1
|
Carreira LM, Silva R, Alves J, Inácio F, Pires G, Azevedo P. The Use of Fast-Acting Insulin Topical Solution on Skin to Promote Surgical Wound Healing in Cats. Animals (Basel) 2024; 14:1358. [PMID: 38731363 PMCID: PMC11082965 DOI: 10.3390/ani14091358] [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: 03/15/2024] [Revised: 04/19/2024] [Accepted: 04/23/2024] [Indexed: 05/13/2024] Open
Abstract
Wound healing is a complex biological process involving a coordinated sequence of events aimed at restoring tissue integrity and function. Recent advancements in wound care have introduced novel therapies, with topical insulin application emerging as a promising strategy for promoting tissue healing. This study, involving 60 female cats (n = 60) undergoing elective spaying, aimed to evaluate the effects of topical fast-acting insulin on the healing process of surgical wounds. Each surgical suture was divided into two regions: the control zone (Zcr) without insulin application and the study zone (Zst), where insulin was applied topically for 10 min every 24 h over eight consecutive days. Assessment of suture healing was conducted using an adapted scale at two time points post-surgery: T1 (day 2) and T2 (day 8). Statistically significant differences were registered in the final healing scale scores between Zcr and Zst (p < 0.022), as well as for the parameter of regional fluid (p-value = 0.017). Additionally, at T2, all Zst regions exhibited wound closure, whereas Zcr did not, although not in a statistically significant manner. The observed discrepancy at T2 between the Zcr and Zst regions may suggest a potential benefit of utilizing insulin. No side effects resulting from the insulin topical application performed by the tutors were recorded in the Zst suture group. This study represents the first exploration of the benefits of topical insulin application for surgical wound healing in cats.
Collapse
Affiliation(s)
- L. Miguel Carreira
- Anjos of Assis Veterinary Medicine Centre—CMVAA, Rua D.ª Francisca da Azambuja Nº9-9A, 2830-077 Barreiro, Portugal; (R.S.); (P.A.)
- Faculty of Veterinary Medicine, University of Lisbon (FMV/ULisboa), Av. da Universidade Técnica, 1300-477 Lisbon, Portugal; (F.I.); (G.P.)
- Interdisciplinary Centre for Research in Animal Health (CIISA), University of Lisbon (FMV/ULisboa), Av. da Universidade Técnica, 1300-477 Lisbon, Portugal
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), 1300-477 Lisbon, Portugal
- Faculty of American Laser Study Club—ALSC, Altamonte Springs, FL 32714, USA
| | - Rúben Silva
- Anjos of Assis Veterinary Medicine Centre—CMVAA, Rua D.ª Francisca da Azambuja Nº9-9A, 2830-077 Barreiro, Portugal; (R.S.); (P.A.)
| | - João Alves
- Divisão de Medicina Veterinária, Guarda Nacional Republicana (GNR), Rua Presidente Arriaga, 9, 1200-771 Lisbon, Portugal;
| | - Filipa Inácio
- Faculty of Veterinary Medicine, University of Lisbon (FMV/ULisboa), Av. da Universidade Técnica, 1300-477 Lisbon, Portugal; (F.I.); (G.P.)
| | - Graça Pires
- Faculty of Veterinary Medicine, University of Lisbon (FMV/ULisboa), Av. da Universidade Técnica, 1300-477 Lisbon, Portugal; (F.I.); (G.P.)
- Interdisciplinary Centre for Research in Animal Health (CIISA), University of Lisbon (FMV/ULisboa), Av. da Universidade Técnica, 1300-477 Lisbon, Portugal
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), 1300-477 Lisbon, Portugal
| | - Pedro Azevedo
- Anjos of Assis Veterinary Medicine Centre—CMVAA, Rua D.ª Francisca da Azambuja Nº9-9A, 2830-077 Barreiro, Portugal; (R.S.); (P.A.)
- Faculty of American Laser Study Club—ALSC, Altamonte Springs, FL 32714, USA
| |
Collapse
|
2
|
Staplin N, Haynes R, Judge PK, Wanner C, Green JB, Emberson J, Preiss D, Mayne KJ, Ng SYA, Sammons E, Zhu D, Hill M, Stevens W, Wallendszus K, Brenner S, Cheung AK, Liu ZH, Li J, Hooi LS, Liu WJ, Kadowaki T, Nangaku M, Levin A, Cherney D, Maggioni AP, Pontremoli R, Deo R, Goto S, Rossello X, Tuttle KR, Steubl D, Petrini M, Seidi S, Landray MJ, Baigent C, Herrington WG, Abat S, Abd Rahman R, Abdul Cader R, Abdul Hafidz MI, Abdul Wahab MZ, Abdullah NK, Abdul-Samad T, Abe M, Abraham N, Acheampong S, Achiri P, Acosta JA, Adeleke A, Adell V, Adewuyi-Dalton R, Adnan N, Africano A, Agharazii M, Aguilar F, Aguilera A, Ahmad M, Ahmad MK, Ahmad NA, Ahmad NH, Ahmad NI, Ahmad Miswan N, Ahmad Rosdi H, Ahmed I, Ahmed S, Ahmed S, Aiello J, Aitken A, AitSadi R, Aker S, Akimoto S, Akinfolarin A, Akram S, Alberici F, Albert C, Aldrich L, Alegata M, Alexander L, Alfaress S, Alhadj Ali M, Ali A, Ali A, Alicic R, Aliu A, Almaraz R, Almasarwah R, Almeida J, Aloisi A, Al-Rabadi L, Alscher D, Alvarez P, Al-Zeer B, Amat M, Ambrose C, Ammar H, An Y, Andriaccio L, Ansu K, Apostolidi A, Arai N, Araki H, Araki S, Arbi A, Arechiga O, Armstrong S, Arnold T, Aronoff S, Arriaga W, Arroyo J, Arteaga D, Asahara S, Asai A, Asai N, Asano S, Asawa M, Asmee MF, Aucella F, Augustin M, Avery A, Awad A, Awang IY, Awazawa M, Axler A, Ayub W, Azhari Z, Baccaro R, Badin C, Bagwell B, Bahlmann-Kroll E, Bahtar AZ, Baigent C, Bains D, Bajaj H, Baker R, Baldini E, Banas B, Banerjee D, Banno S, Bansal S, Barberi S, Barnes S, Barnini C, Barot C, Barrett K, Barrios R, Bartolomei Mecatti B, Barton I, Barton J, Basily W, Bavanandan S, Baxter A, Becker L, Beddhu S, Beige J, Beigh S, Bell S, Benck U, Beneat A, Bennett A, Bennett D, Benyon S, Berdeprado J, Bergler T, Bergner A, Berry M, Bevilacqua M, Bhairoo J, Bhandari S, Bhandary N, Bhatt A, Bhattarai M, Bhavsar M, Bian W, Bianchini F, Bianco S, Bilous R, Bilton J, Bilucaglia D, Bird C, Birudaraju D, Biscoveanu M, Blake C, Bleakley N, Bocchicchia K, Bodine S, Bodington R, Boedecker S, Bolduc M, Bolton S, Bond C, Boreky F, Boren K, Bouchi R, Bough L, Bovan D, Bowler C, Bowman L, Brar N, Braun C, Breach A, Breitenfeldt M, Brenner S, Brettschneider B, Brewer A, Brewer G, Brindle V, Brioni E, Brown C, Brown H, Brown L, Brown R, Brown S, Browne D, Bruce K, Brueckmann M, Brunskill N, Bryant M, Brzoska M, Bu Y, Buckman C, Budoff M, Bullen M, Burke A, Burnette S, Burston C, Busch M, Bushnell J, Butler S, Büttner C, Byrne C, Caamano A, Cadorna J, Cafiero C, Cagle M, Cai J, Calabrese K, Calvi C, Camilleri B, Camp S, Campbell D, Campbell R, Cao H, Capelli I, Caple M, Caplin B, Cardone A, Carle J, Carnall V, Caroppo M, Carr S, Carraro G, Carson M, Casares P, Castillo C, Castro C, Caudill B, Cejka V, Ceseri M, Cham L, Chamberlain A, Chambers J, Chan CBT, Chan JYM, Chan YC, Chang E, Chang E, Chant T, Chavagnon T, Chellamuthu P, Chen F, Chen J, Chen P, Chen TM, Chen Y, Chen Y, Cheng C, Cheng H, Cheng MC, Cherney D, Cheung AK, Ching CH, Chitalia N, Choksi R, Chukwu C, Chung K, Cianciolo G, Cipressa L, Clark S, Clarke H, Clarke R, Clarke S, Cleveland B, Cole E, Coles H, Condurache L, Connor A, Convery K, Cooper A, Cooper N, Cooper Z, Cooperman L, Cosgrove L, Coutts P, Cowley A, Craik R, Cui G, Cummins T, Dahl N, Dai H, Dajani L, D'Amelio A, Damian E, Damianik K, Danel L, Daniels C, Daniels T, Darbeau S, Darius H, Dasgupta T, Davies J, Davies L, Davis A, Davis J, Davis L, Dayanandan R, Dayi S, Dayrell R, De Nicola L, Debnath S, Deeb W, Degenhardt S, DeGoursey K, Delaney M, Deo R, DeRaad R, Derebail V, Dev D, Devaux M, Dhall P, Dhillon G, Dienes J, Dobre M, Doctolero E, Dodds V, Domingo D, Donaldson D, Donaldson P, Donhauser C, Donley V, Dorestin S, Dorey S, Doulton T, Draganova D, Draxlbauer K, Driver F, Du H, Dube F, Duck T, Dugal T, Dugas J, Dukka H, Dumann H, Durham W, Dursch M, Dykas R, Easow R, Eckrich E, Eden G, Edmerson E, Edwards H, Ee LW, Eguchi J, Ehrl Y, Eichstadt K, Eid W, Eilerman B, Ejima Y, Eldon H, Ellam T, Elliott L, Ellison R, Emberson J, Epp R, Er A, Espino-Obrero M, Estcourt S, Estienne L, Evans G, Evans J, Evans S, Fabbri G, Fajardo-Moser M, Falcone C, Fani F, Faria-Shayler P, Farnia F, Farrugia D, Fechter M, Fellowes D, Feng F, Fernandez J, Ferraro P, Field A, Fikry S, Finch J, Finn H, Fioretto P, Fish R, Fleischer A, Fleming-Brown D, Fletcher L, Flora R, Foellinger C, Foligno N, Forest S, Forghani Z, Forsyth K, Fottrell-Gould D, Fox P, Frankel A, Fraser D, Frazier R, Frederick K, Freking N, French H, Froment A, Fuchs B, Fuessl L, Fujii H, Fujimoto A, Fujita A, Fujita K, Fujita Y, Fukagawa M, Fukao Y, Fukasawa A, Fuller T, Funayama T, Fung E, Furukawa M, Furukawa Y, Furusho M, Gabel S, Gaidu J, Gaiser S, Gallo K, Galloway C, Gambaro G, Gan CC, Gangemi C, Gao M, Garcia K, Garcia M, Garofalo C, Garrity M, Garza A, Gasko S, Gavrila M, Gebeyehu B, Geddes A, Gentile G, George A, George J, Gesualdo L, Ghalli F, Ghanem A, Ghate T, Ghavampour S, Ghazi A, Gherman A, Giebeln-Hudnell U, Gill B, Gillham S, Girakossyan I, Girndt M, Giuffrida A, Glenwright M, Glider T, Gloria R, Glowski D, Goh BL, Goh CB, Gohda T, Goldenberg R, Goldfaden R, Goldsmith C, Golson B, Gonce V, Gong Q, Goodenough B, Goodwin N, Goonasekera M, Gordon A, Gordon J, Gore A, Goto H, Goto S, Goto S, Gowen D, Grace A, Graham J, Grandaliano G, Gray M, Green JB, Greene T, Greenwood G, Grewal B, Grifa R, Griffin D, Griffin S, Grimmer P, Grobovaite E, Grotjahn S, Guerini A, Guest C, Gunda S, Guo B, Guo Q, Haack S, Haase M, Haaser K, Habuki K, Hadley A, Hagan S, Hagge S, Haller H, Ham S, Hamal S, Hamamoto Y, Hamano N, Hamm M, Hanburry A, Haneda M, Hanf C, Hanif W, Hansen J, Hanson L, Hantel S, Haraguchi T, Harding E, Harding T, Hardy C, Hartner C, Harun Z, Harvill L, Hasan A, Hase H, Hasegawa F, Hasegawa T, Hashimoto A, Hashimoto C, Hashimoto M, Hashimoto S, Haskett S, Hauske SJ, Hawfield A, Hayami T, Hayashi M, Hayashi S, Haynes R, Hazara A, Healy C, Hecktman J, Heine G, Henderson H, Henschel R, Hepditch A, Herfurth K, Hernandez G, Hernandez Pena A, Hernandez-Cassis C, Herrington WG, Herzog C, Hewins S, Hewitt D, Hichkad L, Higashi S, Higuchi C, Hill C, Hill L, Hill M, Himeno T, Hing A, Hirakawa Y, Hirata K, Hirota Y, Hisatake T, Hitchcock S, Hodakowski A, Hodge W, Hogan R, Hohenstatt U, Hohenstein B, Hooi L, Hope S, Hopley M, Horikawa S, Hosein D, Hosooka T, Hou L, Hou W, Howie L, Howson A, Hozak M, Htet Z, Hu X, Hu Y, Huang J, Huda N, Hudig L, Hudson A, Hugo C, Hull R, Hume L, Hundei W, Hunt N, Hunter A, Hurley S, Hurst A, Hutchinson C, Hyo T, Ibrahim FH, Ibrahim S, Ihana N, Ikeda T, Imai A, Imamine R, Inamori A, Inazawa H, Ingell J, Inomata K, Inukai Y, Ioka M, Irtiza-Ali A, Isakova T, Isari W, Iselt M, Ishiguro A, Ishihara K, Ishikawa T, Ishimoto T, Ishizuka K, Ismail R, Itano S, Ito H, Ito K, Ito M, Ito Y, Iwagaitsu S, Iwaita Y, Iwakura T, Iwamoto M, Iwasa M, Iwasaki H, Iwasaki S, Izumi K, Izumi K, Izumi T, Jaafar SM, Jackson C, Jackson Y, Jafari G, Jahangiriesmaili M, Jain N, Jansson K, Jasim H, Jeffers L, Jenkins A, Jesky M, Jesus-Silva J, Jeyarajah D, Jiang Y, Jiao X, Jimenez G, Jin B, Jin Q, Jochims J, Johns B, Johnson C, Johnson T, Jolly S, Jones L, Jones L, Jones S, Jones T, Jones V, Joseph M, Joshi S, Judge P, Junejo N, Junus S, Kachele M, Kadowaki T, Kadoya H, Kaga H, Kai H, Kajio H, Kaluza-Schilling W, Kamaruzaman L, Kamarzarian A, Kamimura Y, Kamiya H, Kamundi C, Kan T, Kanaguchi Y, Kanazawa A, Kanda E, Kanegae S, Kaneko K, Kaneko K, Kang HY, Kano T, Karim M, Karounos D, Karsan W, Kasagi R, Kashihara N, Katagiri H, Katanosaka A, Katayama A, Katayama M, Katiman E, Kato K, Kato M, Kato N, Kato S, Kato T, Kato Y, Katsuda Y, Katsuno T, Kaufeld J, Kavak Y, Kawai I, Kawai M, Kawai M, Kawase A, Kawashima S, Kazory A, Kearney J, Keith B, Kellett J, Kelley S, Kershaw M, Ketteler M, Khai Q, Khairullah Q, Khandwala H, Khoo KKL, Khwaja A, Kidokoro K, Kielstein J, Kihara M, Kimber C, Kimura S, Kinashi H, Kingston H, Kinomura M, Kinsella-Perks E, Kitagawa M, Kitajima M, Kitamura S, Kiyosue A, Kiyota M, Klauser F, Klausmann G, Kmietschak W, Knapp K, Knight C, Knoppe A, Knott C, Kobayashi M, Kobayashi R, Kobayashi T, Koch M, Kodama S, Kodani N, Kogure E, Koizumi M, Kojima H, Kojo T, Kolhe N, Komaba H, Komiya T, Komori H, Kon SP, Kondo M, Kondo M, Kong W, Konishi M, Kono K, Koshino M, Kosugi T, Kothapalli B, Kozlowski T, Kraemer B, Kraemer-Guth A, Krappe J, Kraus D, Kriatselis C, Krieger C, Krish P, Kruger B, Ku Md Razi KR, Kuan Y, Kubota S, Kuhn S, Kumar P, Kume S, Kummer I, Kumuji R, Küpper A, Kuramae T, Kurian L, Kuribayashi C, Kurien R, Kuroda E, Kurose T, Kutschat A, Kuwabara N, Kuwata H, La Manna G, Lacey M, Lafferty K, LaFleur P, Lai V, Laity E, Lambert A, Landray MJ, Langlois M, Latif F, Latore E, Laundy E, Laurienti D, Lawson A, Lay M, Leal I, Leal I, Lee AK, Lee J, Lee KQ, Lee R, Lee SA, Lee YY, Lee-Barkey Y, Leonard N, Leoncini G, Leong CM, Lerario S, Leslie A, Levin A, Lewington A, Li J, Li N, Li X, Li Y, Liberti L, Liberti ME, Liew A, Liew YF, Lilavivat U, Lim SK, Lim YS, Limon E, Lin H, Lioudaki E, Liu H, Liu J, Liu L, Liu Q, Liu WJ, Liu X, Liu Z, Loader D, Lochhead H, Loh CL, Lorimer A, Loudermilk L, Loutan J, Low CK, Low CL, Low YM, Lozon Z, Lu Y, Lucci D, Ludwig U, Luker N, Lund D, Lustig R, Lyle S, Macdonald C, MacDougall I, Machicado R, MacLean D, Macleod P, Madera A, Madore F, Maeda K, Maegawa H, Maeno S, Mafham M, Magee J, Maggioni AP, Mah DY, Mahabadi V, Maiguma M, Makita Y, Makos G, Manco L, Mangiacapra R, Manley J, Mann P, Mano S, Marcotte G, Maris J, Mark P, Markau S, Markovic M, Marshall C, Martin M, Martinez C, Martinez S, Martins G, Maruyama K, Maruyama S, Marx K, Maselli A, Masengu A, Maskill A, Masumoto S, Masutani K, Matsumoto M, Matsunaga T, Matsuoka N, Matsushita M, Matthews M, Matthias S, Matvienko E, Maurer M, Maxwell P, Mayne KJ, Mazlan N, Mazlan SA, Mbuyisa A, McCafferty K, McCarroll F, McCarthy T, McClary-Wright C, McCray K, McDermott P, McDonald C, McDougall R, McHaffie E, McIntosh K, McKinley T, McLaughlin S, McLean N, McNeil L, Measor A, Meek J, Mehta A, Mehta R, Melandri M, Mené P, Meng T, Menne J, Merritt K, Merscher S, Meshykhi C, Messa P, Messinger L, Miftari N, Miller R, Miller Y, Miller-Hodges E, Minatoguchi M, Miners M, Minutolo R, Mita T, Miura Y, Miyaji M, Miyamoto S, Miyatsuka T, Miyazaki M, Miyazawa I, Mizumachi R, Mizuno M, Moffat S, Mohamad Nor FS, Mohamad Zaini SN, Mohamed Affandi FA, Mohandas C, Mohd R, Mohd Fauzi NA, Mohd Sharif NH, Mohd Yusoff Y, Moist L, Moncada A, Montasser M, Moon A, Moran C, Morgan N, Moriarty J, Morig G, Morinaga H, Morino K, Morisaki T, Morishita Y, Morlok S, Morris A, Morris F, Mostafa S, Mostefai Y, Motegi M, Motherwell N, Motta D, Mottl A, Moys R, Mozaffari S, Muir J, Mulhern J, Mulligan S, Munakata Y, Murakami C, Murakoshi M, Murawska A, Murphy K, Murphy L, Murray S, Murtagh H, Musa MA, Mushahar L, Mustafa R, Mustafar R, Muto M, Nadar E, Nagano R, Nagasawa T, Nagashima E, Nagasu H, Nagelberg S, Nair H, Nakagawa Y, Nakahara M, Nakamura J, Nakamura R, Nakamura T, Nakaoka M, Nakashima E, Nakata J, Nakata M, Nakatani S, Nakatsuka A, Nakayama Y, Nakhoul G, Nangaku M, Naverrete G, Navivala A, Nazeer I, Negrea L, Nethaji C, Newman E, Ng SYA, Ng TJ, Ngu LLS, Nimbkar T, Nishi H, Nishi M, Nishi S, Nishida Y, Nishiyama A, Niu J, Niu P, Nobili G, Nohara N, Nojima I, Nolan J, Nosseir H, Nozawa M, Nunn M, Nunokawa S, Oda M, Oe M, Oe Y, Ogane K, Ogawa W, Ogihara T, Oguchi G, Ohsugi M, Oishi K, Okada Y, Okajyo J, Okamoto