1
|
Van Veen EB, Boeckhout M, Schlünder I, Boiten JW, Dias V. Joint controllers in large research consortia: a funnel model to distinguish controllers in the sense of the GDPR from other partners in the consortium. Open Res Eur 2024; 2:80. [PMID: 37767227 PMCID: PMC10521071 DOI: 10.12688/openreseurope.14825.1] [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] [Accepted: 02/08/2024] [Indexed: 09/29/2023]
Abstract
Large European research consortia in the health sciences face challenges regarding the governance of personal data collected, generated and/or shared during their collective research. A controller in the sense of the GDPR is the entity which decides about purposes and means of the data processing. Case law of the Court of Justice of the European Union (CJEU) and Guidelines of the European Data Protection Board (EDPB) indicate that all partners in the consortium would be joint controllers. This paper summarises the case law, the Guidelines and literature on joint controllership, gives a brief account of a webinar organised on the issue by Lygature and the MLC Foundation. Participants at the webinar agreed in large majority that it would be extreme if all partners in the consortium would become joint controllers. There was less agreement how to disentangle partners who are controllers of a study from those who are not. In order to disentangle responsibilities, we propose a funnel model with consecutive steps acting as sieves in the funnel. It differentiates between two types of partners: all partners who are involved in shaping the project as a whole versus those specific partners who are more closely involved in a sub-study following from the DoA or the use of the data Platform. If the role of the partner would be comparable to that of an outside advisor, that partner would not be a data controller even though the partner is part of the consortium. We propose further nuances for the disentanglement which takes place in various steps. Uncertainty about formal controllership under the GDPR can stifle collaboration in consortia due to concerns over (shared) responsibility and liability. Data subjects' ability to exercise their right can also be affected by this. The funnel model proposes a way out of this conundrum.
Collapse
|
2
|
Souto C, Aguilar B, Dias V, Pascual E, Rodrigues C, Perez-Rozos A, Sallabanda M, Sallabanda K. Implementation of a Patient Specific QA Protocol for a Novel Dedicated Stereotactic Radiosurgery Linear Accelerator. Int J Radiat Oncol Biol Phys 2023; 117:e720. [PMID: 37786102 DOI: 10.1016/j.ijrobp.2023.06.2228] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To describe the patient specific QA (Quality Assurance) protocol implemented for plan integrity verification, in stereotactic radiosurgery (SRS) and radiotherapy (SRT) treatments performed on a novel dedicated frameless image guided radiosurgery system using conical collimator, and a combination of yoked gimbals to cover near2pi solid angle. Startup and commissioning results obtained for planned vs measured dose distributions with several detectors are presented. MATERIALS/METHODS The patient specific QA protocol includes: A) Review of the approved plan based on AAPM TG 275 report recommendations B) 1D verification using small volume ionization chambers inside an anthropomorphic head phantom C) 2D dose verification of a coronal and sagittal dose plan performed with high resolution 2D Array and respective phantom apparatus D) In-house independent MU (Monitor Unit) calculation using the same formalism of the vendor TPS (Treatment Planning Systems) RayTracing dose-calculation algorithm E) Monte Carlo based secondary dose check & plan QA. A retrospective analysis of the results of the first 15 patients treated is presented, focusing on plan complexity vs QA results. RESULTS The 1D results obtained for the 15 SRS plans were within ±5% for all reported cases, with a mean percent difference of -1,25%, confirming an overall good agreement and, as expected, a partial volume effect in plans with smaller collimators. For the 2D dose verifications, with a 10% dose threshold, gamma passing rates of 97,5% (coronal) and 96,78 (sagittal) with 3% 1mm criteria, 95,1% (coronal) and 94,3% (sagittal) for 2% 1 mm criteria and 90,7% (coronal) and 90,0% (sagittal) for 1% 1mm criteria were obtained. Moreover, the results showed a correlation between lesion volume or number of collimators used with gamma passing rates. All MU verification results were within ±0,3% and provides an efficient risk mitigation approach for this new delivery technique. CONCLUSION The verification results of the first 15 treated SRS plans confirmed point dose and planar measurements in agreement with TPS calculations, with superior results for planes with smaller lesions and fewer collimators. This also represents an integral validation of the image-based alignment system and fine treatment couch movements, as treatments are intrinsically multi-isocentric.
