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Lopes-Silva LB, Cunha DMG, Lima AC, Bioni VS, Gonçalves N, Kurita JPF, Wuo-Silva R, Silva RH. Sleep deprivation induces late deleterious effects in a pharmacological model of Parkinsonism. Exp Brain Res 2024:10.1007/s00221-024-06811-0. [PMID: 38499659 DOI: 10.1007/s00221-024-06811-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 02/18/2024] [Indexed: 03/20/2024]
Abstract
Parkinson's disease is a degenerative, chronic and progressive disease, characterized by motor dysfunctions. Patients also exhibit non-motor symptoms, such as affective and sleep disorders. Sleep disorders can potentiate clinical and neuropathological features and lead to worse prognosis. The goal of this study was to evaluate the effects of sleep deprivation (SD) in mice submitted to a progressive pharmacological model of Parkinsonism (chronic administration with a low dose of reserpine). Male Swiss mice received 20 injections of reserpine (0.1 mg/kg) or vehicle, on alternate days. SD was applied before or during reserpine treatment and was performed by gentle handling for 6 h per day for 10 consecutive days. Animals were submitted to motor and non-motor behavioral assessments and neurochemical evaluations. Locomotion was increased by SD and decreased by reserpine treatment. SD during treatment delayed the onset of catalepsy, but SD prior to treatment potentiated reserpine-induced catalepsy. Thus, although SD induced an apparent beneficial effect on motor parameters, a delayed deleterious effect on alterations induced by reserpine was found. In the object recognition test, both SD and reserpine treatment produced cognitive deficits. In addition, the association between SD and reserpine induced anhedonic-like behavior. Finally, an increase in oxidative stress was found in hippocampus of mice subjected to SD, and tyrosine hydroxylase immunoreactivity was reduced in substantia nigra of reserpine-treated animals. Results point to a possible late effect of SD, aggravating the deficits in mice submitted to the reserpine progressive model of PD.
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Affiliation(s)
- L B Lopes-Silva
- Behavioral Neuroscience Laboratory, Department of Pharmacology, Universidade Federal de São Paulo (EPM/UNIFESP), Rua Botucatu, 862, Ed. Leal Prado, São Paulo, Brazil
| | - D M G Cunha
- Behavioral Neuroscience Laboratory, Department of Pharmacology, Universidade Federal de São Paulo (EPM/UNIFESP), Rua Botucatu, 862, Ed. Leal Prado, São Paulo, Brazil
| | - A C Lima
- Behavioral Neuroscience Laboratory, Department of Pharmacology, Universidade Federal de São Paulo (EPM/UNIFESP), Rua Botucatu, 862, Ed. Leal Prado, São Paulo, Brazil
| | - V S Bioni
- Behavioral Neuroscience Laboratory, Department of Pharmacology, Universidade Federal de São Paulo (EPM/UNIFESP), Rua Botucatu, 862, Ed. Leal Prado, São Paulo, Brazil
| | - N Gonçalves
- Behavioral Neuroscience Laboratory, Department of Pharmacology, Universidade Federal de São Paulo (EPM/UNIFESP), Rua Botucatu, 862, Ed. Leal Prado, São Paulo, Brazil
| | - J P F Kurita
- Behavioral Neuroscience Laboratory, Department of Pharmacology, Universidade Federal de São Paulo (EPM/UNIFESP), Rua Botucatu, 862, Ed. Leal Prado, São Paulo, Brazil
| | - R Wuo-Silva
- Behavioral Neuroscience Laboratory, Department of Pharmacology, Universidade Federal de São Paulo (EPM/UNIFESP), Rua Botucatu, 862, Ed. Leal Prado, São Paulo, Brazil
| | - R H Silva
- Behavioral Neuroscience Laboratory, Department of Pharmacology, Universidade Federal de São Paulo (EPM/UNIFESP), Rua Botucatu, 862, Ed. Leal Prado, São Paulo, Brazil.
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Braga S, Barreto J, Torgal A, Pereira J, Leão A, Gonçalves N, Araújo L. T170 Three cases of endocrine immune-related adverse events caused by immune checkpoint inhibitor therapy. Clin Chim Acta 2022. [DOI: 10.1016/j.cca.2022.04.649] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Mainoli B, Gonçalves N, Ferreira JJ, Mégarbane B. Potential drug-drug interactions in acute poisonings managed in the intensive care unit: Occurrence, risk factors and relationship to patient severity on admission. Basic Clin Pharmacol Toxicol 2021; 130:337-345. [PMID: 34873835 DOI: 10.1111/bcpt.13698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/27/2021] [Accepted: 11/29/2021] [Indexed: 11/29/2022]
Abstract
Beyond the direct toxicity resulting from each drug in the poisoned patient, additional toxicities may result from drug-drug interactions (DDIs). We aimed to determine the frequency of potential DDIs in the poisoned patient and investigate whether DDIs are associated with severity. We conducted a 1-year cohort study in a toxicological ICU. DDIs were identified using an electronic interaction-checker tool. Among our 354 ICU poisoned patients, 134 (38%) presented at least one potential DDI between acute poisoning drugs and 180 (51%) at least one potential DDI between acute poisoning and long-term treatment drugs. Using multivariate analyses, previous suicide attempt was associated with the presence of potential DDIs between acute poisoning drugs in suicide attempt patients (P = 0.014). Chronic alcoholism (P = 0.005) and tobacco smoking (P = 0.022) were associated with the presence of potential DDIs between acute poisoning and long-term treatment drugs in recreational drug users. Presence of potential DDIs between acute poisoning and long-term treatment drugs was associated with catecholamine infusion (P = 0.022) in suicidal self-exposure patients. Presence of potential pharmacodynamic DDIs between acute poisoning and long-term treatment drugs was associated with aspiration pneumonia onset in recreational drug users (P = 0.03). ICU poisoned patients present a high rate of potential DDIs that may influence the outcome.
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Affiliation(s)
- Beatrice Mainoli
- Department of Medical and Toxicological Critical Care, Lariboisière Hospital, APHP, Paris University, INSERM UMRS-1144, Paris, France.,Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina Universidade de Lisboa, Lisbon, Portugal.,IMM, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Nilza Gonçalves
- Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina Universidade de Lisboa, Lisbon, Portugal.,IMM, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Joaquim J Ferreira
- Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina Universidade de Lisboa, Lisbon, Portugal.,IMM, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Bruno Mégarbane
- Department of Medical and Toxicological Critical Care, Lariboisière Hospital, APHP, Paris University, INSERM UMRS-1144, Paris, France
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Freitas R, Martins P, Dourado E, Salvador MJ, Santiago T, Cordeiro I, Fernandes BM, Guimarães F, Garcia S, Samões B, Gonçalves N, Fernandes Lourenco MH, Pinto AS, Rocha M, Couto M, Costa E, Araújo F, Resende C, Godinho F, Cordeiro A, Santos MJ. POS0872 CLINICAL FEATURES AND OUTCOME OF 1054 PATIENTS WITH SYSTEMIC SCLEROSIS: AN ANALYSIS OF THE PORTUGUESE REUMA.PT REGISTRY FOR SCLERODERMA (REUMA.PT/SSC). Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.3159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Systemic sclerosis (SSc) may present distinctive manifestations and survival in different ethnic and geographic groups.Objectives:To describe the clinical features, treatments, and survival of adult SSc patients registered in Reuma.pt/SSc.Methods:Demographic features, SSc subsets, fulfilment of classification criteria, clinical and immunologic characteristics, comorbidities, medication and deaths were reviewed. Survival was calculated for patients included in the registry within the first 2 years of diagnosis.Results:In total, 1054 patients were included, 87.5% female, mean age at diagnosis 52.7 ± 14.8 years. The most common subset was limited cutaneous (lc)SSc (56.3%), followed by diffuse cutaneous (dc)SSc (17.5%), preclinical SSc (13%), overlap syndrome (9.8%) and SSc sine scleroderma (3.3%). Raynaud’s phenomenon (93.4%) and skin thickening (76.9%) were the most observed manifestations. Gastrointestinal (62.8% vs 47.8%), pulmonary (59.5% vs 23%) and cardiac (12.8% vs 6.9%) involvement were significantly more prevalent in dcSSc compared to lcSSc (Table 1). 52.5% of patients were ACA positive and 21% anti-topoisomerase positive, with significant differences between lcSSc and dcSSc. One third of patients was treated with immunomodulators, 53.6% with vasodilators, 23% received glucocorticoids and 2.3% biologics.During the median follow-up 12.4 years, 83 deaths (7.9%) were verified. The overall 1, 2 and 5 years survival was 98.0%, 96.8% and 92.6% respectively, without significant differences between lcSSc and dcSSc (Figure 1).Conclusion:Reuma.pt/SSc register is useful in routine patient monitoring and contributes to improve knowledge about this rare and complex disease. Clinical features of Portuguese SSc patients are similar to what has been described in other populations although the overall 5-year survival in recently diagnosed patients appears to be higher than previously reported.Table 1.Cumulative clinical and immunologic characteristics of Portuguese SSc patientsClinical and immunologic featuresTotalN=1054Limited cutaneous SScN= 576 (56.3%)Diffuse cutaneous SScN=180 (17.5%)P valueSkin involvement – N(%) N=987688 (90.6)525 (90.7)180 (100)<0.01Skin thickening * – N (%) N= 962680 (76.9)512 (88.9)180 (100)<0.01Digital ulcers – N (%) N=970325(33.5)186 (34.7)4 (51.5)<0.01Raynaud’s Phenomenon – N (%) N=1010943 (93.4)539 (95.7)157 (92.4)0.06Musculoskeletal involvement – N(%) N=972346 (45.6)247 (42.7)99 (55)<0.01Cardiac involvement –N(%) – N=92471 (7.7)36 (6.9)19 (12.8)0.02Renal involvement –N(%) – N= 91717 (1.9)8!1.5)6 (4.1)0.07Gastrointestinal involvement - N(%) N=933508 (48.2)277 (47.8)113 (62.8)<0.01Pulmonary involvement – N(%) N=915261 (28.5)119 (23)88 (59.5)<0.01PAH – N(%) N= 87114 (1.6)10 (2)1 (0.7)0.23Intersticial lung disease – N(%) N=765218 (28.5)100 (22.7)75 (57.7)<0.01Antinuclear antibodies - N(%) N=1040934 (89.8)522 (90.2)154 (88.5)0.57Anti-centromere – N(%) N= 1027540 (52.6)383 (67.1)16 (9.5)<0.01Anti-Scl70 – N(%) N=1020214 (21)12 (3.3)104 (60.1)<0.01Anti-RNA polymerase III – N(%) N=71025 (3.5)12 (3.3)7 (5.6)0.38ComorbiditiesHypertension – N(%) N=431117 (27.1)76 (29.7)67 (20.7)0.1Hyperlipidemia – N(%) N=43171 (13.4)72 (12.2)24 (15.9)0.08Neoplasia – N(%) N=105429 (2.8)12 (2.1)7 (3.9)0.14PDE-5 (phosdiasterase-5); PPIs (proton pump inhibitors); PAH-Pulmonary arterial hypertension confirmed by right heart catheterization. Immunomodulators includes Metothrexate, Leflunomide, Hydroxycloroquine; Azathioprine, Mycophenolate Mofetil and Cyclophosphamide; * Does not include sclerodactyly.Figure 1.Panel A - Survival in years from diagnosis of patients with SSc included in Reuma.pt in the first 2 years of disease (N=472). Panel B - survival according to SSc subset (lcSSc and dcSSC).Disclosure of Interests:None declared
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Araujo F, Gonçalves N, Mourão AF. POS1180 TREATMENT COMPLIANCE OF PATIENTS WITH RHEUMATOID ARTHRITIS DURING THE FIRST WAVE OF THE SARS-CoV-2/COVID-19 PANDEMIC IN PORTUGAL: RESULTS FROM THE COVID IN RA (COVIDRA) SURVEY. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:The outcomes of the infection by the SARS-CoV-2 in patients with immune-mediated inflammatory diseases were largely unknown during the early days of the COVID-19 pandemic. It was hypothesized that these patients were at higher risk of morbidity and mortality due to their inherent immune dysfunction and immunosuppressive therapy. Several rheumatology societies issued recommendations urging patients not to stop their anti-rheumatic treatments.Objectives:To assess treatment compliance of patients with rheumatoid arthritis (RA) during the first wave of the SARS-CoV-2/COVID-19 pandemic in Portugal.Methods:The web-based survey COVIDRA (COVID in RA) was developed to assess the impact of the first wave mandatory confinement in patients with RA focusing on 5 domains: RA symptoms, attitudes towards medication, employment status, physical exercise and mental health. The questionnaire was sent to RA patients through e-mail and social media of the Portuguese Society of Rheumatology and two patient associations; and it was filled locally at two rheumatology centers in Lisbon. Recruitment took place during June and July 2020. Descriptive statistics were generated by the survey software and were afterwards transported and evaluated using appropriate biostatistics software.Results:We obtained 441 valid questionnaires. Most respondents were female (88.4%), caucasian (93.6%), with a mean age of 58 (+/-13) years. The majority (57.6%) had longstanding disease (>10 years) and were treated with csDMARDs (63.2%) and/or bDMARDs/tsDMARDS (23,7%). Only 14% (N=61) discontinued or reduced the dosage or frequency of their RA treatment. Most of these changes were previously planned by the attending physician (27.9%). Only 11 patients (18%) discontinued their immunosuppressive medication out of fear of becoming infected with SARS-CoV-2 (corresponding to 2.5% of total responders). Another 11 patients did so because they had no prescription, couldn’t go to the community/hospital pharmacy or couldn’t afford the medication. Although these numbers preclude any statistical analysis, when compared to patients who persisted on their treatment, those discontinuing due to fear of contagion were younger (56.4 vs 58.5 years), all female (100 vs 86.8%), with long-lasting disease (≥ 11 years) (90.9% vs 57.5%), more frequently treated with bDMARDs (36.4 vs 23.1%) and presenting more symptoms of depression (54.5 vs 49.7%).Conclusion:Most RA patients complied with their treatment during the first wave of the SARS-CoV-2 pandemic in Portugal. Only a minority changed their immunosuppressive treatment due to fear of SARS-CoV-2 infection. Very similar rates of immunosuppressive discontinuation due to fear of contagion were reported by other authors (such as Schmeiser et al, Pineda-sic et al and Fragoulis et al).Disclosure of Interests:Filipe Araujo Speakers bureau: Pfizer, Biogen, Novartis, Menarini, Consultant of: MSD, Nuno Gonçalves: None declared, Ana Filipa Mourão: None declared.