S, Okamura K, Olufuwa O, Oluyombo R, Omata A, Omori Y, Ong LM, Ong YC, Onyema J, Oomatia A, Oommen A, Oremus R, Orimo Y, Ortalda V, Osaki Y, Osawa Y, Osmond Foster J, O'Sullivan A, Otani T, Othman N, Otomo S, O'Toole J, Owen L, Ozawa T, Padiyar A, Page N, Pajak S, Paliege A, Pandey A, Pandey R, Pariani H, Park J, Parrigon M, Passauer J, Patecki M, Patel M, Patel R, Patel T, Patel Z, Paul R, Paul R, Paulsen L, Pavone L, Peixoto A, Peji J, Peng BC, Peng K, Pennino L, Pereira E, Perez E, Pergola P, Pesce F, Pessolano G, Petchey W, Petr EJ, Pfab T, Phelan P, Phillips R, Phillips T, Phipps M, Piccinni G, Pickett T, Pickworth S, Piemontese M, Pinto D, Piper J, Plummer-Morgan J, Poehler D, Polese L, Poma V, Pontremoli R, Postal A, Pötz C, Power A, Pradhan N, Pradhan R, Preiss D, Preiss E, Preston K, Prib N, Price L, Provenzano C, Pugay C, Pulido R, Putz F, Qiao Y, Quartagno R, Quashie-Akponeware M, Rabara R, Rabasa-Lhoret R, Radhakrishnan D, Radley M, Raff R, Raguwaran S, Rahbari-Oskoui F, Rahman M, Rahmat K, Ramadoss S, Ramanaidu S, Ramasamy S, Ramli R, Ramli S, Ramsey T, Rankin A, Rashidi A, Raymond L, Razali WAFA, Read K, Reiner H, Reisler A, Reith C, Renner J, Rettenmaier B, Richmond L, Rijos D, Rivera R, Rivers V, Robinson H, Rocco M, Rodriguez-Bachiller I, Rodriquez R, Roesch C, Roesch J, Rogers J, Rohnstock M, Rolfsmeier S, Roman M, Romo A, Rosati A, Rosenberg S, Ross T, Rossello X, Roura M, Roussel M, Rovner S, Roy S, Rucker S, Rump L, Ruocco M, Ruse S, Russo F, Russo M, Ryder M, Sabarai A, Saccà C, Sachson R, Sadler E, Safiee NS, Sahani M, Saillant A, Saini J, Saito C, Saito S, Sakaguchi K, Sakai M, Salim H, Salviani C, Sammons E, Sampson A, Samson F, Sandercock P, Sanguila S, Santorelli G, Santoro D, Sarabu N, Saram T, Sardell R, Sasajima H, Sasaki T, Satko S, Sato A, Sato D, Sato H, Sato H, Sato J, Sato T, Sato Y, Satoh M, Sawada K, Schanz M, Scheidemantel F, Schemmelmann M, Schettler E, Schettler V, Schlieper GR, Schmidt C, Schmidt G, Schmidt U, Schmidt-Gurtler H, Schmude M, Schneider A, Schneider I, Schneider-Danwitz C, Schomig M, Schramm T, Schreiber A, Schricker S, Schroppel B, Schulte-Kemna L, Schulz E, Schumacher B, Schuster A, Schwab A, Scolari F, Scott A, Seeger W, Seeger W, Segal M, Seifert L, Seifert M, Sekiya M, Sellars R, Seman MR, Shah S, Shah S, Shainberg L, Shanmuganathan M, Shao F, Sharma K, Sharpe C, Sheikh-Ali M, Sheldon J, Shenton C, Shepherd A, Shepperd M, Sheridan R, Sheriff Z, Shibata Y, Shigehara T, Shikata K, Shimamura K, Shimano H, Shimizu Y, Shimoda H, Shin K, Shivashankar G, Shojima N, Silva R, Sim CSB, Simmons K, Sinha S, Sitter T, Sivanandam S, Skipper M, Sloan K, Sloan L, Smith R, Smyth J, Sobande T, Sobata M, Somalanka S, Song X, Sonntag F, Sood B, Sor SY, Soufer J, Sparks H, Spatoliatore G, Spinola T, Squyres S, Srivastava A, Stanfield J, Staplin N, Staylor K, Steele A, Steen O, Steffl D, Stegbauer J, Stellbrink C, Stellbrink E, Stevens W, Stevenson A, Stewart-Ray V, Stickley J, Stoffler D, Stratmann B, Streitenberger S, Strutz F, Stubbs J, Stumpf J, Suazo N, Suchinda P, Suckling R, Sudin A, Sugamori K, Sugawara H, Sugawara K, Sugimoto D, Sugiyama H, Sugiyama H, Sugiyama T, Sullivan M, Sumi M, Suresh N, Sutton D, Suzuki H, Suzuki R, Suzuki Y, Suzuki Y, Suzuki Y, Swanson E, Swift P, Syed S, Szerlip H, Taal M, Taddeo M, Tailor C, Tajima K, Takagi M, Takahashi K, Takahashi K, Takahashi M, Takahashi T, Takahira E, Takai T, Takaoka M, Takeoka J, Takesada A, Takezawa M, Talbot M, Taliercio J, Talsania T, Tamori Y, Tamura R, Tamura Y, Tan CHH, Tan EZZ, Tanabe A, Tanabe K, Tanaka A, Tanaka A, Tanaka N, Tang S, Tang Z, Tanigaki K, Tarlac M, Tatsuzawa A, Tay JF, Tay LL, Taylor J, Taylor K, Taylor K, Te A, Tenbusch L, Teng KS, Terakawa A, Terry J, Tham ZD, Tholl S, Thomas G, Thong KM, Tietjen D, Timadjer A, Tindall H, Tipper S, Tobin K, Toda N, Tokuyama A, Tolibas M, Tomita A, Tomita T, Tomlinson J, Tonks L, Topf J, Topping S, Torp A, Torres A, Totaro F, Toth P, Toyonaga Y, Tripodi F, Trivedi K, Tropman E, Tschope D, Tse J, Tsuji K, Tsunekawa S, Tsunoda R, Tucky B, Tufail S, Tuffaha A, Turan E, Turner H, Turner J, Turner M, Tuttle KR, Tye YL, Tyler A, Tyler J, Uchi H, Uchida H, Uchida T, Uchida T, Udagawa T, Ueda S, Ueda Y, Ueki K, Ugni S, Ugwu E, Umeno R, Unekawa C, Uozumi K, Urquia K, Valleteau A, Valletta C, van Erp R, Vanhoy C, Varad V, Varma R, Varughese A, Vasquez P, Vasseur A, Veelken R, Velagapudi C, Verdel K, Vettoretti S, Vezzoli G, Vielhauer V, Viera R, Vilar E, Villaruel S, Vinall L, Vinathan J, Visnjic M, Voigt E, von-Eynatten M, Vourvou M, Wada J, Wada J, Wada T, Wada Y, Wakayama K, Wakita Y, Wallendszus K, Walters T, Wan Mohamad WH, Wang L, Wang W, Wang X, Wang X, Wang Y, Wanner C, Wanninayake S, Watada H, Watanabe K, Watanabe K, Watanabe M, Waterfall H, Watkins D, Watson S, Weaving L, Weber B, Webley Y, Webster A, Webster M, Weetman M, Wei W, Weihprecht H, Weiland L, Weinmann-Menke J, Weinreich T, Wendt R, Weng Y, Whalen M, Whalley G, Wheatley R, Wheeler A, Wheeler J, Whelton P, White K, Whitmore B, Whittaker S, Wiebel J, Wiley J, Wilkinson L, Willett M, Williams A, Williams E, Williams K, Williams T, Wilson A, Wilson P, Wincott L, Wines E, Winkelmann B, Winkler M, Winter-Goodwin B, Witczak J, Wittes J, Wittmann M, Wolf G, Wolf L, Wolfling R, Wong C, Wong E, Wong HS, Wong LW, Wong YH, Wonnacott A, Wood A, Wood L, Woodhouse H, Wooding N, Woodman A, Wren K, Wu J, Wu P, Xia S, Xiao H, Xiao X, Xie Y, Xu C, Xu Y, Xue H, Yahaya H, Yalamanchili H, Yamada A, Yamada N, Yamagata K, Yamaguchi M, Yamaji Y, Yamamoto A, Yamamoto S, Yamamoto S, Yamamoto T, Yamanaka A, Yamano T, Yamanouchi Y, Yamasaki N, Yamasaki Y, Yamasaki Y, Yamashita C, Yamauchi T, Yan Q, Yanagisawa E, Yang F, Yang L, Yano S, Yao S, Yao Y, Yarlagadda S, Yasuda Y, Yiu V, Yokoyama T, Yoshida S, Yoshidome E, Yoshikawa H, Young A, Young T, Yousif V, Yu H, Yu Y, Yuasa K, Yusof N, Zalunardo N, Zander B, Zani R, Zappulo F, Zayed M, Zemann B, Zettergren P, Zhang H, Zhang L, Zhang L, Zhang N, Zhang X, Zhao J, Zhao L, Zhao S, Zhao Z, Zhong H, Zhou N, Zhou S, Zhu D, Zhu L, Zhu S, Zietz M, Zippo M, Zirino F, Zulkipli FH. Effects of empagliflozin on progression of chronic kidney disease: a prespecified secondary analysis from the empa-kidney trial. Lancet Diabetes Endocrinol 2024; 12:39-50. [PMID: 38061371 PMCID: PMC7615591 DOI: 10.1016/s2213-8587(23)00321-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Sodium-glucose co-transporter-2 (SGLT2) inhibitors reduce progression of chronic kidney disease and the risk of cardiovascular morbidity and mortality in a wide range of patients. However, their effects on kidney disease progression in some patients with chronic kidney disease are unclear because few clinical kidney outcomes occurred among such patients in the completed trials. In particular, some guidelines stratify their level of recommendation about who should be treated with SGLT2 inhibitors based on diabetes status and albuminuria. We aimed to assess the effects of empagliflozin on progression of chronic kidney disease both overall and among specific types of participants in the EMPA-KIDNEY trial. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA), and included individuals aged 18 years or older with an estimated glomerular filtration rate (eGFR) of 20 to less than 45 mL/min per 1·73 m2, or with an eGFR of 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher. We explored the effects of 10 mg oral empagliflozin once daily versus placebo on the annualised rate of change in estimated glomerular filtration rate (eGFR slope), a tertiary outcome. We studied the acute slope (from randomisation to 2 months) and chronic slope (from 2 months onwards) separately, using shared parameter models to estimate the latter. Analyses were done in all randomly assigned participants by intention to treat. EMPA-KIDNEY is registered at ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and then followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroups of eGFR included 2282 (34·5%) participants with an eGFR of less than 30 mL/min per 1·73 m2, 2928 (44·3%) with an eGFR of 30 to less than 45 mL/min per 1·73 m2, and 1399 (21·2%) with an eGFR 45 mL/min per 1·73 m2 or higher. Prespecified subgroups of uACR included 1328 (20·1%) with a uACR of less than 30 mg/g, 1864 (28·2%) with a uACR of 30 to 300 mg/g, and 3417 (51·7%) with a uACR of more than 300 mg/g. Overall, allocation to empagliflozin caused an acute 2·12 mL/min per 1·73 m2 (95% CI 1·83-2·41) reduction in eGFR, equivalent to a 6% (5-6) dip in the first 2 months. After this, it halved the chronic slope from -2·75 to -1·37 mL/min per 1·73 m2 per year (relative difference 50%, 95% CI 42-58). The absolute and relative benefits of empagliflozin on the magnitude of the chronic slope varied significantly depending on diabetes status and baseline levels of eGFR and uACR. In particular, the absolute difference in chronic slopes was lower in patients with lower baseline uACR, but because this group progressed more slowly than those with higher uACR, this translated to a larger relative difference in chronic slopes in this group (86% [36-136] reduction in the chronic slope among those with baseline uACR <30 mg/g compared with a 29% [19-38] reduction for those with baseline uACR ≥2000 mg/g; ptrend<0·0001). INTERPRETATION Empagliflozin slowed the rate of progression of chronic kidney disease among all types of participant in the EMPA-KIDNEY trial, including those with little albuminuria. Albuminuria alone should not be used to determine whether to treat with an SGLT2 inhibitor. FUNDING Boehringer Ingelheim and Eli Lilly.
Collapse
|
3
|
Judge PK, Staplin N, Mayne KJ, Wanner C, Green JB, Hauske SJ, Emberson JR, Preiss D, Ng SYA, Roddick AJ, Sammons E, Zhu D, Hill M, Stevens W, Wallendszus K, Brenner S, Cheung AK, Liu ZH, Li J, Hooi LS, Liu WJ, Kadowaki T, Nangaku M, Levin A, Cherney D, Maggioni AP, Pontremoli R, Deo R, Goto S, Rossello X, Tuttle KR, Steubl D, Massey D, Landray MJ, Baigent C, Haynes R, Herrington WG, Abat S, Abd Rahman R, Abdul Cader R, Abdul Hafidz MI, Abdul Wahab MZ, Abdullah NK, Abdul-Samad T, Abe M, Abraham N, Acheampong S, Achiri P, Acosta JA, Adeleke A, Adell V, Adewuyi-Dalton R, Adnan N, Africano A, Agharazii M, Aguilar F, Aguilera A, Ahmad M, Ahmad MK, Ahmad NA, Ahmad NH, Ahmad NI, Ahmad Miswan N, Ahmad Rosdi H, Ahmed I, Ahmed S, Ahmed S, Aiello J, Aitken A, AitSadi R, Aker S, Akimoto S, Akinfolarin A, Akram S, Alberici F, Albert C, Aldrich L, Alegata M, Alexander L, Alfaress S, Alhadj Ali M, Ali A, Ali A, Alicic R, Aliu A, Almaraz R, Almasarwah R, Almeida J, Aloisi A, Al-Rabadi L, Alscher D, Alvarez P, Al-Zeer B, Amat M, Ambrose C, Ammar H, An Y, Andriaccio L, Ansu K, Apostolidi A, Arai N, Araki H, Araki S, Arbi A, Arechiga O, Armstrong S, Arnold T, Aronoff S, Arriaga W, Arroyo J, Arteaga D, Asahara S, Asai A, Asai N, Asano S, Asawa M, Asmee MF, Aucella F, Augustin M, Avery A, Awad A, Awang IY, Awazawa M, Axler A, Ayub W, Azhari Z, Baccaro R, Badin C, Bagwell B, Bahlmann-Kroll E, Bahtar AZ, Baigent C, Bains D, Bajaj H, Baker R, Baldini E, Banas B, Banerjee D, Banno S, Bansal S, Barberi S, Barnes S, Barnini C, Barot C, Barrett K, Barrios R, Bartolomei Mecatti B, Barton I, Barton J, Basily W, Bavanandan S, Baxter A, Becker L, Beddhu S, Beige J, Beigh S, Bell S, Benck U, Beneat A, Bennett A, Bennett D, Benyon S, Berdeprado J, Bergler T, Bergner A, Berry M, Bevilacqua M, Bhairoo J, Bhandari S, Bhandary N, Bhatt A, Bhattarai M, Bhavsar M, Bian W, Bianchini F, Bianco S, Bilous R, Bilton J, Bilucaglia D, Bird C, Birudaraju D, Biscoveanu M, Blake C, Bleakley N, Bocchicchia K, Bodine S, Bodington R, Boedecker S, Bolduc M, Bolton S, Bond C, Boreky F, Boren K, Bouchi R, Bough L, Bovan D, Bowler C, Bowman L, Brar N, Braun C, Breach A, Breitenfeldt M, Brenner S, Brettschneider B, Brewer A, Brewer G, Brindle V, Brioni E, Brown C, Brown H, Brown L, Brown R, Brown S, Browne D, Bruce K, Brueckmann M, Brunskill N, Bryant M, Brzoska M, Bu Y, Buckman C, Budoff M, Bullen M, Burke A, Burnette S, Burston C, Busch M, Bushnell J, Butler S, Büttner C, Byrne C, Caamano A, Cadorna J, Cafiero C, Cagle M, Cai J, Calabrese K, Calvi C, Camilleri B, Camp S, Campbell D, Campbell R, Cao H, Capelli I, Caple M, Caplin B, Cardone A, Carle J, Carnall V, Caroppo M, Carr S, Carraro G, Carson M, Casares P, Castillo C, Castro C, Caudill B, Cejka V, Ceseri M, Cham L, Chamberlain A, Chambers J, Chan CBT, Chan JYM, Chan YC, Chang E, Chang E, Chant T, Chavagnon T, Chellamuthu P, Chen F, Chen J, Chen P, Chen TM, Chen Y, Chen Y, Cheng C, Cheng H, Cheng MC, Cherney D, Cheung AK, Ching CH, Chitalia N, Choksi R, Chukwu C, Chung K, Cianciolo G, Cipressa L, Clark S, Clarke H, Clarke R, Clarke S, Cleveland B, Cole E, Coles H, Condurache L, Connor A, Convery K, Cooper A, Cooper N, Cooper Z, Cooperman L, Cosgrove L, Coutts P, Cowley A, Craik R, Cui G, Cummins T, Dahl N, Dai H, Dajani L, D'Amelio A, Damian E, Damianik K, Danel L, Daniels C, Daniels T, Darbeau S, Darius H, Dasgupta T, Davies J, Davies L, Davis A, Davis J, Davis L, Dayanandan R, Dayi S, Dayrell R, De Nicola L, Debnath S, Deeb W, Degenhardt S, DeGoursey K, Delaney M, Deo R, DeRaad R, Derebail V, Dev D, Devaux M, Dhall P, Dhillon G, Dienes J, Dobre M, Doctolero E, Dodds V, Domingo D, Donaldson D, Donaldson P, Donhauser C, Donley V, Dorestin S, Dorey S, Doulton T, Draganova D, Draxlbauer K, Driver F, Du H, Dube F, Duck T, Dugal T, Dugas J, Dukka H, Dumann H, Durham W, Dursch M, Dykas R, Easow R, Eckrich E, Eden G, Edmerson E, Edwards H, Ee LW, Eguchi J, Ehrl Y, Eichstadt K, Eid W, Eilerman B, Ejima Y, Eldon H, Ellam T, Elliott L, Ellison R, Emberson J, Epp R, Er A, Espino-Obrero M, Estcourt S, Estienne L, Evans G, Evans J, Evans S, Fabbri G, Fajardo-Moser M, Falcone C, Fani F, Faria-Shayler P, Farnia F, Farrugia D, Fechter M, Fellowes D, Feng F, Fernandez J, Ferraro P, Field A, Fikry S, Finch J, Finn H, Fioretto P, Fish R, Fleischer A, Fleming-Brown D, Fletcher L, Flora R, Foellinger C, Foligno N, Forest S, Forghani Z, Forsyth K, Fottrell-Gould D, Fox P, Frankel A, Fraser D, Frazier R, Frederick K, Freking N, French H, Froment A, Fuchs B, Fuessl L, Fujii H, Fujimoto A, Fujita A, Fujita K, Fujita Y, Fukagawa M, Fukao Y, Fukasawa A, Fuller T, Funayama T, Fung E, Furukawa M, Furukawa Y, Furusho M, Gabel S, Gaidu J, Gaiser S, Gallo K, Galloway C, Gambaro G, Gan CC, Gangemi C, Gao M, Garcia K, Garcia M, Garofalo C, Garrity M, Garza A, Gasko S, Gavrila M, Gebeyehu B, Geddes A, Gentile G, George A, George J, Gesualdo L, Ghalli F, Ghanem A, Ghate T, Ghavampour S, Ghazi A, Gherman A, Giebeln-Hudnell U, Gill B, Gillham S, Girakossyan I, Girndt M, Giuffrida A, Glenwright M, Glider T, Gloria R, Glowski D, Goh BL, Goh CB, Gohda T, Goldenberg R, Goldfaden R, Goldsmith C, Golson B, Gonce V, Gong Q, Goodenough B, Goodwin N, Goonasekera M, Gordon A, Gordon J, Gore A, Goto H, Goto S, Goto S, Gowen D, Grace A, Graham J, Grandaliano G, Gray M, Green JB, Greene T, Greenwood G, Grewal B, Grifa R, Griffin D, Griffin S, Grimmer P, Grobovaite E, Grotjahn S, Guerini A, Guest C, Gunda S, Guo