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Mattoso AP, Cunha S, Aguiar J, Duarte A, Lemos H. Valorization of Water Treatment Sludge for Applications in the Construction Industry: A Review. Materials (Basel) 2024; 17:1824. [PMID: 38673180 PMCID: PMC11051011 DOI: 10.3390/ma17081824] [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] [Received: 03/19/2024] [Revised: 04/08/2024] [Accepted: 04/12/2024] [Indexed: 04/28/2024]
Abstract
To address the growing global water demand, it is imperative to implement advanced treatment systems and sustainable alternatives for managing the large amount of waste generated during the water purification process, known as water treatment sludge (WTS). Worldwide, researchers and companies are exploring alternatives and methods for the valorization of WTS as a raw material in other processes. It is urgent that all productive sectors, which contribute significantly to greenhouse gas emissions, adopt this management principle to ensure more sustainable production, contributing to the global goal of climate neutrality. Notably, in civil construction, incorporating WTS as a supplementary cementitious material (SCM) shows great promise, considering that the industrial waste currently used for this purpose is increasingly restricted. The use of WTS as a raw material in the cement industry not only contributes to the reduction of the carbon footprint, but also reduces the high waste load still disposed of in landfills. The emerging applications for WTP sludge are reviewed, with emphasis on its valorization in the civil construction as an SCM. The main characteristics of this waste and their impacts on the environment are also addressed.
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Affiliation(s)
- Ana Paula Mattoso
- CTAC—Centre for Territory, Environment and Construction, University of Minho, Campus of Azurém, 4800-058 Guimarães, Portugal; (A.P.M.); (S.C.); (A.D.)
| | - Sandra Cunha
- CTAC—Centre for Territory, Environment and Construction, University of Minho, Campus of Azurém, 4800-058 Guimarães, Portugal; (A.P.M.); (S.C.); (A.D.)
| | - José Aguiar
- CTAC—Centre for Territory, Environment and Construction, University of Minho, Campus of Azurém, 4800-058 Guimarães, Portugal; (A.P.M.); (S.C.); (A.D.)
| | - António Duarte
- CTAC—Centre for Territory, Environment and Construction, University of Minho, Campus of Azurém, 4800-058 Guimarães, Portugal; (A.P.M.); (S.C.); (A.D.)
| | - Helena Lemos
- Águas do Norte, S.A., Dom Pedro de Castro, 5000-669 Vila Real, Portugal;
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Maiorano F, Duarte A, Lopes A, Amorim P, Martins C, Pedro LM. Single Branch Endovascular Aortic Repair Procedure for an Abdominal Aortic Aneurysm in a Patient With Horseshoe Kidney: A Case Report. EJVES Vasc Forum 2024; 61:99-103. [PMID: 38560760 PMCID: PMC10979053 DOI: 10.1016/j.ejvsvf.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 01/30/2024] [Accepted: 02/26/2024] [Indexed: 04/04/2024] Open
Abstract
Introduction Horseshoe kidney (HK) is an anatomical variant characterised by abnormalities in the position, rotation, and vascular supply of the kidney, with functioning renal masses on both sides of the vertebral column fused together at the isthmus. Due to the altered pattern of kidney vasculature, endovascular aortic repair for aortic abdominal aneurysm (AAA) in the presence of HK requires vascular anatomy specific planning. Report A 68 year old male, with multiple comorbidities, presented with an asymptomatic AAA and HK. The kidney vasculature was characterised by the presence of three arteries: two arising laterally at the same level and a third polar artery arising from below. The polar artery was 6 mm in diameter and larger than the other two; therefore, in order to preserve this artery, a custom-made device with a single side branch was implanted below the main renal arteries. A balloon expandable covered stent was used to complete the side branch into the polar renal artery. The follow-up computed tomography angiography revealed a successful outcome, with total aneurysm exclusion, branched graft patency, no endoleak, and unchanged renal function. Discussion This case report shows a possible surgical solution for a case of HK with AAA and the importance of accurate endovascular planning. Large polar arteries, if present, need to be preserved, and custom-made devices in the modern endovascular era permit that. This approach could represent the best option for complicated patients.
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Affiliation(s)
- Francesco Maiorano
- Department of Vascular Surgery, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - António Duarte
- Department of Vascular Surgery, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
- Faculty of Medicine, University of Lisbon, Lisbon, Portugal
- Lisbon Academic Medical Center, Lisbon, Portugal
| | - Alice Lopes
- Department of Vascular Surgery, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
- Faculty of Medicine, University of Lisbon, Lisbon, Portugal
- Lisbon Academic Medical Center, Lisbon, Portugal
| | - Pedro Amorim
- Department of Vascular Surgery, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
- Lisbon Academic Medical Center, Lisbon, Portugal
| | - Carlos Martins
- Department of Vascular Surgery, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
- Lisbon Academic Medical Center, Lisbon, Portugal
| | - Luís Mendes Pedro
- Department of Vascular Surgery, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
- Faculty of Medicine, University of Lisbon, Lisbon, Portugal
- Lisbon Academic Medical Center, Lisbon, Portugal
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Valente PCLG, Peleteiro MC, Dias MJ, Vicente G, Pomba C, Duarte A, Correia J. Multiple myeloma in dogs: Use of the cell block technique as a new diagnostic tool. Vet Clin Pathol 2024; 53:93-98. [PMID: 38240087 DOI: 10.1111/vcp.13320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 10/04/2023] [Accepted: 11/01/2023] [Indexed: 03/14/2024]
Abstract
BACKGROUND The diagnosis of multiple myeloma (MM) in dogs may be challenging and complex. The cell blocks are a diagnostic technique that allows the characterization of neoplastic cells and, therefore, might help in the diagnosis of atypical MM. OBJECTIVE The objective of the present work is to describe three clinical cases in which the cell blocks and immunohistochemistry contributed to the definitive diagnosis of canine MM. METHODS Three dogs, one female and two males, with different clinical signs, were presented for consultation with anemia, hyperproteinemia with monoclonal gammopathy, and the presence of plasmacytosis in the bone marrow. Cytologic analysis of the spleen was performed in two dogs and was suggestive of the presence of lymphocytes or plasma cells of a neoplastic nature in one of the cases and plasma cell hyperplasia associated with extramedullary hematopoiesis in the other. Given the hypotheses of lymphoid neoplasms with a plasma cell phenotype, cell blocks from aspiration punctures were performed for immunohistochemical analysis with anti-CD3, CD20, CD79αcy, PAX5, and MUM1 antibodies. RESULTS The results revealed positive staining for MUM1 in 80% of the cells in the spleen cell block and for CD20 and MUM1 in 70% of the cells in the bone marrow cell blocks, with negative staining for the other antibodies. The immunophenotyping results allowed the diagnosis of MM in the three cases and excluded other lymphoid neoplasms. CONCLUSIONS This work reinforces the importance of using cell blocks in the diagnosis of neoplasms by demonstrating their potential to aid the diagnosis of MM.
