Duggan J, Cordeiro M. Alzheimers Disease and Retinal Neurodegeneration. Curr Alzheimer Res 2010; 7:3-14. [DOI: 10.2174/156720510790274491] [Citation(s) in RCA: 117] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2009] [Accepted: 01/16/2009] [Indexed: 11/22/2022]
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30
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Cordeiro M, Scaglia F, Da Silva SL, Garcia P, Grazina M, Moura C, Diogol L. The Brain-Heart Connection in Mitochondrial Respiratory Chain Diseases. Neuroradiol J 2009; 22:558-63. [DOI: 10.1177/197140090902200508] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2009] [Accepted: 10/20/2009] [Indexed: 11/15/2022] Open
Abstract
Mitochondrial respiratory chain disorders (MRCD) are a heterogeneous group of diseases leading to an inadequate production of ATP. Brain and heart are among the most affected organs. Thus far, no specific relationship has been found between specific affected areas in the central nervous system and cardiac involvement. This study investigated the relationship between specific brain involvement and heart disease in mitochondrial disorders. We hypothesize that specific areas of brain lesions in children with MRCD are more frequently correlated to heart disease than others. A retrospective evaluation of the clinical records of 63 children with a definite MRCD, was performed searching for heart disease, namely, dilated and hypertrophic cardiomyopathy and arrhythmia. Brain MR images were evaluated and characterized regarding specific areas of atrophy and involvement. These findings were correlated using the Fischer exact test whose strength was determined with the Phi coefficient. During the period analyzed, 13 children (20.6%) developed cardiac disease, of whom nine (14.3%) exhibited isolated cardiomyopathy, one (1.6%) exhibited arrhythmia and three both. The main MRI abnormalities observed were brain atrophy (65.1%) and among this group 17.5% of subjects had cerebellar involvement. In addition, supratentorial, cerebellar and brainstem white and grey matter lesions were also found. There was a statistically significant relationship between progression to cardiac disease and cerebellar atrophy (Fisher's Exact Test −0.005 and Phi 0.394) and lesions in the cerebral peduncles (0.035/0.358). Moreover, there was an additional correlation between thalamic lesions and progression to hypertrophic myocardiopathy (0.029/0.397). A statistical relationship between thalamic, mesencephalic and cerebellar involvement and cardiac disease in children with definite MRCD was observed. The true significance of this connection warrants further assessment.
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Affiliation(s)
- M. Cordeiro
- Neuroradiology, Medical Imaging Department, Faculty of Medicine, University Hospital Coimbra; Portugal
| | - F. Scaglia
- Department of Molecular and Human Genetics, Baylor College of Medicine and Texas Children's Hospital; Houston, Texas, USA
| | - S. Lopes Da Silva
- Neuroradiology, Medical Imaging Department, Faculty of Medicine, University Hospital Coimbra; Portugal
| | - P. Garcia
- Metabolic Diseases Unit, Center for Child Development “Luís Borges”, Pediatric Hospital of Coimbra - CHC EPE; Coimbra, Portugal
| | - M. Grazina
- Center for Neuroscience and Cell Biology, University of Coimbra; Coimbra, Portugal
| | - C. Moura
- Neuroradiology, Medical Imaging Department, Faculty of Medicine, University Hospital Coimbra; Portugal
| | - L. Diogol
- Department of Molecular and Human Genetics, Baylor College of Medicine and Texas Children's Hospital; Houston, Texas, USA
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Santiago F, Vieira R, Cordeiro M, Carreira I, Figueiredo A. Late-onset hyperpigmentation: a case with multi-systemic involvement and recombinant X chromosome. J Eur Acad Dermatol Venereol 2009; 24:84-5. [PMID: 19453799 DOI: 10.1111/j.1468-3083.2009.03288.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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32
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Lucio A, Campos F, Richardson M, Cordeiro M, Mazzoni M, de Lima M, Pimenta A, Bemquerer M, Figueiredo S, Gomes P, Beirao P. A New Family of Small (4kDa) Neurotoxins from the Venoms of Spiders of the Genus Phoneutria. Protein Pept Lett 2008; 15:700-8. [DOI: 10.2174/092986608785133708] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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33
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Cordeiro M, Rebimbas S, Rosinha C, Ferreira G, Marques E. 35 Complicação rara de displasia renal multiquística: a propósito de um caso clínico. An Pediatr (Barc) 2007. [DOI: 10.1016/s1695-4033(07)70793-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Miguéis A, Melo Freitas P, Cordeiro M. Anatomic evaluation of the membranous labyrinth by imaging: 3D-MRI volume-rendered reconstructions. Rev Laryngol Otol Rhinol (Bord) 2007; 128:37-40. [PMID: 17633663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