Collapse
Affiliation(s)
- C Souto
- Mercurius Health, Porto Salvo, Portugal; Instituto de Radiocirugía Avanzada, Madrid, Spain
| | - B Aguilar
- Faculdadede Ciênciasda Universidadedo Porto, Porto, Portugal
| | - V Dias
- Mercurius Health, Porto Salvo, Portugal; Instituto de Radiocirugía Avanzada, Madrid, Spain
| | - E Pascual
- Instituto de Radiocirugía Avanzada, Madrid, Spain
| | - C Rodrigues
- Mercurius Health, Porto Salvo, Portugal; Instituto de Radiocirugía Avanzada, Madrid, Spain
| | - A Perez-Rozos
- Instituto de Radiocirugía Avanzada, Madrid, Spain; Servicio Andaluz de Salud, Sevilla, Spain
| | - M Sallabanda
- Instituto de Radiocirugía Avanzada, Madrid, Spain
| | - K Sallabanda
- Instituto de Radiocirugía Avanzada, Madrid, Spain
| |
Collapse
|
3
|
Doetsch JN, Kajantie E, Dias V, Indredavik MS, Devold RK, Teixeira R, Reittu J, Barros H. Record linkage as a vital key player for the COVID-19 syndemic - The call for legal harmonization to overcome research challenges. Int J Popul Data Sci 2023; 8:2131. [PMID: 37670957 PMCID: PMC10476633 DOI: 10.23889/ijpds.v8i1.2131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/07/2023] Open
Abstract
Key messages:
Chronicity and social context influence COVID-19 risk highlighting its syndemic dimension
Record Linkage advances knowledge on COVID-19, associated chronic diseases, and social indicators
Further harmonization of data protection requirements for scientific research may create multilevel public health measures
As a multidimensional tool, it optimizes integrated strategies and fosters solidarity on Health in All Policies (HiAP)
Collapse
Affiliation(s)
- Julia Nadine Doetsch
- EPIUnit – Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, nº135, 4050-600 Porto, Portugal
| | - Eero Kajantie
- Institute for Health and Welfare, Public Health Promotion Unit, Helsinki and Oulu, Finland
- PEDEGO Research Unit, MRC Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU – Norwegian University of Science and Technology, NO-7491 Trondheim, Norway
- Children’s Hospital, Helsinki University Hospital and University of Helsinki, Finland
| | - Vasco Dias
- Institute for Health and Welfare, Public Health Promotion Unit, Helsinki and Oulu, Finland
- PEDEGO Research Unit, MRC Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU – Norwegian University of Science and Technology, NO-7491 Trondheim, Norway
- Children’s Hospital, Helsinki University Hospital and University of Helsinki, Finland
| | - Marit S. Indredavik
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU – Norwegian University of Science and Technology, NO-7491 Trondheim, Norway
| | - Randi Kallar Devold
- Faculty of Medicine and Health Sciences, NTNU – Norwegian University of Science and Technology, NO-7491 Trondheim, Norway
| | - Raquel Teixeira
- EPIUnit – Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, nº135, 4050-600 Porto, Portugal
| | - Jarkko Reittu
- Finnish Institute for Health and Welfare, Legal Services, Helsinki, Finland
- University of Helsinki, Faculty of Law, Finland
| | - Henrique Barros
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto (FMUP), Porto, Portugal
| |
Collapse
|
4
|
Doetsch JN, Dias V, Lopes I, Redinha R, Barros H. Record linkage of routine and cohort data of children in Portugal: challenges and opportunities when using record linkage as a tool for scientific research. Med Law Rev 2023; 31:247-271. [PMID: 36240458 DOI: 10.1093/medlaw/fwac040] [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] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Linking records could serve as a useful tool for scientific research and as a facilitator for local policymaking. This article examines the challenges and opportunities for researchers to lawfully link routinely collected health and education data with cohort data of children when using it as a tool for scientific research in Portugal. Such linking can be lawfully conducted in Portugal if three requirements are met. First, data processing pursues a legitimate purpose, such as scientific research. Secondly, data linking complies with the legal obligations of research entities and researchers, acting as data controllers or processors, and it respects the rights of children as data subjects. Finally, data linking is based on the explicit written consent of those with parental responsibility for the child. So far, the implementation of the General Data Protection Regulation in Portugal has not facilitated record linkage. It is argued that further harmonised implementation of that Regulation across European Union and European Economic Area Member States, establishing a minimum shared denominator for record linkage in scientific research for the common good, including without explicit consent, is needed.
Collapse
Affiliation(s)
- Julia Nadine Doetsch
- EPIUnit-Instituto de Saúde Pública da Universidade do Porto (ISPUP), 4050-600 Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
| | - Vasco Dias
- INESC TEC - Institute for Systems and Computer Engineering, Technology and Science, Campus da Faculdade de Engenharia da Universidade do Porto, 4200-465 Porto, Portugal
| | - Inês Lopes
- Faculdade de Direito da Universidade do Porto (FDUP), 4050-123 Porto, Portugal
- Centro de Investigação Jurídico Económica (CIJE), 4050-123, Porto, Portugal
| | - Regina Redinha
- Faculdade de Direito da Universidade do Porto (FDUP), 4050-123 Porto, Portugal
- Centro de Investigação Jurídico Económica (CIJE), 4050-123, Porto, Portugal
| | - Henrique Barros
- EPIUnit-Instituto de Saúde Pública da Universidade do Porto (ISPUP), 4050-600 Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto (FMUP), Porto, Portugal
| |
Collapse
|
5
|
Ribeiro AI, Dias V, Ribeiro S, Silva JP, Barros H. Geoprivacy in Neighbourhoods and Health Research: A Mini-Review of the Challenges and Best Practices in Epidemiological Studies. Public Health Rev 2022; 43:1605105. [DOI: 10.3389/phrs.2022.1605105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 10/18/2022] [Indexed: 11/13/2022] Open
Abstract
Neighbourhood and health research often relies on personal location data (e.g., home address, daily itineraries), despite the risks of geoprivacy breaches. Thus, geoprivacy is an important emerging topic, contemplated in international regulations such as the General Data Protection Regulation. In this mini-review, we briefly assess the potential risks associated with the usage of personal location data and provide geoprivacy-preserving recommendations to be considered in epidemiological research. Risks include inference of personal information that the individual does not wish to disclose, reverse-identification and security breaches. Various measures should be implemented at different stages of a project (pre-data collection, data processing, data analysis/publication and data sharing) such as informed consent, pseudo-anonymization and geographical methods.