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Affiliation(s)
- Pâmela Cristina Lopes Gurgel Valente
- Faculty of Veterinary Medicine, Centre for Interdisciplinary Research in Animal Health (CIISA), University of Lisbon, Lisbon, Portugal
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), Lisbon, Portugal
- Faculty of Veterinary Medicine, Veterinary Teaching Hospital, University of Lisbon, Lisbon, Portugal
| | - Maria Conceição Peleteiro
- Faculty of Veterinary Medicine, Centre for Interdisciplinary Research in Animal Health (CIISA), University of Lisbon, Lisbon, Portugal
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), Lisbon, Portugal
| | - Maria Joana Dias
- Faculty of Veterinary Medicine, Centre for Interdisciplinary Research in Animal Health (CIISA), University of Lisbon, Lisbon, Portugal
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), Lisbon, Portugal
- Faculty of Veterinary Medicine, Veterinary Teaching Hospital, University of Lisbon, Lisbon, Portugal
| | - Gonçalo Vicente
- Faculty of Veterinary Medicine, Centre for Interdisciplinary Research in Animal Health (CIISA), University of Lisbon, Lisbon, Portugal
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), Lisbon, Portugal
- Faculty of Veterinary Medicine, Veterinary Teaching Hospital, University of Lisbon, Lisbon, Portugal
| | - Constança Pomba
- Faculty of Veterinary Medicine, Centre for Interdisciplinary Research in Animal Health (CIISA), University of Lisbon, Lisbon, Portugal
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), Lisbon, Portugal
| | - António Duarte
- Faculty of Veterinary Medicine, Centre for Interdisciplinary Research in Animal Health (CIISA), University of Lisbon, Lisbon, Portugal
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), Lisbon, Portugal
| | - Jorge Correia
- Faculty of Veterinary Medicine, Centre for Interdisciplinary Research in Animal Health (CIISA), University of Lisbon, Lisbon, Portugal
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), Lisbon, Portugal
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Gouveia E Melo R, Fernandes E Fernandes R, Salvado M, Duarte A, Lopes A, Verhoeven E, Fernandes E Fernandes J, Mendes Pedro L. The Impact of the Proctor Assistance for a Safe Learning Curve in the Development of a Complex Aortic Endovascular Program. J Endovasc Ther 2024; 31:26-36. [PMID: 35735197 DOI: 10.1177/15266028221105186] [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: 11/17/2022]
Abstract
INTRODUCTION Initiating an endovascular aortic program for treatment of complex aortic aneurysms with fenestrated and branched grafts (FB-EVAR) is challenging. Using a Proctor is one option for training and development of the team. However, this approach has not been formally analyzed. The aim of this study was to analyze the learning curve and the effect of the Proctor regarding safety and effectiveness in FB-EVAR. METHODS A single-center retrospective cohort study was performed, including all consecutive elective patients submitted to FB-EVAR (including both thoraco-abdominal-TAAA and complex abdominal aortic aneurysms-C-AAA) from 2013 to 2021. Patients were divided into 2 groups, the first operated with the Proctor present and the second without. Primary outcomes were 30-day mortality (safety) and technical and procedure success (efficacy). Secondary outcomes included treatment performance (procedure time, blood loss, contrast, and radiation use), re-interventions, aneurysm shrinking, target vessel patency, 30-day mortality, aneurysm-related mortality, and overall mortality. RESULTS Overall, 105 patients were included in the study, 35 operated with Proctor and 70 operated without. The first 20 patients were operated always with the Proctor, and the remaining were operated with the Proctor selectively. Mean age was 71.8 (±7.3) years and 95 patients were male (90.5%). Overall, 62 (65%) patients had C-AAA or extent IV TAAAs and 43 (35%) had extensive TAAAs. There were no significant differences regarding 30-day mortality (Log Rank=0.99), technical success (p=0.4), or procedure success (p=0.8). Mean surgical time was longer in the non-Proctor group (p=0.005), as well as significant intra-operative blood loss (p=0.042). Contrast use (p=0.5) and radiation (p=0.53) were non-significantly different between groups. There were no significant differences regarding length of stay (p=0.4), major adverse events (p=0.6), target vessel patency (Log Rank=0.97), early (p=0.7) and late endoleaks (0.7), aneurysm shrinking (p=0.6), re-interventions (p=0.2), and overall mortality (Log Rank=0.87). CONCLUSION In our experience, the use of a Proctor to start and accompany our complex endovascular aortic program for FB-EVAR was both safe and effective and may serve as a template by other countries and centers that aim to developing their programs.
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Affiliation(s)
- Ryan Gouveia E Melo
- Department of Vascular Surgery, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
- Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- Centro Académico de Medicina de Lisboa, Lisbon, Portugal
- Centro Cardiovascular da Universidade de Lisboa, Lisbon, Portugal
| | - Ruy Fernandes E Fernandes
- Department of Vascular Surgery, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
- Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- Centro Académico de Medicina de Lisboa, Lisbon, Portugal
- Centro Cardiovascular da Universidade de Lisboa, Lisbon, Portugal
| | | | - António Duarte
- Department of Vascular Surgery, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
- Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- Centro Académico de Medicina de Lisboa, Lisbon, Portugal
- Centro Cardiovascular da Universidade de Lisboa, Lisbon, Portugal
| | - Alice Lopes
- Department of Vascular Surgery, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
- Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- Centro Académico de Medicina de Lisboa, Lisbon, Portugal
- Centro Cardiovascular da Universidade de Lisboa, Lisbon, Portugal
| | - Eric Verhoeven
- Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- Department of Vascular and Endovascular Surgery, General Hospital Nuremberg, Paracelsus Medical University, Nuremberg, Germany
| | - José Fernandes E Fernandes
- Department of Vascular Surgery, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
- Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- Centro Académico de Medicina de Lisboa, Lisbon, Portugal
- Centro Cardiovascular da Universidade de Lisboa, Lisbon, Portugal
| | - Luís Mendes Pedro
- Department of Vascular Surgery, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
- Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- Centro Académico de Medicina de Lisboa, Lisbon, Portugal
- Centro Cardiovascular da Universidade de Lisboa, Lisbon, Portugal
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Valente PCLG, Peleteiro MC, Carvalho S, Leal RO, Pomba C, Duarte A, Correia J. Co-Expression of T- and B-Cell Markers in a Canine Intestinal Lymphoma: A Case Report. Animals (Basel) 2022; 12:ani12243531. [PMID: 36552451 PMCID: PMC9774803 DOI: 10.3390/ani12243531] [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: 11/27/2022] [Revised: 12/10/2022] [Accepted: 12/12/2022] [Indexed: 12/15/2022] Open
Abstract
An 8-year-old female neutered Labrador retriever was presented for a second opinion consultation due to vomiting and lethargy, having failed to respond to symptomatic therapy. Blood analysis revealed hyperbilirubinemia and hypoalbuminemia, associated with hypocobalaminemia. An abdominal ultrasound identified diffused bowel thickening and hypoechoic hepatomegaly. An ultrasound-guided liver fine-needle aspiration was performed for cytology and also for cell block immunocytochemistry. Gastric and duodenal biopsies were collected by gastroduodenoscopy. Liver cytology showed numerous lymphocytes, suggesting lymphoma at the hepatic infiltration stage, and immunocytochemistry in the cell block of the hepatic aspirate indicated co-expression of CD3 and CD20 in the lymphoid cells present. The histopathology of gastric and duodenal biopsies supported the hypothesis of gastrointestinal lymphoma due to heavy lymphoid infiltration of the gastric epithelium and intestinal mucosa, including the villi. Concurrent immunohistochemistry was performed using CD3, CD20, PAX5, and CD79αcy antibodies. Immunomarking was positive for CD3 and CD20, which overlapped populations of lymphoid cells, and was negative for all other antibodies. In the clonality test, lymphocyte co-expression of CD3 and CD20 was confirmed by monoclonal rearrangement of T-cell gamma receptors. The final diagnosis was type 2 enteropathy-associated T-cell lymphoma with hepatic infiltration. Co-expression was examined in conjunction with the PARR result in the presence of T-cell monoclonal rearrangement.