B, Guo Q, Haack S, Haase M, Haaser K, Habuki K, Hadley A, Hagan S, Hagge S, Haller H, Ham S, Hamal S, Hamamoto Y, Hamano N, Hamm M, Hanburry A, Haneda M, Hanf C, Hanif W, Hansen J, Hanson L, Hantel S, Haraguchi T, Harding E, Harding T, Hardy C, Hartner C, Harun Z, Harvill L, Hasan A, Hase H, Hasegawa F, Hasegawa T, Hashimoto A, Hashimoto C, Hashimoto M, Hashimoto S, Haskett S, Hauske SJ, Hawfield A, Hayami T, Hayashi M, Hayashi S, Haynes R, Hazara A, Healy C, Hecktman J, Heine G, Henderson H, Henschel R, Hepditch A, Herfurth K, Hernandez G, Hernandez Pena A, Hernandez-Cassis C, Herrington WG, Herzog C, Hewins S, Hewitt D, Hichkad L, Higashi S, Higuchi C, Hill C, Hill L, Hill M, Himeno T, Hing A, Hirakawa Y, Hirata K, Hirota Y, Hisatake T, Hitchcock S, Hodakowski A, Hodge W, Hogan R, Hohenstatt U, Hohenstein B, Hooi L, Hope S, Hopley M, Horikawa S, Hosein D, Hosooka T, Hou L, Hou W, Howie L, Howson A, Hozak M, Htet Z, Hu X, Hu Y, Huang J, Huda N, Hudig L, Hudson A, Hugo C, Hull R, Hume L, Hundei W, Hunt N, Hunter A, Hurley S, Hurst A, Hutchinson C, Hyo T, Ibrahim FH, Ibrahim S, Ihana N, Ikeda T, Imai A, Imamine R, Inamori A, Inazawa H, Ingell J, Inomata K, Inukai Y, Ioka M, Irtiza-Ali A, Isakova T, Isari W, Iselt M, Ishiguro A, Ishihara K, Ishikawa T, Ishimoto T, Ishizuka K, Ismail R, Itano S, Ito H, Ito K, Ito M, Ito Y, Iwagaitsu S, Iwaita Y, Iwakura T, Iwamoto M, Iwasa M, Iwasaki H, Iwasaki S, Izumi K, Izumi K, Izumi T, Jaafar SM, Jackson C, Jackson Y, Jafari G, Jahangiriesmaili M, Jain N, Jansson K, Jasim H, Jeffers L, Jenkins A, Jesky M, Jesus-Silva J, Jeyarajah D, Jiang Y, Jiao X, Jimenez G, Jin B, Jin Q, Jochims J, Johns B, Johnson C, Johnson T, Jolly S, Jones L, Jones L, Jones S, Jones T, Jones V, Joseph M, Joshi S, Judge P, Junejo N, Junus S, Kachele M, Kadowaki T, Kadoya H, Kaga H, Kai H, Kajio H, Kaluza-Schilling W, Kamaruzaman L, Kamarzarian A, Kamimura Y, Kamiya H, Kamundi C, Kan T, Kanaguchi Y, Kanazawa A, Kanda E, Kanegae S, Kaneko K, Kaneko K, Kang HY, Kano T, Karim M, Karounos D, Karsan W, Kasagi R, Kashihara N, Katagiri H, Katanosaka A, Katayama A, Katayama M, Katiman E, Kato K, Kato M, Kato N, Kato S, Kato T, Kato Y, Katsuda Y, Katsuno T, Kaufeld J, Kavak Y, Kawai I, Kawai M, Kawai M, Kawase A, Kawashima S, Kazory A, Kearney J, Keith B, Kellett J, Kelley S, Kershaw M, Ketteler M, Khai Q, Khairullah Q, Khandwala H, Khoo KKL, Khwaja A, Kidokoro K, Kielstein J, Kihara M, Kimber C, Kimura S, Kinashi H, Kingston H, Kinomura M, Kinsella-Perks E, Kitagawa M, Kitajima M, Kitamura S, Kiyosue A, Kiyota M, Klauser F, Klausmann G, Kmietschak W, Knapp K, Knight C, Knoppe A, Knott C, Kobayashi M, Kobayashi R, Kobayashi T, Koch M, Kodama S, Kodani N, Kogure E, Koizumi M, Kojima H, Kojo T, Kolhe N, Komaba H, Komiya T, Komori H, Kon SP, Kondo M, Kondo M, Kong W, Konishi M, Kono K, Koshino M, Kosugi T, Kothapalli B, Kozlowski T, Kraemer B, Kraemer-Guth A, Krappe J, Kraus D, Kriatselis C, Krieger C, Krish P, Kruger B, Ku Md Razi KR, Kuan Y, Kubota S, Kuhn S, Kumar P, Kume S, Kummer I, Kumuji R, Küpper A, Kuramae T, Kurian L, Kuribayashi C, Kurien R, Kuroda E, Kurose T, Kutschat A, Kuwabara N, Kuwata H, La Manna G, Lacey M, Lafferty K, LaFleur P, Lai V, Laity E, Lambert A, Landray MJ, Langlois M, Latif F, Latore E, Laundy E, Laurienti D, Lawson A, Lay M, Leal I, Leal I, Lee AK, Lee J, Lee KQ, Lee R, Lee SA, Lee YY, Lee-Barkey Y, Leonard N, Leoncini G, Leong CM, Lerario S, Leslie A, Levin A, Lewington A, Li J, Li N, Li X, Li Y, Liberti L, Liberti ME, Liew A, Liew YF, Lilavivat U, Lim SK, Lim YS, Limon E, Lin H, Lioudaki E, Liu H, Liu J, Liu L, Liu Q, Liu WJ, Liu X, Liu Z, Loader D, Lochhead H, Loh CL, Lorimer A, Loudermilk L, Loutan J, Low CK, Low CL, Low YM, Lozon Z, Lu Y, Lucci D, Ludwig U, Luker N, Lund D, Lustig R, Lyle S, Macdonald C, MacDougall I, Machicado R, MacLean D, Macleod P, Madera A, Madore F, Maeda K, Maegawa H, Maeno S, Mafham M, Magee J, Maggioni AP, Mah DY, Mahabadi V, Maiguma M, Makita Y, Makos G, Manco L, Mangiacapra R, Manley J, Mann P, Mano S, Marcotte G, Maris J, Mark P, Markau S, Markovic M, Marshall C, Martin M, Martinez C, Martinez S, Martins G, Maruyama K, Maruyama S, Marx K, Maselli A, Masengu A, Maskill A, Masumoto S, Masutani K, Matsumoto M, Matsunaga T, Matsuoka N, Matsushita M, Matthews M, Matthias S, Matvienko E, Maurer M, Maxwell P, Mayne KJ, Mazlan N, Mazlan SA, Mbuyisa A, McCafferty K, McCarroll F, McCarthy T, McClary-Wright C, McCray K, McDermott P, McDonald C, McDougall R, McHaffie E, McIntosh K, McKinley T, McLaughlin S, McLean N, McNeil L, Measor A, Meek J, Mehta A, Mehta R, Melandri M, Mené P, Meng T, Menne J, Merritt K, Merscher S, Meshykhi C, Messa P, Messinger L, Miftari N, Miller R, Miller Y, Miller-Hodges E, Minatoguchi M, Miners M, Minutolo R, Mita T, Miura Y, Miyaji M, Miyamoto S, Miyatsuka T, Miyazaki M, Miyazawa I, Mizumachi R, Mizuno M, Moffat S, Mohamad Nor FS, Mohamad Zaini SN, Mohamed Affandi FA, Mohandas C, Mohd R, Mohd Fauzi NA, Mohd Sharif NH, Mohd Yusoff Y, Moist L, Moncada A, Montasser M, Moon A, Moran C, Morgan N, Moriarty J, Morig G, Morinaga H, Morino K, Morisaki T, Morishita Y, Morlok S, Morris A, Morris F, Mostafa S, Mostefai Y, Motegi M, Motherwell N, Motta D, Mottl A, Moys R, Mozaffari S, Muir J, Mulhern J, Mulligan S, Munakata Y, Murakami C, Murakoshi M, Murawska A, Murphy K, Murphy L, Murray S, Murtagh H, Musa MA, Mushahar L, Mustafa R, Mustafar R, Muto M, Nadar E, Nagano R, Nagasawa T, Nagashima E, Nagasu H, Nagelberg S, Nair H, Nakagawa Y, Nakahara M, Nakamura J, Nakamura R, Nakamura T, Nakaoka M, Nakashima E, Nakata J, Nakata M, Nakatani S, Nakatsuka A, Nakayama Y, Nakhoul G, Nangaku M, Naverrete G, Navivala A, Nazeer I, Negrea L, Nethaji C, Newman E, Ng SYA, Ng TJ, Ngu LLS, Nimbkar T, Nishi H, Nishi M, Nishi S, Nishida Y, Nishiyama A, Niu J, Niu P, Nobili G, Nohara N, Nojima I, Nolan J, Nosseir H, Nozawa M, Nunn M, Nunokawa S, Oda M, Oe M, Oe Y, Ogane K, Ogawa W, Ogihara T, Oguchi G, Ohsugi M, Oishi K, Okada Y, Okajyo J, Okamoto S, Okamura K, Olufuwa O, Oluyombo R, Omata A, Omori Y, Ong LM, Ong YC, Onyema J, Oomatia A, Oommen A, Oremus R, Orimo Y, Ortalda V, Osaki Y, Osawa Y, Osmond Foster J, O'Sullivan A, Otani T, Othman N, Otomo S, O'Toole J, Owen L, Ozawa T, Padiyar A, Page N, Pajak S, Paliege A, Pandey A, Pandey R, Pariani H, Park J, Parrigon M, Passauer J, Patecki M, Patel M, Patel R, Patel T, Patel Z, Paul R, Paul R, Paulsen L, Pavone L, Peixoto A, Peji J, Peng BC, Peng K, Pennino L, Pereira E, Perez E, Pergola P, Pesce F, Pessolano G, Petchey W, Petr EJ, Pfab T, Phelan P, Phillips R, Phillips T, Phipps M, Piccinni G, Pickett T, Pickworth S, Piemontese M, Pinto D, Piper J, Plummer-Morgan J, Poehler D, Polese L, Poma V, Pontremoli R, Postal A, Pötz C, Power A, Pradhan N, Pradhan R, Preiss D, Preiss E, Preston K, Prib N, Price L, Provenzano C, Pugay C, Pulido R, Putz F, Qiao Y, Quartagno R, Quashie-Akponeware M, Rabara R, Rabasa-Lhoret R, Radhakrishnan D, Radley M, Raff R, Raguwaran S, Rahbari-Oskoui F, Rahman M, Rahmat K, Ramadoss S, Ramanaidu S, Ramasamy S, Ramli R, Ramli S, Ramsey T, Rankin A, Rashidi A, Raymond L, Razali WAFA, Read K, Reiner H, Reisler A, Reith C, Renner J, Rettenmaier B, Richmond L, Rijos D, Rivera R, Rivers V, Robinson H, Rocco M, Rodriguez-Bachiller I, Rodriquez R, Roesch C, Roesch J, Rogers J, Rohnstock M, Rolfsmeier S, Roman M, Romo A, Rosati A, Rosenberg S, Ross T, Rossello X, Roura M, Roussel M, Rovner S, Roy S, Rucker S, Rump L, Ruocco M, Ruse S, Russo F, Russo M, Ryder M, Sabarai A, Saccà C, Sachson R, Sadler E, Safiee NS, Sahani M, Saillant A, Saini J, Saito C, Saito S, Sakaguchi K, Sakai M, Salim H, Salviani C, Sammons E, Sampson A, Samson F, Sandercock P, Sanguila S, Santorelli G, Santoro D, Sarabu N, Saram T, Sardell R, Sasajima H, Sasaki T, Satko S, Sato A, Sato D, Sato H, Sato H, Sato J, Sato T, Sato Y, Satoh M, Sawada K, Schanz M, Scheidemantel F, Schemmelmann M, Schettler E, Schettler V, Schlieper GR, Schmidt C, Schmidt G, Schmidt U, Schmidt-Gurtler H, Schmude M, Schneider A, Schneider I, Schneider-Danwitz C, Schomig M, Schramm T, Schreiber A, Schricker S, Schroppel B, Schulte-Kemna L, Schulz E, Schumacher B, Schuster A, Schwab A, Scolari F, Scott A, Seeger W, Seeger W, Segal M, Seifert L, Seifert M, Sekiya M, Sellars R, Seman MR, Shah S, Shah S, Shainberg L, Shanmuganathan M, Shao F, Sharma K, Sharpe C, Sheikh-Ali M, Sheldon J, Shenton C, Shepherd A, Shepperd M, Sheridan R, Sheriff Z, Shibata Y, Shigehara T, Shikata K, Shimamura K, Shimano H, Shimizu Y, Shimoda H, Shin K, Shivashankar G, Shojima N, Silva R, Sim CSB, Simmons K, Sinha S, Sitter T, Sivanandam S, Skipper M, Sloan K, Sloan L, Smith R, Smyth J, Sobande T, Sobata M, Somalanka S, Song X, Sonntag F, Sood B, Sor SY, Soufer J, Sparks H, Spatoliatore G, Spinola T, Squyres S, Srivastava A, Stanfield J, Staplin N, Staylor K, Steele A, Steen O, Steffl D, Stegbauer J, Stellbrink C, Stellbrink E, Stevens W, Stevenson A, Stewart-Ray V, Stickley J, Stoffler D, Stratmann B, Streitenberger S, Strutz F, Stubbs J, Stumpf J, Suazo N, Suchinda P, Suckling R, Sudin A, Sugamori K, Sugawara H, Sugawara K, Sugimoto D, Sugiyama H, Sugiyama H, Sugiyama T, Sullivan M, Sumi M, Suresh N, Sutton D, Suzuki H, Suzuki R, Suzuki Y, Suzuki Y, Suzuki Y, Swanson E, Swift P, Syed S, Szerlip H, Taal M, Taddeo M, Tailor C, Tajima K, Takagi M, Takahashi K, Takahashi K, Takahashi M, Takahashi T, Takahira E, Takai T, Takaoka M, Takeoka J, Takesada A, Takezawa M, Talbot M, Taliercio J, Talsania T, Tamori Y, Tamura R, Tamura Y, Tan CHH, Tan EZZ, Tanabe A, Tanabe K, Tanaka A, Tanaka A, Tanaka N, Tang S, Tang Z, Tanigaki K, Tarlac M, Tatsuzawa A, Tay JF, Tay LL, Taylor J, Taylor K, Taylor K, Te A, Tenbusch L, Teng KS, Terakawa A, Terry J, Tham ZD, Tholl S, Thomas G, Thong KM, Tietjen D, Timadjer A, Tindall H, Tipper S, Tobin K, Toda N, Tokuyama A, Tolibas M, Tomita A, Tomita T, Tomlinson J, Tonks L, Topf J, Topping S, Torp A, Torres A, Totaro F, Toth P, Toyonaga Y, Tripodi F, Trivedi K, Tropman E, Tschope D, Tse J, Tsuji K, Tsunekawa S, Tsunoda R, Tucky B, Tufail S, Tuffaha A, Turan E, Turner H, Turner J, Turner M, Tuttle KR, Tye YL, Tyler A, Tyler J, Uchi H, Uchida H, Uchida T, Uchida T, Udagawa T, Ueda S, Ueda Y, Ueki K, Ugni S, Ugwu E, Umeno R, Unekawa C, Uozumi K, Urquia K, Valleteau A, Valletta C, van Erp R, Vanhoy C, Varad V, Varma R, Varughese A, Vasquez P, Vasseur A, Veelken R, Velagapudi C, Verdel K, Vettoretti S, Vezzoli G, Vielhauer V, Viera R, Vilar E, Villaruel S, Vinall L, Vinathan J, Visnjic M, Voigt E, von-Eynatten M, Vourvou M, Wada J, Wada J, Wada T, Wada Y, Wakayama K, Wakita Y, Wallendszus K, Walters T, Wan Mohamad WH, Wang L, Wang W, Wang X, Wang X, Wang Y, Wanner C, Wanninayake S, Watada H, Watanabe K, Watanabe K, Watanabe M, Waterfall H, Watkins D, Watson S, Weaving L, Weber B, Webley Y, Webster A, Webster M, Weetman M, Wei W, Weihprecht H, Weiland L, Weinmann-Menke J, Weinreich T, Wendt R, Weng Y, Whalen M, Whalley G, Wheatley R, Wheeler A, Wheeler J, Whelton P, White K, Whitmore B, Whittaker S, Wiebel J, Wiley J, Wilkinson L, Willett M, Williams A, Williams E, Williams K, Williams T, Wilson A, Wilson P, Wincott L, Wines E, Winkelmann B, Winkler M, Winter-Goodwin B, Witczak J, Wittes J, Wittmann M, Wolf G, Wolf L, Wolfling R, Wong C, Wong E, Wong HS, Wong LW, Wong YH, Wonnacott A, Wood A, Wood L, Woodhouse H, Wooding N, Woodman A, Wren K, Wu J, Wu P, Xia S, Xiao H, Xiao X, Xie Y, Xu C, Xu Y, Xue H, Yahaya H, Yalamanchili H, Yamada A, Yamada N, Yamagata K, Yamaguchi M, Yamaji Y, Yamamoto A, Yamamoto S, Yamamoto S, Yamamoto T, Yamanaka A, Yamano T, Yamanouchi Y, Yamasaki N, Yamasaki Y, Yamasaki Y, Yamashita C, Yamauchi T, Yan Q, Yanagisawa E, Yang F, Yang L, Yano S, Yao S, Yao Y, Yarlagadda S, Yasuda Y, Yiu V, Yokoyama T, Yoshida S, Yoshidome E, Yoshikawa H, Young A, Young T, Yousif V, Yu H, Yu Y, Yuasa K, Yusof N, Zalunardo N, Zander B, Zani R, Zappulo F, Zayed M, Zemann B, Zettergren P, Zhang H, Zhang L, Zhang L, Zhang N, Zhang X, Zhao J, Zhao L, Zhao S, Zhao Z, Zhong H, Zhou N, Zhou S, Zhu D, Zhu L, Zhu S, Zietz M, Zippo M, Zirino F, Zulkipli FH. Impact of primary kidney disease on the effects of empagliflozin in patients with chronic kidney disease: secondary analyses of the EMPA-KIDNEY trial. Lancet Diabetes Endocrinol 2024; 12:51-60. [PMID: 38061372 DOI: 10.1016/s2213-8587(23)00322-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND The EMPA-KIDNEY trial showed that empagliflozin reduced the risk of the primary composite outcome of kidney disease progression or cardiovascular death in patients with chronic kidney disease mainly through slowing progression. We aimed to assess how effects of empagliflozin might differ by primary kidney disease across its broad population. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA). Patients were eligible if their estimated glomerular filtration rate (eGFR) was 20 to less than 45 mL/min per 1·73 m2, or 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher at screening. They were randomly assigned (1:1) to 10 mg oral empagliflozin once daily or matching placebo. Effects on kidney disease progression (defined as a sustained ≥40% eGFR decline from randomisation, end-stage kidney disease, a sustained eGFR below 10 mL/min per 1·73 m2, or death from kidney failure) were assessed using prespecified Cox models, and eGFR slope analyses used shared parameter models. Subgroup comparisons were performed by including relevant interaction terms in models. EMPA-KIDNEY is registered with ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroupings by primary kidney disease included 2057 (31·1%) participants with diabetic kidney disease, 1669 (25·3%) with glomerular disease, 1445 (21·9%) with hypertensive or renovascular disease, and 1438 (21·8%) with other or unknown causes. Kidney disease progression occurred in 384 (11·6%) of 3304 patients in the empagliflozin group and 504 (15·2%) of 3305 patients in the placebo group (hazard ratio 0·71 [95% CI 0·62-0·81]), with no evidence that the relative effect size varied significantly by primary kidney disease (pheterogeneity=0·62). The between-group difference in chronic eGFR slopes (ie, from 2 months to final follow-up) was 1·37 mL/min per 1·73 m2 per year (95% CI 1·16-1·59), representing a 50% (42-58) reduction in the rate of chronic eGFR decline. This relative effect of empagliflozin on chronic eGFR slope was similar in analyses by different primary kidney diseases, including in explorations by type of glomerular disease and diabetes (p values for heterogeneity all >0·1). INTERPRETATION In a broad range of patients with chronic kidney disease at risk of progression, including a wide range of non-diabetic causes of chronic kidney disease, empagliflozin reduced risk of kidney disease progression. Relative effect sizes were broadly similar irrespective of the cause of primary kidney disease, suggesting that SGLT2 inhibitors should be part of a standard of care to minimise risk of kidney failure in chronic kidney disease. FUNDING Boehringer Ingelheim, Eli Lilly, and UK Medical Research Council.