Collapse
|
6
|
Doetsch JN, Dias V, Indredavik MS, Reittu J, Devold RK, Teixeira R, Kajantie E, Barros H. Record linkage of population-based cohort data from minors with national register data: a scoping review and comparative legal analysis of four European countries. Open Res Eur 2021; 1:58. [PMID: 37645179 PMCID: PMC10445839 DOI: 10.12688/openreseurope.13689.2] [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] [Subscribe] [Scholar Register] [Accepted: 09/20/2021] [Indexed: 08/31/2023]
Abstract
Background: The GDPR was implemented to build an overarching framework for personal data protection across the EU/EEA. Linkage of data directly collected from cohort participants, potentially serving as a prominent tool for health research, must respect data protection rules and privacy rights. Our objective was to investigate law possibilities of linking cohort data of minors with routinely collected education and health data comparing EU/EEA member states. Methods: A legal comparative analysis and scoping review was conducted of openly accessible published laws and regulations in EUR-Lex and national law databases on GDPR's implementation in Portugal, Finland, Norway, and the Netherlands and its connected national regulations purposing record linkage for health research that have been implemented up until April 30, 2021. Results: The GDPR does not ensure total uniformity in data protection legislation across member states offering flexibility for national legislation. Exceptions to process personal data, e.g., public interest and scientific research, must be laid down in EU/EEA or national law. Differences in national interpretation caused obstacles in cross-national research and record linkage: Portugal requires written consent and ethical approval; Finland allows linkage mostly without consent through the national Social and Health Data Permit Authority; Norway when based on regional ethics committee's approval and adequate information technology safeguarding confidentiality; the Netherlands mainly bases linkage on the opt-out system and Data Protection Impact Assessment. Conclusions: Though the GDPR is the most important legal framework, national legislation execution matters most when linking cohort data with routinely collected health and education data. As national interpretation varies, legal intervention balancing individual right to informational self-determination and public good is gravely needed for health research. More harmonization across EU/EEA could be helpful but should not be detrimental in those member states which already opened a leeway for registries and research for the public good without explicit consent.
Collapse
Affiliation(s)
- Julia Nadine Doetsch
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, 4050-600, Portugal
- EPIUnit, Instituto de Saúde Pública da, Universidade do Porto (ISPUP), Porto, 4050-600, Portugal
| | - Vasco Dias
- INESC TEC -Institute for Systems and Computer Engineering, Technology and Science, Campus da Faculdade de Engenharia da Universidade do Porto, Porto, 4050-091, Portugal
| | - Marit S. Indredavik
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU – Norwegian University of Science and Technology, Trondheim, NO-7491, Norway
| | - Jarkko Reittu
- Finnish Institute for Health and Welfare, Legal Services, Helsinki, Finland
- University of Helsinki, Faculty of Law, Helsinki, Finland
| | - Randi Kallar Devold
- Faculty of Medicine and Health Sciences, NTNU – Norwegian University of Science and Technology, Trondheim, NO-7491, Norway
| | - Raquel Teixeira
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, 4050-600, Portugal
- EPIUnit, Instituto de Saúde Pública da, Universidade do Porto (ISPUP), Porto, 4050-600, Portugal
| | - Eero Kajantie
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU – Norwegian University of Science and Technology, Trondheim, NO-7491, Norway
- Finnish Institute for Health and Welfare, Population Health Unit, Helsinki and Oulu, Finland
- PEDEGO Research Unit, MRC Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
- Children’s Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Henrique Barros
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, 4050-600, Portugal
- EPIUnit, Instituto de Saúde Pública da, Universidade do Porto (ISPUP), Porto, 4050-600, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto (FMUP), Porto, Portugal
| |
Collapse
|
7
|
Trêpa M, Silveira I, Baggen-Santos R, Loureiro M, Dias V, Cabral S. Sparkling myocardium: a unique contrast pattern in apical hypertrophic cardiomyopathy. Kardiol Pol 2019; 77:233. [DOI: 10.5603/kp.2019.0022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 12/06/2018] [Accepted: 12/11/2018] [Indexed: 11/25/2022]
|
8
|
Trêpa M, Neves I, Salgado M, Carvalheiras G, Dias V. Acute Pericarditis in Crohn's Disease under Pharmacological Immunosuppression: A
Diagnostic and Therapeutic Dilemma. International Journal of Cardiovascular Sciences 2019. [DOI: 10.5935/2359-4802.20190033] [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: 11/20/2022] Open
|
9
|
Monteiro-Soares M, Ribas R, Pereira da Silva C, Bral T, Mota A, Pinheiro Torres S, Morgado A, Couceiro R, Ribeiro R, Dias V, Moreira M, Mourão P, Oliveira MJ, Madureira M, Paixão-Dias V, Dinis-Ribeiro M. Diabetic foot ulcer development risk classifications' validation: A multicentre prospective cohort study. Diabetes Res Clin Pract 2017; 127:105-114. [PMID: 28340359 DOI: 10.1016/j.diabres.2017.02.034] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 02/27/2017] [Indexed: 11/30/2022]
Abstract
AIMS To prospectively validate the existing classifications to stratify subjects with diabetes mellitus (DM) by their risk of diabetic foot ulcer (DFU), in high and low risk settings. METHODS A prospective multicentre cohort study was conducted, including 446 subjects with DM without active DFU followed in the hospital or primary care setting. Demographic, clinical characterization variables, and those included in the classifications were collected at baseline. Subjects were followed for 1year, until DFU or death. RESULTS In our sample, with a mean age of 65years, 52% were male; 32 developed a DFU, 7 required an amputation and 18 died. Differences were found between participants' characteristics and classifications' accuracy according to the setting. The great majority of the variables were associated with higher DFU risk. Globally, classifications were highly and equally valid, positive predictive values (PV) were inferior to 40%, negative PV superior to 90% and area under the receiver operating characteristic curve superior to 0.75. DISCUSSION All the existing classifications are valid to be applied in high risk clinical context and have a very high capacity to categorize as low risk those subjects that will not develop a DFU. Further research is needed in the primary care setting.