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Affiliation(s)
- Pâmela Cristina Lopes Gurgel Valente
- Centre for Interdisciplinary Research in Animal Health (CIISA), Faculty of Veterinary Medicine, University of Lisbon, 1300-477 Lisbon, Portugal
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), 1300-477 Lisbon, Portugal
- Correspondence:
| | - Maria Conceição Peleteiro
- Centre for Interdisciplinary Research in Animal Health (CIISA), Faculty of Veterinary Medicine, University of Lisbon, 1300-477 Lisbon, Portugal
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), 1300-477 Lisbon, Portugal
| | - Sandra Carvalho
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), 1300-477 Lisbon, Portugal
| | - Rodolfo Oliveira Leal
- Centre for Interdisciplinary Research in Animal Health (CIISA), Faculty of Veterinary Medicine, University of Lisbon, 1300-477 Lisbon, Portugal
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), 1300-477 Lisbon, Portugal
| | - Constança Pomba
- Centre for Interdisciplinary Research in Animal Health (CIISA), Faculty of Veterinary Medicine, University of Lisbon, 1300-477 Lisbon, Portugal
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), 1300-477 Lisbon, Portugal
| | - António Duarte
- Centre for Interdisciplinary Research in Animal Health (CIISA), Faculty of Veterinary Medicine, University of Lisbon, 1300-477 Lisbon, Portugal
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), 1300-477 Lisbon, Portugal
| | - Jorge Correia
- Centre for Interdisciplinary Research in Animal Health (CIISA), Faculty of Veterinary Medicine, University of Lisbon, 1300-477 Lisbon, Portugal
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), 1300-477 Lisbon, Portugal
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Duarte A, Gouveia E Melo R, Mendes Pedro D, Martins B, Sobrinho G, Fernandes E Fernandes R, Santos CM, Mendes Pedro L. Predictive Factors for Aortic Graft Infection: A Case-Control Study. Ann Vasc Surg 2022; 87:402-410. [PMID: 35772668 DOI: 10.1016/j.avsg.2022.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 05/03/2022] [Accepted: 05/08/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Graft infections are one of the most serious complications in vascular surgery, with high mortality rates. Few studies addressed risk factors associated with a higher susceptibility to infection. The aim of this study is to identify perioperative factors associated with aortic graft infections (AGI). METHODS We designed a retrospective, case-control study from patients subjected to open aortic repair between 2013 and 2019. Cases of AGI were defined according to the management of aortic graft infection collaboration (MAGIC) criteria and matched to controls without proven infection. Demographics, hospital complications, and laboratory workups were assessed. Predictors of AGI were identified through univariate and multivariate analysis. RESULTS Most graft infections occurred in a late period (n = 17; 85%), after a median interval of 13.5 months interquartile range (IQR 1.5-36). Gram-negative bacteria were most frequently isolated in infected grafts, namely Enterobacteriaceae (n = 12). Cases had significantly lower postoperative serum albumin levels (1.9 g/dL vs. 2.4 g/dL; P = 0.002). Alcohol abuse, malignancy, prolonged lengths of stay, wound infection and dehiscence, in-hospital infection, postoperative heart failure or bowel ischemia were significantly correlated to the onset of AGI. In the multivariate analysis, prolonged hospital stays odds ratio (OR 1.05; P = 0.03), malignancy (OR 5.82; P = 0.03) and alcohol abuse (OR 42.41; P = 0.002) maintained a significant association. CONCLUSIONS The risk of AGI seems to be higher in patients with concurrent malignancy, alcohol abuse or prolonged hospital stays. Strategies to mitigate this complication in these patients are of utmost importance.
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Affiliation(s)
- António Duarte
- Division of Vascular Surgery, Heart and Vessels Department, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal; Lisbon Academic Medical Centre, Lisbon, Portugal.
| | - Ryan Gouveia E Melo
- Division of Vascular Surgery, Heart and Vessels Department, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal; Lisbon Academic Medical Centre, Lisbon, Portugal; Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Diogo Mendes Pedro
- Lisbon Academic Medical Centre, Lisbon, Portugal; Faculty of Medicine, University of Lisbon, Lisbon, Portugal; Department of Infectious Diseases, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - Beatriz Martins
- Lisbon Academic Medical Centre, Lisbon, Portugal; Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Gonçalo Sobrinho
- Division of Vascular Surgery, Heart and Vessels Department, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal; Lisbon Academic Medical Centre, Lisbon, Portugal; Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Ruy Fernandes E Fernandes
- Division of Vascular Surgery, Heart and Vessels Department, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal; Lisbon Academic Medical Centre, Lisbon, Portugal; Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Carla Mimoso Santos
- Lisbon Academic Medical Centre, Lisbon, Portugal; Faculty of Medicine, University of Lisbon, Lisbon, Portugal; Department of Infectious Diseases, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal; Local Coordination Group - Program for Prevention and Control of Infections and Antimicrobial Resistance (GCL-PPCIRA), Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - Luís Mendes Pedro
- Division of Vascular Surgery, Heart and Vessels Department, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal; Lisbon Academic Medical Centre, Lisbon, Portugal; Faculty of Medicine, University of Lisbon, Lisbon, Portugal
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M M de Souza S, Medeiros-Ribeiro AC, Bredemeier M, Duarte A, Pinheiro M, Stadler B, Macieira JC, Ranza R, Miranda J, Valim V, Castro G, Bertolo M, Sauma MDF, Fernandes V, Botelho R, Brenol C, Da Silveira DE Carvalho HM, Studart S, Da Rocha Castelar Pinheiro G, Rocha L, De Leon de Lima H, Pereira I, Ohira Gazzeta M, Kakehasi A, Louzada P, Hayata ALS, Pina F, Alves Ferreira M, Balarini L, Silveira IG, Kowalski S, Titton D, Mendonça Da Silva Chakr R, Ranzolin A, Laurindo I, Xavier R. AB1173 INCIDENT CASES OF COVID-19 AND VACCINATION ADHERENCE IN A MULTICENTRIC COHORT OF INFLAMMATORY ARTHRITIS IN BRAZIL. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundThe SARS-CoV-2 virus has caused a worldwide health crisis. Patients with inflammatory arthritis are at higher risk of hospitalization and death by COVID-19 due to comorbidities or immunosuppressive treatments. Vaccination is one the most important strategies to control the pandemic.ObjectivesTo evaluate the incident cases of SARS-CoV-2 infection in a multicentric cohort of inflammatory arthritis in Brazil.MethodsBiobadaBrasil is a multicentric registry-based cohort study of Brazilian patients with rheumatic diseases starting their first bDMARD or tsDMARD (1). The present analysis is a retrospective evaluation of adult patients with inflammatory arthritis (rheumatoid arthritis – RA, spondylarthritis -SpA and psoriatic arthritis-PsA) that were alive since the beginning of the COVID-19 pandemics in Brazil in February 2020. We evaluated the incidence and severity of COVID-19 infection and the adherence to anti- SARS-CoV-2 vaccines schedules, up to January 2022.ResultsA total of 300 patients were interviewed and 69 (23.0%) reported confirmed anti-SARS-CoV infection and 5 (1.7%) had a second infection. Among known infected patients, 18.8% need hospitalization and oxygen support, 7.2% were admitted at ICU, and 5.8% died. After COVID-19 infection, 31.8% reported worsening of disease activity but only 6.1% had modification in medication due to disease activity. Distribution of cases followed the pattern of waves observed in Brazil (Figure 1). Regarding vaccination, 285 (95%) reported to have received at least one dose of any anti-SARS-CoV-2 vaccine: 43% received the first with the adenovirus ChAdOx1 nCoV-19 (AstraZeneca) adenovirus vaccine, 32% received the Sinovac-CoronaVac inactivated vaccine, 22% received the BNT162b2 (Pfizer-BioNtech) mRNA vaccine and 3% received the BNT162b2 (Pfizer-BioNtech) adenovirus vaccine. Almost all (98.1%) of these patients had already received the second dose of vaccine and after the first and second vaccine doses, 6% and 4% of patients, respectively, reported worsening of articular disease activity, while, after the third dose, no patient reported disease activity worsening.Figure 1.ConclusionDuring the pandemics, patients with inflammatory arthritis had a pattern of distribution of cases very similar to general population. Adherence to vaccination is high and well tolerated.References[1]Bredemeier et al. J Rheumatol 2021;48:1519-27Disclosure of InterestsNone declared
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Abstract
Introduction The recent literature indicates that the gut microbiota may affect brain functions through endocrine and metabolic pathways, antibody production and the enteric network while supporting its possible role in the onset and maintenance of several neuropsychiatric disorders, neurodevelopment and neurodegenerative disorders. Objectives The aim of this work is to discuss the role of probiotics, prebiotics, or synbiotics as a potential treatment for symptoms of depression, anxiety, and stress. Methods Pub Med database was searched using following key words: “probiotics”, “prebiotics”, “mental disorders”, “psychological disorders”. Results Although the exact mechanism is unknown, there is a link between the gut and mood disorders. Psychosocial factors, such as quality of life or well-being, are greatly influenced by gut function and there is a strong correlation between psychosocial features and gastrointestinal disorders. Elevated stress, anxiety, and depression are linked to intestinal dysbiosis and mood disorders are disproportionately high in patients with functional gut disorders. So, psychobiotics may provide benefit when used in conjunction with current antidepressant medications. Probiotics may exert their therapeutic benefits by restoring microbial balance in the gut, and also by minimizing gastrointestinal complaints, allowing for the effects of antidepressant medication to not be reduced. Stress and immune responses were improved following psychobiotic intervention in stressed adults. Psychobiotics offer potential alternative treatment options in mood disorders and their accompanying symptoms. Conclusions Pro and prebiotics can improve mental health and psychological function and can be offered as new medicines for common mental disorders. However, more clinical studies are required to support the clinical use of probiotics. Disclosure No significant relationships.