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Leitão R, Guerreiro C, Nunes RG, Gonçalves N, Galati G, Rosário M, Guedes LC, Ferreira JJ, Reimão S. Neuromelanin Magnetic Resonance Imaging of the Substantia Nigra in Huntington's Disease. J Huntingtons Dis 2021; 9:143-148. [PMID: 32065802 DOI: 10.3233/jhd-190388] [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] [Indexed: 11/15/2022]
Abstract
BACKGROUND Huntington's disease (HD) is an autosomal-dominant neurodegenerative disorder inducing motor, psychiatric changes and cognitive decline, characterized pathologically by striatal atrophy. Pathological changes in the extra-striatal structures, such as the substantia nigra (SN), and abnormalities in pre-synaptic striatal dopamine neurotransmission are also known to occur. Neuromelanin (NM)-sensitive magnetic resonance imaging (NM-MRI) is an innovative technique that was recently developed allowing the in vivo study of pathological changes in the dopaminergic neurons of the SN. OBJECTIVE To investigate the SN MR signal in HD patients. METHODS We performed a cross-sectional study using a specific T1-weighted MR sequence to visualize NM. The areas and signal intensity contrast ratios of the T1 hyperintense SN regions were obtained using a semi-automatic segmentation method. RESULTS A total of 8 HD patients and 12 healthy subjects were evaluated. The SN area was markedly reduced in the HD group compared with the control group (p = 0.02), even after normalization of the SN area with the midbrain area and age correction (p = 0.01). There was a significant reduction in the intensity contrast ratio of the hyperintense SN areas to crus cerebri in HD patients comparing with controls (p = 0.04) after correction for age. CONCLUSIONS NM-sensitive MR techniques were used for the first time to study the SN in HD patients, showing loss of NM in this region, supporting the implication of dopaminergic neuronal changes in disease pathology. Future research needs to be conducted to evaluate the potential of SN area and intensity contrast as biomarkers for HD.
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Affiliation(s)
- Ricardo Leitão
- ISR-Lisboa/LARSyS and Department of Bioengineering, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal
| | - Carla Guerreiro
- Neurological Imaging Department, Hospital de Santa Maria - CHULN, Lisbon, Portugal
| | - Rita G Nunes
- ISR-Lisboa/LARSyS and Department of Bioengineering, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal
| | - Nilza Gonçalves
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Giulia Galati
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Madalena Rosário
- Department of Neuroscience and Mental Health, Neurology, Hospital de Santa Maria - CHULN, Lisbon, Portugal
| | - Leonor Correia Guedes
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.,Department of Neuroscience and Mental Health, Neurology, Hospital de Santa Maria - CHULN, Lisbon, Portugal
| | - Joaquim J Ferreira
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.,CNS - Campus Neurológico Sénior, Torres Vedras, Portugal.,Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Sofia Reimão
- Neurological Imaging Department, Hospital de Santa Maria - CHULN, Lisbon, Portugal.,Imaging University Clinic, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
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Macedo A, Gonçalves N, Febra C. COVID-19 fatality rates in hospitalized patients: systematic review and meta-analysis. Ann Epidemiol 2021; 57:14-21. [PMID: 33662494 PMCID: PMC7920817 DOI: 10.1016/j.annepidem.2021.02.012] [Citation(s) in RCA: 85] [Impact Index Per Article: 28.3] [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: 05/06/2020] [Revised: 10/10/2020] [Accepted: 02/18/2021] [Indexed: 02/07/2023]
Abstract
Background Coronavirus disease (COVID-19) is an infectious disease caused by a newly discovered coronavirus. Although general and local public health report deathly cases, case fatality rates are still largely unknown. Thus, we sought to evaluate the mortality of COVID-19. Methods We searched PubMed and EMBASE databases for articles evaluating the clinical characteristics of COVID-19 patients that included clinical outcomes, between December 2020 and 24 April 2020. Two authors performed an independent selection using predefined terms of search. Results We retrieved 33 studies with a total of 13,398 patients with COVID-19 diagnosis. The mortality rate of the COVID‐19 patients was 17.1% (95% CI 12.7; 22.7, I2 = 96.9%). For general patients admitted to the hospital (excluding critical care-only studies) the mortality rate of the COVID‐19 was 11.5% (95% CI 7.7; 16.9, I2 = 96.7%). Among critical illness studies (n = 7) we found a 40.5% mortality (95% CI 31.2; 50.6, I2 = 91.8%). Conclusion High COVID-19 mortality among general admitted patients and critical care cases should guide resources allocations and economic burden calculations during the pandemics.
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Affiliation(s)
- Ana Macedo
- Keypoint - Consultoria Científica, Lda, Lisbon, Portugal; Departamento de Ciências Biomédicas e Medicina, Universidade do Algarve, Faro, Portugal.
| | - Nilza Gonçalves
- Keypoint - Consultoria Científica, Lda, Lisbon, Portugal; Nova IMS - Universidade Nova de Lisboa, Lisbon, Portugal
| | - Cláudia Febra
- Faculdade de Medicina, Universidade do Porto, Porto, Portugal
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Mainoli B, Machado T, Duarte GS, Prada L, Gonçalves N, Ferreira JJ, Costa J. Analysis of clinical and methodological characteristics of early COVID-19 treatment clinical trials: so much work, so many lost opportunities. BMC Med Res Methodol 2021; 21:42. [PMID: 33637044 PMCID: PMC7908009 DOI: 10.1186/s12874-021-01233-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 02/17/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic continues to rage on, and clinical research has been promoted worldwide. We aimed to assess the clinical and methodological characteristics of treatment clinical trials that have been set forth as an early response to the COVID-19 pandemic. METHODS First, we reviewed all registered clinical trials on COVID-19. The World Health Organization International Trials Registry Platform and national trial registries were searched for COVID-19 trials through April 19th, 2020. For each record, independent researchers extracted interventions, participants, and methodological characteristics. Second, on September 14th, 2020 we evaluated the recruitment status and availability of the results of COVID-19 treatment trials previously identified. RESULTS In April 2020, a total of 580 trials evaluating COVID-19 treatment were registered. Reporting quality was poor (core participant information was missing in 24.1 to 92.7%). Between 54.0 and 93.8% of the trials did not plan to include older people or those with a higher baseline risk. Most studies were randomised (67.9%), single-centre (58.3%), non-industry-funded (81.1%), to be conducted in China (47.6%), with a median duration of 184 days and a median sample size of 100 participants. Core endpoints (mortality, clinical status, and hospitalization length) were planned to be assessed in 5.2 to 13.1% of the trials. Five months later, 66 trials (11.4%) were reported as "Completed", and only 46 (7.9%) had public results available. One hundred forty-four of 580 trials (24.8%) either had the status "Not yet recruiting" or "Suspended", and 18 (3.1%) trials were prematurely stopped ("Terminated" or "Withdrawn") The number of completed trials and trials with results are much lower than anticipated, considering the planned follow-up. CONCLUSIONS Our results raise concerns about the success of the initial global research effort on COVID-19 treatment. The clinical and methodological characteristics of early COVID-19 treatment trials limit their capability to produce clear answers to critical questions in the shortest possible time.
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Affiliation(s)
- Beatrice Mainoli
- Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Avenida Prof. Egas Moniz, 1649-028, Lisbon, Portugal
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Tiago Machado
- Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Avenida Prof. Egas Moniz, 1649-028, Lisbon, Portugal
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Gonçalo S Duarte
- Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Avenida Prof. Egas Moniz, 1649-028, Lisbon, Portugal
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- Centro de Estudos de Medicina Baseada na Evidência, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Luísa Prada
- Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Avenida Prof. Egas Moniz, 1649-028, Lisbon, Portugal
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Nilza Gonçalves
- Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Avenida Prof. Egas Moniz, 1649-028, Lisbon, Portugal
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- Nova IMS - Universidade Nova de Lisboa, Lisbon, Portugal
| | - Joaquim J Ferreira
- Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Avenida Prof. Egas Moniz, 1649-028, Lisbon, Portugal
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - João Costa
- Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Avenida Prof. Egas Moniz, 1649-028, Lisbon, Portugal.
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.
- Centro de Estudos de Medicina Baseada na Evidência, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.
- Cochrane Movement Disorders Group, Lisbon, Portugal.
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Borém C, Maranhão A, Campos A, Freire C, Ferreira G, Araújo G, Gonçalves N. A IMPORTÂNCIA DO DIAGNÓSTICO E ESCOLHA TERAPÊUTICA NA PREVENÇÃO DE COMPLICAÇÕES E SEQUELAS PSICOSSOCIAIS NA HEMOFILIA A: RELATO DE CASO. Hematol Transfus Cell Ther 2020. [DOI: 10.1016/j.htct.2020.10.502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Bouça-Machado R, Gonçalves N, Lousada I, Patriarca MA, Costa P, Nunes R, Dias S, Caldas AC, Valadas A, Lobo PP, Guedes LC, Rosa MM, Coelho M, Ferreira JJ. Patients and Health Professional's Perspective of Functional Mobility in Parkinson's Disease. Front Neurol 2020; 11:575811. [PMID: 33193027 PMCID: PMC7657224 DOI: 10.3389/fneur.2020.575811] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 08/31/2020] [Indexed: 11/26/2022] Open
Abstract
Background: Functional mobility (FM) is the person's ability to move to accomplish daily living tasks and activities. FM limitations are common in Parkinson's disease, increase with disease progression, and can be highly disabling. Although several studies in Parkinson's disease (PD) field use this concept, only recently, a formal definition has been proposed. Objective: We aimed to explore patient's and health professional's perspectives of FM in PD. Methods: A focus group methodology has been used. Four focus groups, with a total of 10 patients and 10 health professionals, were performed. Six patients were early stage and four advanced stage. The health professional's group was composed of five neurologists and five physiotherapists. The suitability of the new concept, the impact of FM limitations in PD patient's daily routine, and the potential benefit of walking aids have been discussed. Results: All participants were able to provide a spontaneous definition of FM, matching with the proposed concept. All agreed that PD affects patient's FM, increasing the limitations with disease progression, and with the existence of a serious prejudice with walking aids that hinders its use. Early-stage patient's perspective seems to be more in line with neurologist's perspective, while the views of advanced-stage patients were closer to physiotherapist's views. Conclusion: FM concept was considered as intuitive and useful. FM limitations have an important physical and social impact in the advanced stage of the disease. Although patients and health professionals acknowledge walking aid's benefit improving patient's FM, the prejudice associated with this type of tools limits its recommendation and use.