Collapse
|
4
|
Branco AC, Silva R, Jorge H, Santos T, Lorenz K, Polido M, Colaço R, Serro AP, Figueiredo-Pina CG. Corrigendum to "Tribological performance of the pair human teeth vs 3D printed zirconia: An in vitro chewing simulation study" [J. Mech. Behav. Biomed. Mater. 110 (2020) 103900]. J Mech Behav Biomed Mater 2023; 147:106041. [PMID: 37544794 DOI: 10.1016/j.jmbbm.2023.106041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Affiliation(s)
- A C Branco
- CQE, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal; CDP2T, Escola Superior de Tecnologia de Setúbal, Instituto Politécnico de Setúbal, Setúbal, Portugal
| | - R Silva
- CQE, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal
| | - H Jorge
- Centro Tecnológico da Cerâmica e Do Vidro (CTCV), Coimbra, Portugal
| | | | - K Lorenz
- INESC-MN, IPFN, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal
| | - M Polido
- CiiEM, Escola Superior de Saúde Egas Moniz, Monte de Caparica, Portugal
| | - R Colaço
- IDMEC e Departamento de Engenharia Mecânica, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal
| | - A P Serro
- CQE, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal; CiiEM, Escola Superior de Saúde Egas Moniz, Monte de Caparica, Portugal.
| | - C G Figueiredo-Pina
- CDP2T, Escola Superior de Tecnologia de Setúbal, Instituto Politécnico de Setúbal, Setúbal, Portugal; CiiEM, Escola Superior de Saúde Egas Moniz, Monte de Caparica, Portugal; CeFEMA, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal
| |
Collapse
|
5
|
Branco AC, Silva R, Santos T, Jorge H, Rodrigues AR, Fernandes R, Bandarra S, Barahona I, Matos APA, Lorenz K, Polido M, Colaço R, Serro AP, Figueiredo-Pina CG. Corrigendum to "Suitability of 3D printed nanostructured zirconia pieces for dental applications" [Dent Mater 36 (2020) 442-455]. Dent Mater 2023; 39:861. [PMID: 37544861 DOI: 10.1016/j.dental.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Affiliation(s)
- A C Branco
- CQE, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal; CDP2T, Escola Superior de Tecnologia de Setúbal, Instituto Politécnico de Setúbal, Setúbal, Portugal
| | - R Silva
- CQE, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal
| | | | - H Jorge
- Centro Tecnológico da Cerâmica e do Vidro (CTCV), Coimbra, Portugal
| | - A R Rodrigues
- CDP2T, Escola Superior de Tecnologia de Setúbal, Instituto Politécnico de Setúbal, Setúbal, Portugal
| | - R Fernandes
- CDP2T, Escola Superior de Tecnologia de Setúbal, Instituto Politécnico de Setúbal, Setúbal, Portugal
| | - S Bandarra
- CiiEM, Instituto Universitário Egas Moniz, Monte de Caparica, Portugal
| | - I Barahona
- CiiEM, Instituto Universitário Egas Moniz, Monte de Caparica, Portugal
| | - A P A Matos
- CiiEM, Instituto Universitário Egas Moniz, Monte de Caparica, Portugal
| | - K Lorenz
- INESC-MN, IPFN, Instituto Superior Técnico, Universidade de Lisboa, Bobadela, Portugal
| | - M Polido
- CiiEM, Instituto Universitário Egas Moniz, Monte de Caparica, Portugal
| | - R Colaço
- IDMEC e Departamento de Engenharia Mecânica, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal
| | - A P Serro
- CQE, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal; CiiEM, Instituto Universitário Egas Moniz, Monte de Caparica, Portugal.
| | - C G Figueiredo-Pina
- CDP2T, Escola Superior de Tecnologia de Setúbal, Instituto Politécnico de Setúbal, Setúbal, Portugal; CiiEM, Instituto Universitário Egas Moniz, Monte de Caparica, Portugal; CeFEMA, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal
| |
Collapse
|
6
|
Silva R, Guedes A, Ribeiro D, Vale C, Meixedo A, Mosleh A, Montenegro P. Early Identification of Unbalanced Freight Traffic Loads Based on Wayside Monitoring and Artificial Intelligence. Sensors (Basel) 2023; 23:s23031544. [PMID: 36772583 PMCID: PMC9919230 DOI: 10.3390/s23031544] [Citation(s) in RCA: 1] [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] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 01/26/2023] [Accepted: 01/27/2023] [Indexed: 05/27/2023]
Abstract
The identification of instability problems in freight trains circulation such as unbalanced loads is of particular importance for railways management companies and operators. The early detection of unbalanced loads prevents significant damages that may cause service interruptions or derailments with high financial costs. This study aims to develop a methodology capable of automatically identifying unbalanced vertical loads considering the limits proposed by the reference guidelines. The research relies on a 3D numerical simulation of the train-track dynamic response to the presence of longitudinal and transverse scenarios of unbalanced vertical loads and resorting to a virtual wayside monitoring system. This methodology is based on measured data from accelerometers and strain gauges installed on the rail and involves the following steps: (i) feature extraction, (ii) features normalization based on a latent variable method, (iii) data fusion, and (iv) feature discrimination based on an outlier and a cluster analysis. Regarding feature extraction, the performance of ARX and PCA models is compared. The results prove that the methodology is able to accurately detect and classify longitudinal and transverse unbalanced loads with a reduced number of sensors.
Collapse
Affiliation(s)
- R. Silva
- CONSTRUCT-LESE, School of Engineering, Polytechnic of Porto, 4249-015 Porto, Portugal
| | - A. Guedes
- CONSTRUCT-LESE, School of Engineering, Polytechnic of Porto, 4249-015 Porto, Portugal
| | - D. Ribeiro
- CONSTRUCT-LESE, School of Engineering, Polytechnic of Porto, 4249-015 Porto, Portugal
| | - C. Vale
- CONSTRUCT-LESE, Faculty of Engineering, University of Porto, 4249-015 Porto, Portugal
| | - A. Meixedo
- CONSTRUCT-LESE, Faculty of Engineering, University of Porto, 4249-015 Porto, Portugal
| | - A. Mosleh
- CONSTRUCT-LESE, Faculty of Engineering, University of Porto, 4249-015 Porto, Portugal
| | - P. Montenegro
- CONSTRUCT-LESE, Faculty of Engineering, University of Porto, 4249-015 Porto, Portugal
| |
Collapse
|
7
|
Petty LE, Silva R, de Souza LC, Vieira AR, Shaw DM, Below JE, Letra A. Genome-wide association study identifies novel risk loci for apical periodontitis. Res Sq 2023:rs.3.rs-2515434. [PMID: 36747740 PMCID: PMC9901028 DOI: 10.21203/rs.3.rs-2515434/v1] [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] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Apical periodontitis (AP) is a common consequence of root canal infection leading to periapical bone resorption. Microbial and host genetic factors, and their interactions, have been shown to play a role in AP development and progression. Variations in a few genes have been reported in association with AP, however, the lack of genome-wide studies has hindered progress in understanding the mechanisms involved in AP. Here, we report the first genome-wide association study of AP in a well-characterized population. Male and female adults (n=932) presenting with deep caries with AP (cases) or without AP (controls) were included. Genotyping was performed using the Illumina Expanded Multi-Ethnic Genotyping Array. Single-variant association testing was performed adjusting for sex and five principal components. Subphenotype association testing, analyses of genetically regulated gene expression, polygenic risk score and phenome-wide association (PheWAS) analyses were also performed. Eight loci reached near-genome-wide significant association with AP (p < 5 x 10-6); gene-focused analyses replicated three previously reported associations (p < 8.9 x 10-5). Sex-specific and subphenotype analyses revealed additional significant associations with variants genome-wide. Functionally oriented gene-based analyses revealed eight genes significantly associated with AP (p < 5 x 10-5), and PheWAS analysis revealed 33 phecodes associated with AP risk score (p < 3.08 x 10-5). This study identified novel genes/loci contributing to AP and revealed specific contributions to AP risk in males and females. Importantly, we identified additional systemic conditions significantly associated with AP risk. Our findings provide strong evidence for host-mediated effects on AP susceptibility.
Collapse
Affiliation(s)
- L E Petty
- Vanderbilt University Medical Center
| | - R Silva
- University of Pittsburgh School of Dental Medicine
| | - L Chaves de Souza
- University of Texas Health Science Center at Houston School of Dentistry: The University of Texas Health Science Center at Houston School of Dentistry
| | - A R Vieira
- University of Pittsburgh School of Dental Medicine
| | - D M Shaw
- Vanderbilt University Medical Center
| | - J E Below
- Vanderbilt University Medical Center
| | | |
Collapse
|
8
|
Abstract
In this work, by considering superstatistics we investigate the short-range correlations (SRCs) and the fluctuations in the distribution of lengths of strings of nucleotides. To this end, a stochastic model provides the distributions of the size of the exons based on the q-Gamma and inverse q-Gamma distributions. Specifically, we define a time series for exon sizes to investigate the SRC and the fluctuations through the superstatistics distributions. To test the model's viability, we use the Project Ensembl database of genes to extract the time evolution of exon sizes, calculated in terms of the number of base pairs (bp) in these biological databases. Our findings show that, depending on the chromosome, both distributions are suitable for describing the length distribution of human DNA for lengths greater than 10 bp. In addition, we used Bayesian statistics to perform a selection model approach, which revealed weak evidence for the inverse q-Gamma distribution for a considerable number of chromosomes.
Collapse
Affiliation(s)
- M O Costa
- Departamento de Física, Universidade Federal do Rio Grande do Norte, Natal - RN, 59072-970, Brasil
| | - R Silva
- Departamento de Física, Universidade Federal do Rio Grande do Norte, Natal - RN, 59072-970, Brasil and Programa de Pós-Graduação em Física, Universidade do Estado do Rio Grande do Norte, Mossoró - Rio Grande do Norte, 59610-210, Brasil
| | - D H A L Anselmo
- Departamento de Física, Universidade Federal do Rio Grande do Norte, Natal - RN, 59072-970, Brasil and Programa de Pós-Graduação em Física, Universidade do Estado do Rio Grande do Norte, Mossoró - Rio Grande do Norte, 59610-210, Brasil
| |
Collapse
|
9
|
Al-Falahi Z, Tran H, Middleton P, Basilakis J, Lo S, Dang V, Joseph V, Femia G, Nia A, Moore N, Houltham J, Silva R. Corrigendum to ‘Automation of Optical Coherence Tomography (OCT) Tissued Morphology and Vessel Sizing With Artificial Intelligence’ [Heart, Lung and Circulation volume 31 (2022) S321-S322]. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.11.005] [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: 12/24/2022]
|
10
|
Alcaniz JS, Neto JP, Queiroz FS, da Silva DR, Silva R. The Hubble constant troubled by dark matter in non-standard cosmologies. Sci Rep 2022; 12:20113. [PMID: 36418495 PMCID: PMC9684474 DOI: 10.1038/s41598-022-24608-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 11/17/2022] [Indexed: 11/24/2022] Open
Abstract
The Standard Cosmological Model has experienced tremendous success at reproducing observational data by assuming a universe dominated by a cosmological constant and dark matter in a flat geometry. However, several studies, based on local measurements, indicate that the universe is expanding too fast, in disagreement with the Cosmic Microwave Background. Taking into account combined data from CMB, Baryon Acoustic Oscillation, and type Ia Supernovae, we show that if the mechanism behind the production of dark matter particles has at least a small non-thermal origin, one can induce larger values of the Hubble rate [Formula: see text], within the [Formula: see text]CDM, to alleviate the trouble with [Formula: see text]. In the presence of non-standard cosmology, however, we can fully reconcile CMB and local measurements and reach [Formula: see text]-74 [Formula: see text].
Collapse
Affiliation(s)
- J. S. Alcaniz
- grid.440352.4Observatório Nacional, General José Cristino 77, Rio de Janeiro, RJ 20921-400 Brasil
| | - J. P. Neto
- grid.411087.b0000 0001 0723 2494Instituto de Física Gleb Wataghin, Universidade Estadual de Campinas, Campinas, SP 13083-859 Brasil ,grid.411233.60000 0000 9687 399XInternational Institute of Physics, Universidade Federal do Rio Grande do Norte, Natal, RN 59078-970 Brasil ,grid.411233.60000 0000 9687 399XDepartamento de Física, Universidade Federal do Rio Grande do Norte, Natal, RN 59078-970 Brasil
| | - F. S. Queiroz
- grid.411233.60000 0000 9687 399XInternational Institute of Physics, Universidade Federal do Rio Grande do Norte, Natal, RN 59078-970 Brasil ,grid.411233.60000 0000 9687 399XDepartamento de Física, Universidade Federal do Rio Grande do Norte, Natal, RN 59078-970 Brasil ,Millennium Institute for Subatomic Physics at High-Energy Frontier (SAPHIR), Fernandez Concha 700, Santiago, Chile
| | - D. R. da Silva
- grid.411216.10000 0004 0397 5145Departamento de Fisica, Universidade Federal da Paraiba, João Pessoa, PB 58051-970 Brasil
| | - R. Silva
- grid.411233.60000 0000 9687 399XDepartamento de Física, Universidade Federal do Rio Grande do Norte, Natal, RN 59078-970 Brasil
| |
Collapse
|
11
|
Ciolli G, Silva R, Giovannetti de Sanctis E, Proietti L, Mocini F, Corona K, Mazzoleni MG, Romanini E, Marescalchi M, Brancaccio V, Maccauro G, Cerciello S. Liner dissociation in total hip arthroplasty: a systematic review. Eur Rev Med Pharmacol Sci 2022; 26:138-150. [PMID: 36448866 DOI: 10.26355/eurrev_202211_30293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE Liner dissociation (LD) is a rare catastrophic mechanical failure of total hip arthroplasty (THA). The study aims at reviewing the available literature regarding liner dissociations to point out their prevalence, describing any possible association and highlighting the surgical management at the time of revision. MATERIALS AND METHODS A systematic review of the literature was conducted from January 2002, until February 2022, according to the PRISMA guidelines. The main keywords were: "dissociation" AND "liner" OR "hip arthroplasty" OR "THA" and their MeSH terms in any possible combination. Cases of liner dissociation with all levels of evidence of any age published in indexed journals were included. The study quality of all included studies was evaluated using the MINORS criteria. The kappa (k) value was used to assess the consensus between reviewers in the selection of articles and methodological quality assessment. Finally, a sub-analysis was performed specifically concerning the elderly population. RESULTS Thirty-one manuscripts met the inclusion criteria of the systematic review (21 case reports and 10 case series). 124 LD in 123 patients, (53% females and 47% males) were evaluated. The overall prevalence of LD was 0.15%. The mean age at surgery was of 56.5 years (range 31-75 years). LD occurred in a primary surgery setting in 86% of the cases, at a mean time of presentation of 45.8 months after replacement surgery. 39.5% of the cups and 8.8% of the stems required revision. The mean follow-up after the revision was 18.4 months. Complications after revision occurred in 19.6% of cases, including 3 cases of re-dissociations. Re-revision was required in 13.6% of the revisions. The sub-analysis of the elderly population included 28 cases of LD identified in 10 manuscripts, with an average age of 73.5 years. CONCLUSIONS LD is a rare but catastrophic mechanical complication of modular THA that requires implant revision. The LD is not related to a specific prosthetic implant, liner material or design, acetabular positioning within the safe zone or age group.
Collapse
Affiliation(s)
- G Ciolli
- Orthopedics and Traumatology, Fondazione Policlinico Universitario A. Gemelli IRCCS - Sacred Heart Catholic University, Rome, Italy.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Del Mastro L, Poggio F, Blondeaux E, De Placido S, Giuliano M, Forestieri V, De Laurentiis M, Gravina A, Bisagni G, Rimanti A, Turletti A, Nisticò C, Vaccaro A, Cognetti F, Fabi A, Gasparro S, Garrone O, Alicicco MG, Urracci Y, Mansutti M, Poletti P, Correale P, Bighin C, Puglisi F, Montemurro F, Colantuoni G, Lambertini M, Boni L, Venturini M, Abate A, Pastorino S, Canavese G, Vecchio C, Guenzi M, Lambertini M, Levaggi A, Giraudi S, Accortanzo V, Floris C, Aitini E, Fornari G, Miraglia S, Buonfanti G, Cherchi M, Petrelli F, Vaccaro A, Magnolfi E, Contu A, Labianca R, Parisi A, Basurto C, Cappuzzo F, Merlano M, Russo S, Mansutti M, Poletto E, Nardi M, Grasso D, Fontana A, Isa L, Comandè M, Cavanna L, Iacobelli S, Milani S, Mustacchi G, Venturini S, Scinto A, Sarobba M, Pugliese P, Bernardo A, Pavese I, Coccaro M, Massidda B, Ionta M, Nuzzo A, Laudadio L, Chiantera V, Dottori R, Barduagni M, Castiglione F, Ciardiello F, Tinessa V, Ficorella A, Moscetti L, Vallini I, Giardina G, Silva R, Montedoro M, Seles E, Morano F, Cruciani G, Adamo V, Pancotti A, Palmisani V, Ruggeri A, Cammilluzzi E, Carrozza F, D'Aprile M, Brunetti M, Gallotti P, Chiesa E, Testore F, D'Arco A, Ferro A, Jirillo A, Pezzoli M, Scambia G, Iacono C, Masullo P, Tomasello G, Gandini G, Zoboli A, Bottero C, Cazzaniga M, Genua G, Palazzo S, D'Amico M, Perrone D. Fluorouracil and dose-dense adjuvant chemotherapy in patients with early-stage breast cancer (GIM2): end-of-study results from a randomised, phase 3 trial. Lancet Oncol 2022; 23:1571-1582. [DOI: 10.1016/s1470-2045(22)00632-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 10/06/2022] [Accepted: 10/07/2022] [Indexed: 11/11/2022]
|
13
|
Correia AC, Monteiro AR, Silva R, Moreira JN, Sousa Lobo JM, Silva AC. Lipid nanoparticles strategies to modify pharmacokinetics of central nervous system targeting drugs: Crossing or circumventing the blood-brain barrier (BBB) to manage neurological disorders. Adv Drug Deliv Rev 2022; 189:114485. [PMID: 35970274 DOI: 10.1016/j.addr.2022.114485] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [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: 03/30/2022] [Revised: 07/30/2022] [Accepted: 08/03/2022] [Indexed: 01/24/2023]
Abstract
The main limitation to the success of central nervous system (CNS) therapies lies in the difficulty for drugs to cross the blood-brain barrier (BBB) and reach the brain. Regarding its structure and enzymatic complexity, crossing the BBB is a challenge, although several alternatives have been identified. For instance, the use of drugs encapsulated in lipid nanoparticles has been described as one of the most efficient approaches to bypass the BBB, as they allow the passage of drugs through this barrier, improving brain bioavailability. In particular, solid lipid nanoparticles (SLN) and nanostructured lipid carriers (NLC) have been a focus of research related to drug delivery to the brain. These systems provide protection of lipophilic drugs, improved delivery and bioavailability, having a major impact on treatments outcomes. In addition, the use of lipid nanoparticles administered via routes that transport drugs directly into the brain seems a promising solution to avoid the difficulties in crossing the BBB. For instance, the nose-to-brain route has gained considerable interest, as it has shown efficacy in 3D human nasal models and in animal models. This review addresses the state of the art on the use of lipid nanoparticles to modify the pharmacokinetics of drugs employed in the management of neurological disorders. A description of the structural components of the BBB, the role of the neurovascular unit and limitations for drugs to entry into the CNS is first addressed, along with the developments to increase drug delivery to the brain, with a special focus on lipid nanoparticles. In addition, the obstacle of BBB complexity in the creation of new effective drugs for the treatment of the most prevalent neurological disorders is also addressed. Finally, the proposed strategies for lipid nanoparticles to reach the CNS, crossing or circumventing the BBB, are described. Although promising results have been reported, especially with the nose-to-brain route, they are still ongoing to assess its real efficacy in vivo in the management of neurological disorders.
Collapse
Affiliation(s)
- A C Correia
- UCIBIO, REQUIMTE, MEDTECH, Laboratory of Pharmaceutical Technology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, Portugal
| | - A R Monteiro
- UCIBIO, REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, Porto University, Porto, Portugal
| | - R Silva
- UCIBIO, REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, Porto University, Porto, Portugal.
| | - J N Moreira
- CNC - Center for Neuroscience and Cell Biology, Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Faculty of Medicine (Pólo I), Coimbra, Portugal; Univ Coimbra - University of Coimbra, CIBB, Faculty of Pharmacy, Pólo das Ciências da Saúde, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal
| | - J M Sousa Lobo
- UCIBIO, REQUIMTE, MEDTECH, Laboratory of Pharmaceutical Technology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, Portugal
| | - A C Silva
- UCIBIO, REQUIMTE, MEDTECH, Laboratory of Pharmaceutical Technology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, Portugal; FP-I3ID (Instituto de Investigação, Inovação e Desenvolvimento), FP-BHS (Biomedical and Health Sciences Research Unit), Faculty of Health Sciences, University Fernando Pessoa, 4249 004 Porto, Portugal.
| |
Collapse
|
14
|
Silva R, Barbosa D, Carmo H, Carvalho F, Dias da Silva D, Silva J. P16-12 The synthetic cannabinoid THJ-2201 increases the differentiation of primary hippocampal neurons and early astrocyte activation but decreases neuronal maturation. Toxicol Lett 2022. [DOI: 10.1016/j.toxlet.2022.07.602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
15
|
Novac O, Silva R, Hughes D, Kostrzewski T. LP-45 Evaluating different modalities of drug-induced liver injury using a sensitive and selective human liver microphysiological system and clinical biomarkers. Toxicol Lett 2022. [DOI: 10.1016/j.toxlet.2022.07.784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
16
|
Costa I, Benfeito S, Cagide F, Silva V, Borges F, Remião F, Silva R. LP-74 New mitochondria-targeted antioxidants as promising drug candidates for the treatment of Parkinson’s disease. Toxicol Lett 2022. [DOI: 10.1016/j.toxlet.2022.07.803] [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: 11/24/2022]
|
17
|
Fontes R, Rodrigues J, Oliveira C, Peixoto M, Doria S, Martins S, Silva R, Marques A, Nabico R. 1275P Chemotherapy at the end of life: The reality of an oncological centre. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
|
18
|
Coppi L, Peri C, Bonacina F, Longo R, Silva R, Norata G, Catapano A, Crestani M. Role of histone deacetylase 3 in immunophenotype of adipose tissue. Atherosclerosis 2022. [DOI: 10.1016/j.atherosclerosis.2022.06.206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
|
19
|
Cunha L, Bonfim L, Lima G, Silva R, Silva L, Lima P, Oliveira-Bahia V, Freitas J, Burbano R, Rocha C. In vivo evaluation of the potential protective effects of prolactin against damage caused by methylmercury. Braz J Med Biol Res 2022; 55:e11976. [PMID: 35857996 PMCID: PMC9296129 DOI: 10.1590/1414-431x2022e11976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 05/17/2022] [Indexed: 11/30/2022] Open
Abstract
Non-biodegradable metals such as mercury accumulate in living organisms during
life (bioaccumulation) and also within trophic webs (biomagnification) and may
reach high concentrations in humans. The contamination of humans by mercury in
drinking water and food may be common, in particular in riverside communities
that have a diet rich in fish. In vitro studies of human cell
lines exposed to the cytotoxic and mutagenic effects of methylmercury have shown
that prolactin has potential cytoprotective properties and may act as a
co-mitogenic factor and inhibitor of apoptosis. The present in
vivo study investigated the protective potential of prolactin
against the toxic effects of methylmercury in the mammal Mus
musculus. Histological and biochemical analyses, together with
biomarker of genotoxicity, were used to verify the protective potential of
prolactin in mice exposed to methylmercury. The reduction in kidney and liver
tissue damage was not significant. However, results of biochemical and genotoxic
analyses were excellent. After prolactin treatment, a significant reduction was
observed in biochemical parameters and mutagenic effects of methylmercury. The
study results therefore indicated that prolactin has protective effects against
the toxicity of methylmercury and allowed us to suggest the continuation of
research to propose prolactin in the future, as an alternative to prevent the
damage caused by mercury, especially in populations that are more exposed.