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Lourenço A, Ribeiro M, Lemos M, Duarte A, Neves A. Global world, global hospitals. Ethnic differences and psychotic symptoms presentation – a review. Eur Psychiatry 2022. [PMCID: PMC9568105 DOI: 10.1192/j.eurpsy.2022.1622] [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 We live in a global world, where immigration is no longer just an escape, but also a demand and a desire. Globalization imposes the challenge of recognizing psychiatric illness in the most diverse of patients. Objectives To review the literature about the documentation of ethnic differences and the psychotic symptoms presentation. Methods We performed a MEDLINE search using the key words: ethnic differences and psychotic symptoms. We only included studies with full text published in English. Results
Since the 1970s, some studies have shown that there are differences in the manifestation of psychiatric illness in ethnic minorities. Most recent studies confirm this statement, mainly with an increase in immigration in the 20th century, with the receiving countries having an increase in the number of cases of psychosis (affective and non-affective). Belonging to an ethnic minority increases the risk of psychotic symptoms and experiences, witch is related to the patients perception of discrimination, social differences, family separation and the stress associated with immigration. On the other hand, these groups also have less access to health care. Conclusions Currently, professionals are more aware of the global world and what this implies in the manifestations of psychiatric illnesses. However, more studies will be needed to identify these natural differences. In this way, we will be able to help our patients anywhere and support their families. Disclosure No significant relationships.
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Duarte A, Laginhas C, Lourenço A, Simões I, Martins P. Is Praecox Feeling at risk of extinction? Eur Psychiatry 2022. [PMCID: PMC9567006 DOI: 10.1192/j.eurpsy.2022.569] [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 Praecox feeling (PF) is a characteristic feeling of bizarreness or unease that a psychiatrist experiences when facing a patient with schizophrenia. This term, proposed by Rumke in 1941, was considered an important feature of a schizophrenia diagnosis. However, since the movement toward operational diagnostic methods in the late 1970s, it has fallen out of use. Objectives This work aims to discuss the role of Praecox Feeling in the clinical approach to schizophrenia diagnosis. Methods PubMed database was searched using combinations of the terms “praecox”, combined with “feeling” and “schizophrenia”. Results PF is sometimes experienced silently before the patient participates verbally. An experienced and attentive clinician can intuitively feels changes in the body posture, facial expression, the tone of the voice, motor behavior, and attitude that could look insignificant, but as a whole they present the patient as “definitely un-understandable.” Although there is lacking evidence to sustain the rehabilitation of the PF as a reliable and valid clinical criterion consistent with the operational approach, a broader scientific approach is called for. PF should not be trivialized, as is sometimes the case, into a quick diagnosis but could be a real determinant of medical decision. Conclusions Even though there may not be sufficient evidence to consider it valid clinical diagnostic criteria, it still appears to play an important role in the clinical decision-making process and should not be underestimated or stigmatized. This concept is not completely subjective and does rely on objective information, such as the patient’s behaviour and body language. Disclosure No significant relationships.
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Ribeiro M, Lourenço A, Lemos M, Duarte A. Levothyroxine supplementation among individuals with Subclinical Hypothyroidism and Depression | a review. Eur Psychiatry 2022. [PMCID: PMC9568179 DOI: 10.1192/j.eurpsy.2022.1437] [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 Depression is known to be associated with changes in the hypothalamic-pituitary-thyroid axis and the brain is a major target organ for thyroid hormone. Overt hypothyroidism can cause symptoms compatible with depression. However, its relationship with subclinical hypothyroidism (SCH) is not well established. Objectives To review the literature regarding the effect of levothyroxine therapy among patients with SCH and coexistent depression. Methods We conducted a MEDLINE search using depression, subclinical hypothyroidism and levothyroxine as keywords, selecting studies written in English. Results SCH is defined as an elevated thyroid stimulating hormone with normal peripheric hormone levels. The association between SCH and depression is controversial. Some studies indicate that SCH had the same propensity with overt hypothyroidism, while others report that major affective symptoms are not associated with SCH, but are likely due to independent psychiatric diagnoses, which are common in the general population and occur with similar frequency in patients with SCH. Individuals with SCH are recommended to initiate levothyroxine replacement therapy only when their TSH level is above 10 mIU/L or if symptoms are present. There is a lack of evidence supporting the use of levothyroxine therapy to improve mental health outcomes and the majority of meta-analysis do not show relief of affective symptoms after levothyroxine therapy, among individuals with SCH. Conclusions Routine screening for depressive symptoms among individuals with SCH is important to prevent morbidity. Nevertheless, there is no evidence enduring levothyroxine supplementation in these cases. Further studies, with larger sample sizes and longer follow-up periods are needed to enlighten the potential benefit of this therapy. Disclosure No significant relationships.