OBJECTIVES Recent advances in magnetic resonance imaging (MRI) technology has allowed the development of imaging sequences tailored to the assessment of minute anatomic detail of the temporal bone structures. Volume Rendering (VR) is a 3D rendering method used in MRI. It helps in understanding complex anatomic conditions and is particularly useful in the evaluation of tiny structures as the membranous labyrinth. The authors aimed at verifying the contribution of VR in the study of labyrinthine pathology in view of all the possible anatomic correlation. MATERIAL AND METHODS We performed 3D T2-weighted FSE MRI at 1.5 T with a dedicated surface coil, at high resolution (0.5 mm partition). All selected patients were volunteers and unknown for temporal bone pathology. RESULTS The anatomy of the cochlea and vestibule were clearly defined. We could distinguish components of the cochlea to the level of the scala tympani, the vestibule and the cochlear duct. The saccule, utricle, endolymphatic duct and sac, and semicircular canals were also distinguished. CONCLUSION Volume reconstructions yielded excellent spatial information regarding the cochlea, vestibule, semicircular canals and all three ampullae. Maximum Intensity Projection (MIP) images are useful as a preliminary study, to show eventual inner acoustic canal pathology and to provide information with the use of contrasting agents. We conclude therefore that VR seems to be essential in evaluating labyrinthine anatomy and pathology. Our results suggest that improved diagnostic information can be obtained by applying this volume visualization reconstruction technique in all inner ear neuroradiological protocols.
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Affiliation(s)
- A Miguéis
- Coimbra University School of Medicine, Department of Anatomy, Rua Larga, 3004-504 Coimbra, Portugal.
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Mascarenhas R, Tellechea O, Oliveira H, Reis JP, Cordeiro M, Migueis J. Nasal septum perforation as the presenting sign of lupus erythematosus. Dermatol Online J 2005; 11:12. [PMID: 16150220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023] Open
Abstract
Nasal septum perforation is an uncommon and not well known feature of lupus erythematosus (LE). In general, it occurs during exacerbations and in a context of systemic vasculitis. Very rarely it can be a presenting sign, accompanying more usual manifestations of LE. We report the case of a 30-year-old woman who presented with a 2-year history of painful, slowly progressive nasal septum perforation. Laboratory study disclosed positive antinuclear antibodies, circulating immune complexes, hypocomplementemia, nuclear epidermal deposition of IgG in normal skin and transitory positive antiphospholipid antibodies. Symmetric peripheral joint arthritis, photosensitivity and diffuse alopecia subsequently developed. This case seems unique in that the nasal septum perforation occurred as an isolated presenting sign; it emphasizes the value of this feature in the diagnosis of LE.
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Affiliation(s)
- R Mascarenhas
- Department of Dermatology, Coimbra University Hospital, Coimbra, Portugal
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36
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Mascarenhas R, Tellechea O, Oliveira H, Reis JP, Cordeiro M, Migueis J. Nasal septum perforation as the presenting sign of lupus erythematosus. Dermatol Online J 2005. [DOI: 10.5070/d38n61708j] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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37
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Cordeiro M. Banning the word "accident". Inj Prev 2002. [DOI: 10.1136/ip.8.1.87] [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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38
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Leiria Pinto P, Cordeiro M, Pinto R. Adolescents and school asthma knowledge and attitudes. Allergol Immunopathol (Madr) 1999; 27:245-53. [PMID: 10568874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
INTRODUCTION bronchial asthma is a chronic disease that affects a high percentage of adolescents, with a significant restriction of daily activities, and is a cause of school absenteeism. The relationships between adolescents and asthma disease in school were assessed, with a view to improving knowledge about the asthmatic adolescent. METHODS a survey was conducted in the Lisbon metropolitan area, covering urban (Lisbon) and rural (LourinhU a ) zones and including 1879 students and 81 teachers from the 7th to 9th high school years. The study groups were asthmatic students, their peers, and teachers. A self-administered questionnaire was applied to collect information. The results were compared with a reference group of 91 asthmatic students attending our Department of Immunoallergy-Hospital Dona Estefânia. Cotinine urinary measurements were made in a sample of asthmatics and a control group. RESULTS the prevalence of current asthma among students was 10%. Estimates of asthma annual burden among 7th to 9th year students from Lisbon and LourinhUa high schools included 4,307 days missed from school, 4,148 medical consultations and a minimum of 351 hospital emergency care and 80 hospital admissions. Exposure to passive smoking was not significantly different between asthmatic students and theirs peers. Cotinine urinary measurements did not discriminate between exposed and non-exposed individuals. Cigarette smoking was almost as common among adolescent asthmatics (5.4%) as it was in non-asthmatic subjects (6.7%). However, 55% of asthmatics mentioned active and passive smoking as an asthma-exacerbating factor. Asthmatic students, theirs peers and teachers showed a deficient knowledge about asthma (mean group scores: 17.6; 14.2 and 17.7 of a possible 30), particularly in the areas related to asthma recognition and its management. Asthmatics attending our Allergy Department had the highest scores. All groups showed tolerance in the sense of a positive and understanding attitude toward a person with asthma. However, traditional beliefs about asthma disease (dependence, inferiority.) were confirmed. A positive correlation between knowledge levels and tolerance attitudes was found. CONCLUSION in view of the dimension of the asthma problem in adolescence and its social and economic impact, it is justifiable to assess the need for the implementation of asthma education programs in schools in order to improve asthma management by the adolescents and their schools.