Collapse
Affiliation(s)
- L Cunha
- Laboratório de Citogenética Humana, Universidade Federal do Pará, Belém, PA, Brasil
| | - L Bonfim
- Laboratório de Citogenética Humana, Universidade Federal do Pará, Belém, PA, Brasil
| | - G Lima
- Laboratório Multidisciplinar de Morfofisiologia Animal, Universidade Federal do Pará, Belém, PA, Brasil
| | - R Silva
- Laboratório de Morfofisiologia Aplicada à Saúde, Universidade do Estado do Pará, Belém, PA, Brasil
| | - L Silva
- Laboratório de Morfofisiologia Aplicada à Saúde, Universidade do Estado do Pará, Belém, PA, Brasil
| | - P Lima
- Laboratório de Citogenética, Universidade do Estado do Pará, Belém, PA, Brasil
| | - V Oliveira-Bahia
- Laboratório Multidisciplinar de Morfofisiologia Animal, Universidade Federal do Pará, Belém, PA, Brasil
| | - J Freitas
- Laboratório de Morfofisiologia Aplicada à Saúde, Universidade do Estado do Pará, Belém, PA, Brasil
| | - R Burbano
- Laboratório de Biologia Molecular, Hospital Ophir Loyola, Belém, PA, Brasil
| | - C Rocha
- Instituto Federal de Educação, Ciência e Tecnologia do Pará, Diretoria de Pós-Graduação, Pesquisa e Inovação (DPI), Belém, PA, Brasil
| |
Collapse
|
20
|
Santos R, Silva R, Gomes A, Cardoso H. Subarachnoid and subdural haematoma after attempted spinal anaesthesia for caesarean section. Anaesth Rep 2022; 10:e12181. [PMID: 35924029 PMCID: PMC9338784 DOI: 10.1002/anr3.12181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2022] [Indexed: 11/09/2022] Open
Abstract
We report a case of a previously healthy patient who developed a vertebral canal haematoma in the subarachnoid and subdural spaces after a spinal puncture for elective caesarean section. Vertebral canal haematomas are rare. There are different mechanisms for haematoma formation, but coagulation disturbances and trauma, most often due to needle punctures, are the most important. Vertebral canal haematoma may warrant emergent surgical decompression. In this case report we discuss vertebral canal haematomas, including possible mechanisms, clinical diagnosis, imaging modalities, methods for management and advice for patients. We consider the possible association between a vertebral canal haematoma and non-steroidal anti-inflammatory drugs, and draw attention to an existing black box warning for ketorolac. In this case, we explain why a conservative approach was chosen with a good outcome. We also report the effect of this complication on the patient experience.
Collapse
Affiliation(s)
- R. Santos
- Department of Anaesthesiology Penafiel Hospital Centre Porto Portugal
| | - R. Silva
- Department of Anaesthesiology Penafiel Hospital Centre Porto Portugal
| | - A. Gomes
- Department of Anaesthesiology Penafiel Hospital Centre Porto Portugal
| | - H. Cardoso
- Department of Anaesthesiology Penafiel Hospital Centre Porto Portugal
| |
Collapse
|
21
|
Simões G, Jesus S, Silva R. Erythropoietin – a potential tool in the treatment of depressive disorders? Eur Psychiatry 2022. [PMCID: PMC9567545 DOI: 10.1192/j.eurpsy.2022.1440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Introduction Depression is one of the leading causes of psychiatric disability across the globe because of its high prevalence and chronic, treatment resistant and recurrent nature. Erythropoietin (EPO), well known for its effects on blood cells, has also a key role in neuroprotection and cognitive function. Objectives The authors aim to explore the potential of EPO to treat depressive disorders (DD) and related cognitive dysfunction. Methods A literature research was conducted on PubMed starting from the MeSH terms: “Erythropoietin” and “Depressive Disorders”. The results selected for our analysis corresponded to investigations using EPO based on an adult population with DD. Results
The research provided 14 results, of which 9 met the defined criteria. Different types of studies with variable samples were considered, including randomized clinical trials (RCTs) and a systematic review. Overall, despite records of reduction in depression symptomatology and increased quality of life, evidence does not demonstrate statistically significant reductions in depression severity through the use of EPO in the treatment of DD. However, several RCTs examined its effect on cognitive performance, founding effective improvements in memory, verbal recall and recognition. The underlying potential mechanisms and the current limitations in the use of EPO, and of the available studies are analysed and discussed. Conclusions Although EPO does not appear to be effective treating depression, it may play a role in improvement of deficits in memory and executive function. Larger RCTs evaluating its potential use are needed, in order to move towards better clinical practice, quality of life and functional reintegration of these patients. Disclosure No significant relationships.
Collapse
|
22
|
Simões G, Jesus S, Silva R. Imagery and perception: where is the phenomenological line? Eur Psychiatry 2022. [PMCID: PMC9568002 DOI: 10.1192/j.eurpsy.2022.1821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Introduction The overlap between imagery and perception has long fascinated philosophers and scientists. Many scientists considered how the mind is capable of constructing an internal world without intervention of the external environment. Descriptions of their core characteristics often draw attention to differential features, but other currents reveal that many of these are shared rather than unique and differential. Objectives The authors aim to analyse and discuss conceptualisation, similarities and differences of imagery and perception at the level of phenomenology, at the intersection with other psychopathological concepts, and thus reassemble them within a common framework. Methods A brief literature review was developed based on relevant works containing subject matter most relevant to the topic. Results Perception is conceived as a transformation of raw sensory stimuli into sensory information that is then decoded into meaningful at the cortical level. Imagery, in turn, corresponds to the internal mental representation of the world, actively drawn from memory. The differentiation between these concepts at a phenomenological level is analysed and discussed. Additionally, their individual role is evaluated in the pshycopathological expression of alterations of perception such as hallucinations, pseudohallucinations, pareidolic illusions, abnormal imagery, sensory deprivation and also of dreams, in an analytical perspective of integration and simultaneous conceptual differentiation. Conclusions Understanding imagery, its nature and formal characteristics is required for better recognising the nature of perceptions and related psychopathological alterations, as well as the mechanisms uniting these concepts. Further research is needed as these entities represent features of useful clinical and diagnostic significance. Disclosure No significant relationships.
Collapse
|
23
|
Simões G, Jesus S, Silva R. Therapeutic use of ayahuasca: a review of the evidence of its use in approaching depressive disorders. Eur Psychiatry 2022. [PMCID: PMC9568220 DOI: 10.1192/j.eurpsy.2022.1843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction
Ayahuasca (AYA) is a psychotropic plant from South America used for religious purposes by indigenous people of the Amazon. Increasing evidence indicates that AYA may have therapeutic potential in the treatment of mental health disorders like depression – a common life-disrupting, highly recurrent disorder – that is among the leading causes of disability worldwide.
Objectives
The aim of this exploratory study is to gather and assess scientific evidence about clinical effects of AYA in the treatment and symptomatological expression of patients with depression.
Methods
A literature research was conducted on PubMed, starting from the MeSH terms: “Banisteriopsis” and “Depression”. Results corresponding to investigations using AYA, and based on an adult population with depressive disorders, were selected for our analysis.
Results
The research provided 8 results, of which 6 met the defined criteria. Different types of studies with variable samples were considered, including retrospective and prospective observational studies, meta-analysis and a narrative review. Overall, evidence about the use of AYA in depressive disorders is associated to reductions in depression scales, to significant antidepressant effects and in mediating improvement of grief symptoms. AYA administration increased introspection and positive mood, self-acceptance, empathy, openness and potentiated improvements in emotional processing. The underlying potential mechanisms, adverse effects and the current limitations related to its study and use are analysed and discussed.
Conclusions
The use of AYA in depression shows promising results that should be further explored in controlled trials with larger sample sizes, in order to better evaluate its clinical effects, safety profile and related short and long-term effects.
Disclosure
No significant relationships.
Collapse
|
24
|
DeRamus TP, Wu L, Qi S, Iraji A, Silva R, Du Y, Pearlson G, Mayer A, Bustillo JR, Stromberg SF, Calhoun VD. Multimodal data fusion of cortical-subcortical morphology and functional network connectivity in psychotic spectrum disorder. Neuroimage Clin 2022; 35:103056. [PMID: 35709557 PMCID: PMC9207350 DOI: 10.1016/j.nicl.2022.103056] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 04/18/2022] [Accepted: 05/21/2022] [Indexed: 11/20/2022]
Abstract
Overlap has been noted disorders which fall on the psychotic spectrum. Univariate studies may miss joint brain features across diagnostic categories. mCCA with jICA is paired with features across the psychotic spectrum to produce joint components. One joint component displayed a significant relationship with cognitive scores. The replicate trends of cortical-subcortical irregularity in psychotic spectrum disorders.
Multiple authors have noted overlapping symptoms and alterations across clinical, anatomical, and functional brain features in schizophrenia (SZ), schizoaffective disorder (SZA), and bipolar disorder (BPI). However, regarding brain features, few studies have approached this line of inquiry using analytical techniques optimally designed to extract the shared features across anatomical and functional information in a simultaneous manner. Univariate studies of anatomical or functional alterations across these disorders can be limited and run the risk of omitting small but potentially crucial overlapping or joint neuroanatomical (e.g., structural images) and functional features (e.g., fMRI-based features) which may serve as informative clinical indicators of across multiple diagnostic categories. To address this limitation, we paired an unsupervised multimodal canonical correlation analysis (mCCA) together with joint independent component analysis (jICA) to identify linked spatial gray matter (GM), resting-state functional network connectivity (FNC), and white matter fractional anisotropy (FA) features across these diagnostic categories. We then calculated associations between the identified linked features and trans-diagnostic behavioral measures (MATRICs Consensus Cognitive Battery, MCCB). Component number 4 of the 13 identified displayed a statistically significant relationship with overall MCCB scores across GM, resting-state FNC, and FA. These linked modalities of component 4 consisted primarily of positive correlations within subcortical structures including the caudate and putamen in the GM maps with overall MCCB, sparse negative correlations within subcortical and cortical connection tracts (e.g., corticospinal tract, superior longitudinal fasciculus) in the FA maps with overall MCCB, and negative relationships with MCCB values and loading parameters with FNC matrices displaying increased FNC in subcortical-cortical regions with auditory, somatomotor, and visual regions.
Collapse
Affiliation(s)
- T P DeRamus
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS) - Georgia State University, Georgia Institute of Technology, and Emory University, Atlanta, GA, USA.
| | - L Wu
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS) - Georgia State University, Georgia Institute of Technology, and Emory University, Atlanta, GA, USA
| | - S Qi
- College of Computer Science and Technology, Nanjing University of Aeronautics and Astronautics, Nanjing, China
| | - A Iraji
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS) - Georgia State University, Georgia Institute of Technology, and Emory University, Atlanta, GA, USA
| | - R Silva
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS) - Georgia State University, Georgia Institute of Technology, and Emory University, Atlanta, GA, USA
| | - Y Du
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS) - Georgia State University, Georgia Institute of Technology, and Emory University, Atlanta, GA, USA; School of Computer and Information Technology, Shanxi University, Taiyuan, China
| | - G Pearlson
- Olin Neuropsychiatry Research Center, Institute of Living at Hartford Hospital, Hartford, CT, USA; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Department of Neuroscience, Yale University School of Medicine, New Haven, CT, USA
| | - A Mayer
- The Mind Research Network, Lovelace Biomedical and Environmental Research Institute, Albuquerque, USA
| | - J R Bustillo
- Department of Psychiatry, University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - S F Stromberg
- Psychiatry and Behavioral Health Clinical Program, Presbyterian Healthcare System, Albuquerque, NM, USA
| | - V D Calhoun
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS) - Georgia State University, Georgia Institute of Technology, and Emory University, Atlanta, GA, USA; The Mind Research Network, Lovelace Biomedical and Environmental Research Institute, Albuquerque, USA; Department of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, USA; Department of Computer Science, Georgia State University, Atlanta, USA; Department of Psychology, Georgia State University, Atlanta, USA
| |
Collapse
|
25
|
Londral A, Azevedo S, Dias P, Ramos C, Santos J, Martins F, Silva R, Semedo H, Vital C, Gualdino A, Falcão J, Lapão LV, Coelho P, Fragata JG. Developing and validating high-value patient digital follow-up services: a pilot study in cardiac surgery. BMC Health Serv Res 2022; 22:680. [PMID: 35597936 PMCID: PMC9123610 DOI: 10.1186/s12913-022-08073-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 05/06/2022] [Indexed: 11/22/2022] Open
Abstract
Background The existing digital healthcare solutions demand a service development approach that assesses needs, experience, and outcomes, to develop high-value digital healthcare services. The objective of this study was to develop a digital transformation of the patients’ follow-up service after cardiac surgery, based on a remote patient monitoring service that would respond to the real context challenges. Methods The study followed the Design Science Research methodology framework and incorporated concepts from the Lean startup method to start designing a minimal viable product (MVP) from the available resources. The service was implemented in a pilot study with 29 patients in 4 iterative develop-test-learn cycles, with the engagement of developers, researchers, clinical teams, and patients. Results Patients reported outcomes daily for 30 days after surgery through Internet-of-Things (IoT) devices and a mobile app. The service’s evaluation considered experience, feasibility, and effectiveness. It generated high satisfaction and high adherence among users, fewer readmissions, with an average of 7 ± 4.5 clinical actions per patient, primarily due to abnormal systolic blood pressure or wound-related issues. Conclusions We propose a 6-step methodology to design and validate a high-value digital health care service based on collaborative learning, real-time development, iterative testing, and value assessment.
Collapse
Affiliation(s)
- A Londral
- Value for Health CoLAB, Lisbon, Portugal. .,Comprehensive Health Research Center, Nova Medical School, Nova University of Lisbon, Lisbon, Portugal.
| | - S Azevedo
- Value for Health CoLAB, Lisbon, Portugal.,Comprehensive Health Research Center, Nova Medical School, Nova University of Lisbon, Lisbon, Portugal.,CEG-IST, Instituto Superior Técnico, University of Lisbon, Lisbon, Portugal
| | - P Dias
- Value for Health CoLAB, Lisbon, Portugal.,Comprehensive Health Research Center, Nova Medical School, Nova University of Lisbon, Lisbon, Portugal
| | - C Ramos
- Value for Health CoLAB, Lisbon, Portugal.,Comprehensive Health Research Center, Nova Medical School, Nova University of Lisbon, Lisbon, Portugal
| | - J Santos
- Comprehensive Health Research Center, Nova Medical School, Nova University of Lisbon, Lisbon, Portugal.,Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal
| | - F Martins
- Value for Health CoLAB, Lisbon, Portugal.,NOVA-LINCS, NOVA School of Science and Technology, Nova University of Lisbon, Lisbon, Portugal
| | - R Silva
- Value for Health CoLAB, Lisbon, Portugal.,NOVA CLUNL - Center of Linguistics, Nova University of Lisbon, Lisbon, Portugal
| | - H Semedo
- Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal
| | - C Vital
- Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal
| | - A Gualdino
- Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal
| | - J Falcão
- Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal
| | - L V Lapão
- Comprehensive Health Research Center, Nova Medical School, Nova University of Lisbon, Lisbon, Portugal.,UNIDEMI, NOVA School of Science and Technology, Nova University of Lisboa, Lisbon, Portugal
| | - P Coelho
- Comprehensive Health Research Center, Nova Medical School, Nova University of Lisbon, Lisbon, Portugal.,Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal
| | - J G Fragata
- Comprehensive Health Research Center, Nova Medical School, Nova University of Lisbon, Lisbon, Portugal.,Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal
| |
Collapse
|
26
|
Al-Falahi Z, Tran H, Middleton P, Basilakis J, Lo S, Dang V, Joseph V, Fema G, Nia A, Moore N, Houltham J, Silva R. Automation of Optical Coherence Tomography (OCT) Tissued Morphology and Vessel Sizing With Artificial Intelligence. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
|
27
|
Silva R, Ramiro de Castro AJ, da Silva Filho JG, de Sousa FF, Paraguassu W, Freire PTC, Façanha Filho PF. Pressure-induced phase transition in Glycinium maleate crystal. Spectrochim Acta A Mol Biomol Spectrosc 2021; 262:120076. [PMID: 34174678 DOI: 10.1016/j.saa.2021.120076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 05/31/2021] [Accepted: 06/09/2021] [Indexed: 06/13/2023]
Abstract
The multicomponent glycinium maleate single crystal was grown by the slow evaporation method. The crystal was submitted to pressures ranging from 1 atm to 5.6 GPa and Raman spectroscopy was used as a spectroscopic probe. The modifications of relative intensity bands related to the lattice modes at 0.3 GPa were associated with rearrangements of hydrogen bonds. Moreover, between 1.7 and 4.8 GPa the Raman results indicate that the crystal experience a long structural phase transition, which was confirmed by PCA analysis. DFT calculations gave us more precision in the assignments of modes. The behavior of the internal modes under pressure showed that the maleic acid molecule undergoes greater modifications than glycine amino acid. All observed modifications were reversible when the pressure was released.
Collapse
Affiliation(s)
- R Silva
- Centro de Ciências Sociais, Saúde e Tecnologia, CCSST, Universidade Federal do Maranhão, Imperatriz, MA 65900-410, Brazil
| | | | - J G da Silva Filho
- Centro de Ciências Sociais, Saúde e Tecnologia, CCSST, Universidade Federal do Maranhão, Imperatriz, MA 65900-410, Brazil
| | - F F de Sousa
- Instituto de Ciências Exatas e Naturais, Universidade Federal do Pará, Belém, PA 66075-110, Brazil
| | - W Paraguassu
- Instituto de Ciências Exatas e Naturais, Universidade Federal do Pará, Belém, PA 66075-110, Brazil
| | - P T C Freire
- Departamento de Física, Universidade Federal do Ceará, Campus do Pici, Fortaleza, CE 60455-760, Brazil
| | - P F Façanha Filho
- Centro de Ciências Sociais, Saúde e Tecnologia, CCSST, Universidade Federal do Maranhão, Imperatriz, MA 65900-410, Brazil.
| |
Collapse
|
28
|
Mane FG, Flores R, Silva R, Conde I, Rodrigues C, Medeiros P, Oliveira C, Campos I, Ferreira AS, Costa J, Quina C, Braga C, Marques J. On- vs off-hours primary percutaneous coronary intervention: a single-centre experience. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
In ST-segment elevation myocardial infarction (STEMI) patients, emergency medical system delays importantly affect outcomes. The effect of admission time in STEMI patients is dubious when percutaneous coronary intervention (PCI) is the preferred reperfusion strategy.
Aims
The authors aimed to retrospectively describe the association between admission time and STEMI patient's care standards and outcomes.
Methods
Characteristics and outcomes of 1222 consecutive STEMI patients treated in a PCI-centre were collected. On-hours were defined as admission on non-national-holidays from Monday to Friday from 8 AM to 6 PM. Time delays, in-hospital and one-year all-cause mortality were assessed.
Results
A total of 439 patients (36%) were admitted on-hours and 783 patients (64%) were admitted off-hours. Baseline characteristics were well-balanced between groups, including the percentage of patients admitted in cardiogenic shock (on-hours: 4.6% vs off-hours 4%; p=0.62).
Median emergency system dependent time to reperfusion (i.e. first-medical contact to reperfusion) did not differ between the two groups (on-hours: 120 min vs. off-hours 123 min, p=0.54). The authors observed no association between admission time and in-hospital mortality (on-hours: 5% vs. off-hours 4.9%, p=0.90) or 1-year mortality (on-hours: 10% vs. off-hours 10%, p=0.97).
In patients admitted directly in the PCI-centre, median time from first-medical contact to reperfusion (on-hours: 87 min vs off-hours: 88 min, p=0.54), in-hospital mortality (on-hours: 4% vs off-hours: 7%, p=0.30) and 1 year mortality (on-hours: 9% vs off-hours: 13%, p=0.27) did not differ between the two groups.
Survival analysis showed no survival benefit of on-hours PCI over off-hours PCI (HR 1.01; 95% CI [0.77–1.46], p=0.95).
Conclusion
In a contemporary well-organized emergency network, STEMI patients admission time in the PCI-centre was not associated with reperfusion delays or increased mortality.