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Chakr R, Bredemeier M, Duarte A, Pinheiro M, Stadler B, Macieira JC, Ranza R, Miranda J, Valim V, Castro G, Bertolo M, Sauma MDF, Fernandes V, Medeiros-Ribeiro AC, Botelho R, Brenol C, Da Silveira De Carvalho HM, Studart S, Da Rocha Castelar Pinheiro G, Rocha L, Pereira I, De Leon de Lima H, Ohira Gazzeta M, Kakehasi A, Louzada P, Hayata ALS, Pina F, Lupo C, Balarini L, Silveira I, Schowalski S, Titton D, Ranzolin A, Laurindo I, Xavier R. POS0650 THE IMPACT OF OLD AGE ON THE PERSISTENCE AND SAFETY OF TREATMENT WITH BIOLOGIC AGENTS OR JAK INHIBITORS IN RHEUMATOID ARTHRITIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundThe effect of age on persistence and safety of treatment with biologic disease modifying anti-rheumatic drugs (bDMARDs) in rheumatoid arthritis has been a subject to research interest. Two recently published studies did not observe significantly different survival of treatment with bDMARDs among older age (≥ 65 years) individuals (1,2); incidence of serious adverse events was higher in these patients (2).Objectivesto evaluate association of the age with treatment survival and overall safety among patients receiving one or multiple courses of bDMARDs or targeted synthetic (ts-) DMARDs.MethodsBiobadaBrasil is a multicentric registry-based cohort study of Brazilian patients with rheumatic diseases starting their first bDMARD or tsDMARD (3). The present analysis includes RA patients recruited from Jan 2009 to Oct 2019, followed-up over one or multiple (up to six) courses of treatment necessarily involving a bDMARD or tsDMARD (latest date, Nov 19, 2019). Treatment course is defined as a period during which the medication scheme does not change, except for dose adjustments. Primary outcome was the incidence treatment interruption for any reason (except for pregnancy or disease remission), while interruption due to adverse events (AEs; including death) and due to inefficacy served as secondary outcomes. Incidence of serious adverse events (SAEs) also served as a secondary outcome. Extended (frailty) multivariate Cox proportional hazards models and negative binomial regression with generalized estimating equations (to calculate incidence rate ratios [IRRs]) were used for statistical analyses (both types of analyses including time-varying covariates over multiple courses of treatment).ResultsIn total, 1316 patients (2335 treatment courses, 6508 patient-years [PY]) were enrolled. Of these, 160 patients (643 PY; 237 treatment courses) were ≥ 65 years old, mean age at starting treatment = 71 ± 5 yrs (84% female). Old age was not significantly associated with treatment interruption for any reason, but presented higher risk of interruption due to adverse events (after multivariate adjustment) and lower risk of stopping because of inefficacy (see Table 1). Older patients presented higher incidence of SAEs than younger ones (16.0 vs 8.4/100 PY, respectively; multivariate IRR: 2.06, 95% CI: 1.51 to 2.80, P<0.001). Among old patients, tocilizumab (HR: 2.73, 95% CI: 1.13 to 6.64, P=0.026), etanercept (2.13, 1.12 to 4.07, P=0.022), and infliximab (2.39, 1.19 to 4.79, P=0.014) presented higher risk of treatment termination as compared with adalimumab. In this subgroup (age ≥65 yrs), there was no significant difference in the risk of SAEs between different bDMARDs/tsDMARDs.Table 1.Univariate and multivariate hazard ratios (HRs) of interruption of treatment course comparing older (≥65 years) versus younger patients (reference category). Results are HRs, 95% CIs, and P values.Cause of interruption (n of events)Crude analysisAdjusted covariates*Interruption - any reason (1321)0.96 (0.75 to 1.23), P=0.7601.09 (0.82 to 1.43), P=0.550Interruption - adverse events (368)1.33 (0.75 to 0.89), P=0.1601.59 (1.07 to 2.35), P=0.020Interruption - inefficacy (680)0.56 (0.39 to 0.80), P=0.0020.57 (0.38 to 0.87), P=0.009* Age, baseline DAS28, disease duration, gender, smoking, RF or anti-CCP, previous malignancy, interstitial lung disease, diabetes, hypertension, hypercholesterolemia, renal failure, ischemic cardiomyopathy, COPD, heart failure, concomitant use of each cs-, b-, and tsDMARDs, corticosteroids, starting year, osteoporosis, hepatitis B,C, treatment sequence.ConclusionThe overall risk of treatment interruption with biologic or targeted synthetic DMARDs is not higher in older patients. Higher risk of interruption due to AE was balanced by a lower risk of stopping treatment due to inefficacy. Older patients had a higher incidence of SAEs.References[1]Mathieu et al. Rheumatol Int 2021;41:879-85.[2]Freitas et al. Drugs Aging 2020;37:899-907.[3]Bredemeier et al. J Rheumatol 2021;48:1519-27.Disclosure of InterestsNone declared
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Duarte A, Ribeiro M, Lopes J, Oliveira S, Martins P. Risk of suicide during pregnacy and postpartum period. Eur Psychiatry 2022. [PMCID: PMC9568081 DOI: 10.1192/j.eurpsy.2022.2214] [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 Pregnancy and the postpartum are generally characterized by positive feelings and expectations but they may also disguise maternal stress and difficulties. These are typical periods for the onset or relapse of psychiatric symptoms and disorders. Even though suicide during pregnancy and postpartum is rare, it is among the leading causes of maternal perinatal mortality. Objectives To provide an overview on the risk of suicide during pregnancy and postpartum. Methods PubMed database was searched using combinations of the terms “suicide”, combined with “pregnancy” and “depression”. Results The major risk factors for suicidal ideation are previous suicide attempts, self-harm, current or past history of psychiatric disorder, young maternal age, being unmarried, an unplanned pregnancy, substance use disorders, lack effective psychosocial support and discontinuation of psychotropic drugs. Pregnant women with suicidality behavior have also an increased risk for various adverse obstetric outcomes, including miscarriage, preterm delivery, maternal hemorrhage, and stillbirth. Furthermore, the postpartum period is often associated with the onset of mood and psychotic disorders with an increased risk of both suicide and infanticide. Women who have suffered from serious psychiatric conditions either after childbirth or in other phases of life should be informed about the possibility of relapse after subsequent pregnancies, thus presenting a higher risk of suicide. Conclusions During pregnancy and postpartum, it is fundamental to investigate suicide risk, including suicidal ideation, thoughts, and intent, especially (but not only) in women affected by mental pathology. Moreover, maternal suicide behaviour affects the child’s neuropsychological development and can also increase the infant´s suicide risk. Disclosure No significant relationships.