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Affiliation(s)
- P Leiria Pinto
- Hospital de Dona Estefânia, Serviço de Imunoalergologia, Lisboa, 1150, Portugal.
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39
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Cordeiro M, Lowther T, Dunn BM, Guruprasad K, Blundell T, Pais MS, Brodelius PE. Substrate specificity and molecular modelling of aspartic proteinases (cyprosins) from flowers of Cynara cardunculus subsp. flavescens cv. cardoon. Adv Exp Med Biol 1998; 436:473-9. [PMID: 9561255 DOI: 10.1007/978-1-4615-5373-1_65] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- M Cordeiro
- Department of Plant Biochemistry, Lund University, Sweden
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Brodelius PE, Cordeiro M, Mercke P, Domingos A, Clemente A, Pais MS. Molecular cloning of aspartic proteinases from flowers of Cynara cardunculus SUBSP. flavescens CV. cardoon and Centaurea calcitrapa. Adv Exp Med Biol 1998; 436:435-9. [PMID: 9561250 DOI: 10.1007/978-1-4615-5373-1_59] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- P E Brodelius
- Department of Plant Biochemistry, Lund University, Sweden
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Afzal MA, Buchanan J, Dias JA, Cordeiro M, Bentley ML, Shorrock CA, Minor PD. RT-PCR based diagnosis and molecular characterisation of mumps viruses derived from clinical specimens collected during the 1996 mumps outbreak in Portugal. J Med Virol 1997; 52:349-53. [PMID: 9260679 DOI: 10.1002/(sici)1096-9071(199708)52:4<349::aid-jmv1>3.0.co;2-1] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Clinical specimens collected during an outbreak of mumps were characterised by RT-PCR, nested PCR, and nucleotide sequencing. Mumps virus was positively identified in 12/21(57%) saliva, 9/21(43%), throat and 1/33(3%) urine specimens and further sequence comparison revealed that at least six strains of viruses, which differed from 0-9.43% at the nucleotide levels, were cocirculating during the epidemic. However, phylogenetic analysis showed that these viruses grouped with two previously identified lineages which were mostly composed of other European mumps virus isolates.
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Affiliation(s)
- M A Afzal
- Division of Virology, National Institute for Biological Standards and Control, Potters Bar, Herts, United Kingdom.
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Palminha JM, Lemos L, Cordeiro M. [Health care delivered to Portuguese children. The past, present and new challenges]. ACTA MEDICA PORT 1997; 10:119-25. [PMID: 9235841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The socio-economic development of a country as well as the state of its health, its communications network, cultural level and health care organisation together affect what is known as the health indicators. Portugal belongs to the group of UNICEF countries with the best indicators in what concerns infant mortality and death below the age of five. It is still, however, 25th and 28th respectively at world level. The authors review some of the factors which have most contributed towards the progress of the indicators over the last twenty years, namely, the role played by general practitioners, the creation of health centers, the development of a maternal-infant assistance programme and the activity of Central and District Hospitals. They analyse the recent maternal-infant programme and discuss the main short and mid-term problems in the perinatal and paediatric age groups. The socio-economic changes seen in Portuguese society, together with sociological changes and those observed in the field of pathology, call for a new approach in the organisation of care which includes the need for a new dialogue between the different health structures of a society, namely, through maintaining the functional coordinating maternal-infant units, the creation of the same units for paediatrics, new efforts by the general paediatrician, the community paediatrician and the sub-specialised paediatrician together with the general practitioners within a specific action programme of a Health Unit.