Funding Acknowledgement
Type of funding sources: None. Kaplan-Meier curve
Collapse
Affiliation(s)
- F G Mane
- Hospital de Braga, Braga, Portugal
| | - R Flores
- Hospital de Braga, Braga, Portugal
| | - R Silva
- Hospital de Braga, Braga, Portugal
| | - I Conde
- Hospital de Braga, Braga, Portugal
| | | | | | | | - I Campos
- Hospital de Braga, Braga, Portugal
| | - A S Ferreira
- ULSAM - Hospital de Santa Luzia, Internal Medicine, Viana do Castelo, Portugal
| | - J Costa
- Hospital de Braga, Braga, Portugal
| | - C Quina
- Hospital de Braga, Braga, Portugal
| | - C Braga
- Hospital de Braga, Braga, Portugal
| | | |
Collapse
|
29
|
Oliveira CC, Coutinho R, Flores R, Medeiros P, Pires C, Mane F, Silva R, Braga C, Vieira C, Pereira VH. The Predictive role of speckle-tracking and left ventricular ejection fraction estimation using 2D and 3D echocardiography in the detection of chemotherapy related cardiotoxicity. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
2D left ventricular ejection fraction (LVEF) estimation through echocardiography has been the classic parameter for cancer therapy–related cardiac dysfunction (CTrCD) detection. However, it is hypothesized that other parameters can be used in order to detect early stages of subclinical cardiotoxicity when LVEF is still preserved. Therefore, 3D LVEF and 2D and 3D strain parameters assessments have been evaluated in patients submitted to anthracyclines treatment.
Objectives
To compare 2D and 3D LVEF and strain parameters estimation using echocardiography regarding its ability to predict and detect subclinical and clinical cardiotoxicity during and after anthracyclines treatment.
Search methods and criteria
A systematic review was done and search was performed on PubMed and EMBASE from January 1st of 2000 to October 31th of 2020. Observational studies comparing 2D and 3D echocardiographic exams performed in adult patients submitted to anthracyclines were analyzed. Studies that evaluated survivors of pediatric cancer were excluded. 11 studies were included (n=844 patients).
Main results
2D and 3D LVEF decreased throughout the echocardiographic assessments of 7 studies, but 2D LVEF drops were not statistically significant in 4 studies and 3 studies showed that 3D LVEF detected a superior number of patients with abnormal LVEF. Compared to 3D LVEF,
2D GLS decreased at an earlier point of treatment and detected a superior number of patients with subclinical LV dysfunction. Despite 2D and 3D GLS decreased throughout treatment, 3D GLS measurements were consistently lower and had higher relative variation. All 3D strain parameters decreased during and after the treatment and have higher relative variations than 2D GLS, with the exception of 1 study. 3D GLS reference values are not yet recognized by guidelines, so subclinical LV dysfunction was not evaluated.
Conclusions
LVEF estimation through 3D proved to be a better parameter for CTrCD detection vs 2D imaging. GLS is superior to 3D LVEF in detecting earlier LV changes, even if calculated using 2D echocardiography. Moreover, GLS reduction can be a predictor of subsequent LVEF decrease. 3DE is a growing potential technique and may be superior to 2DE in detecting and predicting subclinical LVEF dysfunction and CTrCD, respectively. Though 3D strain parameters presented promising results, more studies are needed to prove its incremental value over 2D strain echocardiography
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
| | - R Coutinho
- University of Minho - Life and Health Sciences Research Institute (ICVS), Braga, Portugal
| | - R Flores
- Hospital de Braga, Braga, Portugal
| | | | - C Pires
- Hospital de Braga, Braga, Portugal
| | - F Mane
- Hospital de Braga, Braga, Portugal
| | - R Silva
- Hospital de Braga, Braga, Portugal
| | - C Braga
- Hospital de Braga, Braga, Portugal
| | - C Vieira
- Hospital de Braga, Braga, Portugal
| | | |
Collapse
|
30
|
Araujo Leite Medeiros P, Braga C, Campos I, Oliveira C, Pires C, Flores R, Mane F, Silva R, Costa J, Marques J, Braga C. Managing bifurcations: are two stents better than one? Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Bifurcation percutaneous coronary intervention (PCI) is associated with a higher degree of complexity when compared with non-bifurcation procedures. Although 1-stent PCI remains the standard approach for most bifurcation lesions, data is constantly being published on 2-stent PCI.
Aim
To evaluate and compare the characteristics and outcomes of patients that underwent bifurcation PCI with one or two stents.
Methods
Single center, retrospective observational study including all patients who underwent bifurcation PCI between January 2015-December 2018. We defined two groups: 1-stent PCI group (1s-PCI) and 2-stent PCI group (2s-PCI). The 2s-PCI group included PCI patients with all the different techniques used in our center: provisional stenting with 2 stents, Cullote, crushing stent and DK Crush.
Results
1s-PCI group included 376 individuals and 2s-PCI group included 26. Overall baseline clinical characteristics were balanced between groups. There was no statistically significant difference in age (mean 64 vs 66; p=0.388), gender (79% vs 85% males; p=0.622) and comorbidities (hypertension, diabetes mellitus, hypercholesterolemia, chronic kidney disease, smoking and previous history of coronary artery disease). Also, there was no difference in clinical status (NSTEMI 36% vs 38%; stable disease 32% vs 42%; STEMI 28% vs 19%; unstable angina 5% vs 0%; p=0.419). Coronary angiography and lesion distribution were similar in both groups (p=0.367). However, radiation dose (median 90.5 [IQR=79] vs 156 [IQR=84] mGy cm2; p<0,001) and contrast volume (median 150 [IQR=100] vs 156 [IQR=83] ml; p<0,001) were significantly higher in 2s-PCI group. At 12-month follow-up, mortality rate was higher in 1s-PCI group, but without statistical significance (8% vs 4%; p=0.71); the same is true for acute myocardial infarction at 12 months (3% vs 0%; p=0.368). Target-lesion failure was only reported in 4 patients in the 1s-PCI group. Survival tests showed no significant difference between groups (χ2(1,n=402)=0.634; p=0.426).
Conclusion
Individuals that underwent 1s-PCI were overall similar to those who underwent 2s-PCI. Predictably, deploying more than 1 stent required more contrast volume and implied a higher radiation dose. We should note that our studied is greatly limited by the 2s-PCI group size, which may justify the lack of difference in the evaluated outcomes.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
| | - C Braga
- Hospital de Braga, Braga, Portugal
| | - I Campos
- Hospital de Braga, Braga, Portugal
| | | | - C Pires
- Hospital de Braga, Braga, Portugal
| | - R Flores
- Hospital de Braga, Braga, Portugal
| | - F Mane
- Hospital de Braga, Braga, Portugal
| | - R Silva
- Hospital de Braga, Braga, Portugal
| | - J Costa
- Hospital de Braga, Braga, Portugal
| | | | - C Braga
- Hospital de Braga, Braga, Portugal
| |
Collapse
|
31
|
Oliveira CC, Matos M, Azevedo R, Flores R, Medeiros P, Pires C, Mane F, Silva R, Braga C, Pereira VH. Impact of a cardio-oncology rehabilitation program in patients with breast cancer undergoing cardiotoxic treatment. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Cancer treatment–related cardiotoxicity (CTrCD) is commonly associated with anthracyclines and anti-HER2 agents which are widely used for the treatment of breast cancer. In order to mitgate CTrCD, exercise-based cardio-oncology rehabilitation (COR) involving a structured exercise program has been proposed.
Objectives
To evaluate the impact of a cardiac-rehabilitation program in breast cancer patients submitted to chemotherapy with known cardiotoxicity.
Methods
A systematic review was performed. Two databases were searched, PubMed and SCOPUS. All randomized or controlled trials and other prospective studies published between 2000 and March 2020 which evaluate the impact of an aerobic exercise program on cardiorespiratory fitness (CRF), health-related quality of life (QOL), vascular/endothelial function as well as cardiac assessment namely through the evaluation of left ventricular function and cardiac biomarkers in patients undergoing anthracycline and/or anti-HER2 treatments were included.
Main results
Fourteen studies were included enrolling 578 breast cancer patients with a mean age of 48.80 years. Regarding the impact of exercise in CRF, 5 studies (n=176) reported a significant improvement of VO2 max. and 4 studies of VO2max./kg (n=137). The peak power output was also improved in 4 studies (n=95) in the exercise-group. Considering the assessment of QOL, 3 studies (n=180) revealed significant differences favoring the exercise-group. The results regarding the evaluation of the LVEF were not clear: 2 studies (n=48) reported a significant decrease on LVEF when compared to baseline at the end of the intervention in both groups, despite the exercise program. However, 2 studies (n=97) showed a significant increase on LVEF in the exercise-group. Three studies (n=82) did not found significant differences in global longitudinal strain between groups. Limited evidence was found in vascular and endothelial functon. In 2 studies (n=50), endothelial function measured by brachial artery flow-mediated dilatation significantly improved in the exercise-group. Two studies (n=98) reported no significant impact of exercise on atenuating the increase of cTnI and BNP levels in the course of chemotherapy. On the other hand, when considering NT-proBNP, an increase in its levels was attenuated in the exercise-group.
Conclusions
This study confirms that exercise-based COR seems to be an effective approach to improve several cardiovascular outcomes and quality of life in breast cancer patients.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
| | - M Matos
- University of Minho - Life and Health Sciences Research Institute (ICVS), Braga, Portugal
| | - R Azevedo
- University of Minho - Life and Health Sciences Research Institute (ICVS), Braga, Portugal
| | - R Flores
- Hospital de Braga, Braga, Portugal
| | | | - C Pires
- Hospital de Braga, Braga, Portugal
| | - F Mane
- Hospital de Braga, Braga, Portugal
| | - R Silva
- Hospital de Braga, Braga, Portugal
| | - C Braga
- Hospital de Braga, Braga, Portugal
| | | |
Collapse
|
32
|
Gil Martins E, Martins D, Silva V, Fernandes C, Remião F, Borges F, Silva R. Mechanisms underlying new psychoactive phenethylamines cytotoxicity. Toxicol Lett 2021. [DOI: 10.1016/s0378-4274(21)00472-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
33
|
Martins M, Maia M, Gil-Martins E, Gales L, Remião F, Pinto M, Silva R, Sousa E. Towards the development of potential dual GSK-β/BACE-1 inhibitors: a strategy to fight Alzheimer's disease. Toxicol Lett 2021. [DOI: 10.1016/s0378-4274(21)00507-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
34
|
Pinto M, Barreiro S, Silva R, Remiao F, Borges F, Fernandes C. Rescuing a troubled tolcapone: nanomedicine on hepatotoxicity fight club. Toxicol Lett 2021. [DOI: 10.1016/s0378-4274(21)00632-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
35
|
Costa CP, Cunha S, Moreira JN, Silva R, Gil-Martins E, Silva V, Azevedo L, Peixoto AF, Sousa Lobo JM, Silva AC. Quality by design (QbD) optimization of diazepam-loaded nanostructured lipid carriers (NLC) for nose-to-brain delivery: Toxicological effect of surface charge on human neuronal cells. Int J Pharm 2021; 607:120933. [PMID: 34324988 DOI: 10.1016/j.ijpharm.2021.120933] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [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: 05/24/2021] [Revised: 07/10/2021] [Accepted: 07/21/2021] [Indexed: 12/24/2022]
Abstract
Diazepam is commonly used in the management of epileptic seizures, although it has limitations that can be overcome by using formulations that are easier to administer and capable of directing the drug to the brain. In this field, it has been reported that the use of nanostructured lipid carriers (NLC) via intranasal (or via nose-to-brain) promotes the targeting of drugs to the brain, improving the effectiveness of therapy. The aim of this work was to optimize two diazepam-loaded NLC formulations for nose-to-brain delivery, one with positive surface charge and one with negative surface charge. The quality by design (QbD) approach was used to design the experiments, where the quality target product profile (QTPP), the risk assessment and the critical quality attributes (CQAs) were defined to ensure safety, efficacy and quality of the final formulations. The experiments started with the optimization of critical material attributes (CMAs), related to the ratios of lipids and emulsifiers, followed by the selection of critical process parameters (CPPs), related to the production methods of the diazepam-loaded NLC formulation (ultrasound technique and high-pressure homogenization - HPH). Afterwards, the positive surface charge of the diazepam-loaded NLC was optimized. Finally, the biocompatibility with human neuronal cells of the formulation with a negative surface charge and of the formulation with a positive surface charge was evaluated. The results of the optimization of the CMAs showed that the ratios of lipids and emulsifiers more adequate were 6.7:2.9 and 4.2:0.3 (% w,w), respectively. Regarding the CPPs, HPH was considered the most suitable production method, resulting in an optimized diazepam-loaded NLC formulation (F1C15) with negative surface charge, showing particle size of 69.59 ± 0.22 nm, polydispersity index (PDI) of 0.19 ± 0.00, zeta potential (ZP) of -23.50 ± 0.24 mV and encapsulation efficiency (EE) of 96.60 ± 0.03 %. The optimized diazepam-loaded NLC formulation (F2A8) with positive surface charge had particle size of 124.40 ± 0.84 nm, PDI of 0.17 ± 0.01, ZP of 32.60 ± 1.13 mV and EE of 95.76 ± 0.24 %. In addition, the incorporation of diazepam in NLC resulted in a sustained release of the drug. No significant changes in particle size, PDI, ZP and EE were observed for the formulation F1C15, after 3 months of storage, whereas for formulation F2A8, particle size increased significantly. Biocompatibility studies showed that the formulation F2A8 was more cytotoxic than the formulation F1C15. Thereby, we conclude that the formulation F1C15 is more suitable for targeting the brain, when compared with the formulation F2A8. From the results of these studies, it can be confirmed that the QbD approach is an adequate and central tool to optimize NLC formulations.
Collapse
Affiliation(s)
- C P Costa
- UCIBIO/REQUIMTE, MEDTECH, Laboratory of Pharmaceutical Technology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
| | - S Cunha
- UCIBIO/REQUIMTE, MEDTECH, Laboratory of Pharmaceutical Technology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
| | - J N Moreira
- CNC - Center for Neuroscience and Cell Biology, Center for Innovative Biomedicine and Biotechnology (CIBB), Faculty of Medicine (Pólo I), University of Coimbra, 3004-531 Coimbra, Portugal; UC - University of Coimbra, CIBB, Faculty of Pharmacy, Pólo das Ciências da Saúde, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal
| | - R Silva
- UCIBIO, REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, Porto University, Porto, Portugal
| | - E Gil-Martins
- UCIBIO, REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, Porto University, Porto, Portugal
| | - V Silva
- UCIBIO, REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, Porto University, Porto, Portugal
| | - L Azevedo
- UCIBIO/REQUIMTE, MEDTECH, Laboratory of Pharmaceutical Technology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
| | - A F Peixoto
- LAQV/REQUIMTE, Department of Chemistry and Biochemistry, Faculty of Sciences, University of Porto, 4169-007 Porto, Portugal
| | - J M Sousa Lobo
- UCIBIO/REQUIMTE, MEDTECH, Laboratory of Pharmaceutical Technology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
| | - A C Silva
- UCIBIO/REQUIMTE, MEDTECH, Laboratory of Pharmaceutical Technology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal; FP-ENAS (UFP Energy, Environment and Health Research Unit), CEBIMED (Biomedical Research Centre), Faculty of Health Sciences, University Fernando Pessoa, 4249-004 Porto, Portugal.
| |
Collapse
|
36
|
Borges-Rosa J, Oliveira-Santos M, Silva R, Pereira Da Silva N, Abrunhosa A, Castelo-Branco M, Goncalves L, Ferreira MJ. Cardiac microcalcification burden is associated with cardiac fat variables in high cardiovascular risk patients. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeab111.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
Calcification plays a major role in coronary atherogenesis. Positron emission tomography (PET) imaging with fluorine-18 sodium fluoride (Na[18F]F) is able to detect microcalcification and is associated with cardiovascular (CV) risk factors. Thoracic fat volume (TFV) and epicardial adipose tissue (EAT) are associated with atherosclerosis, pro-inflammatory state, and CV events.
Purpose
We aimed to evaluate the association between Na[18F]F uptake and cardiac fat variables.
Methods
Cardiac Na[18F]F uptake was assessed as global molecular calcification score (GMCS): the sum of the product of the mean standardized uptake value times the area of the cardiac regions of interest times the slice thickness for all cardiac transaxial slices, divided by the total number of slices. TFV was assessed in computed tomography (CT) using automated software to sum the voxels consisting of fat (threshold of -190 to -30 Hounsfield units) between the bifurcation of pulmonary artery and the end of pericardial sac. EAT was segmented manually tracing the counter of the pericardium with 3DSlicer and the final volume calculated using the dedicated software. Coronary artery calcium score (CAC) was measured with dedicated software for calcium scoring (GE Healthcare Advantage Workstation 4.2).
Results
Thirty-four high CV risk individuals without previous CV events (50% with ≥5 CV risk factors) were retrospectively scanned with Na[18F]F PET-CT. Mean age is 63.5 ± 7.8 years and 62% male. Median values are: GMCS 320.9 (240.8-402.8), TFV 167.8 (131.4-211.3) mL, EAT 81.3 (60.7-107.2) cm3, and CAC 0.0 (2.5-20.0). There is a positive correlation between GMCS and abdominal perimeter (rs = 0.74), weight (rs = 0.61), TFV (rs = 0.47), and EAT (rs = 0.41), all with p ≤ 0.01. Thoracic and epicardial fat volumes are strongly correlated (rs = 0.80, p < 0.01). Both TFV and EAT are correlated with abdominal perimeter (rs = 0.60, p < 0.01 and rs = 0.46, p < 0.01, respectively) and weight (rs = 0.47, p < 0.01 and rs = 0.42, p = 0.01, respectively). GMCS [356.7 (321.0-409.6) vs. 261.1 (225.6-342.1), p = 0.01] and thoracic fat volume [184.3 (153.2-303.7) vs. 142.1 (90.0-173.1) mL, p = 0.01] are higher in patients with ≥5 CV risk factors, but not EAT [92.5 (62.0-145.7) vs. 76.7 (56.2-86.8) cm3, p = 0.14]. Neither GMCS (rs=-0.06, p = 0.77), TFV (rs = 0.20, p < 0.32) nor EAT (rs = 0.06, p < 0.76) are correlated with CAC score.
Conclusions
In this exploratory analysis with high CV risk patients, the global cardiac microcalcification burden assessed by GMCS is associated with TFV and EAT, but there was no correlation between these variables and CAC. We hypothesize that both GMCS and cardiac fat variables might help to identify higher-risk patients in earlier phases than traditional CT.
Collapse
Affiliation(s)
| | | | - R Silva
- University Hospitals of Coimbra, Coimbra, Portugal
| | | | - A Abrunhosa
- Institute of Nuclear Sciences Applied to Health, Coimbra, Portugal
| | - M Castelo-Branco
- Institute of Nuclear Sciences Applied to Health, Coimbra, Portugal
| | - L Goncalves
- University Hospitals of Coimbra, Coimbra, Portugal
| | - MJ Ferreira
- University Hospitals of Coimbra, Coimbra, Portugal
| |
Collapse
|
37
|
Borges-Rosa J, Oliveira-Santos M, Silva R, Lopes De Almeida J, Goncalves L, Costa G, Ferreira MJ. The prevalence of cardiac sarcoidosis is underestimated: [18F]FDG-PET is the answer. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeab111.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Overt cardiac involvement is reported in 5% of patients with sarcoidosis, although autopsy and imaging studies suggest higher prevalence, worldwide variation. The role of 18F-fluorodeoxyglucose positron emission tomography ([18F]FDG-PET) in non-invasive diagnosis and follow-up has increased in the last decade.
Purpose
Our goal is to describe the prevalence, clinical manifestations and outcomes of cardiac sarcoidosis (CS), diagnosed through [18F]FDG-PET, in a southern European population.
Methods
We included all patients with histological diagnosis of extracardiac sarcoidosis screened with [18F]FDG-PET between 2009 and 2020. We collected data on clinical manifestations, cardiac magnetic resonance (CMR) results, and mortality outcomes and compared those with and without cardiac involvement. We applied the criteria for the diagnosis of CS from Heart Rhythm Society.
Results
Of the 400 patients screened with [18F]FDG-PET, 128 had a histological diagnosis of extracardiac sarcoidosis (54.7% females, mean age 51.0 ± 14.2 years). None underwent endomyocardial biopsy. Ten patients had a pattern of [18F]FDG uptake consistent with CS defined as diffuse (n = 5), focal (n = 3), and focal on diffuse (n = 2). Of the 128 patients, 14 also underwent CMR, which identified 2 subjects with positive findings in both modalities and 3 additional patients: focal (n = 1), multifocal mid-wall (n = 2), focal mid-wall (n = 2), and multifocal subepicardial (n = 1) delayed gadolinium enhancement. Overall, 13 patients (10.2%) fulfilled the criteria for probable CS (53.8% female, mean age 56.2 ± 12.6 years), all with multiorgan involvement, mostly lung and lymph nodes (each 92%), followed by skin and central nervous system (each 15%). Median left ventricle ejection fraction was 62% [55-65] and there were cardiac manifestations of CS in 6 patients (46%): sick sinus syndrome (n = 2), complete heart block (n = 1), frequent premature ventricular complexes (n = 1), ventricular tachycardia plus heart failure (n = 1), and bifascicular block plus heart failure (n = 1). Eleven patients (85%) with probable CS were medicated with immunosuppressant drugs: corticosteroids (n = 9), methotrexate (n = 4), and azathioprine (n = 2). Four patients with previous [18F]FDG screening were revaluated after treatment, each showing no cardiac uptake. After a mean follow-up of 4.0 ± 1.0 years, mortality was three-fold higher in patients with cardiac involvement, despite the absence of statistical significance (15% vs. 5%, P = 0.151).
Conclusions
In a southern European population with histological extracardiac sarcoidosis, the prevalence of cardiac involvement was 10.2%, most asymptomatic. [18F]FDG-PET improves the diagnostic yield and plays an important role in monitoring response to therapy. The higher mortality trend in those with CS needs to be ascertained in longer follow-up.