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Bredemeier M, Duarte A, Pinheiro M, Stadler B, Macieira JC, Ranza R, Miranda J, Valim V, Castro G, Bertolo M, Sauma MDF, Fernandes V, Medeiros-Ribeiro AC, Botelho R, Brenol C, Da Silveira DE Carvalho HM, Studart S, Da Rocha Castelar Pinheiro G, Rocha L, De Leon de Lima H, Pereira I, Ohira Gazzeta M, Kakehasi A, Louzada P, Hayata ALS, Pina F, Alves Ferreira M, Balarini L, Silveira IG, Kowalski S, Titton D, Mendonça Da Silva Chakr R, Ranzolin A, Laurindo I, Xavier R. POS0242 THE EFFECT OF ANTIMALARIALS ON THE OVERALL SAFETY AND PERSISTENCE OF TREATMENT WITH BIOLOGIC AGENTS OR JAK INHIBITORS IN RHEUMATOID ARTHRITIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundAntimalarials (AM) are frequently part of the initial scheme of conventional synthetic DMARDs in the treatment of rheumatoid arthritis (RA), and have been associated with lower incidence of diabetes and better lipid profile in these patients (1). However, the role of AM in schemes involving biologic (b-) or targeted synthetic (ts-) DMARDs has been much less extensively studied. In addition, a recent large scale study (2) and a consensus article (1) casted doubt on the long-term cardiovascular safety of AM.ObjectivesTo evaluate the association of concomitant use of AM with the overall safety and survival oftreatment course among patients receiving one or multiple courses of bDMARDs or tsDMARDsMethodsBiobadaBrasil is a multicentric registry-based cohort study of Brazilian patients with rheumatic diseases starting their first bDMARD or tsDMARD (3). The present analysis includes RA patients recruited from Jan 2009 to Oct 2019, followed-up over one or multiple (up to six) courses of treatment (latest date, Nov 19, 2019). A treatment course is defined as a period during which the medication scheme does not change. The primary outcome was the incidence of serious adverse events (SAEs). Total and system-specific adverse events (AEs), treatment interruption for any reason, interruption due to AEs and due to inefficacy served as secondary outcomes. Negative binomial regression with generalized estimating equations (to calculate the incidence rate ratios [ÌRRs]) and extended (frailty) Cox proportional hazards models were used for statistical analyses (both types of analyses including time-varying covariates over multiple courses of treatment).ResultsIn total, 1316 patients (2335 treatment courses, 6711 patient-years [PY]) were enrolled. The overall incidence of serious adverse events was 9.2/100 PY. AM were used over 354 courses (1254.5 PY) of therapy. The IRRs for the primary and secondary outcomes are presented in Table 1. AM were also associated with better treatment course survival (Figure 1), reducing the risk of interruption due to AEs (multivariate hazard ratio: 0.56, 95% CI: 0.39 to 0.81, P=0.002) and inefficacy (0.65, 0.48 to 0.87, P=0.003).Figure 1.Table 1.Univariate and multivariate incidence rate ratios (IRRs) of adverse events comparing use versus non-use (reference category) of antimalarials. Results are IRRs, 95% CIs, and P values.Type of adverse event (n of events)Crude analysisAdjusted covariates*Serious adverse events (617)0.60 (0.41 to 0.87), P=0.0070.51 (0.37 to 0.69), P<0.001Any adverse event (3494)0.65 (0.54 to 0.77), P<0.0010.68 (0.57 to 0.81), P<0.001Cardiovascular‡Serious (52)1.04 (0.49 to 2.20), P=0.9241.06 (0.45 to 2.50), P=0.891Total (163)0.90 (0.59 to 1.38), P=0.6420.93 (0.59 to 1.45), P=0.737InfectionsSerious (277)0.78 (0.44 to 1.39), P=0.4040.53 (0.34 to 0.83), P=0.006Total (1400)0.77 (0.61 to 0.98), P=0.0330.75 (0.60 to 0.94), P=0.014Hepatic‡Total (66)0.20 (0.07 to 0.64), P=0.0070.16 (0.04 to 0.57), P=0.005Glicemic control-relatedTotal (34)0.74 (0.29 to 1.92), P=0.5400.73 (0.26 to 2.00), P=0.535DyslipidemiaTotal (83)0.60 (0.31 to 1.13), P=0.1140.55 (0.28 to 1.06), P=0.074*Age, baseline DAS28, disease duration, gender, smoking, seropositivity (RF or anti-CCP), previous malignancy, interstitial lung disease, diabetes, hypertension, hypercholesterolemia, renal failure, ischemic cardiomyopathy, COPD, heart failure, concomitant use of each cs-, b-, and tsDMARDs, corticosteroids, starting year, osteoporosis, hepatitis B and C, and treatment sequence. ‡ Excluding infections.ConclusionAmong RA patients on treatment with bDMARDs or tsDMARDs, concomitant use of antimalarials reduced the incidence of serious and total AEs, including infections and hepatic AEs, and prolonged treatment course survival. No significant increase in the risk of cardiovascular AEs was observed.References[1]Desmarais et al. Arthritis Rheumatol 2021;73:2151-60.[2]Lane et al. Lancet Rheumatol 2020;2:e698–e711[3]Bredemeier et al. J Rheumatol 2021;48:1519-27.Disclosure of InterestsNone declared
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Martín-Santamaría R, Sánchez-Oro J, Pérez-Peló S, Duarte A. Strategic oscillation for the balanced minimum sum-of-squares clustering problem. Inf Sci (N Y) 2022. [DOI: 10.1016/j.ins.2021.11.048] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Silva E, Diniz P, Trindade A, Batista M, Torres A, Duarte A, Lopes-da-Costa L. Immunolocalization of Notch Signaling in Mouse Preimplantation Embryos. Methods Mol Biol 2022; 2472:173-185. [PMID: 35674900 DOI: 10.1007/978-1-0716-2201-8_14] [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: 06/15/2023]
Abstract
The Notch signaling pathway is an important determinant of cell diversity and identity in most developing embryonic tissues. The pathway components are expressed dynamically, and their function is critical for embryonic survival.This protocol addresses the immunolocalization of Notch pathway components by confocal microscopy.
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Affiliation(s)
- Elisabete Silva
- Reproduction and Development Laboratory, CIISA - Centro de Investigação Interdisciplinar em Sanidade Animal, Faculdade de Medicina Veterinária, Universidade de Lisboa, Avenida da Universidade Técnica, Lisbon, Portugal
| | - Patrícia Diniz
- Reproduction and Development Laboratory, CIISA - Centro de Investigação Interdisciplinar em Sanidade Animal, Faculdade de Medicina Veterinária, Universidade de Lisboa, Avenida da Universidade Técnica, Lisbon, Portugal
| | - Alexandre Trindade
- Reproduction and Development Laboratory, CIISA - Centro de Investigação Interdisciplinar em Sanidade Animal, Faculdade de Medicina Veterinária, Universidade de Lisboa, Avenida da Universidade Técnica, Lisbon, Portugal.
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz, Egas Moniz - Cooperativa de Ensino Superior, Crl, Quinta da Granja, Monte da Caparica, Portugal.
| | - Mariana Batista
- Reproduction and Development Laboratory, CIISA - Centro de Investigação Interdisciplinar em Sanidade Animal, Faculdade de Medicina Veterinária, Universidade de Lisboa, Avenida da Universidade Técnica, Lisbon, Portugal
- FMV-ULHT - Faculdade de Medicina Veterinária, Universidade Lusófona de Humanidades e Tecnologias, Lisbon, Portugal
| | - Ana Torres
- Reproduction and Development Laboratory, CIISA - Centro de Investigação Interdisciplinar em Sanidade Animal, Faculdade de Medicina Veterinária, Universidade de Lisboa, Avenida da Universidade Técnica, Lisbon, Portugal
| | - António Duarte
- Reproduction and Development Laboratory, CIISA - Centro de Investigação Interdisciplinar em Sanidade Animal, Faculdade de Medicina Veterinária, Universidade de Lisboa, Avenida da Universidade Técnica, Lisbon, Portugal
| | - Luís Lopes-da-Costa
- Reproduction and Development Laboratory, CIISA - Centro de Investigação Interdisciplinar em Sanidade Animal, Faculdade de Medicina Veterinária, Universidade de Lisboa, Avenida da Universidade Técnica, Lisbon, Portugal
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Casagrande L, Avella M, De Deus A, Campos P, Maia A, Duarte A. Systematization of Laparoscopic Surgery for Deep Endometriosis. J Minim Invasive Gynecol 2021. [DOI: 10.1016/j.jmig.2021.09.280] [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]
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Rosário R, Augusto C, Silva MJ, Martins S, Duarte A, Ramos N, Martins MRO, Fronteira I. Digital health literacy and online information queries in Portuguese university students. Eur J Public Health 2021. [PMCID: PMC8574568 DOI: 10.1093/eurpub/ckab164.039] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Worldwide there is an overwhelming amount of information about COVID-19 circulating online, also named infodemic. Misinformation (the unintentional) and disinformation (the intentional) spreading of false information have proven to be very dangerous to public health. Hence, more than ever, people need skills for searching, evaluating and integrating information related to health in daily life, i.e., health literacy. Until now, little is known about the digital health literacy of university students and their information-seeking behaviour. Hence, this study aimed to analyse the associations between university students' digital health literacy and online information queries during the beginning of the COVID-19 pandemic (and infodemic) in Portugal. Methods A cross-sectional study of 3.084 Portuguese university students (75.7% females), with an average age of 24.2 (SD = 7.5), was conducted using an online survey. We used sociodemographic data (sex, age, subjective social status) and the digital health literacy questionnaire adapted to the specific COVID-19 context. Online information queries included the topics related to SARS-CoV-2 and COVID-19 searched by students. Logistic regression models were performed. Results Online information queries (e.g., individual measures to protect against infection, current spread of the virus, current situation assessments and recommendations) were associated with an increased odds of achieving sufficient digital health literacy. Conclusions Online information queries related to epidemiological and public health topics are significantly associated with digital health literacy in times of COVID-19. Further studies are needed, including programs that improve digital health literacy among university students and increase the availability of high-quality content information.