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Affiliation(s)
- Raquel Bouça-Machado
- Faculdade de Medicina, Instituto de Medicina Molecular, Universidade de Lisboa, Lisbon, Portugal.,CNS-Campus Neurológico, Torres Vedras, Portugal
| | - Nilza Gonçalves
- Faculdade de Medicina, Instituto de Medicina Molecular, Universidade de Lisboa, Lisbon, Portugal
| | | | | | | | | | - Susana Dias
- CNS-Campus Neurológico, Torres Vedras, Portugal
| | | | - Anabela Valadas
- Faculdade de Medicina, Instituto de Medicina Molecular, Universidade de Lisboa, Lisbon, Portugal.,CNS-Campus Neurológico, Torres Vedras, Portugal.,Department of Neuroscience and Mental Health, Neurology, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), Lisbon, Portugal
| | - Patrícia Pita Lobo
- CNS-Campus Neurológico, Torres Vedras, Portugal.,Department of Neuroscience and Mental Health, Neurology, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), Lisbon, Portugal
| | - Leonor Correia Guedes
- Faculdade de Medicina, Instituto de Medicina Molecular, Universidade de Lisboa, Lisbon, Portugal.,CNS-Campus Neurológico, Torres Vedras, Portugal.,Department of Neuroscience and Mental Health, Neurology, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), Lisbon, Portugal
| | - Mário M Rosa
- Faculdade de Medicina, Instituto de Medicina Molecular, Universidade de Lisboa, Lisbon, Portugal.,Department of Neuroscience and Mental Health, Neurology, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), Lisbon, Portugal.,Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Miguel Coelho
- Faculdade de Medicina, Instituto de Medicina Molecular, Universidade de Lisboa, Lisbon, Portugal.,CNS-Campus Neurológico, Torres Vedras, Portugal.,Department of Neuroscience and Mental Health, Neurology, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), Lisbon, Portugal
| | - Joaquim J Ferreira
- Faculdade de Medicina, Instituto de Medicina Molecular, Universidade de Lisboa, Lisbon, Portugal.,CNS-Campus Neurológico, Torres Vedras, Portugal.,Department of Neuroscience and Mental Health, Neurology, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), Lisbon, Portugal.,Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
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Nascimento Dias R, Maximiliano Dutra Da Silva G, Oliveira Porfírio L, Gonçalves N. O-52 Breast Reconstruction in Women with Breast Cancer Attended in the Sexology Department of Center for Women's Health Pérola Byington Hospital. J Sex Med 2020. [DOI: 10.1016/j.jsxm.2020.07.051] [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: 11/17/2022]
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Cardoso AR, Guimarães I, Santos H, Carvalho J, Abreu D, Gonçalves N, Ferreira JJ. Cross-cultural adaptation and validation of the Swallowing Disturbance Questionnaire and the Sialorrhea Clinical Scale in Portuguese patients with Parkinson's disease. LOGOP PHONIATR VOCO 2020; 46:163-170. [PMID: 32772888 DOI: 10.1080/14015439.2020.1792979] [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] [Indexed: 01/31/2023]
Abstract
INTRODUCTION To date, no valid outcome measure has been developed in European Portuguese (EP) to evaluate the Parkinsons' Disease (PD) patients' (PwP) reports regarding their swallowing disturbances. OBJECTIVES The aim of this study was to translate and cross-culturally adapt the Swallowing Disturbance Questionnaire (SDQ) and the Sialorrhea Clinical Scale for PD (SCS-PD) into EP and to determine its clinimetric properties in PwP. MATERIALS AND METHODS The original English SDQ and SCS-PD versions were cross-culturally adapted following recommendations established in international guidelines. The validation process involved 75 PwP and 65 healthy sex- and age-matched participants. RESULTS The EP versions of the SDQ and SCS-PD are equivalent to the original versions (content, depth, and scoring). Statistical analyses for the SDQ tool revealed good feasibility (missing data <5%), acceptability (no floor or ceiling effects), excellent internal consistency (Cronbach´s α = 0.95), good construct validity (78.5% revealed large to moderate loadings), moderate convergent validity (r = 0.60), good divergent validity (r = 0.40), good known-groups validity (p-value < .05) and a fair sensitivity and specificity (AUC = 0.700). Statistical analyses for the SCS-PD tool shows good feasibility, reasonable acceptability (floor effect), good internal consistency (Cronbach´s α = 0.85), good construct validity (85.7% showed between large to moderate loadings), good convergent validity (r = 0.78), good divergent validity (r = 0.39), good known groups validity (p-value < .05) and a fair sensitivity and specificity (AUC = 0.704). CONCLUSIONS The EP versions of the SDQ and SCS-PD maintained the characteristics of the original versions and therefore consistent tools to be used in PwP.
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Affiliation(s)
- Ana Rita Cardoso
- Clinical Pharmacology and Therapeutics Unit, Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, Lisbon, Portugal.,Campus Neurológico Sénior, Torres Vedras, Portugal
| | - Isabel Guimarães
- Clinical Pharmacology and Therapeutics Unit, Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, Lisbon, Portugal.,Department of Speech Therapy, Alcoitão Health School of Sciences, Estoril, Portugal
| | | | - Joana Carvalho
- Clinical Pharmacology and Therapeutics Unit, Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, Lisbon, Portugal.,Campus Neurológico Sénior, Torres Vedras, Portugal
| | - Daisy Abreu
- Clinical Pharmacology and Therapeutics Unit, Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Nilza Gonçalves
- Clinical Pharmacology and Therapeutics Unit, Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Joaquim J Ferreira
- Clinical Pharmacology and Therapeutics Unit, Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, Lisbon, Portugal.,Campus Neurológico Sénior, Torres Vedras, Portugal
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Oliveira SR, Dionísio PA, Correia Guedes L, Gonçalves N, Coelho M, Rosa MM, Amaral JD, Ferreira JJ, Rodrigues CMP. Circulating Inflammatory miRNAs Associated with Parkinson's Disease Pathophysiology. Biomolecules 2020; 10:biom10060945. [PMID: 32585840 PMCID: PMC7356527 DOI: 10.3390/biom10060945] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 06/16/2020] [Accepted: 06/17/2020] [Indexed: 12/31/2022] Open
Abstract
Parkinson’s disease (PD) is the second most common neurodegenerative disease worldwide, being largely characterized by motor features. MicroRNAs (miRNAs) are small non-coding RNAs, whose deregulation has been associated with neurodegeneration in PD. In this study, miRNAs targeting cell death and/or inflammation pathways were selected and their expression compared in the serum of PD patients and healthy controls. We used two independent cohorts (discovery and validation) of 20 idiopathic PD patients (iPD) and 20 healthy controls each. We also analyzed an additional group of 45 patients with a mutation in the leucine-rich repeat kinase 2 (LRRK2) gene (LRRK2-PD). miRNA expression was determined using Taqman qRT-PCR and their performance to discriminate between groups was assessed by receiver operating characteristic (ROC) curve analysis. We found miR-146a, miR-335-3p, and miR-335-5p downregulated in iPD and LRRK2-PD patients versus controls in both cohorts. In addition, miR-155 was upregulated in LRRK2-PD compared to iPD patients showing an appropriate value of area under the ROC curve (AUC 0.80) to discriminate between the two groups. In conclusion, our study identified a panel of inflammatory related miRNAs differentially expressed between PD patients and healthy controls that highlight key pathophysiological processes and may contribute to improve disease diagnosis.
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Affiliation(s)
- Sara R. Oliveira
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, 1649-003 Lisbon, Portugal; (S.R.O.); (P.A.D.); (J.D.A.)
| | - Pedro A. Dionísio
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, 1649-003 Lisbon, Portugal; (S.R.O.); (P.A.D.); (J.D.A.)
| | - Leonor Correia Guedes
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal; (N.G.); (M.C.); (M.M.R.); (J.J.F.); (L.C.G.)
- Department of Neuroscience and Mental Health, Neurology, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, 1600-190 Lisbon, Portugal
| | - Nilza Gonçalves
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal; (N.G.); (M.C.); (M.M.R.); (J.J.F.); (L.C.G.)
| | - Miguel Coelho
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal; (N.G.); (M.C.); (M.M.R.); (J.J.F.); (L.C.G.)
- Department of Neuroscience and Mental Health, Neurology, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, 1600-190 Lisbon, Portugal
| | - Mário M. Rosa
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal; (N.G.); (M.C.); (M.M.R.); (J.J.F.); (L.C.G.)
- Department of Neuroscience and Mental Health, Neurology, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, 1600-190 Lisbon, Portugal
- Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, 1600-190 Lisbon, Portugal
| | - Joana D. Amaral
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, 1649-003 Lisbon, Portugal; (S.R.O.); (P.A.D.); (J.D.A.)
| | - Joaquim J. Ferreira
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal; (N.G.); (M.C.); (M.M.R.); (J.J.F.); (L.C.G.)
- Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, 1600-190 Lisbon, Portugal
| | - Cecília M. P. Rodrigues
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, 1649-003 Lisbon, Portugal; (S.R.O.); (P.A.D.); (J.D.A.)
- Correspondence: ; Tel.: +(351)-217946490
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Gonçalves N, Domingues L, Mashayekhi Sardoo A, Radu L, Rodrigues-Manica S, Neto A, Torres R, Marona J, Branco J, Mendes C, Matias R, Pimentel Dos Santos F. AB0688 GAIT PATTERN DIFFERENCES BETWEEN PATIENTS WITH RADIOGRAPHIC AND NON-RADIOGRAPHIC AXIAL SPONDYLOARTHRITIS, THE MyoSpA STUDY. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.5632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Axial spondyloarthritis (axSpA) is a chronic inflammatory disease classified as radiographic (r-axSpA) or non-radiographic (nr-axSpA). Defining the gait patterns associated with these two groups can improve its detection and promote early intervention. In normal walking, body segments move around the joints as struts of an inverted pendulum. The resultant cyclic rotations contribute to the forward translation of the body, while minimizing muscle work and maintaining stability. Recent literature describes a decline in this pendulum-like mechanism associated with aging and some neurological diseases (Parkinson and multiple sclerosis).Objectives:The aim was to compare the 3D gait kinematics of patients with r-axSpA and nr-axSpA.Methods:A cross-sectional study was conducted on 54 participants (18-50 years old), 27 patients with axSpA (according to ASAS criteria, with less than 10 years since symptoms onset) and 27 healthy controls, matched by gender, age and level of physical activity. A sub-analysis was performed involving the whole group of patients classified as r-axSpA (n=14) and nr-axSpA (n=6). Subjects movement was reconstructed using a 3D full-body kinematic model (Kinetikos, Coimbra, Portugal) fed by 15 inertial sensors placed in the head, arms, trunk, pelvis, thighs, shanks and feet. 3D gait kinematics was characterised based on variables that analyse the body movement as a whole (e.g. center of mass displacement, speed), conventional spatiotemporal parameters (e.g. stance/swing time, step length) and joints kinematics time-normalized to 101 points, comprising the gait cycle from 0 to 100%. Nonparametric statistical tests were used.Results:In the r-axSpA group, 71,4% were male, with a mean age of 34.43±7.84 years and a BASDAI of 2.84±2.39, whereas in the nr-axSpA, 50% were male, with a mean age of 41.83±6.27 years and a BASDAI of 2.99±0.58. A statistically significant difference was observed in the displacement of the center of mass (with respect to the pelvis local coordinate system) along the anteroposterior axis between the two studied groups (H = 4.96, p = 0.03), with a mean rank displacement of 8.6 for r-axSpA and 15.00 for nr-axSpa, corresponding to a reduction in displacement of 38% (mean 0.00986 vs 0.01579m), in the r-axSpa group.Conclusion:Our preliminary results in r-axSpA subjects show a reduction of the pendulum mechanism. Although no significant segmental (kinematics) changes were observed, the sum of all studied variables result in a clear different gait pattern between the two groups. The observed decline can be an early sign of the inefficiency of the r-axSpA group to minimise the cost of transport of the center of mass during walking (i.e. increased instability). This study shows the potential of gait analysis to identify subjects who may benefit from early physiotherapy intervention.Disclosure of Interests:Nuno Gonçalves: None declared, Lúcia Domingues: None declared, Atlas Mashayekhi Sardoo: None declared, Lucian Radu: None declared, Santiago Rodrigues-Manica Speakers bureau: Jansse, MSD, Novartis, Agna Neto: None declared, Rita Torres: None declared, José Marona: None declared, Jaime Branco Speakers bureau: Vitoria, César Mendes: None declared, Ricardo Matias: None declared, Fernando Pimentel dos Santos Speakers bureau: Novartis, Pfizer, Biogen, Vitoria,
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Bouça-Machado R, Pona-Ferreira F, Gonçalves N, Leitão M, Cacho R, Castro-Caldas A, Ferreira JJ, and CNS Multidisciplinary Team. Outcome Measures for Evaluating the Effect of a Multidisciplinary Intervention on Axial Symptoms of Parkinson's Disease. Front Neurol 2020; 11:328. [PMID: 32477239 PMCID: PMC7235279 DOI: 10.3389/fneur.2020.00328] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 04/03/2020] [Indexed: 11/13/2022] Open
Abstract
Introduction: The satisfactory symptomatic control of the axial symptoms of Parkinson's disease (PD) remains challenging. As these symptoms are an important cause of disability, new therapeutic strategies should be developed and evaluated. To do this, it is necessary to select the outcomes to be measured and reported in a clinical trial. In this study, we sought to identify the most responsive outcome measures for assessing the efficacy of a multidisciplinary intervention on the axial symptoms of PD. Methods: An exploratory prospective clinical study was conducted. PD patients engaged in a pre-defined multidisciplinary intervention program for parkinsonian patients were assessed at admission and discharge by a multidisciplinary team. The responsiveness to intervention was evaluated and the smallest sample size needed to enable statistically significant results for an expected 30% change from baseline for each outcome was calculated. Results: Twenty-two patients were included in the study. The effect size detected varied between 0.04 and 0.83. The Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) total score and each subsection, the N-FOG questionnaire, the 10-m walk test, and Frenchay Dysarthria Assessment-2 Edition (FDA-2) showed a medium to large effect size. Sample size calculations for 90% power and assuming 30% change from baseline ranged from eight to 180 participants. The outcome measures that require a small number of participants to enable statistically significant results were the FDA-2 rating scale (n = 4 participants), the MDS-UPDRS total score (n = 9), the 10-m walk test (n = 9), and the MDS-UPDRS motor examination (n = 10). Conclusions: The MDS-UPDRS part III and total score and the 10-m walk test were the outcomes with the best responsiveness to a multidisciplinary intervention and required a small number of participants to enable statistically significant results. Further studies are needed to clarify the suitability of the Timed Up and Go test.