Collapse
Affiliation(s)
- M Monteiro-Soares
- MEDCIDES/CINTESIS - Departamento de Medicina da Comunidade Informação e Decisão em Saúde, Oporto University Faculty of Medicine, Oporto U753-FCT, Portugal.
| | - R Ribas
- Unidade de Saúde Familiar Aquae Flaviae, Chaves, Portugal
| | | | - T Bral
- Unidade de Saúde Familiar Aquae Flaviae, Chaves, Portugal
| | - A Mota
- Unidade de Saúde Familiar Aquae Flaviae, Chaves, Portugal
| | | | - A Morgado
- Unidade de Saúde Familiar Aquae Flaviae, Chaves, Portugal
| | - R Couceiro
- Unidade de Saúde Familiar Aquae Flaviae, Chaves, Portugal
| | - R Ribeiro
- Unidade de Saúde Familiar Aquae Flaviae, Chaves, Portugal
| | - V Dias
- Unidade de Saúde Familiar Santo André de Canidelo, Vila Nova de Gaia, Portugal
| | - M Moreira
- Unidade de Saúde Familiar Santo André de Canidelo, Vila Nova de Gaia, Portugal
| | - P Mourão
- Unidade de Saúde Familiar Santo André de Canidelo, Vila Nova de Gaia, Portugal
| | - M J Oliveira
- Diabetic Foot Clinic, Endocrinology, Diabetes and Metabolism Department, Centro Hospitalar de Vila Nova de Gaia/Espinho EPE, Vila Nova de Gaia, Portugal
| | - M Madureira
- Diabetic Foot Clinic, Internal Medicine Department, Centro Hospitalar de Vila Nova de Gaia/Espinho EPE, Vila Nova de Gaia, Portugal
| | - V Paixão-Dias
- Diabetic Foot Clinic, Internal Medicine Department, Centro Hospitalar de Vila Nova de Gaia/Espinho EPE, Vila Nova de Gaia, Portugal
| | - M Dinis-Ribeiro
- MEDCIDES/CINTESIS - Departamento de Medicina da Comunidade Informação e Decisão em Saúde, Oporto University Faculty of Medicine, Oporto U753-FCT, Portugal
| |
Collapse
|
10
|
Dinis P, Nunes P, Marconi L, Furriel F, Parada B, Moreira P, Figueiredo A, Bastos C, Roseiro A, Dias V, Rolo F, Alves R, Mota A. Small Kidneys for Large Recipients: Does Size Matter in Renal Transplantation? Transplant Proc 2015; 47:920-5. [DOI: 10.1016/j.transproceed.2015.03.035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
11
|
Luz A, Santos M, Magalhães R, Silveira J, Cabral S, Dias V, Oliveira F, Pereira S, Leite-Moreira A, Carvalho H, Torres S. Lack of Benefit of Ischemic Postconditioning After Routine Thrombus Aspiration During Reperfusion. J Cardiovasc Pharmacol Ther 2015; 20:523-31. [DOI: 10.1177/1074248415578171] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [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] [Received: 11/14/2014] [Accepted: 02/02/2015] [Indexed: 11/16/2022]
Abstract
Objectives: The underutilization of manual thrombus aspiration (MTA) may have reduced the benefits of ischemic postconditioning (PostCon), as it reduces thrombus embolization. We aimed to assess the benefits of PostCon in patients with ST-segment elevation myocardial infarction (STEMI) after the systematic utilization of MTA. Methods: A total of 87 patients were enrolled in a prospective, randomized trial (43 PostCon and 44 controls). After MTA, PostCon was performed on the treatment group by applying 4 cycles of alternate reperfusion and reocclusion (60 seconds each) using the angioplasty balloon. The primary end point was infarct size assessed by the area under the curve (AUC) of troponin T (TnT) activity. The secondary end points were left ventricle ejection fraction (LVEF) and major cardiac events (new myocardial infarction or cardiac death) both at discharge and at follow-up. Results: The AUC for TnT was no different with respect to study arms (median [interquartile range]): PostCon = 8.9 (10.6) versus control = 8.2 (10.6), P = .68. Left ventricle ejection fraction improved from in-hospital to follow-up (9 ± 3 months) for the entire cohort (46.3% ± 7.3% vs 52.2% ± 10.7%, P < .001), with no differences between PostCon and controls (51.6% ± 9.5% vs 52.7% ± 11.9%, P = .89); major cardiac events at 14 ± 4 months of follow-up were also no different (PostCon = 1.0 (2.3%) vs control = 0, P = .49). Conclusion: In patients with STEMI treated with MTA, PostCon offered no benefits to infarct size, LVEF, or major cardiac events.