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Affiliation(s)
- J M Palminha
- Serviço de Pediatria, Hospital S. Francisco Xavier, Lisboa
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Robinson WE, Cordeiro M, Abdel-Malek S, Jia Q, Chow SA, Reinecke MG, Mitchell WM. Dicaffeoylquinic acid inhibitors of human immunodeficiency virus integrase: inhibition of the core catalytic domain of human immunodeficiency virus integrase. Mol Pharmacol 1996; 50:846-55. [PMID: 8863829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Integration of a cDNA copy of the human immunodeficiency virus (HIV) genome is mediated by an HIV-1-encoded enzyme, integrase (IN), and is required for productive infection of CD4+ lymphocytes. It had been shown that 3,5-dicaffeoylquinic acid and two analogues were potent and selective inhibitors of HIV-1 IN in vitro. To determine whether the inhibition of IN by dicaffeoylquinic acids was limited to the 3,5 substitution, 3,4-, 4,5-, and 1,5-dicaffeoylquinic acids were tested for inhibition of HIV-1 replication in tissue culture and inhibition of HIV-1 IN in vitro. All of the dicaffeoylquinic acids were found to inhibit HIV-1 replication at concentrations ranging from 1 to 6 microM in T cell lines, whereas their toxic concentrations in the same cell lines were > 120 microM. In addition, the compounds inhibited HIV-1 IN in vitro at submicromolar concentrations. Molecular modeling of these ligands with the core catalytic domain of IN indicated an energetically favorable reaction, with the most potent inhibitors filling a groove within the predicted catalytic site of IN. The calculated change in internal free energy of the ligand/IN complex correlated with the ability of the compounds to inhibit HIV-1 IN in vitro. These results indicate that the dicaffeoylquinic acids as a class are potent and selective inhibitors of HIV-1 IN and form important lead compounds for HIV drug discovery.
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Affiliation(s)
- W E Robinson
- Department of Pathology, University of California, Irvine 92697-4800, USA.
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Dias J, Cordeiro M, Afzal M, Freitas M, Morgado M, Silva J, Nunes L, Lima M, Avilez F. Mumps epidemic in Portugal despite high vaccine coverage - preliminary report. Euro Surveill 1996; 1:25-28. [PMID: 12631842 DOI: 10.2807/esm.01.04.00160-en] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A measles, mumps, and rubella (MMR) trivalent vaccine was added to Portugal's National Immunisation Programme (NIP) in 1987. All vaccines are given at health centres, free of charge, but an epidemic of mumps began in 1995, firstly in northern Portugal and
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Cordeiro M. Effect of TGF-β 1,2 and 3 on human ocular fibroblast populated collagen lattice contraction. Vision Res 1995. [DOI: 10.1016/0042-6989(95)98330-c] [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: 10/18/2022]
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Cordeiro M, Jacob E, Puhan Z, Pais M, Brodelius P. Poster C4 Milk clotting and proteolytic activity of purified cynarases from Cynara cardunculus; A comparison to chymosin. Int Dairy J 1993. [DOI: 10.1016/0958-6946(93)90045-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Schaimberg L, Ikeda F, Cordeiro M, Santos RA, Murakami S, Scheinberg MA. [Beta 2 microglobulin in lymphoproliferative status]. Rev Paul Med 1987; 105:183-4. [PMID: 3329760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Cordeiro M, Wheeler L, Lee CS, Kastritsis CD, Richardson RH. Heterochromatic chromosomes and satellite DNAs of Drosophila nasutoides. Chromosoma 1975; 51:65-73. [PMID: 49261 DOI: 10.1007/bf00285809] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Drosophila nasutoides is distinguished from other Drosophila species in that the metaphase karyotype shows a pair of very large V-shaped chromosomes. With Giemsa, a distinctive C-banding pattern is revealed along the arms of this large chromosome, indicating a largely heterochromatic nature. Furthermore, the banding patterns of the arms are symmetrical, indicating that it is an iso-chromosome. A comparison between the metaphase karyotype and polytene chromosomes suggests that the large V chromosome appears as the dot chromosome in polytene squash. One autosome has twice the arm length of typical Drosophila polytene chromosomes and arose either by centric fusion and a pericentric inversion, or by translocation connecting distal ends with a subsequent loss of one centromere. This chromosome appears to have a short arm which ectopically pairs with the proximal region of the long arm, representing a duplication of about ten bands. When the nuclear DNA is examined by neutral CsCl gradient, four satellites are observed. As much as sixty percent of the total DNA appears as satellites in the lysate of larval brains. No satellite was detectable in the lysate of salivary glands. These observations led us to suggest that the heterochromatic nature of the large V chromosome is due to the presence of all four satellites in this chromosome and that this large chromosome appears as the dot because of the under-reduplication of the satellites during polytenization.
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