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Affiliation(s)
- Raquel Bouça-Machado
- Instituto de Medicina Molecular, Lisbon, Portugal
- CNS—Campus Neurológico Sénior, Torres Vedras, Portugal
| | | | | | | | - Ricardo Cacho
- CNS—Campus Neurológico Sénior, Torres Vedras, Portugal
| | | | - Joaquim J. Ferreira
- Instituto de Medicina Molecular, Lisbon, Portugal
- CNS—Campus Neurológico Sénior, Torres Vedras, Portugal
- Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
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Caldeira D, Marques A, Almeida J, Rodrigues T, Alves M, David C, Gonçalves N, Costa J, Ferreira JJ, Pinto FJ. Recommendations and levels of evidence in the guidelines of the European Society of Cardiology: current scenario and time trends. Eur Heart J Cardiovasc Pharmacother 2020; 6:122-124. [PMID: 31621843 DOI: 10.1093/ehjcvp/pvz060] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 10/08/2019] [Accepted: 10/14/2019] [Indexed: 11/14/2022]
Affiliation(s)
- Daniel Caldeira
- Centro Cardiovascular da Universidade de Lisboa-CCUL, CAML, Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, Lisboa 1649-028, Portugal.,Serviço de Cardiologia, Hospital Universitário de Santa Maria-CHULN, Lisboa, Portugal.,Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.,Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Ana Marques
- Serviço de Cardiologia, Hospital Garcia de Orta, Almada, Portugal
| | - João Almeida
- Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Tiago Rodrigues
- Serviço de Cardiologia, Hospital Universitário de Santa Maria-CHULN, Lisboa, Portugal
| | - Mariana Alves
- Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.,Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.,Serviço de Medicina III, Hospital Pulido Valente, CHULN, Lisboa, Portugal
| | - Cláudio David
- Centro Cardiovascular da Universidade de Lisboa-CCUL, CAML, Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, Lisboa 1649-028, Portugal.,Serviço de Cardiologia, Hospital Universitário de Santa Maria-CHULN, Lisboa, Portugal.,Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Nilza Gonçalves
- Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.,Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - João Costa
- Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.,Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Joaquim J Ferreira
- Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.,Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Fausto J Pinto
- Centro Cardiovascular da Universidade de Lisboa-CCUL, CAML, Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, Lisboa 1649-028, Portugal.,Serviço de Cardiologia, Hospital Universitário de Santa Maria-CHULN, Lisboa, Portugal
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Miranda D, Breda J, Cardoso R, Gonçalves N, Caldas AC, Ferreira JJ. Should the Energy Contribution of Commercial Thickeners Be Considered in the Nutrition Plan of Patients With Dysphagia? Nutr Clin Pract 2019; 35:649-654. [PMID: 31489690 DOI: 10.1002/ncp.10408] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Clinical management options for dysphagia include the use of thickeners to increase the consistency of liquids. Health professionals may not be aware of the nutrition value of these products, since there are no such recommendation in clinical guidelines. Our aim was to estimate the added nutrition value of the 2 types of commercial thickeners (starch and xanthan gum) to daily nutrition intake and compare their nutrition value for nectar, honey, and pudding consistencies. Additionally, we compared the nutrition value of both thickeners with a high-energy powder, since they share the same main ingredients. METHODS We collected recommended dosages for obtaining the 3 different consistencies and nutrition content from the technical food labels. Daily intake of fluids was estimated from the Portuguese National Food, Nutrition and Physical Activity Survey. Total daily amount of thickener needed was estimated, as well as their correspondent nutrition contributions. RESULTS Estimated daily fluid intake was 2439 mL. Starch thickeners provide significantly more energy at all consistencies than xanthan gum provides (423-846 kcal, P < 0.05, and 103-308 kcal, P < 0.05, respectively). Significantly more fiber is provided by xanthan gum thickeners (9 g in nectar and 27 g in pudding consistencies, P < 0.05). Median energy and carbohydrate values per 100 g of high-energy powder modules and starch thickeners are similar. CONCLUSION The nutrition value of thickeners should be routinely considered in the nutrition assessment and planning of patients with dysphagia for liquids, since they contribute significantly with energy, carbohydrate, and fiber.
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Affiliation(s)
- Diana Miranda
- CNS- Campus Neurológico Sénior, Torres Vedras, Portugal
| | - Joana Breda
- CNS- Campus Neurológico Sénior, Torres Vedras, Portugal
| | - Rita Cardoso
- CNS- Campus Neurológico Sénior, Torres Vedras, Portugal.,Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Nilza Gonçalves
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Ana Castro Caldas
- CNS- Campus Neurológico Sénior, Torres Vedras, Portugal.,Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Joaquim J Ferreira
- CNS- Campus Neurológico Sénior, Torres Vedras, Portugal.,Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.,Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
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Denysiuk R, Gonçalves N, Pinto R, Silva H, Duarte F, Nunes J, Gaspar-Cunha A. Optimization of Injection Stretch Blow Molding: Part I – Defining Part Thickness Profile. INT POLYM PROC 2019. [DOI: 10.3139/217.3746] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract
This paper suggests a methodology based on a neuroevolutionary approach to optimize the use of material in blow molding applications. This approach aims at determining the optimal thickness distribution for a certain blow molded product as a function of its geometry. Multiobjective search is performed by neuroevolution to reflect the conflicting nature of the design problem and to capture some possible trade-offs. During the search, each design alternative is evaluated through a finite element analysis. The coordinates of the mesh elements are the inputs to an artificial neural network whose output determines the thickness for the corresponding location. The proposed approach is applied to the design of an industrial bottle. The results reveal the validity and usefulness of the proposed technique, which was able to distribute the material along the most critical regions to obtain adequate mechanical properties. The approach is general and can be applied to products with different geometries.
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Affiliation(s)
- R. Denysiuk
- IPC , Institute for Polymer and Composites, University of Minho, Guimarães , Portugal
| | - N. Gonçalves
- PIEP , Innovation in Polymer Engineering, University of Minho, Guimarães , Portugal
| | - R. Pinto
- IPC , Institute for Polymer and Composites, University of Minho, Guimarães , Portugal
| | - H. Silva
- IPC , Institute for Polymer and Composites, University of Minho, Guimarães , Portugal
| | - F. Duarte
- IPC , Institute for Polymer and Composites, University of Minho, Guimarães , Portugal
| | - J. Nunes
- IPC , Institute for Polymer and Composites, University of Minho, Guimarães , Portugal
| | - A. Gaspar-Cunha
- IPC , Institute for Polymer and Composites, University of Minho, Guimarães , Portugal
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Sevilha J, Calle M, Gonçalves N, Ferreira C, Torgal A, Reynolds C, Freitas J, Dias M. The importance of the clinical pathologist in the diagnosis of a medical emergency. Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Cardoso R, Guimarães I, Santos H, Loureiro R, Domingos J, Abreu D, Gonçalves N, Pinto S, Ferreira JJ. Psychosocial impact of Parkinson's disease-associated dysarthria: Cross-cultural adaptation and validation of the Dysarthria Impact Profile into European Portuguese. Geriatr Gerontol Int 2018; 18:767-774. [PMID: 29372587 DOI: 10.1111/ggi.13255] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 11/21/2017] [Accepted: 12/10/2017] [Indexed: 11/30/2022]
Abstract
AIM The present study sought to make a cross-cultural adaptation of the Dysarthria Impact Profile (DIP) for European Portuguese (EP) and validate it for use in Parkinson's disease (PD) patients. METHODS The cross-cultural adaptation was carried out in accordance with the guidelines. The EP version of the DIP was administered to 80 people with PD, and 30 sex- and age-matched control participants. Psychometric properties, acceptability, feasibility reliability (internal consistency and intrarater agreement) and validity (construct, convergent and known-groups validity) were assessed using other assessment tools (motor disability and impairment, and voice impact). RESULTS Overall, the EP-DIP final version has the same conceptual meaning, semantics, idiomatic and score equivalences as the original version. Statistical analyses showed adequate feasibility (missing data <5%), good acceptability (ceiling or floor effects <15%; high requests of assistance to complete the questionnaire), satisfactory internal consistency (Cronbach's α = 0.9), weak-to-moderate intrarater reliability, good construct validity, strong convergent validity (with the Voice Handicap Index; Spearman's P = -0.8) and good known-groups validity (between those with PD and control participants). CONCLUSIONS The EP-DIP version displays the salient features of a valid patient-based assessment tool used to measure the psychosocial impact of slight-to-mild dysarthria in people with PD. Geriatr Gerontol Int 2018; 18: 767-774.
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Affiliation(s)
- Rita Cardoso
- Clinical Pharmacological Unit, Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, Lisbon, Portugal.,Movement Disorders Unit, Torres Vedras, Portugal
| | - Isabel Guimarães
- Clinical Pharmacological Unit, Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, Lisbon, Portugal.,Department of Speech Therapy, Escola superior de Saúde de Alcoitão, Estoril, Portugal
| | - Helena Santos
- Clinical Pharmacological Unit, Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, Lisbon, Portugal.,Movement Disorders Unit, Torres Vedras, Portugal
| | | | - Josefa Domingos
- Clinical Pharmacological Unit, Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Daisy Abreu
- Clinical Pharmacological Unit, Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Nilza Gonçalves
- Clinical Pharmacological Unit, Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Serge Pinto
- Laboratoire Parole et Language (LPL), Aix-Marseille Université/CNRS, Aix-en-Provence, France
| | - Joaquim J Ferreira
- Clinical Pharmacological Unit, Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, Lisbon, Portugal.,Movement Disorders Unit, Torres Vedras, Portugal
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21
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Wiederkehr JC, Igreja MR, Gonçalves N, Nogara M, Godoy M, Drago C, Massutti AM, Wiederkehr HA, Wiederkehr BA. Liver Transplantation Using Prolonged Cold Ischemia Time Grafts Preserved With Institute George-Lopez-1 Solution. Transplant Proc 2018; 50:711-713. [PMID: 29661421 DOI: 10.1016/j.transproceed.2018.02.041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Institute George-Lopez-1 (IGL-1) solution is a preservation solution with lower potassium and lower viscosity than the University of Wisconsin solution that has been recently used in liver transplantation. In the present series, we compare the outcome of liver grafts from brain-dead donors preserved in IGL-1cold storage solution, with cold ischemia times (CITs) longer than 8 hours and those less than 8 hours. Two hundred fifty-two liver transplantations performed from January 2014 to December 2016 at Hospital Santa Isabel, Blumenau, Brazil, were retrospectively analyzed. The patients were divided in two groups according to the CIT. Group I patients (N = 155) had less than 8 hours of CIT with a mean age of 54 ± 11.35 years, whereas group II patients (N = 97) had more than 8 hours of CIT with a mean age of 52 ± 12.5 years. There was no difference between the groups related to indication for liver transplantation and donor characteristics. The only difference statically significant on laboratory data was between the levels of aspartate aminotransferase at day 1 after transplantation. On day 7 post-transplantation there was no difference statistically significant between aspartate aminotransferase, alanine aminotransferase, and bilirubin levels between the two groups. Similar 1-year patient survival rates were found in both groups, with 85.88% for group I and 85.75% in group II. The IGL-1 solution has been shown to be safe, effective, and with good results in liver transplantations. Early graft function and 1-year patient survival rates did not differ when grafts preserved for less than 8 hours were compared to those with CIT greater than 8 hours.
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Affiliation(s)
- J C Wiederkehr
- Liver Transplant Division, Santa Isabel Hospital, Blumenau, SC, Brazil.
| | - M R Igreja
- Liver Transplant Division, Santa Isabel Hospital, Blumenau, SC, Brazil
| | - N Gonçalves
- Liver Transplant Division, Santa Isabel Hospital, Blumenau, SC, Brazil
| | - M Nogara
- Liver Transplant Division, Santa Isabel Hospital, Blumenau, SC, Brazil
| | - M Godoy
- Liver Transplant Division, Santa Isabel Hospital, Blumenau, SC, Brazil
| | - C Drago
- Liver Transplant Division, Santa Isabel Hospital, Blumenau, SC, Brazil
| | - A M Massutti
- Liver Transplant Division, Santa Isabel Hospital, Blumenau, SC, Brazil
| | - H A Wiederkehr
- Liver Transplant Division, Santa Isabel Hospital, Blumenau, SC, Brazil
| | - B A Wiederkehr
- Liver Transplant Division, Santa Isabel Hospital, Blumenau, SC, Brazil
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22
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Pinho R, Guedes LC, Soreq L, Lobo PP, Mestre T, Coelho M, Rosa MM, Gonçalves N, Wales P, Mendes T, Gerhardt E, Fahlbusch C, Bonifati V, Bonin M, Miltenberger-Miltényi G, Borovecki F, Soreq H, Ferreira JJ, Outeiro TF. Correction: Gene Expression Differences in Peripheral Blood of Parkinson's Disease Patients with Distinct Progression Profiles. PLoS One 2017; 12:e0190552. [PMID: 29284061 PMCID: PMC5746279 DOI: 10.1371/journal.pone.0190552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
[This corrects the article DOI: 10.1371/journal.pone.0157852.].
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23
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Castro J, Costa JC, Castro I, Abreu D, Gonçalves N, Conceição I. P269 Small fiber assessment by sudoscan in transthyretin familial amyloid polyneuropathy treated patients – A longitudinal study. Clin Neurophysiol 2017. [DOI: 10.1016/j.clinph.2017.07.277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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24
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Fabbri M, Guimarães I, Cardoso R, Coelho M, Guedes LC, Rosa MM, Godinho C, Abreu D, Gonçalves N, Antonini A, Ferreira JJ. Speech and Voice Response to a Levodopa Challenge in Late-Stage Parkinson's Disease. Front Neurol 2017; 8:432. [PMID: 28878734 PMCID: PMC5572389 DOI: 10.3389/fneur.2017.00432] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 08/08/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Parkinson's disease (PD) patients are affected by hypokinetic dysarthria, characterized by hypophonia and dysprosody, which worsens with disease progression. Levodopa's (l-dopa) effect on quality of speech is inconclusive; no data are currently available for late-stage PD (LSPD). OBJECTIVE To assess the modifications of speech and voice in LSPD following an acute l-dopa challenge. METHOD LSPD patients [Schwab and England score <50/Hoehn and Yahr stage >3 (MED ON)] performed several vocal tasks before and after an acute l-dopa challenge. The following was assessed: respiratory support for speech, voice quality, stability and variability, speech rate, and motor performance (MDS-UPDRS-III). All voice samples were recorded and analyzed by a speech and language therapist blinded to patients' therapeutic condition using Praat 5.1 software. RESULTS 24/27 (14 men) LSPD patients succeeded in performing voice tasks. Median age and disease duration of patients were 79 [IQR: 71.5-81.7] and 14.5 [IQR: 11-15.7] years, respectively. In MED OFF, respiratory breath support and pitch break time of LSPD patients were worse than the normative values of non-parkinsonian. A correlation was found between disease duration and voice quality (R = 0.51; p = 0.013) and speech rate (R = -0.55; p = 0.008). l-Dopa significantly improved MDS-UPDRS-III score (20%), with no effect on speech as assessed by clinical rating scales and automated analysis. CONCLUSION Speech is severely affected in LSPD. Although l-dopa had some effect on motor performance, including axial signs, speech and voice did not improve. The applicability and efficacy of non-pharmacological treatment for speech impairment should be considered for speech disorder management in PD.