Collapse
Affiliation(s)
- André Luz
- Cardiology Department, Porto Hospital Centre, Porto, Portugal
| | - Mário Santos
- Cardiology Department, Porto Hospital Centre, Porto, Portugal
- Department of Physiology and Cardio-Thoracic Surgery, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Rui Magalhães
- Institute of Biomedical Sciences “Abel Salazar,” University of Porto, Porto, Portugal
| | - João Silveira
- Cardiology Department, Porto Hospital Centre, Porto, Portugal
- Institute of Biomedical Sciences “Abel Salazar,” University of Porto, Porto, Portugal
| | - Sofia Cabral
- Cardiology Department, Porto Hospital Centre, Porto, Portugal
| | - Vasco Dias
- Cardiology Department, Porto Hospital Centre, Porto, Portugal
| | | | - Sousa Pereira
- Cardiology Department, Porto Hospital Centre, Porto, Portugal
| | - Adelino Leite-Moreira
- Department of Physiology and Cardio-Thoracic Surgery, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Henrique Carvalho
- Cardiology Department, Porto Hospital Centre, Porto, Portugal
- Institute of Biomedical Sciences “Abel Salazar,” University of Porto, Porto, Portugal
| | - Severo Torres
- Cardiology Department, Porto Hospital Centre, Porto, Portugal
- Institute of Biomedical Sciences “Abel Salazar,” University of Porto, Porto, Portugal
| |
Collapse
|
12
|
Rodrigues P, Monteiro M, Palma P, Sousa-Pereira L, Cabral S, Oliveira F, Dias V, Torres S. Body position and oxygenation: An intriguing relationship. Rev Port Cardiol 2014; 33:385.e1-5. [PMID: 25001164 DOI: 10.1016/j.repc.2014.01.016] [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: 08/27/2013] [Revised: 01/01/2014] [Accepted: 01/07/2014] [Indexed: 10/25/2022] Open
Abstract
Dyspnea and hypoxemia are among the most common symptoms and signs that need to be assessed in clinical practice. This case illustrates how simple steps in history taking and physical examination can be crucial for diagnosis. We present a patient with intermittent hypoxemia, initially attributed to a pulmonary infection. However, the hypoxemia persisted even after successful treatment of the infection. Computed tomography angiography of the chest and ventilation/perfusion lung scan excluded pulmonary embolism. We then observed that the hypoxemia and dyspnea were triggered by orthostatism. An echocardiogram with a bubble test showed a patent foramen ovale, with a right-to-left shunt, without pulmonary hypertension. After percutaneous closure of the foramen ovale, the symptoms completely resolved. This is a case of platypnea-orthodeoxia syndrome, which is usually associated with patent foramen ovale or atrial septal defect and is typically observed in the elderly. The features and causes of this curious syndrome are discussed.
Collapse
Affiliation(s)
| | - Marta Monteiro
- Internal Medicine Departments, Centro Hospitalar do Porto, Porto, Portugal
| | - Paulo Palma
- Cardiology, Centro Hospitalar do Porto, Porto, Portugal
| | | | - Sofia Cabral
- Cardiology, Centro Hospitalar do Porto, Porto, Portugal
| | | | - Vasco Dias
- Cardiology, Centro Hospitalar do Porto, Porto, Portugal
| | - Severo Torres
- Cardiology, Centro Hospitalar do Porto, Porto, Portugal
| |
Collapse
|
13
|
Antunes N, Dias V, Sá I, Cabral S, Vieira P, Torres S. Giant left ventricular pseudoaneurysm: A silent catastrophe. Revista Portuguesa de Cardiologia (English Edition) 2012. [DOI: 10.1016/j.repce.2012.09.009] [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] Open
|
14
|
Antunes N, Dias V, Sá I, Cabral S, Vieira P, Torres S. [Giant left ventricular pseudoaneurysm: a silent catastrophe]. Rev Port Cardiol 2012; 31:757-9. [PMID: 23040869 DOI: 10.1016/j.repc.2012.05.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2012] [Accepted: 05/03/2012] [Indexed: 10/27/2022] Open
Affiliation(s)
- Nuno Antunes
- Serviço de Cardiologia, Centro Hospitalar do Porto, Porto, Portugal.
| | | | | | | | | | | |
Collapse
|
15
|
Santos M, Dias V, Meireles A, Gomes C, Luz A, Mendes D, Caiado L, Carvalho H, Cabral S, Torres S. Hyponatremia--an unusual trigger of Takotsubo cardiomyopathy. Rev Port Cardiol 2012; 30:845-8. [PMID: 22030327 DOI: 10.1016/j.repc.2011.09.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2011] [Accepted: 05/10/2011] [Indexed: 11/20/2022] Open
Abstract
Takotsubo cardiomyopathy is an acute cardiac entity with clinical manifestations similar to myocardial infarction, accounting for 1-2% of acute coronary syndrome admissions. Its underlying pathophysiology is not yet well established. It is usually associated with acute physical or emotional stress, but the list of potential triggers has grown as the condition attracts the attention of the medical community. In order to diagnose the condition correctly and to gain new insights into it, we need to know its potential triggers as well as its clinical presentation and diagnostic criteria. We report a case of takotsubo cardiomyopathy triggered by hyponatremia.
Collapse
Affiliation(s)
- Mário Santos
- Serviço de Cardiologia, Hospital Santo António, Centro Hospitalar do Porto, Porto, Portugal.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Santos M, Dias V, Meireles A, Gomes C, Luz A, Mendes D, Caiado L, Carvalho H, Cabral S, Torres S. Hyponatremia – an unusual trigger of Takotsubo cardiomyopathy. Revista Portuguesa de Cardiologia (English Edition) 2011. [DOI: 10.1016/j.repce.2011.11.003] [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] Open
|
17
|
Dias V, Cabral S, Anjo D, Vieira M, Antunes N, Carvalheiras G, Gomes C, Meireles A, Mendonça T, Torres S. Successful management of Listeria monocytogenes pericarditis: case report and review of the literature. Acta Cardiol 2011; 66:537-8. [PMID: 21894816 DOI: 10.1080/ac.66.4.2126608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Listeria monocytogenes, although an uncommon cause of illness in the general population, is feared principally because of the morbidity and mortality associated with CNS infections. Cardiovascular involvement with L. monocytogenes is very rare, and has been limited to endocarditis. We describe a case of Listeria pericarditis, which occurred in a 60-year-old man with Child-Pugh B cirrhosis who presented to the emergency department with asthenia, anorexia, and respiratory distress. The echocardiogram showed severe pericardial effusion and after pericardiocentesis, L. monocytogenes was isolated in the culture of pericardial fluid. After surgical pericardiectomy with draining of the pericardial effusion and antibiotic treatment with ampicillin, the patient experienced a slow, but full recovery. Documentation of L. monocytogenes pericarditis is an extremely rare entity with very scarce reports in medical literature, and is usually associated with a very poor prognosis. A case report is presented together with a review of the literature.