Collapse
Affiliation(s)
| | | | - R Silva
- University Hospitals of Coimbra, Coimbra, Portugal
| | | | - L Goncalves
- University Hospitals of Coimbra, Coimbra, Portugal
| | - G Costa
- University Hospitals of Coimbra, Coimbra, Portugal
| | - MJ Ferreira
- University Hospitals of Coimbra, Coimbra, Portugal
| |
Collapse
|
38
|
Marques Pires C, Passos RM, Medeiros P, Oliveira C, Flores R, Mane F, Silva R, Antunes N, Vieira C, Queiros S, Pereira VH. Temporal characterization of ventricular function and deformation after Takotsubo syndrome using cardiovascular magnetic resonance imaging. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeab090.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
INTRODUCTION
The time course of ventricular recovery in Takotsubo Syndrome (TS) patients(pts) is still not well characterized. Quantification of myocardial deformation using Cardiovascular Magnetic Resonance Feature-Tracking (CMR-FT) may be a useful method to better characterize ventricular recovery during TS.
AIM
To assess the time course of ventricular function using CMR-FT myocardial strain in patients (pts) with an episode of TS.
METHODS
We performed a single-center, retrospective cohort study including 130 pts admitted with TS over a 10-year period. From this cohort, 39 (30%) pts were selected and age and sex-matched with 16 healthy controls for a comparative analysis of myocardial strain using CMR-FT. TS pts were divided in 3 homogeneous subgroups according to the time from index-event and the CMR acquisition: Group 1(G1): <8 days; Group 2(G2): 8 to 30 days; Group 3 (G3): >30 days.
One operator blinded for the study group performed the analysis. Left ventricle (LV) radial strain (RS), longitudinal strain (LS) and right ventricle (RV) LS were quantified.
RESULTS
The mean age of TS group was 66 years and 90% were female. The median ejection fraction (EF) at admission was 38%; 82% displayed an apical ballooning (AB) pattern. Around 19% had at least 1 in-hospital complication and 1.5% died during hospitalization. A significant increase use of CMR was observed over the years (p = 0.001).
Myocardial deformation analysis showed a significant group interaction for LV LS and RS. Specifically, the global values of G1 LV LS and RS were significantly decreased when compared with G3 (LS:-15vs-20%;p = 0.002; RS:40vs61%; p < 0.001) and controls (LS:-15vs-22%;p < 0.001; RS: 40vs70; p < 0.001). There were no significant differences in the RV LS across groups.
The CMR-quantified EF was significantly decreased in G1 when compared with G3 (52vs64%; p < 0.003) and controls (52vs64%; p < 0.001). Differences between G1 and G2 were found in LV RS (LS:40vs57%; p < 0.001) and EF (52vs62%; p < 0.001). No differences were observed for any parameters between G3 and controls.
This study showed that global LV LS (r=-0.6, p < 0.001) and RS (r = 0.7, p < 0.001) had a significant correlation with the CMR-quantified EF.
A comparison between the different patterns of TS was also performed (Figure 1). Pts with AB pattern in G1 displayed lower global RS (P = 0.014), although there were no differences regarding global LS. As expected, in the AB group the reduction in myocardial strain was limited to the apical segments.
Despite not being significantly different across groups RV LS was the only CMR-derived predictor of complications during follow-up (OR = 1.17; p = 0.026).
CONCLUSION
This study revealed that after an episode of TS myocardial function quantified either by EF or CMR-FT strain fully recovers between the 8th and 30th day of the event. RV strain was a predictor of complications during follow-up.
Collapse
Affiliation(s)
| | - RM Passos
- ULSAM - Hospital de Santa Luzia, Intensive Care, Viana do Castelo, Portugal
| | | | | | | | - F Mane
- Braga Hospital, Braga, Portugal
| | - R Silva
- Braga Hospital, Braga, Portugal
| | | | | | - S Queiros
- University of Minho - Life and Health Sciences Research Institute (ICVS), Braga, Portugal
| | | |
Collapse
|
39
|
Marques Pires C, Medeiros P, Oliveira C, Flores R, Mane F, Silva R, Campos I, Azevedo P, Gaspar A, Pereira MA, Galvao CB, Antunes N, Marques J. Impact of Atrial Fibrillation type in Acute Coronary Syndrome and the antithrombotic strategy. Europace 2021. [DOI: 10.1093/europace/euab116.142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
INTRODUCTION
Atrial fibrillation (AF) is an adverse prognostic factor during acute coronary syndrome (ACS). Current evidence recommends dual antithrombotic therapy (DAT), 1 antiplatelet drug and 1 anticoagulant drug, as the default strategy after nonST elevation ACS.
AIM
To identify the clinical differences and prognosis of AF type-new onset (nAF) or pre-existing (pFA)- during ACS, to evaluate antithrombotic strategy at hospital discharge (HD) and its impact on haemorrhagic and ischemic events.
METHODS
We performed a retrospective observational cohort study including 3241 patients (pts) with ACS (mean age 64 years, 77.5% male) admitted to a single center over a 6-year period, with 12-months follow-up.
RESULTS
AF rhythm was identified in 11.2% pts, of whom 63.2% presented nAF and 36.8% pAF.
When AF types where compared, pts with pAF had a higher prevalence of cardiovascular (Cv) comorbidities, including hypertension (p < 0.001), previous ACS (p = 0.03), valvular disease (p = 0.01) or stroke (p = 0.05), had greater left atrial diameter (p < 0.001) and were less likely to have significant coronary lesions (p = 0.05). Pts with nAF more frequently presented with STelevation ACS (p < 0.001) and had a lower Hemoglobin nadir (p < 0.001). The independent predictors of nAF in ACS were age (OR 1.1, p< =0.001), LVEF ≤ 40% (OR 2.2, p = 0.001), STelevation ACS (OR 2.6, p< =0.001) and previous valvular disease (OR 3.5, p< =0.01). Compared with the population without AF, nAF was a predictor of in-hospital death (OR 2.9, p = 0.027) and in-hospital composite endpoint (death, stroke, reinfarction and cardiogenic shock) (OR 2.5, p = 0.001) in multivariate analysis, but pAF wasn’t. During 12-months follow-up of pts with ACS and AF, there was no difference regarding death or follow-up composite endpoint (death, stroke and ACS) between the AF types.Regarding antithrombotic therapy, nAF pts were less often anticoagulated (p < 0.001) and pAF pts where more often treated with triple antithrombotic therapy (TAT) at HD (<0.001). Most of the pts with TAT stopped the second antiplatelet at agent 6-months (43.8%) or 12 months (25.5%) after HD. During 12-months follow-up, pts discharged with TAT had trend towards more haemorrhagic events (TAT 6.2% vs DAT2.7%,p = 0.69) and both groups had similar ischaemic events (death, ACS, stroke) (TAT 20.9% vs DAT23.7%,p = 0.714). In multivariate analysis the choice of TAT or DAT wasn’t a predictor of ischaemic events.
CONCLUSIONS
In ACS, pts with nAF had worst in-hospital outcomes than pts with pAF. Regarding antithrombotic strategy at HD pts with nFA were less often anticoagulated and less often treated with TAT. In our study the choice between DAT or TAT had no statistical impact on follow-up outcomes.
Collapse
Affiliation(s)
| | | | | | | | - F Mane
- Braga Hospital, Braga, Portugal
| | - R Silva
- Braga Hospital, Braga, Portugal
| | | | | | | | | | | | | | | |
Collapse
|
40
|
Araujo Leite Medeiros P, Martins J, Campos I, Oliveira C, Pires C, Flores R, Mane F, Silva R, Rodrigues J, Arantes C, Magalhaes S, Rebelo A, Rocha S. Syncope: call for the missed diagnosis. Europace 2021. [DOI: 10.1093/europace/euab116.315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Syncope is a common reason for emergency department attendance. This entity may be associated with significant morbidity and mortality and its differential diagnosis is not straightforward. Arrhythmic causes include tachycardia and bradycardia; the later may require pacemaker implantation. Many hospitals lack a dedicated syncope unit to approach these patients. So, patients’ triage may fall into medical or surgical (trauma) areas.
Purpose
To describe the population of patients that required permanent pacemaker implantation in the year of 2019, particularly those who had a previous visit to the emergency department with syncope or presyncope.
Methods
Single-center descriptive analysis of patients that implanted a permanent pacemaker in 2019 (inclusion criteria). Additional information was collected in patients with emergency department visits in the 365 days that preceded the device implantation.
Results
In 2019, a total of 398 patients were admitted for pacemaker implantation in 2019, 55% male (n = 218), 45% female (n = 180), with mean age of 79 years. Regarding indications for pacing, 41% (n= 156) had complete atrioventricular (AV) block, 26% (n = 105) had a second degree AV block, 16% (n = 64) had sinus node dysfunction, 13.5% (n = 53) had atrial fibrillation with slow ventricular conduction, and 3.5% (n = 14) had other indications.
Twenty-two percent (n = 88) of patients had a previous visit to the emergency department (other than the ones that triggered the pacemaker implantation) with complaints of syncope (60%) or presyncope (40%). Of these, 73% (n = 64) were referred to a medical area and 27% (n = 24) were referred to a surgical area; 40 patients presented with traumatic lesions (68% cranioencephalic trauma and 32% other traumas). Of the 88 patients, only 67% (n = 59) performed an ECG and only 23% (n = 20) were referred for observation by a cardiologist in the emergency department.
Comparing medical and surgical triage, we observe that patients referred to the surgical area were less likely to perform an ECG and to be observed by a cardiologist (with statistical significance).
Conclusions
Our work describes a common problem in hospitals without dedicated syncope evaluation units. As all the patients ended up implanting a pacemaker, it is interesting to observe that 22%of these had a "warning" visit to the emergency and 33% of the last did not get and ECG. Also, trauma-oriented approaches result in a lower likelihood of performing a complete evaluation of the cause of the syncopal event. This analysis highlights the need for a comprehensive and multidisciplinary approach of patients presenting with syncope and presyncope to promote early identification and treatment of arrhythmic causes, reducing patient morbidity and healthcare costs.
Collapse
Affiliation(s)
| | | | - I Campos
- Hospital de Braga, Braga, Portugal
| | | | - C Pires
- Hospital de Braga, Braga, Portugal
| | - R Flores
- Hospital de Braga, Braga, Portugal
| | - F Mane
- Hospital de Braga, Braga, Portugal
| | - R Silva
- Hospital de Braga, Braga, Portugal
| | | | | | | | - A Rebelo
- Hospital de Braga, Braga, Portugal
| | - S Rocha
- Hospital de Braga, Braga, Portugal
| |
Collapse
|
41
|
Santos CGM, Rolim-Filho NG, Domingues CA, Dornelas-Ribeiro M, King JL, Budowle B, Moura-Neto RS, Silva R. Association of whole mtDNA, an NADPH G11914A variant, and haplogroups with high physical performance in an elite military troop. ACTA ACUST UNITED AC 2021; 54:e10317. [PMID: 33909855 PMCID: PMC8075130 DOI: 10.1590/1414-431x202010317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 12/29/2020] [Indexed: 11/22/2022]
Abstract
Physical performance is a multifactorial and complex trait influenced by environmental and hereditary factors. Environmental factors alone have been insufficient to characterize all outstanding phenotypes. Recent advances in genomic technologies have enabled the investigation of whole nuclear and mitochondrial genome sequences, increasing our ability to understand interindividual variability in physical performance. Our objective was to evaluate the association of mitochondrial polymorphic loci with physical performance in Brazilian elite military personnel. Eighty-eight male military personnel who participated in the Command Actions Course of the Army were selected. Total DNA was obtained from blood samples and a complete mitochondrial genome (mtDNA) was sequenced using Illumina MiSeq platform. Twenty-nine subjects completed the training program (FINISHED, 'F'), and fifty-nine failed to complete (NOT_FINISHED, 'NF'). The mtDNA from NF was slightly more similar to genomes from African countries frequently related to endurance level. Twenty-two distinct mtDNA haplogroups were identified corroborating the intense genetic admixture of the Brazilian population, but their distribution was similar between the two groups (FST=0.0009). Of 745 polymorphisms detected in the mtDNA, the position G11914A within the NADPH gene component of the electron transport chain, was statistically different between F and NF groups (P=0.011; OR: 4.286; 95%CI: 1.198-16.719), with a higher frequency of the G allele in group F individuals). The high performance of military personnel may be mediated by performance-related genomic traits. Thus, mitochondrial genetic markers such as the ND4 gene may play an important role on physical performance variability.
Collapse
Affiliation(s)
- C G M Santos
- Instituto de Biologia do Exército, Rio de Janeiro, RJ, Brasil
| | - N G Rolim-Filho
- Centro de Instrução de Operações Especiais do Exército Brasileiro, Rio de Janeiro, RJ, Brasil
| | - C A Domingues
- Centro de Instrução de Operações Especiais do Exército Brasileiro, Rio de Janeiro, RJ, Brasil
| | | | - J L King
- Center for Human Identification, Department of Microbiology, Immunology, and Genetics, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - B Budowle
- Center for Human Identification, Department of Microbiology, Immunology, and Genetics, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - R S Moura-Neto
- Instituto de Biologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - R Silva
- Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| |
Collapse
|
42
|
Simião H, Santana L, Silva R, Gago J. Early intervention program for psychosis in a portuguese hospital: The first results of the open program. Eur Psychiatry 2021. [PMCID: PMC9475750 DOI: 10.1192/j.eurpsy.2021.1421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction OPEN is a structured intervention program for patients who present with untreated psychosis at an early stage, under the guidance of a case manager and a periodic evaluation performed by a multidisciplinary team. Objectives The aim of the OPEN program is to create an individual care plan, promoting recovery, functionality, quality of life and prevent relapses. One year after implementation of the program, we present the first results. Methods We performed a retrospective review of the patients’ clinical profiles included in the OPEN program. Results Nine patients were included in the program. The most frequent diagnosis was schizophrenia (n=5). By the time of inclusion in the program, 5 patients used cannabis frequently; one patient kept substance use. At the 6th month assessment, 4 in 5 patients showed an improvement in social functioning (Personal and Social Performance Scale; ± 16 points), and a decrease in symptom severity in all (Brief Psychiatric Rating Scale; ± 11 points). Due to COVID-19 pandemics, group interventions were suspended, and some visits were performed by teleconsultation. No patients lost follow-up. Conclusions We observed an overall positive result of the first months of this program, regarding both functionality and clinical outcomes. The main obstacle so far is the impossibility of performing group interventions since the start of the contingency measures regarding COVID-19 pandemics. We expect further results of the OPEN program with the inclusion of more patients.
Collapse
|
43
|
Camilo J, Silva R, Vaz I, Roque M. “I am the coronavirus”: A case report and review. Eur Psychiatry 2021. [PMCID: PMC9471651 DOI: 10.1192/j.eurpsy.2021.788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
IntroductionAs disorders of thought, delusions are modified by patients’ background, and so their content varies widely according to location and throughout the ages. The COVID-19 pandemic has shown its global impact on society and mental health of the population, thus becoming a new delusional topic.ObjectivesWe report a case where the COVID-19 pandemic has been integrated into a patient’s delusion in an attempt to raise professional awareness for this new psychotic presentation.MethodsReview of clinical notes and literature review.ResultsA 38-year-old female patient with no prior psychiatric history presented with psychotic symptoms characterized by self-referential ideas, feelings of guilt and delusions of ruin, with a sudden onset of less than 24 hours prior to observation. The patient claimed that she was the coronavirus and, as such, she was a common topic of conversation in both television and social media, and the reported deaths caused by COVID-19 were her own doing. As a result of this, the patient was asking doctors to kill her in order to save everyone else affected by the virus. After evaluation, a diagnosis of Acute and Transient Psychotic Disorder was considered. The patient was initially treated with paliperidone, but due to hyperprolactinemia and menstrual changes this was switched to aripiprazole. Symptoms remitted fully after 21 days of treatment, and six months later no recurrences have been described.ConclusionsThis case illustrates the potential of the coronavirus pandemic outbreak as a new delusional topic. Possible side effects of treatment are also discussed.
Collapse
|
44
|
Dias I, Hernâni-Eusébio J, Silva R. “How many likes?”: The use of social media, body image insatisfaction and disordered eating. Eur Psychiatry 2021. [PMCID: PMC9480138 DOI: 10.1192/j.eurpsy.2021.1847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Introduction Social media use has grown exponentially over the past few years, having a key role in communication among our youngsters. The impact of social media in mental health is still unclear. While some studies advocate that it increases social support and general satisfaction, others associate social media with the development of mental health issues. Social media can also perform some pressure regarding body image and eating behavior, caused by the idealistic appearance shown there in a very visual way. Objectives This review intends to identify the existing evidence regarding social media use, its impact on body image and eating behavior. Methods Search performed on May 11, 2020, including articles published since January 1st, 2006, written in Portuguese, English, Spanish and French. We used the MeSH terms ‘Body dissatisfaction’, ‘Body image’, ‘Feeding and eating disorders’, ‘Eating behaviors’ and ‘Social media’. The quality and strength of recommendation of the articles were evaluated using the Strength of Recommendation Taxonomy (SORT) scale from the American Academy of Family Physicians. Results 716 articles were initially found. Eight were selected: two systematic reviews, three cohort studies, two cross-sectional studies and one observational study. Conclusions This review presents studies that establish a correlation between social media use, body image dissatisfaction and disordered eating. However, methodological and population heterogeneity can compromise the conclusions observed. With the current evidence, we can conclude that there is a relationship between the use of social media and changes in body image and/or eating behaviors in adolescents and young adults (SORT B). Disclosure No significant relationships.
Collapse
|
45
|
Silva R, Camilo J, Vaz I, Ribeiro A. From hysteria to conversion: A case of stuttering. Eur Psychiatry 2021. [PMCID: PMC9471763 DOI: 10.1192/j.eurpsy.2021.495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Introduction
Conversion Disorder is a condition defined by the sudden appearance of neurologic symptoms without an identifiable organic cause, often thought to be associated with psychological triggers. This disorder can lead to severe distress and loss of functionality which, without appropriate treatment, can be made permanent. Objectives To raise awareness for this unexplained and often misunderstood disorder using a clinical case as background. Methods Clinical history, organic evaluation, psychological evaluation and literature review. Results 28-year-old female, single, with two children, working from home as a call-centre operator. Previously followed and medicated for depression. Presents to the ER due to sudden loss of consciousness while working, after which her speech became hindered by stuttering. Neurologic evaluation was unremarkable and she was referred for Psychiatric assessment, resulting in a diagnosis of Conversion Disorder. Speech was at first understandable but in the following weeks became progressively worse and eventually led to aphonia, while written communication remained normal and was the patient’s method of choice. Conclusions Once a favourite of Psychiatrists, little is yet known about the underlying mechanisms behind this disorder. Experts disagree on whether to classify it as a dissociative disorder, a somatoform disorder, or its own category. Patients presenting with this condition are often mistaken for malingering and thus subject to unhelpful or outright discriminatory practices. Broadened awareness is required to ensure patients get early access to the best possible care and thus improve their quality of life.
Collapse
|
46
|
Gama N, Godinho B, Marques G, Silva R, Barros-Timmons A, Ferreira A. Recycling of polyurethane by acidolysis: The effect of reaction conditions on the properties of the recovered polyol. POLYMER 2021. [DOI: 10.1016/j.polymer.2021.123561] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
47
|
Raimundo I, Silva R, Meunier L, Valente SM, Lago-Lestón A, Keller-Costa T, Costa R. Functional metagenomics reveals differential chitin degradation and utilization features across free-living and host-associated marine microbiomes. Microbiome 2021; 9:43. [PMID: 33583433 PMCID: PMC7883442 DOI: 10.1186/s40168-020-00970-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 10/18/2020] [Indexed: 06/01/2023]
Abstract
BACKGROUND Chitin ranks as the most abundant polysaccharide in the oceans yet knowledge of shifts in structure and diversity of chitin-degrading communities across marine niches is scarce. Here, we integrate cultivation-dependent and -independent approaches to shed light on the chitin processing potential within the microbiomes of marine sponges, octocorals, sediments, and seawater. RESULTS We found that cultivatable host-associated bacteria in the genera Aquimarina, Enterovibrio, Microbulbifer, Pseudoalteromonas, Shewanella, and Vibrio were able to degrade colloidal chitin in vitro. Congruent with enzymatic activity bioassays, genome-wide inspection of cultivated symbionts revealed that Vibrio and Aquimarina species, particularly, possess several endo- and exo-chitinase-encoding genes underlying their ability to cleave the large chitin polymer into oligomers and dimers. Conversely, Alphaproteobacteria species were found to specialize in the utilization of the chitin monomer N-acetylglucosamine more often. Phylogenetic assessments uncovered a high degree of within-genome diversification of multiple, full-length endo-chitinase genes for Aquimarina and Vibrio strains, suggestive of a versatile chitin catabolism aptitude. We then analyzed the abundance distributions of chitin metabolism-related genes across 30 Illumina-sequenced microbial metagenomes and found that the endosymbiotic consortium of Spongia officinalis is enriched in polysaccharide deacetylases, suggesting the ability of the marine sponge microbiome to convert chitin into its deacetylated-and biotechnologically versatile-form chitosan. Instead, the abundance of endo-chitinase and chitin-binding protein-encoding genes in healthy octocorals leveled up with those from the surrounding environment but was found to be depleted in necrotic octocoral tissue. Using cultivation-independent, taxonomic assignments of endo-chitinase encoding genes, we unveiled previously unsuspected richness and divergent structures of chitinolytic communities across host-associated and free-living biotopes, revealing putative roles for uncultivated Gammaproteobacteria and Chloroflexi symbionts in chitin processing within sessile marine invertebrates. CONCLUSIONS Our findings suggest that differential chitin degradation pathways, utilization, and turnover dictate the processing of chitin across marine micro-niches and support the hypothesis that inter-species cross-feeding could facilitate the co-existence of chitin utilizers within marine invertebrate microbiomes. We further identified chitin metabolism functions which may serve as indicators of microbiome integrity/dysbiosis in corals and reveal putative novel chitinolytic enzymes in the genus Aquimarina that may find applications in the blue biotechnology sector. Video abstract.