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Affiliation(s)
- Margherita Fabbri
- Faculty of Medicine, Instituto de Medicina Molecular, University of Lisbon, Lisbon, Portugal
| | - Isabel Guimarães
- Faculty of Medicine, Instituto de Medicina Molecular, University of Lisbon, Lisbon, Portugal.,Department of Speech Therapy, Escola Superior de Saúde de Alcoitão, Estoril, Portugal
| | - Rita Cardoso
- Faculty of Medicine, Instituto de Medicina Molecular, University of Lisbon, Lisbon, Portugal.,Campus Neurológico Sénior, Torres Vedras, Portugal
| | - Miguel Coelho
- Department of Neurosciences, Hospital Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal.,Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Leonor Correia Guedes
- Department of Neurosciences, Hospital Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal.,Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Mario M Rosa
- Faculty of Medicine, Instituto de Medicina Molecular, University of Lisbon, Lisbon, Portugal.,Department of Neurosciences, Hospital Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal.,Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Catarina Godinho
- Center for Interdisciplinary Research Egas Moniz (CiiEM), Instituto Superior de Ciências da Saúde Egas Moniz, Almada, Portugal
| | - Daisy Abreu
- Faculty of Medicine, Instituto de Medicina Molecular, University of Lisbon, Lisbon, Portugal
| | - Nilza Gonçalves
- Faculty of Medicine, Instituto de Medicina Molecular, University of Lisbon, Lisbon, Portugal
| | - Angelo Antonini
- Parkinson Disease and Movement Disorders Unit, IRCCS San Camillo Hospital Foundation, Venice-Lido, Italy.,Department of Neurosciences, University of Padua, Padua, Italy
| | - Joaquim J Ferreira
- Faculty of Medicine, Instituto de Medicina Molecular, University of Lisbon, Lisbon, Portugal.,Campus Neurológico Sénior, Torres Vedras, Portugal.,Department of Neurosciences, Hospital Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal.,Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
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25
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Correia Guedes L, Reimão S, Paulino P, Nunes RG, Bouça-Machado R, Abreu D, Gonçalves N, Soares T, Fabbri M, Godinho C, Pita Lobo P, Neutel D, Quadri M, Coelho M, Rosa MM, Campos J, Outeiro TF, Sampaio C, Bonifati V, Ferreira JJ. Neuromelanin magnetic resonance imaging of the substantia nigra in LRRK2
-related Parkinson's disease. Mov Disord 2017; 32:1331-1333. [DOI: 10.1002/mds.27083] [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: 03/28/2017] [Revised: 05/17/2017] [Accepted: 05/31/2017] [Indexed: 11/06/2022] Open
Affiliation(s)
- Leonor Correia Guedes
- Department of Neurosciences and Mental Health, Neurology; Hospital de Santa Maria-CHLN; Lisbon Portugal
- Clinical Pharmachology Unit; Instituto de Medicina Molecular; Lisbon Portugal
| | - Sofia Reimão
- Clinical Pharmachology Unit; Instituto de Medicina Molecular; Lisbon Portugal
- Neurological Imaging Department; Hospital de Santa Maria-CHLN; Lisbon Portugal
| | - Patrícia Paulino
- Instituto de Biofísica e Engenharia Biomédica, Faculty of Science; University of Lisbon; Portugal
- Faculty of Science and Technology; Nova University of Lisbon; Campus da Caparica Portugal
| | - Rita G. Nunes
- Instituto de Biofísica e Engenharia Biomédica, Faculty of Science; University of Lisbon; Portugal
| | | | - Daisy Abreu
- Clinical Pharmachology Unit; Instituto de Medicina Molecular; Lisbon Portugal
| | - Nilza Gonçalves
- Clinical Pharmachology Unit; Instituto de Medicina Molecular; Lisbon Portugal
| | - Tiago Soares
- Clinical Pharmachology Unit; Instituto de Medicina Molecular; Lisbon Portugal
| | - Margherita Fabbri
- Clinical Pharmachology Unit; Instituto de Medicina Molecular; Lisbon Portugal
| | - Catarina Godinho
- Clinical Pharmachology Unit; Instituto de Medicina Molecular; Lisbon Portugal
| | - Patrícia Pita Lobo
- Clinical Pharmachology Unit; Instituto de Medicina Molecular; Lisbon Portugal
| | - Dulce Neutel
- Clinical Pharmachology Unit; Instituto de Medicina Molecular; Lisbon Portugal
| | - Marialuisa Quadri
- Department of Clinical Genetics; Erasmus MC; Rotterdam The Netherlands
| | - Miguel Coelho
- Department of Neurosciences and Mental Health, Neurology; Hospital de Santa Maria-CHLN; Lisbon Portugal
- Clinical Pharmachology Unit; Instituto de Medicina Molecular; Lisbon Portugal
| | - Mario M. Rosa
- Department of Neurosciences and Mental Health, Neurology; Hospital de Santa Maria-CHLN; Lisbon Portugal
- Clinical Pharmachology Unit; Instituto de Medicina Molecular; Lisbon Portugal
- Laboratory of Clinical Pharmachology and Therapeutics, Faculty of Medicine; University of Lisbon; Portugal
| | - Jorge Campos
- Neurological Imaging Department; Hospital de Santa Maria-CHLN; Lisbon Portugal
| | - Tiago F. Outeiro
- CEDOC, Chronic Diseases Research Centre, Nova Medical School; Nova University of Lisbon; Lisboa Portugal
- Department of Experimental Neurodegeneration, Center for Biostructural Imaging of Neurodegeneration, Center for Nanoscale Microscopy and Molecular Physiology of the Brain (CNMPB); University Medical Center Gottingen; Germany
- Max Planck Institute for Experimental Medicine; Gottingen Germany
| | - Cristina Sampaio
- Laboratory of Clinical Pharmachology and Therapeutics, Faculty of Medicine; University of Lisbon; Portugal
| | - Vincenzo Bonifati
- Department of Clinical Genetics; Erasmus MC; Rotterdam The Netherlands
| | - Joaquim J. Ferreira
- Clinical Pharmachology Unit; Instituto de Medicina Molecular; Lisbon Portugal
- Laboratory of Clinical Pharmachology and Therapeutics, Faculty of Medicine; University of Lisbon; Portugal
- CNS-Campus Neurológico Sénior; Torres Vedras Portugal
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26
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Fabbri M, Coelho M, Guedes LC, Rosa MM, Abreu D, Gonçalves N, Antonini A, Ferreira JJ. Acute response of non-motor symptoms to subthalamic deep brain stimulation in Parkinson's disease. Parkinsonism Relat Disord 2017; 41:113-117. [PMID: 28528805 DOI: 10.1016/j.parkreldis.2017.05.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [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: 03/21/2017] [Revised: 05/03/2017] [Accepted: 05/06/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND Subthalamic deep brain stimulation (STN-DBS) is an established treatment for the motor complications of Parkinson's disease (PD) and may have beneficial effects on non-motor symptoms (NMS). However, the acute effect of STN stimulation on NMS has only been explored in small PD cohorts with short post-surgical follow-up. OBJECTIVE To study NMS response to an acute stimulation challenge in an STN-DBS PD population with a medium/long-term post-surgical follow-up. METHODS 32 STN-DBS PD patients were tested twice (MED OFF/STIM OFF and MED OFF/STIM ON). MDS-UPDRS-III, blood pressure (BP) assessment, a visual analogue scale for pain and fatigue and State Trait Anxiety Scale score were evaluated during both stimulation conditions. NMS were assessed with MDS-UPDRS-I, Non-Motor Symptoms Scale, Geriatric Depression Scale and the Neuropsychiatric Inventory scale. RESULTS Mean (SD) age was 62.5 (±13.3) years, mean disease duration 18.7 (±5.1) years, mean post-surgical follow-up 4.6 (±1.3) years, and the mean reduction of levodopa equivalent daily dose after surgery was 58.9% (±25.4%). Mean (SD) motor response to stimulation was 40% (15%). STN stimulation significantly improved anxiety (mean 18% ± 19%, P < 0.005) and fatigue (mean 25% ± 51%; P < 0.05), while pain, although improved did not reach statistical significance. With stimulation ON, BP significantly decreased during orthostatism (P < 0.05) and there was a significant increase in asymptomatic orthostatic hypotension (P < 0.05). CONCLUSIONS Acute STN stimulation improves anxiety and fatigue but decreases orthostatic BP in PD, several years after surgery. These effects should be considered when assessing long-term effect of DBS.
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Affiliation(s)
- Margherita Fabbri
- Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, Portugal
| | - Miguel Coelho
- Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, Portugal; Neurology Service, Department of Neurosciences, Hospital Santa Maria, Lisbon, Portugal
| | - Leonor Correia Guedes
- Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, Portugal; Neurology Service, Department of Neurosciences, Hospital Santa Maria, Lisbon, Portugal
| | - Mario M Rosa
- Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, Portugal; Neurology Service, Department of Neurosciences, Hospital Santa Maria, Lisbon, Portugal; Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine, University of Lisbon, Portugal
| | - Daisy Abreu
- Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, Portugal
| | - Nilza Gonçalves
- Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, Portugal
| | - Angelo Antonini
- Fondazione Ospedale San Camillo"-I.R.C.C.S., Parkinson and Movement Disorders Unit, Venice, Italy; Department of Neurosciences (DNS), Padova University, Padova, Italy
| | - Joaquim J Ferreira
- Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, Portugal; Neurology Service, Department of Neurosciences, Hospital Santa Maria, Lisbon, Portugal; Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine, University of Lisbon, Portugal.