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Affiliation(s)
- R Rosário
- School of Nursing, University of Minho, Braga, Portugal
- Health Sciences Research Unit, Nursing, Nursing School of Coimbra, Coimbra, Portugal
- Research Centre in Child Studies, University of Minho, Braga, Portugal
| | - C Augusto
- School of Nursing, University of Minho, Braga, Portugal
- Health Sciences Research Unit, Nursing, Nursing School of Coimbra, Coimbra, Portugal
| | - MJ Silva
- School of Nursing, University of Minho, Braga, Portugal
- Health Sciences Research Unit, Nursing, Nursing School of Coimbra, Coimbra, Portugal
| | - S Martins
- School of Nursing, University of Minho, Braga, Portugal
- Health Sciences Research Unit, Nursing, Nursing School of Coimbra, Coimbra, Portugal
| | - A Duarte
- School of Nursing, University of Minho, Braga, Portugal
- Health Sciences Research Unit, Nursing, Nursing School of Coimbra, Coimbra, Portugal
- Research Centre in Child Studies, University of Minho, Braga, Portugal
| | - N Ramos
- Global Health and Tropical Medicine, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - MRO Martins
- Global Health and Tropical Medicine, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - I Fronteira
- Global Health and Tropical Medicine, Universidade NOVA de Lisboa, Lisbon, Portugal
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Gouveia E Melo R, Mourão M, Caldeira D, Alves M, Lopes A, Duarte A, Fernandes E Fernandes R, Mendes Pedro L. A Systematic Review and Meta-analysis of the Incidence of Acute Aortic Dissections in Population-Based Studies. J Vasc Surg 2021; 75:709-720. [PMID: 34560218 DOI: 10.1016/j.jvs.2021.08.080] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 08/22/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To perform a systematic-review and meta-analysis of all population-based studies reporting on incidence of acute aortic dissections. METHODS We searched MEDLINE, EMBASE, CENTRAL and Open Grey databases from inception to August 2020 for population-based studies reporting on the incidence of AAD. A systematic review was conducted following the PRISMA guidelines using a registered protocol (CRD42020204007). Data was pooled using a random-effects model of proportions using Freeman-Tukey double arcsine transformation. The main outcome was the incidence of AAD. Secondary outcomes were incidence type A aortic dissections (TAAD) and type B aortic dissections (TBAD); incidence of aortic dissection repair and medical management and incidence of in-hospital mortality. In addition, we estimated the proportion of aortic dissection repair and mortality (in hospital, overall and specific mortality according to sub-type) among patients with AAD. RESULTS Thirty-three studies were included. The pooled incidence of AADs was 4.8 per 100 000 individuals/year (95%CI: 3.6; 6.1). Incidence of TAAD was 3.0 per 100 000/year (95%CI: 1.8; 4.4) and incidence of TBAD was 1.6 per 100 000/year (95%CI: 1.1; 2.2). The incidence of AAD needing repair was 1.4 per 100 000/year (95%CI: 1.0; 2.0) [1.4 (95%CI: 1.2; 1.7) for TAAD and 0.4 (95%CI: 0.2; 0.7) for TBAD]. Incidence of medically managed AAD was 3.4 per 100 000/year (95%CI: 2.4; 4.5). Incidence of in-hospital death due to AAD was 1.3 per 100 000 individuals/year (95%CI: 0.9; 1.9); 1.0 (95%CI: 0.6; 1.4; I297%) for TAAD and 0.3 for TBAD (95%CI: 0.2; 0.4; I296%). CONCLUSION A global estimate regarding the incidence rate of acute aortic dissections was achieved. Incidence of acute aortic dissection varied significantly between study designs and geographical regions. More accurate information on acute aortic dissection epidemiology is crucial for public-health decisions, clinical understanding, and healthcare management.
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Affiliation(s)
- Ryan Gouveia E Melo
- Vascular Surgery Department, Hospital Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), Lisboa, Portugal; Faculty of Medicine, University of Lisbon, Lisboa, Portugal; Cardiovascular Center of the University of Lisbon (CCUL), Lisboa, Portugal.
| | - Mariana Mourão
- Faculty of Medicine, University of Lisbon, Lisboa, Portugal
| | - Daniel Caldeira
- Faculty of Medicine, University of Lisbon, Lisboa, Portugal; Cardiovascular Center of the University of Lisbon (CCUL), Lisboa, Portugal; Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine, University of Lisbon, Lisboa, Portugal; Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, Lisboa, Portugal; Serviço de Cardiologia, Hospital Universitário de Santa Maria (CHULN), Lisboa, Portugal
| | - Mariana Alves
- Faculty of Medicine, University of Lisbon, Lisboa, Portugal; Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine, University of Lisbon, Lisboa, Portugal; Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, Lisboa, Portugal; Serviço de Medicina III, Hospital Pulido Valente (CHULN), Lisboa, Portugal
| | - Alice Lopes
- Vascular Surgery Department, Hospital Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), Lisboa, Portugal; Cardiovascular Center of the University of Lisbon (CCUL), Lisboa, Portugal
| | - António Duarte
- Vascular Surgery Department, Hospital Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), Lisboa, Portugal; Cardiovascular Center of the University of Lisbon (CCUL), Lisboa, Portugal
| | - Ruy Fernandes E Fernandes
- Vascular Surgery Department, Hospital Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), Lisboa, Portugal; Faculty of Medicine, University of Lisbon, Lisboa, Portugal; Cardiovascular Center of the University of Lisbon (CCUL), Lisboa, Portugal
| | - Luís Mendes Pedro
- Vascular Surgery Department, Hospital Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), Lisboa, Portugal; Faculty of Medicine, University of Lisbon, Lisboa, Portugal; Cardiovascular Center of the University of Lisbon (CCUL), Lisboa, Portugal
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Bredemeier M, Duarte A, Pinheiro M, Stadler B, Macieira JC, Ranza R, Miranda J, Valim V, Castro G, Bertolo M, Sauma MDF, Fernandes V, Medeiros A, Botelho R, Brenol C, Negrão Gonçalo Dias D, Carvalho H, Studart S, Da Rocha Castelar Pinheiro G, Rocha L, Pereira I, Ohira Gazzeta M, Maria Kakehasi A, Louzada P, Hayata ALS, Pina F, Lupo C, Balarini L, Silveira I, Kowalski S, Titton D, Chakr R, Ranzolin A, Laurindo I, Xavier R. POS0676 SURVIVAL OF THE FIRST COURSE OF BIOLOGIC OR JAK INHIBITOR IN RHEUMATOID ARTHRITIS: ASSOCIATION WITH THE CHOICE OF AGENT AND CONCOMITANT CONVENTIONAL SYNTHETIC DMARDS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.3841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:After failure of conventional synthetic disease modifying anti-rheumatic drugs (csDMARDs) in the therapy of rheumatoid arthritis (RA), treatment may be escalated to biologic (bDMARDs) or JAK inhibitors (JAKi) (1). Analysis of drug survival can provide useful information on the effectiveness of these therapeutic schemes.Objectives:to evaluate the association of the choice of therapeutic agent with the survival of treatment course in RA patients receiving their first bDMARD or JAKi.Methods:BiobadaBrasil is a multicentric registry-based cohort study of Brazilian