Collapse
Affiliation(s)
- I. Raimundo
- Instituto de Bioengenharia e Biociências, Instituto Superior Técnico (IST), Universidade de Lisboa, Av. Rovisco Pais 1, Torre Sul, Piso 11, 11.6.11b, 1049-001 Lisbon, Portugal
| | - R. Silva
- Instituto de Bioengenharia e Biociências, Instituto Superior Técnico (IST), Universidade de Lisboa, Av. Rovisco Pais 1, Torre Sul, Piso 11, 11.6.11b, 1049-001 Lisbon, Portugal
| | - L. Meunier
- Instituto de Bioengenharia e Biociências, Instituto Superior Técnico (IST), Universidade de Lisboa, Av. Rovisco Pais 1, Torre Sul, Piso 11, 11.6.11b, 1049-001 Lisbon, Portugal
- Laboratory of Aquatic Systems Ecology, Université Libre de Bruxelles, Brussels, Belgium
| | - S. M. Valente
- Instituto de Bioengenharia e Biociências, Instituto Superior Técnico (IST), Universidade de Lisboa, Av. Rovisco Pais 1, Torre Sul, Piso 11, 11.6.11b, 1049-001 Lisbon, Portugal
| | - A. Lago-Lestón
- Department of Medical Innovation, Centro de Investigación Científica y de Educación Superior de Ensenada (CICESE), 22860 Ensenada, Mexico
| | - T. Keller-Costa
- Instituto de Bioengenharia e Biociências, Instituto Superior Técnico (IST), Universidade de Lisboa, Av. Rovisco Pais 1, Torre Sul, Piso 11, 11.6.11b, 1049-001 Lisbon, Portugal
| | - R. Costa
- Instituto de Bioengenharia e Biociências, Instituto Superior Técnico (IST), Universidade de Lisboa, Av. Rovisco Pais 1, Torre Sul, Piso 11, 11.6.11b, 1049-001 Lisbon, Portugal
- Centro de Ciências do Mar (CCMAR), Universidade do Algarve, 8005-139 Faro, Portugal
- Department of Energy, Joint Genome Institute, Berkeley, CA 94720 USA
- Lawrence Berkeley National Laboratory, Berkeley, CA 94720 USA
| |
Collapse
|
48
|
Bottino C, Silva R, Moura-Neto R. Research Article Resolving a human identification case for the Rio de Janeiro Police with massively parallel sequencing of mtDNA using a proposed pipeline. Genet Mol Res 2021. [DOI: 10.4238/gmr18757] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
49
|
Ebersole CR, Mathur MB, Baranski E, Bart-Plange DJ, Buttrick NR, Chartier CR, Corker KS, Corley M, Hartshorne JK, IJzerman H, Lazarević LB, Rabagliati H, Ropovik I, Aczel B, Aeschbach LF, Andrighetto L, Arnal JD, Arrow H, Babincak P, Bakos BE, Baník G, Baskin E, Belopavlović R, Bernstein MH, Białek M, Bloxsom NG, Bodroža B, Bonfiglio DBV, Boucher L, Brühlmann F, Brumbaugh CC, Casini E, Chen Y, Chiorri C, Chopik WJ, Christ O, Ciunci AM, Claypool HM, Coary S, Čolić MV, Collins WM, Curran PG, Day CR, Dering B, Dreber A, Edlund JE, Falcão F, Fedor A, Feinberg L, Ferguson IR, Ford M, Frank MC, Fryberger E, Garinther A, Gawryluk K, Ashbaugh K, Giacomantonio M, Giessner SR, Grahe JE, Guadagno RE, Hałasa E, Hancock PJB, Hilliard RA, Hüffmeier J, Hughes S, Idzikowska K, Inzlicht M, Jern A, Jiménez-Leal W, Johannesson M, Joy-Gaba JA, Kauff M, Kellier DJ, Kessinger G, Kidwell MC, Kimbrough AM, King JPJ, Kolb VS, Kołodziej S, Kovacs M, Krasuska K, Kraus S, Krueger LE, Kuchno K, Lage CA, Langford EV, Levitan CA, de Lima TJS, Lin H, Lins S, Loy JE, Manfredi D, Markiewicz Ł, Menon M, Mercier B, Metzger M, Meyet V, Millen AE, Miller JK, Montealegre A, Moore DA, Muda R, Nave G, Nichols AL, Novak SA, Nunnally C, Orlić A, Palinkas A, Panno A, Parks KP, Pedović I, Pękala E, Penner MR, Pessers S, Petrović B, Pfeiffer T, Pieńkosz D, Preti E, Purić D, Ramos T, Ravid J, Razza TS, Rentzsch K, Richetin J, Rife SC, Rosa AD, Rudy KH, Salamon J, Saunders B, Sawicki P, Schmidt K, Schuepfer K, Schultze T, Schulz-Hardt S, Schütz A, Shabazian AN, Shubella RL, Siegel A, Silva R, Sioma B, Skorb L, de Souza LEC, Steegen S, Stein LAR, Sternglanz RW, Stojilović D, Storage D, Sullivan GB, Szaszi B, Szecsi P, Szöke O, Szuts A, Thomae M, Tidwell ND, Tocco C, Torka AK, Tuerlinckx F, Vanpaemel W, Vaughn LA, Vianello M, Viganola D, Vlachou M, Walker RJ, Weissgerber SC, Wichman AL, Wiggins BJ, Wolf D, Wood MJ, Zealley D, Žeželj I, Zrubka M, Nosek BA. Many Labs 5: Testing Pre-Data-Collection Peer Review as an Intervention to Increase Replicability. Advances in Methods and Practices in Psychological Science 2020. [DOI: 10.1177/2515245920958687] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Replication studies in psychological science sometimes fail to reproduce prior findings. If these studies use methods that are unfaithful to the original study or ineffective in eliciting the phenomenon of interest, then a failure to replicate may be a failure of the protocol rather than a challenge to the original finding. Formal pre-data-collection peer review by experts may address shortcomings and increase replicability rates. We selected 10 replication studies from the Reproducibility Project: Psychology (RP:P; Open Science Collaboration, 2015) for which the original authors had expressed concerns about the replication designs before data collection; only one of these studies had yielded a statistically significant effect ( p < .05). Commenters suggested that lack of adherence to expert review and low-powered tests were the reasons that most of these RP:P studies failed to replicate the original effects. We revised the replication protocols and received formal peer review prior to conducting new replication studies. We administered the RP:P and revised protocols in multiple laboratories (median number of laboratories per original study = 6.5, range = 3–9; median total sample = 1,279.5, range = 276–3,512) for high-powered tests of each original finding with both protocols. Overall, following the preregistered analysis plan, we found that the revised protocols produced effect sizes similar to those of the RP:P protocols (Δ r = .002 or .014, depending on analytic approach). The median effect size for the revised protocols ( r = .05) was similar to that of the RP:P protocols ( r = .04) and the original RP:P replications ( r = .11), and smaller than that of the original studies ( r = .37). Analysis of the cumulative evidence across the original studies and the corresponding three replication attempts provided very precise estimates of the 10 tested effects and indicated that their effect sizes (median r = .07, range = .00–.15) were 78% smaller, on average, than the original effect sizes (median r = .37, range = .19–.50).
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Martin Corley
- Psychology, School of Philosophy, Psychology & Language Sciences, University of Edinburgh
| | | | - Hans IJzerman
- LIP/PC2S, Université Grenoble Alpes
- Institut Universitaire de France
| | - Ljiljana B. Lazarević
- Institute of Psychology, Faculty of Philosophy, University of Belgrade
- Laboratory for Research of Individual Differences, Faculty of Philosophy, University of Belgrade
| | - Hugh Rabagliati
- Psychology, School of Philosophy, Psychology & Language Sciences, University of Edinburgh
| | - Ivan Ropovik
- Institute for Research and Development of Education, Faculty of Education, Charles University
- Faculty of Education, University of Presov
| | - Balazs Aczel
- Institute of Psychology, ELTE Eötvös Loránd University
| | | | | | | | - Holly Arrow
- Department of Psychology, University of Oregon
| | - Peter Babincak
- Institute of Psychology, Faculty of Arts, University of Presov
| | | | - Gabriel Baník
- Institute of Psychology, Faculty of Arts, University of Presov
| | - Ernest Baskin
- Department of Food Marketing, Haub School of Business, Saint Joseph’s University
| | | | - Michael H. Bernstein
- Department of Behavioral and Social Sciences, School of Public Health, Brown University
- Department of Psychology, University of Rhode Island
| | | | | | - Bojana Bodroža
- Department of Psychology, Faculty of Philosophy, University of Novi Sad
| | | | - Leanne Boucher
- Department of Psychology and Neuroscience, Nova Southeastern University
| | | | | | - Erica Casini
- Department of Psychology, University of Milano-Bicocca
| | - Yiling Chen
- John A. Paulson School of Engineering and Applied Sciences, Harvard University
| | - Carlo Chiorri
- Department of Educational Science, University of Genova
| | | | | | | | | | - Sean Coary
- Quinlan School of Business, Loyola University Chicago
| | - Marija V. Čolić
- Faculty of Sport and Physical Education, University of Belgrade
| | | | | | - Chris R. Day
- Centre for Trust, Peace and Social Relations, Coventry University
| | | | - Anna Dreber
- Department of Economics, Stockholm School of Economics
- Department of Economics, University of Innsbruck
| | - John E. Edlund
- Department of Psychology, Rochester Institute of Technology
| | | | - Anna Fedor
- Institute of Evolution, Centre for Ecological Research, Budapest, Hungary
| | - Lily Feinberg
- Psychology and Neuroscience Department, Boston College
| | - Ian R. Ferguson
- Department of Psychology, Virginia Commonwealth University
- Department of Psychology, New York University
| | - Máire Ford
- Department of Psychology, Loyola Marymount University
| | | | | | | | | | - Kayla Ashbaugh
- Department of Biology and Biomedical Engineering, Rose-Hulman Institute of Technology
| | - Mauro Giacomantonio
- Department of Social & Developmental Psychology, Sapienza University of Rome
| | | | - Jon E. Grahe
- Department of Psychology, Pacific Lutheran University
| | | | - Ewa Hałasa
- Faculty of Economics, Maria Curie-Skłodowska University
| | | | - Rias A. Hilliard
- Department of Humanities, Social Sciences, and the Arts, Rose-Hulman Institute of Technology
| | | | - Sean Hughes
- Department of Experimental Clinical and Health Psychology, Ghent University
| | | | | | - Alan Jern
- Department of Humanities, Social Sciences, and the Arts, Rose-Hulman Institute of Technology
| | | | | | | | | | | | | | | | - Amanda M. Kimbrough
- School of Arts, Technology, Emerging Media, & Communication, University of Texas at Dallas
| | - Josiah P. J. King
- Psychology, School of Philosophy, Psychology & Language Sciences, University of Edinburgh
| | | | | | - Marton Kovacs
- Institute of Psychology, ELTE Eötvös Loránd University
| | | | | | - Lacy E. Krueger
- Department of Psychology & Special Education, Texas A&M University-Commerce
| | | | - Caio Ambrosio Lage
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro
| | | | | | | | - Hause Lin
- Department of Psychology, University of Toronto
| | - Samuel Lins
- Department of Psychology, University of Porto
| | - Jia E. Loy
- Linguistics & English Language, School of Philosophy, Psychology & Language Sciences, University of Edinburgh
| | - Dylan Manfredi
- Marketing Department, The Wharton School of the University of Pennsylvania
| | | | - Madhavi Menon
- Department of Psychology and Neuroscience, Nova Southeastern University
| | - Brett Mercier
- Department of Psychological Science, University of California, Irvine
| | | | - Venus Meyet
- Department of Psychology, Brigham Young University–Idaho
| | | | | | | | - Don A. Moore
- Haas School of Business, University of California at Berkeley
| | - Rafał Muda
- Faculty of Economics, Maria Curie-Skłodowska University
| | - Gideon Nave
- Marketing Department, The Wharton School of the University of Pennsylvania
| | | | | | - Christian Nunnally
- Department of Computer Science and Software Engineering, Rose-Hulman Institute of Technology
| | - Ana Orlić
- Faculty of Sport and Physical Education, University of Belgrade
| | - Anna Palinkas
- Institute of Psychology, ELTE Eötvös Loránd University
| | - Angelo Panno
- Department of Human Science, European University of Rome
| | | | - Ivana Pedović
- Department of Psychology, Faculty of Philosophy, University of Niš
| | | | | | | | - Boban Petrović
- Laboratory for Research of Individual Differences, Faculty of Philosophy, University of Belgrade
- Institute of Criminological and Sociological Research, Belgrade, Serbia
| | | | | | | | - Danka Purić
- Laboratory for Research of Individual Differences, Faculty of Philosophy, University of Belgrade
- Department of Psychology, Faculty of Philosophy, University of Belgrade
| | - Tiago Ramos
- Department of Psychology, University of Porto
| | | | - Timothy S. Razza
- Department of Psychology and Neuroscience, Nova Southeastern University
| | | | | | - Sean C. Rife
- Department of Psychology, Murray State University
| | - Anna Dalla Rosa
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padova
| | | | - Janos Salamon
- Institute of Psychology, ELTE Eötvös Loránd University
- Doctoral School of Psychology, ELTE Eötvös Loránd University
| | | | | | - Kathleen Schmidt
- School of Psychological and Behavioral Sciences, Southern Illinois University Carbondale
| | | | - Thomas Schultze
- Institute of Psychology, University of Göttingen
- Leibniz Science Campus Primate Cognition, Göttingen, Germany
| | - Stefan Schulz-Hardt
- Institute of Psychology, University of Göttingen
- Leibniz Science Campus Primate Cognition, Göttingen, Germany
| | | | | | - Rachel L. Shubella
- Department of Humanities, Social Sciences, and the Arts, Rose-Hulman Institute of Technology
| | | | - Rúben Silva
- Department of Psychology, University of Porto
| | - Barbara Sioma
- Faculty of Economics, Maria Curie-Skłodowska University
| | - Lauren Skorb
- Psychology and Neuroscience Department, Boston College
| | | | - Sara Steegen
- Psychology and Educational Sciences, University of Leuven
| | - L. A. R. Stein
- Department of Behavioral and Social Sciences, School of Public Health, Brown University
- Department of Psychology, University of Rhode Island
- Rhode Island Training School, Rhode Island Department of Children, Youth and Families
| | | | | | | | | | | | - Peter Szecsi
- Institute of Psychology, ELTE Eötvös Loránd University
| | - Orsolya Szöke
- Institute of Psychology, ELTE Eötvös Loránd University
| | - Attila Szuts
- Institute of Psychology, ELTE Eötvös Loránd University
| | - Manuela Thomae
- MEU - Die Multiversität
- Diploma University of Applied Sciences
| | | | - Carly Tocco
- Department of Psychology, Queens College, City University of New York
| | | | | | - Wolf Vanpaemel
- Psychology and Educational Sciences, University of Leuven
| | | | - Michelangelo Vianello
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padova
| | | | - Maria Vlachou
- Psychology and Educational Sciences, University of Leuven
| | | | | | - Aaron L. Wichman
- Department of Psychological Sciences, Western Kentucky University
| | | | - Daniel Wolf
- Department of Psychology, University of Bamberg
| | | | - David Zealley
- Department of Psychology, Brigham Young University–Idaho
| | - Iris Žeželj
- Laboratory for Research of Individual Differences, Faculty of Philosophy, University of Belgrade
- Department of Psychology, Faculty of Philosophy, University of Belgrade
| | - Mark Zrubka
- Department of Psychology, University of Amsterdam
| | - Brian A. Nosek
- Department of Psychology, University of Virginia
- Center for Open Science, Charlottesville, Virginia
| |
Collapse
|
50
|
Mathur MB, Bart-Plange DJ, Aczel B, Bernstein MH, Ciunci AM, Ebersole CR, Falcão F, Ashbaugh K, Hilliard RA, Jern A, Kellier DJ, Kessinger G, Kolb VS, Kovacs M, Lage CA, Langford EV, Lins S, Manfredi D, Meyet V, Moore DA, Nave G, Nunnally C, Palinkas A, Parks KP, Pessers S, Ramos T, Rudy KH, Salamon J, Shubella RL, Silva R, Steegen S, Stein LAR, Szaszi B, Szecsi P, Tuerlinckx F, Vanpaemel W, Vlachou M, Wiggins BJ, Zealley D, Zrubka M, Frank MC. Many Labs 5: Registered Multisite Replication of the Tempting-Fate Effects in Risen and Gilovich (2008). Advances in Methods and Practices in Psychological Science 2020. [DOI: 10.1177/2515245918785165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Risen and Gilovich (2008) found that subjects believed that “tempting fate” would be punished with ironic bad outcomes (a main effect), and that this effect was magnified when subjects were under cognitive load (an interaction). A previous replication study (Frank & Mathur, 2016) that used an online implementation of the protocol on Amazon Mechanical Turk failed to replicate both the main effect and the interaction. Before this replication was run, the authors of the original study expressed concern that the cognitive-load manipulation may be less effective when implemented online than when implemented in the lab and that subjects recruited online may also respond differently to the specific experimental scenario chosen for the replication. A later, large replication project, Many Labs 2 (Klein et al. 2018), replicated the main effect (though the effect size was smaller than in the original study), but the interaction was not assessed. Attempting to replicate the interaction while addressing the original authors’ concerns regarding the protocol for the first replication study, we developed a new protocol in collaboration with the original authors. We used four university sites ( N = 754) chosen for similarity to the site of the original study to conduct a high-powered, preregistered replication focused primarily on the interaction effect. Results from these sites did not support the interaction or the main effect and were comparable to results obtained at six additional universities that were less similar to the original site. Post hoc analyses did not provide strong evidence for statistical inconsistency between the original study’s estimates and our estimates; that is, the original study’s results would not have been extremely unlikely in the estimated distribution of population effects in our sites. We also collected data from a new Mechanical Turk sample under the first replication study’s protocol, and results were not meaningfully different from those obtained with the new protocol at universities similar to the original site. Secondary analyses failed to support proposed substantive mechanisms for the failure to replicate.
Collapse
Affiliation(s)
| | | | - Balazs Aczel
- Institute of Psychology, ELTE Eötvös Loránd University
| | - Michael H. Bernstein
- Department of Behavioral and Social Sciences, School of Public Health, Brown University
- Department of Psychology, University of Rhode Island
| | | | | | | | - Kayla Ashbaugh
- Department of Biology and Biomedical Engineering, Rose-Hulman Institute of Technology
| | - Rias A. Hilliard
- Department of Humanities, Social Sciences, and the Arts, Rose-Hulman Institute of Technology
| | - Alan Jern
- Department of Humanities, Social Sciences, and the Arts, Rose-Hulman Institute of Technology
| | | | | | | | - Marton Kovacs
- Institute of Psychology, ELTE Eötvös Loránd University
| | - Caio Ambrosio Lage
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro
| | | | - Samuel Lins
- Department of Psychology, University of Porto
| | - Dylan Manfredi
- Marketing Department, The Wharton School of the University of Pennsylvania
| | - Venus Meyet
- Department of Psychology, Brigham Young University–Idaho
| | - Don A. Moore
- Haas School of Business, University of California at Berkeley
| | - Gideon Nave
- Marketing Department, The Wharton School of the University of Pennsylvania
| | - Christian Nunnally
- Department of Computer Science and Software Engineering, Rose-Hulman Institute of Technology
| | - Anna Palinkas
- Institute of Psychology, ELTE Eötvös Loránd University
| | | | | | - Tiago Ramos
- Department of Psychology, University of Porto
| | | | - Janos Salamon
- Institute of Psychology, ELTE Eötvös Loránd University
- Doctoral School of Psychology, ELTE Eötvös Loránd University
| | - Rachel L. Shubella
- Department of Humanities, Social Sciences, and the Arts, Rose-Hulman Institute of Technology
| | - Rúben Silva
- Department of Psychology, University of Porto
| | - Sara Steegen
- Psychology and Educational Sciences, University of Leuven
| | - L. A. R. Stein
- Department of Behavioral and Social Sciences, School of Public Health, Brown University
- Department of Psychology, University of Rhode Island
- Rhode Island Training School, Rhode Island
Department of Children, Youth and Families
| | | | - Peter Szecsi
- Institute of Psychology, ELTE Eötvös Loránd University
| | | | - Wolf Vanpaemel
- Psychology and Educational Sciences, University of Leuven
| | - Maria Vlachou
- Psychology and Educational Sciences, University of Leuven
| | | | - David Zealley
- Department of Psychology, Brigham Young University–Idaho
| | - Mark Zrubka
- Department of Psychology, University of Amsterdam
| | | |
Collapse
|