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27
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Ferreira JJ, Gonçalves N, Valadas A, Januário C, Silva MR, Nogueira L, Vieira JLM, Lima AB. Prevalence of Parkinson's disease: a population-based study in Portugal. Eur J Neurol 2017; 24:748-750. [DOI: 10.1111/ene.13273] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 02/01/2017] [Indexed: 11/30/2022]
Affiliation(s)
- J. J. Ferreira
- Clinical Pharmacology Unit; Instituto de Medicina Molecular; Lisbon
- Neurology Department; Hospital de Santa Maria; Centro Hospitalar Lisboa Norte; Lisbon
- CNS - Campus Neurológico Sénior; Torres Vedras
- Laboratory of Clinical Pharmacology and Therapeutics; Faculty of Medicine; University of Lisbon; Lisbon
| | - N. Gonçalves
- Clinical Pharmacology Unit; Instituto de Medicina Molecular; Lisbon
| | - A. Valadas
- Clinical Pharmacology Unit; Instituto de Medicina Molecular; Lisbon
| | - C. Januário
- Neurology Department; Coimbra University Hospital Centre (CHUC); Coimbra
| | - M. R. Silva
- Neurology Department; S. Pedro Hospital - Trás-os-montes and Alto Douro Hospital Center; Vila Real
| | - L. Nogueira
- KeyPoint; Scientific Consulting Lda; Miraflores
| | - J. L. M. Vieira
- Associacão Portuguesa de Doentes de Parkinson (APDPk); Lisboa
| | - A. B. Lima
- Abel Salazar Institute for the Biomedical Sciences (ICBAS); University of Porto; Porto Portugal
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28
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Carreira BM, Segurado P, Orizaola G, Gonçalves N, Pinto V, Laurila A, Rebelo R. Warm vegetarians? Heat waves and diet shifts in tadpoles. Ecology 2016; 97:2964-2974. [DOI: 10.1002/ecy.1541] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 06/21/2016] [Accepted: 07/05/2016] [Indexed: 01/03/2023]
Affiliation(s)
- B. M. Carreira
- cE3c Centre for Ecology, Evolution and Environmental Changes; Faculdade de Ciências da Universidade de Lisboa; Bloco C2, Campo Grande 1749-016 Lisboa Portugal
- Animal Ecology/Department of Ecology and Genetics; Uppsala University; Norbyvägen 18D S-75236 Uppsala Sweden
| | - P. Segurado
- Centro de Estudos Florestais; Instituto Superior de Agronomia da Universidade de Lisboa; 1349-017 Lisboa Portugal
| | - G. Orizaola
- Animal Ecology/Department of Ecology and Genetics; Uppsala University; Norbyvägen 18D S-75236 Uppsala Sweden
| | - N. Gonçalves
- cE3c Centre for Ecology, Evolution and Environmental Changes; Faculdade de Ciências da Universidade de Lisboa; Bloco C2, Campo Grande 1749-016 Lisboa Portugal
| | - V. Pinto
- cE3c Centre for Ecology, Evolution and Environmental Changes; Faculdade de Ciências da Universidade de Lisboa; Bloco C2, Campo Grande 1749-016 Lisboa Portugal
| | - A. Laurila
- Animal Ecology/Department of Ecology and Genetics; Uppsala University; Norbyvägen 18D S-75236 Uppsala Sweden
| | - R. Rebelo
- cE3c Centre for Ecology, Evolution and Environmental Changes; Faculdade de Ciências da Universidade de Lisboa; Bloco C2, Campo Grande 1749-016 Lisboa Portugal
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29
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Alves DR, Cruz C, Antunes C, Gonçalves N, Aquino E, Franco S, Carvalho C, Pais Martins A. Posterior Reversible Encephalopathy Syndrome in a pregnant patient: a PRESsing matter. Acta Anaesthesiol Scand 2016; 60:1473-1476. [PMID: 27666320 DOI: 10.1111/aas.12812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Revised: 07/12/2016] [Accepted: 08/31/2016] [Indexed: 11/30/2022]
Affiliation(s)
- D. R. Alves
- Centro Hospitalar de Lisboa Ocidental; Lisbon Portugal
| | - C. Cruz
- Centro Hospitalar de Lisboa Central; Lisbon Portugal
| | - C. Antunes
- Centro Hospitalar de Lisboa Ocidental; Lisbon Portugal
| | - N. Gonçalves
- Centro Hospitalar de Lisboa Ocidental; Lisbon Portugal
| | - E. Aquino
- Centro Hospitalar de Lisboa Ocidental; Lisbon Portugal
| | - S. Franco
- Centro Hospitalar de Lisboa Ocidental; Lisbon Portugal
| | - C. Carvalho
- Centro Hospitalar de Lisboa Ocidental; Lisbon Portugal
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30
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Cardoso R, Guimarães I, Santos H, Loureiro R, Domingos J, de Abreu D, Gonçalves N, Pinto S, Ferreira J. Frenchay dysarthria assessment (FDA-2) in Parkinson’s disease: cross-cultural adaptation and psychometric properties of the European Portuguese version. J Neurol 2016; 264:21-31. [DOI: 10.1007/s00415-016-8298-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 09/23/2016] [Accepted: 10/03/2016] [Indexed: 02/05/2023]
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31
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Gonçalves N, Gomes-Ferreira C, Moura C, Roncon-Albuquerque R, Leite-Moreira A, Falcão-Pires I. Worse cardiac remodeling in response to pressure overload in type 2 diabetes mellitus. Int J Cardiol 2016; 217:195-204. [DOI: 10.1016/j.ijcard.2016.04.178] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2016] [Revised: 04/19/2016] [Accepted: 04/30/2016] [Indexed: 12/17/2022]
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32
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Godinho C, Domingos J, Cunha G, Santos AT, Fernandes RM, Abreu D, Gonçalves N, Matthews H, Isaacs T, Duffen J, Al-Jawad A, Larsen F, Serrano A, Weber P, Thoms A, Sollinger S, Graessner H, Maetzler W, Ferreira JJ. Erratum to: A systematic review of the characteristics and validity of monitoring technologies to assess Parkinson's disease. J Neuroeng Rehabil 2016; 13:71. [PMID: 27480970 PMCID: PMC4970265 DOI: 10.1186/s12984-016-0181-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 07/22/2016] [Indexed: 11/10/2022] Open
Affiliation(s)
- Catarina Godinho
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, 1649-028, Portugal.,Instituto Superior de Ciências da Saúde Egas Moniz, Center for Interdisciplinary Research Egas Moniz (CiiEM), Monte de Caparica, Portugal.,CNS-Campus Neurológico Sénior, Torres Vedras, Portugal
| | - Josefa Domingos
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, 1649-028, Portugal.,CNS-Campus Neurológico Sénior, Torres Vedras, Portugal
| | - Guilherme Cunha
- Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Ana T Santos
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, 1649-028, Portugal
| | - Ricardo M Fernandes
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, 1649-028, Portugal.,Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Daisy Abreu
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, 1649-028, Portugal
| | - Nilza Gonçalves
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, 1649-028, Portugal
| | | | | | | | | | - Frank Larsen
- Norwegian Centre for Telemedicine, Tromso, Norway
| | | | | | | | | | - Holm Graessner
- Institute for Medical Genetics and Applied Genomics, University of Tuebingen, Tuebingen, Germany
| | - Walter Maetzler
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, Center of Neurology, University of Tuebingen, Tuebingen, Germany
| | - Joaquim J Ferreira
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, 1649-028, Portugal. .,Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine, University of Lisbon, Lisbon, Portugal. .,CNS-Campus Neurológico Sénior, Torres Vedras, Portugal.
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Reimão S, Pita Lobo P, Neutel D, Guedes LC, Coelho M, Rosa MM, Ferreira J, Abreu D, Gonçalves N, Morgado C, Nunes RG, Campos J, Ferreira JJ. Quantitative Analysis Versus Visual Assessment of Neuromelanin MR Imaging for the Diagnosis of Parkinson's disease. J Parkinsons Dis 2016; 5:561-7. [PMID: 26406136 DOI: 10.3233/jpd-150551] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Specific MR sequences have been able to identify the loss of neuromelanin in the substantia nigra (SN) of early stage Parkinson's disease (PD) patients. Since this technique may have a significant impact in clinical patient management, easy and widely available imaging analysis is needed for routine use. OBJECTIVE In this study we compared a quantitative analysis with a visual assessment of SN neuromelanin-sensitive MR images in early stage PD patients, in terms of pattern changes recognition and diagnostic accuracy. METHODS The inclusion criteria were untreated "de novo" PD patients or a 2-5 year PD duration; in addition, age matched controls were enrolled. These were studied with a high-resolution T1-weighted MR imaging sequence at 3.0 Tesla to visualize neuromelanin. The primary outcome was the comparison of quantitative width measurement with visual assessment by experienced neuroradiologists of SN neuromelanin sensitive MR images for PD diagnosis. RESULTS A total of 12 "de novo" PD patients, 10 PD patients with 2-5 year disease duration and 10 healthy controls were evaluated. We obtained a good accuracy in discriminating early-stage PD patients from controls using either a quantitative width measurement of the T1 high signal or a simple visual image inspection of the SN region. CONCLUSIONS Visual inspection of neuromelanin-sensitive MR images by experienced neuroradiologists provides comparable results to quantitative width measurement in the detection of early stage PD SN changes and may become a useful tool in clinical practice.
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Affiliation(s)
- Sofia Reimão
- Neurological Imaging Department, Hospital de Santa Maria - Centro Hospitalar Lisboa Norte, Portugal.,Clinical Pharmacology Unit, Instituto de Medicina Molecular, University of Lisbon, Portugal
| | - Patrícia Pita Lobo
- Neurology Department, Hospital de Santa Maria - Centro Hospitalar Lisboa Norte, Portugal.,Clinical Pharmacology Unit, Instituto de Medicina Molecular, University of Lisbon, Portugal
| | - Dulce Neutel
- Neurology Department, Hospital de Santa Maria - Centro Hospitalar Lisboa Norte, Portugal.,Clinical Pharmacology Unit, Instituto de Medicina Molecular, University of Lisbon, Portugal
| | - Leonor Correia Guedes
- Neurology Department, Hospital de Santa Maria - Centro Hospitalar Lisboa Norte, Portugal.,Clinical Pharmacology Unit, Instituto de Medicina Molecular, University of Lisbon, Portugal
| | - Miguel Coelho
- Neurology Department, Hospital de Santa Maria - Centro Hospitalar Lisboa Norte, Portugal.,Clinical Pharmacology Unit, Instituto de Medicina Molecular, University of Lisbon, Portugal
| | - Mario M Rosa
- Neurology Department, Hospital de Santa Maria - Centro Hospitalar Lisboa Norte, Portugal.,Clinical Pharmacology Unit, Instituto de Medicina Molecular, University of Lisbon, Portugal
| | - Joana Ferreira
- Instituto de Biofísica e Engenharia Biomédica, Faculdade de Ciências, Universidade de Lisboa, Portugal
| | - Daisy Abreu
- Clinical Pharmacology Unit, Instituto de Medicina Molecular, University of Lisbon, Portugal
| | - Nilza Gonçalves
- Clinical Pharmacology Unit, Instituto de Medicina Molecular, University of Lisbon, Portugal
| | - Carlos Morgado
- Neurological Imaging Department, Hospital de Santa Maria - Centro Hospitalar Lisboa Norte, Portugal
| | - Rita G Nunes
- Instituto de Biofísica e Engenharia Biomédica, Faculdade de Ciências, Universidade de Lisboa, Portugal
| | - Jorge Campos
- Neurological Imaging Department, Hospital de Santa Maria - Centro Hospitalar Lisboa Norte, Portugal
| | - Joaquim J Ferreira
- Clinical Pharmacology Unit, Instituto de Medicina Molecular, University of Lisbon, Portugal.,Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine, University of Lisbon, Portugal
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Landwehrmeyer GB, Fitzer-Attas CJ, Giuliano JD, Gonçalves N, Anderson KE, Cardoso F, Ferreira JJ, Mestre TA, Stout JC, Sampaio C. Data Analytics from Enroll-HD, a Global Clinical Research Platform for Huntington's Disease. Mov Disord Clin Pract 2016; 4:212-224. [PMID: 30363395 DOI: 10.1002/mdc3.12388] [Citation(s) in RCA: 122] [Impact Index Per Article: 15.3] [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: 02/14/2016] [Revised: 04/03/2016] [Accepted: 04/22/2016] [Indexed: 02/02/2023] Open
Abstract
Background The study of complex neurodegenerative diseases is moving away from hypothesis-driven biological methods toward large scale multimodal approaches, requiring standardized collaborative efforts. Enroll-HD exemplifies such an integrated clinical research platform, designed and implemented to meet the research and clinical needs of Huntington's disease (HD). The aim of this study was to describe the unique organization of Enroll-HD and report baseline data analyses of its core study. Methods The Enroll-HD platform incorporates electronic data capture, biosampling, and a longitudinal observational study spanning four continents (ClinicalTrials.gov Identifier: NCT01574053). The primary study population includes HD gene expansion carriers (HDGECs; CAG expansion ≥36), subdivided into manifest/premanifest HD. The control population consists of genotype-negative first-degree relatives and family controls not genetically related. The study includes 10 core clinical assessments covering motor, cognitive, and behavioral domains. Results This data set comprises 1,534 participants (HDGEC = 1,071; controls = 463). Participant retention was high; 42 participants prematurely withdrew from the study. Mean ± standard deviation SD CAG repeat size was 43.5 ± 3.5 for HDGECs and 19.8 ± 3.4 for controls. Motor and behavioral assessments identified numerical differences between controls and HDGECs (manifest > premanifest > controls). Functional and independence assessments were generally similar for the premanifest and control groups with overlap in range of scores obtained. For the majority of cognitive tests, there were large differences between participants with manifest HD and all other groups. Conclusions These first data from the Enroll-HD clinical research platform demonstrate the maturity and potential of the platform in collecting high-quality, clinically relevant data. Future data sets will be substantially larger as the platform expands longitudinally and regionally.
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Affiliation(s)
- Georg B Landwehrmeyer
- Department of Neurology University of Ulm Ulm Germany.,CHDI Management/CHDI Foundation Princeton New Jersey USA
| | | | | | | | - Karen E Anderson
- MedStar Georgetown University Hospital & Georgetown University Medical Center-Huntington Disease Care, Education & Research Center Washington DC USA
| | - Francisco Cardoso
- Movement Disorders Clinic, Medical School Universidade Federal de Minas Gerais Belo Horizonte Brazil
| | | | - Tiago A Mestre
- Parkinson's disease and Movement Disorders Center Division of Neurology Department of Medicine The Ottawa Hospital Research Institute University of Ottawa Ottawa Ontario Canada
| | - Julie C Stout
- School of Psychological Sciences Monash University Melbourne Victoria Australia
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Pinho R, Guedes LC, Soreq L, Lobo PP, Mestre T, Coelho M, Rosa MM, Gonçalves N, Wales P, Mendes T, Gerhardt E, Fahlbusch C, Bonifati V, Bonin M, Miltenberger-Miltényi G, Borovecki F, Soreq H, Ferreira JJ, F. Outeiro T. Gene Expression Differences in Peripheral Blood of Parkinson's Disease Patients with Distinct Progression Profiles. PLoS One 2016; 11:e0157852. [PMID: 27322389 PMCID: PMC4913914 DOI: 10.1371/journal.pone.0157852] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 06/06/2016] [Indexed: 12/22/2022] Open
Abstract
The prognosis of neurodegenerative disorders is clinically challenging due to the inexistence of established biomarkers for predicting disease progression. Here, we performed an exploratory cross-sectional, case-control study aimed at determining whether gene expression differences in peripheral blood may be used as a signature of Parkinson’s disease (PD) progression, thereby shedding light into potential molecular mechanisms underlying disease development. We compared transcriptional profiles in the blood from 34 PD patients who developed postural instability within ten years with those of 33 patients who did not develop postural instability within this time frame. Our study identified >200 differentially expressed genes between the two groups. The expression of several of the genes identified was previously found deregulated in animal models of PD and in PD patients. Relevant genes were selected for validation by real-time PCR in a subset of patients. The genes validated were linked to nucleic acid metabolism, mitochondria, immune response and intracellular-transport. Interestingly, we also found deregulation of these genes in a dopaminergic cell model of PD, a simple paradigm that can now be used to further dissect the role of these molecular players on dopaminergic cell loss. Altogether, our study provides preliminary evidence that expression changes in specific groups of genes and pathways, detected in peripheral blood samples, may be correlated with differential PD progression. Our exploratory study suggests that peripheral gene expression profiling may prove valuable for assisting in prediction of PD prognosis, and identifies novel culprits possibly involved in dopaminergic cell death. Given the exploratory nature of our study, further investigations using independent, well-characterized cohorts will be essential in order to validate our candidates as predictors of PD prognosis and to definitively confirm the value of gene expression analysis in aiding patient stratification and therapeutic intervention.