Collapse
Affiliation(s)
- Vasco Dias
- Departments of Cardiology and Internal - Oporto Hospital Centre, Porto, Portugal
| | - Sofia Cabral
- Departments of Cardiology and Internal - Oporto Hospital Centre, Porto, Portugal
| | - Diana Anjo
- Departments of Cardiology and Internal - Oporto Hospital Centre, Porto, Portugal
| | - Miguel Vieira
- Departments of Cardiology and Internal - Oporto Hospital Centre, Porto, Portugal
| | - Nuno Antunes
- Departments of Cardiology and Internal - Oporto Hospital Centre, Porto, Portugal
| | - Graziela Carvalheiras
- Departments of Medicine, Santo António General Hospital - Oporto Hospital Centre, Porto, Portugal
| | - Catarina Gomes
- Departments of Cardiology and Internal - Oporto Hospital Centre, Porto, Portugal
| | - Ana Meireles
- Departments of Cardiology and Internal - Oporto Hospital Centre, Porto, Portugal
| | - Teresa Mendonça
- Departments of Medicine, Santo António General Hospital - Oporto Hospital Centre, Porto, Portugal
| | - Severo Torres
- Departments of Cardiology and Internal - Oporto Hospital Centre, Porto, Portugal
| |
Collapse
|
18
|
Furriel F, Parada B, Campos L, Moreira P, Castelo D, Dias V, Mota A. Pretransplantation overweight and obesity: does it really affect kidney transplantation outcomes? Transplant Proc 2011; 43:95-9. [PMID: 21335163 DOI: 10.1016/j.transproceed.2010.12.027] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE The objective of this study was to compare kidney transplant outcomes among pretransplantation overweight and obese patients with those with normal weight. METHODS We performed a retrospective analysis of a sample of 448 kidney transplantations performed between 1984 and 2008 in our institution. We compared of initial graft function, postoperative length of stay, surgical complications, acute and chronic rejection rates, creatinine serum levels, and patient and graft survival, between normal weight, overweight, and obesity groups. RESULTS Overweight was detected on 28.3% of the patients, and obesity on 5.8%. A male predominance was noted among the normal and overweight groups, and the opposite in the obesity group: namely, male:female ratios of 2.17:1, 3.37:1, and 0.37:1, respectively. Mean age was lower in the normal weight group (41.51 years) versus 48.36 and 46.08 years in the overweight and obesity groups, respectively. Compared with the normal weight group, recipient creatinine serum levels between 1 and 6 months were higher among the obese group, but not the overweight one. Both overweight and obese groups showed significantly higher incidences of delayed graft function (26.8% and 26.9%, respectively) versus 16.9% in the normal weight group (P = .028) and longer surgery times, ie, greater than 3 hours in 22.8% and 42.3%, respectively, versus 20.7% of the normal weight patients. Surgical complication rates were higher in both non-normal weight groups (17.3% and 26.9% vs 15.9% in the normal weight group), especially lymphocele formation and wound dehiscence (P = .031 and P < .0005, respectively). However, no differences were detected concerning postoperative length of stay, graft loss, acute or chronic rejection, and graft or patient survival. CONCLUSION Pretransplantation overweight and obesity did not seem to significantly affect kidney transplantation in the medium and long terms. The early posttransplantation period can however be disturbed by an increased incidence of surgical complications and reversible degradation of some graft functional parameters.
Collapse
Affiliation(s)
- F Furriel
- Department of Urology and Renal Transplantation, Coimbra University Hospital, Coimbra, Portugal.
| | | | | | | | | | | | | |
Collapse
|
19
|
Dias V, Cabral S, Gomes C, Antunes N, Sousa C, Vieira M, Meireles A, Oliveira F, Torres S. Intramyocardial dissecting haematoma: a rare complication of acute myocardial infarction. ACTA ACUST UNITED AC 2009; 10:585-7. [PMID: 19339261 DOI: 10.1093/ejechocard/jep027] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Intramyocardial dissecting haematoma (IDH) is a rare complication of myocardial infarction, with very scarce reports in medical literature. Before the advent of non-invasive imaging techniques, the diagnosis of IDH was only made by necropsy. It can develop in the left ventricular free wall, the right ventricle, or the interventricular septum. We present a case of a patient with an IDH after acute anterolateral myocardial infarction, focusing on the utility of echocardiography in the diagnosis and follow-up of this unusual complication. By this imaging modality, it was possible to see the various acoustic densities of the progressive clotting of the intramyocardial haematoma, its extension through the haemorrhagic dissection, as well as its independency in relation to ventricular cavities and extracardiac space by confirming intact epicardial and endocardial layers. Based on this report, we believe that serial two-dimensional echocardiography, added, when necessary, by the use of contrast agents is the non-invasive method ideally suited to confirm the diagnosis and monitor its evolution at the patient's bedside.