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Affiliation(s)
- Raquel Pinho
- Department of NeuroDegeneration and Restorative Research, Center for Nanoscale Microscopy and Molecular Physiology of the Brain, University Medical Center Göttingen, Göttingen, Niedersachsen, Germany
- Faculty of Medicine, University of Porto, Porto, Portugal
| | - Leonor C. Guedes
- Clinical Pharmacology Unit, Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Lilach Soreq
- Department of Molecular Neuroscience, The Institute of Neurology, University College London, London, United Kingdom
| | - Patrícia P. Lobo
- Clinical Pharmacology Unit, Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Tiago Mestre
- Clinical Pharmacology Unit, Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Miguel Coelho
- Clinical Pharmacology Unit, Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Mário M. Rosa
- Clinical Pharmacology Unit, Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Nilza Gonçalves
- Clinical Pharmacology Unit, Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Pauline Wales
- Department of NeuroDegeneration and Restorative Research, Center for Nanoscale Microscopy and Molecular Physiology of the Brain, University Medical Center Göttingen, Göttingen, Niedersachsen, Germany
| | - Tiago Mendes
- Clinical Pharmacology Unit, Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Ellen Gerhardt
- Department of NeuroDegeneration and Restorative Research, Center for Nanoscale Microscopy and Molecular Physiology of the Brain, University Medical Center Göttingen, Göttingen, Niedersachsen, Germany
| | - Christiane Fahlbusch
- Department of NeuroDegeneration and Restorative Research, Center for Nanoscale Microscopy and Molecular Physiology of the Brain, University Medical Center Göttingen, Göttingen, Niedersachsen, Germany
| | - Vincenzo Bonifati
- Department Clinical Genetics, Erasmus MC, Rotterdam, South Holland, The Netherlands
| | - Michael Bonin
- Institute of Medical Genetics and Applied Genomics, Eberhard-Karls-University Tübingen, Tübingen, Baden-Württemberg, Germany
| | - Gabriel Miltenberger-Miltényi
- Clinical Pharmacology Unit, Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Fran Borovecki
- Department for Functional Genomics, Center for Translational and Clinical Research, University Hospital Center Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia
| | - Hermona Soreq
- The Edmond and Lily Safra Center for Brain Sciences, The Hebrew University of Jerusalem, Jerusalem, Israel
- Department of Biological Chemistry, The Life Sciences Institute, Jerusalem, Israel
| | - Joaquim J. Ferreira
- Clinical Pharmacology Unit, Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
- * E-mail: (TFO); (JJF)
| | - Tiago F. Outeiro
- Department of NeuroDegeneration and Restorative Research, Center for Nanoscale Microscopy and Molecular Physiology of the Brain, University Medical Center Göttingen, Göttingen, Niedersachsen, Germany
- CEDOC, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal
- * E-mail: (TFO); (JJF)
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Godinho C, Domingos J, Cunha G, Santos AT, Fernandes RM, Abreu D, Gonçalves N, Matthews H, Isaacs T, Duffen J, Al-Jawad A, Larsen F, Serrano A, Weber P, Thoms A, Sollinger S, Graessner H, Maetzler W, Ferreira JJ. A systematic review of the characteristics and validity of monitoring technologies to assess Parkinson's disease. J Neuroeng Rehabil 2016; 13:24. [PMID: 26969628 PMCID: PMC4788909 DOI: 10.1186/s12984-016-0136-7] [Citation(s) in RCA: 124] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Accepted: 03/09/2016] [Indexed: 11/21/2022] Open
Abstract
Background There is growing interest in having objective assessment of health-related outcomes using technology-based devices that provide unbiased measurements which can be used in clinical practice and scientific research. Many studies have investigated the clinical manifestations of Parkinson’s disease using such devices. However, clinimetric properties and clinical validation vary among the different devices. Methods Given such heterogeneity, we sought to perform a systematic review in order to (i) list, (ii) compare and (iii) classify technological-based devices used to measure motor function in individuals with Parkinson's disease into three groups, namely wearable, non-wearable and hybrid devices. A systematic literature search of the PubMed database resulted in the inclusion of 168 studies. These studies were grouped based on the type of device used. For each device we reviewed availability, use, reliability, validity, and sensitivity to change. The devices were then classified as (i) ‘recommended’, (ii) ‘suggested’ or (iii) ‘listed’ based on the following criteria: (1) used in the assessment of Parkinson’s disease (yes/no), (2) used in published studies by people other than the developers (yes/no), and (3) successful clinimetric testing (yes/no). Results Seventy-three devices were identified, 22 were wearable, 38 were non-wearable, and 13 were hybrid devices. In accordance with our classification method, 9 devices were ‘recommended’, 34 devices were ‘suggested’, and 30 devices were classified as ‘listed’. Within the wearable devices group, the Mobility Lab sensors from Ambulatory Parkinson’s Disease Monitoring (APDM), Physilog®, StepWatch 3, TriTrac RT3 Triaxial accelerometer, McRoberts DynaPort, and Axivity (AX3) were classified as ‘recommended’. Within the non-wearable devices group, the Nintendo Wii Balance Board and GAITRite® gait analysis system were classified as ‘recommended’. Within the hybrid devices group only the Kinesia® system was classified as ‘recommended’. Electronic supplementary material The online version of this article (doi:10.1186/s12984-016-0136-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Catarina Godinho
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028, Lisboa, Portugal.,Center for Interdisciplinary Research Egas Moniz (CiiEM), Instituto Superior de Ciências da Saúde Egas Moniz, Monte de Caparica, Portugal.,CNS-Campus Neurológico Sénior, Torres Vedras, Portugal
| | - Josefa Domingos
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028, Lisboa, Portugal.,CNS-Campus Neurológico Sénior, Torres Vedras, Portugal
| | - Guilherme Cunha
- Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Ana T Santos
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028, Lisboa, Portugal
| | - Ricardo M Fernandes
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028, Lisboa, Portugal.,Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Daisy Abreu
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028, Lisboa, Portugal
| | - Nilza Gonçalves
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028, Lisboa, Portugal
| | | | | | | | | | - Frank Larsen
- Norwegian Centre for Telemedicine, Tromso, Norway
| | | | | | | | | | - Holm Graessner
- Institute for Medical Genetics and Applied Genomics, University of Tuebingen, Tuebingen, Germany
| | - Walter Maetzler
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, Center of Neurology, University of Tuebingen, Tuebingen, Germany
| | - Joaquim J Ferreira
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028, Lisboa, Portugal. .,Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine, University of Lisbon, Lisbon, Portugal. .,CNS-Campus Neurológico Sénior, Torres Vedras, Portugal.
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Li P, Rial D, Canas PM, Yoo JH, Li W, Zhou X, Wang Y, van Westen GJP, Payen MP, Augusto E, Gonçalves N, Tomé AR, Li Z, Wu Z, Hou X, Zhou Y, PIJzerman A, Boyden ES, Cunha RA, Qu J, Chen JF. Optogenetic activation of intracellular adenosine A2A receptor signaling in the hippocampus is sufficient to trigger CREB phosphorylation and impair memory. Mol Psychiatry 2015; 20:1481. [PMID: 25802981 DOI: 10.1038/mp.2015.43] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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38
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Reimão S, Ferreira S, Nunes RG, Pita Lobo P, Neutel D, Abreu D, Gonçalves N, Campos J, Ferreira JJ. Magnetic resonance correlation of iron content with neuromelanin in the substantia nigra of early-stage Parkinson's disease. Eur J Neurol 2015; 23:368-74. [PMID: 26518135 DOI: 10.1111/ene.12838] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Accepted: 08/04/2015] [Indexed: 01/23/2023]
Abstract
BACKGROUND AND PURPOSE Magnetic resonance (MR) studies have demonstrated a significant reduction of neuromelanin in the substantia nigra (SN) of Parkinson's disease (PD) patients with high accuracy for differential diagnosis compared to non-PD controls and essential tremor. However, studies state that not knowing how paramagnetic effects of iron influence neuromelanin signal is a limitation. In this study a neuromelanin-sensitive MR sequence was combined with T2* relaxometry iron quantification analysis to study the SN of early-stage PD patients to investigate the correlation between these parameters. METHODS The inclusion criteria were untreated de novo PD patients and a 2-5 year disease duration (early PD); in addition, age-matched controls were enrolled. These were studied at 3.0 T with a high-resolution T1-weighted MR sequence to visualize neuromelanin and a relaxometry sequence for iron quantification. The primary outcome was the correlation of the width of the neuromelanin high signal region and the T2* values in the lateral, central and medial segments of the SN. RESULTS Very weak correlations of T2* values with neuromelanin width, positive for global and negative for the medial and lateral SN segments, were found in both PD groups and control subjects. The SN neuromelanin width was markedly reduced in the de novo and early PD groups compared with controls in all SN segments, but no significant difference in T2* values was found between the groups. CONCLUSIONS The SN neuromelanin signal does not have a significant correlation with iron content in PD patients or controls. The neuromelanin MR signal reduction in PD does not seem to be significantly influenced by paramagnetic iron effects.
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Affiliation(s)
- S Reimão
- Neurological Imaging Department, Hospital de Santa Maria - Centro Hospitalar Lisboa Norte, Lisbon, Portugal.,Clinical Pharmacology Unit, Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - S Ferreira
- Instituto de Biofísica e Engenharia Biomédica, Faculdade de Ciências, Universidade de Lisboa, Lisbon, Portugal
| | - R G Nunes
- Instituto de Biofísica e Engenharia Biomédica, Faculdade de Ciências, Universidade de Lisboa, Lisbon, Portugal
| | - P Pita Lobo
- Clinical Pharmacology Unit, Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, Lisbon, Portugal.,Neurology Department, Hospital de Santa Maria - Centro Hospitalar Lisboa Norte, Lisbon, Portugal.,CNS - Campus Neurológico Sénior, Torres Vedras, Portugal
| | - D Neutel
- Clinical Pharmacology Unit, Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, Lisbon, Portugal.,Neurology Department, Hospital de Santa Maria - Centro Hospitalar Lisboa Norte, Lisbon, Portugal
| | - D Abreu
- Clinical Pharmacology Unit, Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - N Gonçalves
- Clinical Pharmacology Unit, Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - J Campos
- Neurological Imaging Department, Hospital de Santa Maria - Centro Hospitalar Lisboa Norte, Lisbon, Portugal
| | - J J Ferreira
- Clinical Pharmacology Unit, Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, Lisbon, Portugal.,Neurology Department, Hospital de Santa Maria - Centro Hospitalar Lisboa Norte, Lisbon, Portugal.,CNS - Campus Neurológico Sénior, Torres Vedras, Portugal.,Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
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Ferreira JJ, Godinho C, Santos AT, Domingos J, Abreu D, Lobo R, Gonçalves N, Barra M, Larsen F, Fagerbakke Ø, Akeren I, Wangen H, Serrano JA, Weber P, Thoms A, Meckler S, Sollinger S, van Uem J, Hobert MA, Maier KS, Matthew H, Isaacs T, Duffen J, Graessner H, Maetzler W. Quantitative home-based assessment of Parkinson's symptoms: the SENSE-PARK feasibility and usability study. BMC Neurol 2015; 15:89. [PMID: 26059091 PMCID: PMC4460963 DOI: 10.1186/s12883-015-0343-z] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Accepted: 05/20/2015] [Indexed: 11/13/2022] Open
Abstract
Background Currently, assessment of symptoms associated with Parkinson’s disease is mainly performed in the clinic. However, these assessments have limitations because they provide only a snapshot of the condition. Methods The feasibility and usability of an objective, continuous and relatively unobtrusive system (SENSE-PARK System), which consists of wearable sensors (three worn during the day and one worn at night), a smartphone-based App, a balance board and computer software, was tested 24/7 over 12 weeks in a study including 22 PD patients. During the first four weeks of the study, patients did not get feedback about their performance, during the last eight weeks they did. The study included seven clinical visits with standardized interviews, and regular phone contact. The primary outcome was the number of drop-outs during the study. As secondary outcomes, the Post-Study System Usability Questionnaire (PSSUQ), score and information obtained from the standardized interviews were used to evaluate the usability of the system. Results All patients completed the study. The participants rated the usability of the SENSE-PARK System with a mean score of 2.67 (±0.49) on the PSSUQ. The interviews revealed that most participants liked using the system and appreciated that it signaled changes in their health condition. Conclusions This 12 week controlled study demonstrates that the acceptance level of PD patients using the SENSE-PARK System as a home-based 24/7 assessment is very good. Particular emphasis should be given to a user-friendly design. Motivation to wear such a system can be increased by providing direct feedback about the individual health condition.
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Affiliation(s)
- Joaquim J Ferreira
- Clinical Pharmacology Unit, Instituto de Medicina Molecular, Lisbon, Portugal. .,Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine, University of Lisbon, Lisbon, Portugal. .,CNS - Campus Neurológico Sénior, Torres Vedras, Portugal.
| | - Catarina Godinho
- Clinical Pharmacology Unit, Instituto de Medicina Molecular, Lisbon, Portugal. .,CNS - Campus Neurológico Sénior, Torres Vedras, Portugal. .,Center for Interdisciplinary Research Egas Moniz (CiiEM), Cooperativa de Ensino Superior Egas Moniz, Monte de Caparica, Caparica, Portugal.
| | - Ana T Santos
- Clinical Pharmacology Unit, Instituto de Medicina Molecular, Lisbon, Portugal.
| | - Josefa Domingos
- Clinical Pharmacology Unit, Instituto de Medicina Molecular, Lisbon, Portugal.
| | - Daisy Abreu
- Clinical Pharmacology Unit, Instituto de Medicina Molecular, Lisbon, Portugal.
| | - Raquel Lobo
- Clinical Pharmacology Unit, Instituto de Medicina Molecular, Lisbon, Portugal.
| | - Nilza Gonçalves
- Clinical Pharmacology Unit, Instituto de Medicina Molecular, Lisbon, Portugal.
| | - Marcio Barra
- Clinical Pharmacology Unit, Instituto de Medicina Molecular, Lisbon, Portugal.
| | - Frank Larsen
- NST-Norwegian Centre for Integrated Care and Telemedicine, University Hospital North Norway, Tromsø, Norway.
| | - Øyvind Fagerbakke
- NST-Norwegian Centre for Integrated Care and Telemedicine, University Hospital North Norway, Tromsø, Norway.
| | - Ingvild Akeren
- NST-Norwegian Centre for Integrated Care and Telemedicine, University Hospital North Norway, Tromsø, Norway.
| | - Hilde Wangen
- NST-Norwegian Centre for Integrated Care and Telemedicine, University Hospital North Norway, Tromsø, Norway.
| | - J Artur Serrano
- NST-Norwegian Centre for Integrated Care and Telemedicine, University Hospital North Norway, Tromsø, Norway. .,Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromsø, Norway.
| | | | | | | | | | - Janet van Uem
- Hertie Institute for Clinical Brain Research, Department of Neurodegeneration, Center of Neurology, University of Tuebingen, Tuebingen, Germany. .,DZNE, German Center for Neurodegenerative Diseases, Tübingen, Germany.
| | - Markus A Hobert
- Hertie Institute for Clinical Brain Research, Department of Neurodegeneration, Center of Neurology, University of Tuebingen, Tuebingen, Germany. .,DZNE, German Center for Neurodegenerative Diseases, Tübingen, Germany.
| | - Katrin S Maier
- Hertie Institute for Clinical Brain Research, Department of Neurodegeneration, Center of Neurology, University of Tuebingen, Tuebingen, Germany. .,DZNE, German Center for Neurodegenerative Diseases, Tübingen, Germany.
| | | | | | | | - Holm Graessner
- Institute for Medical Genetics and Applied Genomics, University of Tübingen, Tuebingen, Germany.
| | - Walter Maetzler
- Hertie Institute for Clinical Brain Research, Department of Neurodegeneration, Center of Neurology, University of Tuebingen, Tuebingen, Germany. .,DZNE, German Center for Neurodegenerative Diseases, Tübingen, Germany.
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Caldeira D, Rodrigues FB, Barra M, Santos AT, de Abreu D, Gonçalves N, Pinto FJ, Ferreira JJ, Costa J. Non-vitamin K antagonist oral anticoagulants and major bleeding-related fatality in patients with atrial fibrillation and venous thromboembolism: a systematic review and meta-analysis. Heart 2015; 101:1204-11. [DOI: 10.1136/heartjnl-2015-307489] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2015] [Accepted: 05/06/2015] [Indexed: 12/30/2022] Open
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Caldeira D, Gonçalves N, Pinto FJ, Costa J, Ferreira JJ. Risk of renal failure with the non-vitamin K antagonist oral anticoagulants: systematic review and meta-analysis. Pharmacoepidemiol Drug Saf 2015; 24:757-64. [PMID: 26009864 DOI: 10.1002/pds.3791] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Revised: 02/15/2015] [Accepted: 03/30/2015] [Indexed: 12/30/2022]
Abstract
PURPOSE Vitamin K antagonists (VKA)-related nephropathy is a novel entity characterized by acute kidney injury related to International Normalized Ratio supratherapeutic levels. Non-vitamin K antagonists oral anticoagulants (NOACs) have a predictable dose-response relationship and an improved safety profile. We hypothesized that these drugs do not have an increased risk of incident renal failure, which may be detrimental for the use of NOACs. METHODS Systematic review and meta-analysis of phase III randomized controlled trials (RCTs). Trials were searched through Medline, Cochrane Library and public assessment reports in August 2014. Primary outcome was renal failure. NOACs were evaluated against any comparator. Random-effects meta-analysis was performed by default, and pooled estimates were expressed as Risk Ratio (RR) and 95%CI. Heterogeneity was evaluated with I(2) test. RESULTS Ten RCTs fulfilled inclusion criteria (one apixaban RCT, three dabigatran RCTs, and six rivaroxaban RCTs), enrolling 75 100 patients. Overall NOACs did not increase the risk of renal failure with an RR 0.96, 95%CI 0.88-1.05 compared with VKA or Low-molecular weight heparin (LMWH), without significant statistical heterogeneity (I(2) = 3.5%). Compared with VKA, NOACs did not increase the risk of renal failure (RR 0.96, 95%CI 0.87-1.07; I(2) = 17.8%; six RCTs). Rivaroxaban did not show differences in the incidence of renal failure compared with LMWH (RR 1.20, 95%CI 0.37-3.94; four trials), but there was an increased risk of creatinine elevation RR 1.25, 95%CI 1.08-1.45; I(2) = 0%. CONCLUSIONS NOACs had a similar risk of renal failure compared with VKA/LMWH in phase III RCTs. Post-marketing surveillance should be warranted.
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Affiliation(s)
- Daniel Caldeira
- Clinical Pharmacology Unit, Instituto de Medicina Molecular, Lisbon, Portugal.,Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine, University of Lisbon, Portugal.,Cardiology Department, Hospital Garcia de Orta, Almada, Portugal
| | - Nilza Gonçalves
- Clinical Pharmacology Unit, Instituto de Medicina Molecular, Lisbon, Portugal
| | - Fausto J Pinto
- Cardiology Department, CCUL, CAML, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - João Costa
- Clinical Pharmacology Unit, Instituto de Medicina Molecular, Lisbon, Portugal.,Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine, University of Lisbon, Portugal.,Evidence Based Medicine Centre, Faculty of Medicine, University of Lisbon, Portugal.,Portuguese Collaborating Centre of the Cochrane Iberoamerican Network, Faculty of Medicine, University of Lisbon, Portugal
| | - Joaquim J Ferreira
- Clinical Pharmacology Unit, Instituto de Medicina Molecular, Lisbon, Portugal.,Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine, University of Lisbon, Portugal
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Reimão S, Pita Lobo P, Neutel D, Guedes LC, Coelho M, Rosa MM, Azevedo P, Ferreira J, Abreu D, Gonçalves N, Nunes RG, Campos J, Ferreira JJ. Substantia nigra
neuromelanin-MR imaging differentiates essential tremor from Parkinson's disease. Mov Disord 2015; 30:953-9. [DOI: 10.1002/mds.26182] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Revised: 01/21/2015] [Accepted: 01/26/2015] [Indexed: 02/02/2023] Open
Affiliation(s)
- Sofia Reimão
- Neurological Imaging Department; Hospital de Santa Maria, Centro Hospitalar Lisboa Norte; Portugal
- Clinical Pharmacology Unit; Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon; Portugal
| | - Patrícia Pita Lobo
- Clinical Pharmacology Unit; Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon; Portugal
- Neurology Department; Hospital de Santa Maria, Centro Hospitalar Lisboa Norte; Portugal
- CNS-Campus Neurológico Sénior; Torres Vedras Portugal
| | - Dulce Neutel
- Clinical Pharmacology Unit; Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon; Portugal
- Neurology Department; Hospital de Santa Maria, Centro Hospitalar Lisboa Norte; Portugal
| | - Leonor Correia Guedes
- Clinical Pharmacology Unit; Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon; Portugal
- Neurology Department; Hospital de Santa Maria, Centro Hospitalar Lisboa Norte; Portugal
- CNS-Campus Neurológico Sénior; Torres Vedras Portugal
| | - Miguel Coelho
- Clinical Pharmacology Unit; Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon; Portugal
- Neurology Department; Hospital de Santa Maria, Centro Hospitalar Lisboa Norte; Portugal
| | - Mário M. Rosa
- Clinical Pharmacology Unit; Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon; Portugal
- Neurology Department; Hospital de Santa Maria, Centro Hospitalar Lisboa Norte; Portugal
- Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine; University of Lisbon; Portugal
| | - Pedro Azevedo
- Instituto de Biofísica e Engenharia Biomédica, Faculdade de Ciências, Universidade de Lisboa; Portugal
| | - Joana Ferreira
- Instituto de Biofísica e Engenharia Biomédica, Faculdade de Ciências, Universidade de Lisboa; Portugal
| | - Daisy Abreu
- Clinical Pharmacology Unit; Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon; Portugal
| | - Nilza Gonçalves
- Clinical Pharmacology Unit; Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon; Portugal
| | - Rita G. Nunes
- Instituto de Biofísica e Engenharia Biomédica, Faculdade de Ciências, Universidade de Lisboa; Portugal
| | - Jorge Campos
- Neurological Imaging Department; Hospital de Santa Maria, Centro Hospitalar Lisboa Norte; Portugal
| | - Joaquim J. Ferreira
- Clinical Pharmacology Unit; Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon; Portugal
- Neurology Department; Hospital de Santa Maria, Centro Hospitalar Lisboa Norte; Portugal
- CNS-Campus Neurológico Sénior; Torres Vedras Portugal
- Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine; University of Lisbon; Portugal
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Caldeira D, Barra M, Gonçalves N, Pinto FJ, Ferreira JJ, Costa J. Pericardial bleeding risk with non-vitamin K oral anticoagulants: A meta-analysis. Int J Cardiol 2015; 182:187-8. [DOI: 10.1016/j.ijcard.2014.12.062] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2014] [Accepted: 12/21/2014] [Indexed: 11/30/2022]
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Reimão S, Pita Lobo P, Neutel D, Correia Guedes L, Coelho M, Rosa MM, Ferreira J, Abreu D, Gonçalves N, Morgado C, Nunes RG, Campos J, Ferreira JJ. Substantia nigra neuromelanin magnetic resonance imaging in de novo Parkinson's disease patients. Eur J Neurol 2014; 22:540-6. [PMID: 25534480 DOI: 10.1111/ene.12613] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2014] [Accepted: 10/07/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND Depigmentation of the substantia nigra (SN) and locus coeruleus (LC) is a conspicuous pathological feature of Parkinson's disease (PD) and is related to the loss of neuromelanin, whose paramagnetic properties result in high signal on specific T1-weighted magnetic resonance imaging (MRI). Recent studies have suggested that neuromelanin decrease in the SN and LC of PD patients may emerge as a possible diagnostic biomarker. The SN neuromelanin signal in de novo and early stage PD patients was studied to assess its diagnostic accuracy. This is the first study based on a semi-automated MRI analysis of the neuromelanin signal in de novo PD patients. METHODS The inclusion criteria were untreated de novo PD and a 2-5 year disease duration; in addition, age matched healthy controls were enrolled. These were studied with a high-resolution T1-weighted MRI sequence at 3 T to visualize neuromelanin. The primary outcome was SN high signal area, length and neuromelanin/midbrain ratio obtained with semi-automated methods. RESULTS A total of 12 de novo PD patients and 10 PD patients with a 2-5 year disease duration were evaluated. The area, length of the SN T1 high signal and the SN neuromelanin/midbrain ratio were markedly decreased in the PD groups compared with age-matched controls, with a substantial overlap between the two PD groups. CONCLUSIONS Neuromelanin-sensitive MRI techniques can discriminate PD patients from healthy individuals with high sensitivity and specificity. Our findings are consistent with recent findings showing that PD neuromelanin changes remain stable during the course of the disease.
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Affiliation(s)
- S Reimão
- Neurological Imaging Department, Hospital de Santa Maria - Centro Hospitalar Lisboa Norte, Lisbon, Portugal; Clinical Pharmacology Unit, Instituto de Medicina Molecular, Lisbon, Portugal
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Cunha-Miranda L, Simões E, Fernandes S, Gonçalves N, Leiria E, Nogueira L. AB1028 Do information sources translates to knowledge in osteoporosis? Corpo study: Comprehending osteoporosis real perception and overview. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1028] [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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Cunha-Miranda L, Fernandes S, Simões E, Gonçalves N, Leiria E, Nogueira L. SAT0362 Quality of life and pain evaluation in patients with and without self-reported osteoporosis - corpo study: Comprehending osteoporosis real perception and overview:. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.3308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Cunha-Miranda L, Simões E, Fernandes S, Gonçalves N, Leiria E, Nogueira L. AB1027 Characterization of medication compliance in patients with osteoporosis. Corpo study: Comprehending osteoporosis real perception and overview. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1027] [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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Cunha-Miranda L, Simões E, Fernandes S, Gonçalves N, Leiria E, Nogueira L. AB1026 Frax determination in the portuguese population - corpo study: Comprehending osteoporosis real perception and overview. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Cunha-Miranda L, Simões E, Fernandes S, Gonçalves N, Leiria E, Nogueira L. SAT0363 Is there a before and after femoral neck fracture regarding quality of life? Corpo study: Comprehending osteoporosis real perception and overview:. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.3309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Cunha-Miranda L, Fernandes S, Simões E, Gonçalves N, Leiria E, Nogueira L. AB1025 Corpo study: Comprehending osteoporosis real perception and overview. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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