Collapse
Affiliation(s)
- Vasco Dias
- Cardiology Department, Santo António General Hospital, Oporto Hospital Center, Largo Prof. Abel Salazar, 4099-001 Porto, Portugal.
| | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Dias V, Cabral S, Meireles A, Gomes C, Antunes N, Vieira M, Caiado L, Torres S. Stunned Myocardium following Ischemic Stroke. Cardiology 2009; 113:287-90. [DOI: 10.1159/000205963] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2008] [Accepted: 12/16/2008] [Indexed: 11/19/2022]
|
21
|
Dias V, Meachem S, Rajpert-De Meyts E, McLachlan R, Manuelpillai U, Loveland KL. Activin receptor subunits in normal and dysfunctional adult human testis. Hum Reprod 2007; 23:412-20. [PMID: 18077314 DOI: 10.1093/humrep/dem343] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The cellular sites of activin action and its regulation in the normal and dysfunctional adult human testis are unknown. METHODS Activin type I (ALK2 and ALK4) and type II (ActRIIA and ActRIIB) receptors were detected using immunohistochemistry on Bouins fixed sections of normal, carcinoma in situ (CIS), seminoma, non-seminoma and gonadotropin-deprived human testis. ActRIIA mRNA was localized by in situ hybridization. RESULTS ALK2, ALK4 and ActRIIB proteins were observed in Sertoli cells, spermatogonia and some spermatocytes within normal and gonadotropin-suppressed adult human testis; all three receptor subunits were also detected in CIS, seminoma and non-seminoma cells. ActRIIA immunoreactivity was faint to absent in the normal testis and in CIS and non-seminoma cells, whereas some seminoma cells displayed a strong signal. Also in contrast to the normal testis, a majority of spermatogonia and Sertoli cells in gonadotropin-deprived samples exhibited a strong ActRIIA immunohistochemical and in situ hybridization signal. CONCLUSIONS Spermatogonia and Sertoli cells appear as the primary targets of activin action in the adult human testis. Changes in testicular function associated with altered hormone levels may enhance ActRIIA mRNA and protein synthesis, thus modifying signalling by activin or other TGFbeta ligands within specific cells of the seminiferous epithelium.
Collapse
Affiliation(s)
- V Dias
- Monash Institute of Medical Research, 27-31 Wright Street Clayton, Victoria 3168, Australia
| | | | | | | | | | | |
Collapse
|
22
|
Nunes P, Mota A, Figueiredo A, Macário F, Rolo F, Dias V, Parada B. Efficacy of Renal Preservation: Comparative Study of Celsior and University of Wisconsin Solutions. Transplant Proc 2007; 39:2478-9. [DOI: 10.1016/j.transproceed.2007.07.024] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
23
|
Loveland KL, Dias V, Meachem S, Rajpert-De Meyts E. The transforming growth factor-? superfamily in early spermatogenesis: potential relevance to testicular dysgenesis. ACTA ACUST UNITED AC 2007; 30:377-84; discussion 384. [PMID: 17705810 DOI: 10.1111/j.1365-2605.2007.00785.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Regulated transforming growth factor-beta (TGFbeta) superfamily signalling is an integral part of normal testicular development and the processes that enable the production of fertile sperm. Through shared utilization of receptors, signal transduction components and inhibitors, many ligands in this family exhibit functional overlaps; this facet of their function is critical to understand because these ligands are often co-expressed and, hence, they may compete with or compensate for one another, depending on the specific cellular context. This review describes particular germ cell maturation steps governed by bone morphogenetic proteins, glial cell line-derived neurotrophic factor and activins, focusing on data predominantly from rodent studies that implicate activin and other family members in modulation of gonocyte and spermatogonial stem cell development. We also review knowledge of the TGFbeta superfamily signalling components in the human testis, exploring their potential impact on the processes associated with disrupted gonocyte development and an enhanced risk of testicular cancer.
Collapse
Affiliation(s)
- K L Loveland
- Monash Institute of Medical Research, Monash University, Clayton, Vic., Australia.
| | | | | | | |
Collapse
|
24
|
Nunes P, Parada B, Figueiredo A, Roseiro A, Dias V, Bastos C, Rolo F, Mota A. PD-09.03. Urology 2006. [DOI: 10.1016/j.urology.2006.08.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
25
|
Parada B, Figueiredo A, Nunes P, Bastos C, Macário F, Roseiro A, Dias V, Rolo F, Mota A. Pediatric renal transplantation: comparative study with renal transplantation in the adult population. Transplant Proc 2006; 37:2771-4. [PMID: 16182806 DOI: 10.1016/j.transproceed.2005.05.046] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To retrospectively review our experience with pediatric renal transplantation and to compare the results with the adult population. PATIENTS AND METHODS Between January 1981 and August 2003, 74 renal transplants were performed in patients < or =18 years at the time of the transplant--the pediatric group versus 1153 patients in the adult group. We analyzed various risk factors for actuarial kidney graft and patient survivals using the Kaplan-Meier method. RESULTS Median ages were 13.8 +/- 3.5 and 42.6 +/- 2.4 years, respectively. There was no statistically significant difference in the human leukocyte antigen matching or immunosuppression. There was, however, a younger donor age and shorter ischemia time in the pediatric group. Overall, kidney transplant survival rates for patients < or =18 years at 1, 2, 5, and 10 years were 94.4%, 91.3%, 70.6%, and 58.2%, respectively, with no significant difference for patients older than 18 (91.2%, 89.3%, 78.8%, 60.5%, P = .4325). There was a significantly decreased graft survival in the adult group at 10 years when the donor age was over 60 years and when the ischemia time was > or =20 hours. The incidence of delayed graft function and the creatinine levels of functioning grafts did not differ between the two groups. During the follow-up, acute rejections were more frequent in the younger group. Patient survival in the pediatric group at 1, 2, 5, and 10 years was 98.6%, 98.8%, 98.6%, and 90.3%, respectively, significantly lower in the adult group (95.3%, 94.0%, 87.9%, 76.8%, P < .02). CONCLUSIONS Renal transplantation may be successfully performed in the pediatric patients with end-stage renal disease. Overall graft survival at 10 years did not differ significantly between the two groups. There is a higher incidence of acute rejections but longer patient survival in the pediatric population.
Collapse
Affiliation(s)
- B Parada
- Department of Urology and Renal Transplantation, University Hospital of Coimbra, Coimbra, Portugal.
| | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Hoag G, Dias V. Mo-P5:326 Apolipoprotein B and non-HDL-cholesterol assessments in different at risk categories: A community based analysis. ATHEROSCLEROSIS SUPP 2006. [DOI: 10.1016/s1567-5688(06)80458-7] [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: 11/27/2022]
|
27
|
Gleeson PA, Dias V. N-linked oligosaccharides of the murine transferrin receptor from a plasmacytoma cell line. Comparison with total cellular N-glycans. Biochim Biophys Acta 1990; 1036:47-54. [PMID: 2223825 DOI: 10.1016/0304-4165(90)90212-f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The N-linked oligosaccharides synthesised by the murine plasmacytoma cell line NS-1 have been analysed by lectin affinity chromatography on columns of immobilised concanavalin A (Con A), Lens culinaris (lentil), Ricinus communis agglutinin (RCA) and leuko-phytohemagglutinin (L-PHA). The majority of complex N-glycans in this transformed cell line were branched structures with only a low level of biantennary complex chains detected. The analysis showed the major complex N-glycan fraction consisted of a minimum sialylated triantennary structure. [3H]Mannose-labelled transferrin receptor was isolated from NS-1 cells by immunoprecipitation followed by electroelution from SDS polyacrylamide gels. The isolated receptor was digested with Pronase and the 3H-labelled glycopeptides analysed by lectin affinity chromatography. Analysis by Con A-Sepharose indicated that approx. 50% of the labelled glycopeptides were branched complex N-glycans (unbound fraction) while the remainder were oligomannose structures (strongly bound). The presence of tri and/or tetraantennary structures in the Con A unbound fraction was further suggested by the interaction of 61% of the fraction with L-PHA. The lectin profiles obtained for the complex N-glycans of the transferrin receptor glycopeptides were similar to those for the total cellular glycopeptides of NS-1 cells. Reverse-phase HPLC analysis of tryptic glycopeptides of the isolated [3H]mannose-labelled transferrin receptor gave three 3H-labelled peaks, indicating that all three potential N-glycosylation sites on the receptor are utilised. The Con A-Sepharose profiles of the three fractions indicated the presence of branched complex N-glycans and high mannose chains at each site. The profiles of two of the tryptic glycopeptide fractions were very similar, while the third had a higher content of oligomannose oligosaccharides.
Collapse
Affiliation(s)
- P A Gleeson
- Department of Pathology and Immunology, Monash University Medical School, Melbourne, Australia
| | | |
Collapse
|
28
|
Parsons HG, Thirsk JE, Frohlich J, Dias V, Minuk GY. Effect of cyclosporin A on serum lipids in primary biliary cirrhosis patients. CLIN INVEST MED 1989; 12:386-91. [PMID: 2612091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Hyperlipidemia is a common complication of PBC. Ten patients with serologically and histologically defined PBC were randomized to receive either oral cyclosporin A (CyA) or placebo for one year. Fasting blood samples were obtained from subjects at the beginning, and following one year of treatment, for plasma lipids, apolipoproteins AI (apo AI) and B (apo B), and lecithin-cholesterol acyltransferase (LCAT) activity. On entry to the study there were no significant differences between groups for serum concentrations of total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), free cholesterol (FC), total phospholipids (TPL), apo AI, apo B and LCAT activity. Compared to normal laboratory values, baseline TC was elevated in 5/10, LDL-C in 5/10, TPL in 6/10, while LCAT activity was decreased in 8/10 patients. The percent change after one year for CyA group vs the placebo group are as follows: total cholesterol, -22 vs -8%; LDL cholesterol -33 vs -25%; free cholesterol, -39 vs -14%; total phospholipids, -46 vs -23%; and LCAT activity, +/- 236 vs +/- 43%. The decrease in TC, LDL-C, FC, TPL with increase in LCAT activity suggests that CyA administration is associated with improvement in the lipid abnormalities of PBC.
Collapse
Affiliation(s)
- H G Parsons
- Faculty of Medicine, University of Calgary, Alberta
| | | | | | | | | |
Collapse
|
29
|
Crow RS, Prineas RJ, Dias V, Taylor HL, Jacobs D, Blackburn H. Ventricular premature beats in a population sample. Frequency and associations with coronary risk characteristics. Circulation 1975; 52:III211-5. [PMID: 52417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
In a large epidemiological survey, 10,880 men aged 35 to 57 years were screened for ectopic ventricular activity and estimated risk of future coronary heart disease death. A 2-minute lead I electrocardiogram (ECG) was recorded for each man, together with measurement of serum cholesterol, blood pressure, and the number of cigarettes currently smoked. Ventricular premature beats (VPB) occurred in 540 (4.96%) men; of these 459 (4.21%) were uniform, while complex forms were detected in only 7/1000 men. VPB occurring with a frequency of greater than or equal to 10 in the 2-min recording were also rare, occurring in 9/1000 men. No relation was found between the frequency of simple or complex VPB and estimated coronary risk status or between the prevalence of VPB and the individual risk factors of diastolic blood pressure, cholesterol, or cigarette smoking. There was, however, a strong positive association between VPB and the level of systolic blood pressure, and between VPB and increasing age. The lack of association between VPB and overall coronary risk status indicates that myocardial "ischemic" changes in high-risk men may not have progressed sufficiently to alter ventricular excitability or to increase the frequency of VPB.
Collapse
|