patients starting their first bDMARD/JAKi (2). This analysis includes RA patients recruited from Jan 2009 to Oct 2019, followed-up over the first course of treatment with a bDMARD/JAKi until censoring (latest date, Nov 19, 2019) or occurrence of the outcome of interest. A treatment course is defined as a period during which the medication scheme does not change, except for dose adjustments. The primary outcome was the interruption of treatment course for any reason (except for pregnancy or disease remission); interruption of treatment due to adverse events (AEs) or death and due to inefficacy served as secondary outcomes. Multivariate Cox proportional hazards models were used for analyses.Results:In total, 1177 patients (3800 patient-years [PY]) were enrolled. The overall incidence of treatment interruption was 17.5/100 PY. Adalimumab was the most frequently prescribed agent, followed by infliximab (n= 267). The hazards ratios (HR) of the primary and secondary outcomes are presented in Table 1. Figure 1 compares the survival of treatment curves of different bDMARDs/JAKi.Table 1.Hazard ratios (HR) of interruption of therapy course of each therapeutic agent (the reference category for bDMARDs/ JAKi is infliximab). Results are HR, 95% CIs, and P values*.Agent (number of patients)Interruption for any reason (665 events)Interruption due to adverse events or death (196 events)Interruption due to inefficacy (319 events)Adalimumab (354)0.83 (0.68 to 1.01), P= 0.0620.68 (0.48 to 0.96), P=0.0291.08 (0.80 to 1.44), P=0.621Etanercept (257)0.81 (0.66 to 1.01), P=0.0630.56 (0.37 to 0.83), P=0.0040.93 (0.68 to 1.29), P=0.674Certolizumab (80)0.74 (0.47 to 1.16), P=0.1850.33 (0.13 to 0.86), P=0.0241.32 (0.74 to 2.35), P=0.350Golimumab (53)0.86 (0.53 to 1.38), P=0.5300.46 (0.18 to 1.19), P=0.1111.07 (0.53 to 2.15), P=0.849JAKi (tofacitinib) (59)0.54 (0.30 to 0.99), P=0.0470.19 (0.04 to 0.82), P=0.0260.89 (0.41 to 1.96), P=0.779Rituximab (48)0.87 (0.55 to 1.37), P=0.5400.48 (0.20 to 1.18), P=0.1090.58 (0.26 to 1.34), P=0.205Abatacept (30)0.52 (0.25 to 1.07), P=0.0770.46 (0.14 to 1.56), P=0.2150.46 (0.14 to 1.52), P=0.203Tocilizumab (29)0.29 (0.14 to 0.63), P=0.0020.40 (0.12 to 1.30), P=0.1260.28 (0.09 to 0.90), P=0.033Methotrexate (792)0.95 (0.79 to 1.14), P=0.5610.86 (0.62 to 1.19), P=0.3620.98 (0.75 to 1.28), P=0.860Leflunomide (497)1.17 (0.99 to 1.39), P=0.0611.44 (1.06 to 1.96), P=0.0201.02 (0.80 to 1.30), P=0.856Sulfasalazine (48)1.18 (0.80 to 1.75), P=0.4011.94 (1.07 to 3.54), P=0.0300.85 (0.45 to 1.59), P=0.605Antimalarials (230)0.80 (0.65 to 0.98), P=0.0270.67 (0.45 to 0.99), P=0.0430.67 (0.50 to 0.92), P=0.011* All tests adjusted for other variables presented in the table and for age, baseline DAS28, disease duration, gender, smoking, seropositivity (RF/anti-CCP), previous malignancy, diabetes, hypertension, hypercholesterolemia, renal failure, ischemic cardiomyopathy, COPD, heart failure, use of corticosteroids, starting year, hypercholesterolemia, osteoporosis, hepatitis B and C.Conclusion:In our study, infliximab was related to an overall higher hazard of treatment course interruption than tolicizumab and tofacitinib, and higher hazard of interruption due to AEs than most other anti-TNF agents and tofacitinib. Maintaining antimalarials in patients receiving advanced therapies for RA may reduce interruption of treatment due to inefficacy and AEs.Disclosure of Interests:None declared
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Basualto S, Ziroldo Lopes JV, Rizzo Borges A, Abreu M, Albuquerque C, Araújo N, Bacchiega AB, Bica B, Brito D, Duarte A, Realle P, Ferreira G, Wagner Poti Gomes K, Melo AK, Stadler B, Maria Kakehasi A, Klumb E, Mariz H, Marques C, Mota L, Munhoz G, Paiva E, Pereira H, Salviato Pileggi G, Pinheiro M, Provenza JR, Gomides AP, Reis Neto E, Ribeiro S, Sato E, Laroca Skare T, De Souza V, Teodoro MLM, Valadares LDDA, Valim V, Calderaro D. AB0848 PARTICIPATION OF UNDERGRADUATE MEDICAL STUDENTS AS INVESTIGATORS IN A RHEUMATOLOGIC COHORT: IMPACT ON DEPRESSION, ANXIETY & STRESS SCALE. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Mental health was widely affected during the new coronavirus pandemic. In addition, some measures adopted by most countries in order to contain the virus spread, such as isolation and social distancing, leading to the interruption of routine activities, including partial or complete interruption of face-to-face classes may be associated with increased stress, depression and anxiety among undergraduate medical students (1). From March to September, 2020, the Brazilian Society of Rheumatology carried out the Mario Pinotti II Project (MPII), a prospective, multicenter, observational cohort study designed to monitor the COVID-19 in patients with rheumatic disease on hydroxychloroquine, using periodic telephone calls performed by undergraduate medical students (2).Objectives:To compare the mental health status of medical students who were participating from the MPII with theirs colleagues not involved in this project.Methods:A web-based survey via google forms platform was developed by a panel composed of undergraduate medical students, rheumatologists, medical school professors, and a psychology professor. It included details on demographic and life habits data and domains regarding depression, anxiety and stress, using the DASS-21 (Depression, Anxiety & Stress Scale), Brazilian version. Data collection occurred from July 20th to August 31st, 2020. Statistical analysis was performed using the SPSS version 20.0. Univariate and multivariate linear regression analysis were performed to verify associations with the DASS-21, defined as dependent variable. A p-value < 0.05 was deemed as significant. This study was approved by the Institutional Research Ethics Committee.Results:A total of 684 undergraduate medical students were included in this study, of whom 228 as MPII volunteers (VG) and 456 as control group (CG). Median age was 23 years (IQ 21-24) and the CG was older than the VG (p<0.03). Most of them were white (68.8%) and women (63%). There were no significant differences regarding comorbidities, ethnicity, smoking status, alcohol intake and physical activity. Older age, male gender, participation of MPII study, absence of a worsening in sleep pattern during the pandemic and a lower number of prior comorbidities were associated with lower DASS21 scores, suggesting a better mental health (Table 1).Conclusion:Several aspects may be involved with mental health, including increased emotional maturity, gender and sleep pattern. Although with marginal independent association, medical students with participation in the MPII study had better mental health than their student colleagues not engaged with this research. Our data pointed out that voluntary participation in a research project which foresees interaction by telephone contact with rheumatic patients, professors, rheumatologists, and colleagues is associated with better mental health.References:[1]Meo SA, Abukhalaf AA, Alomar AA, Sattar K, Klonoff DC. Covid-19 pandemic: Impact of quarantine on medical students’ mental wellbeing and learning behaviors. Pakistan J Med Sci 2020;36(COVID19-S4):S43–8.[2]Gomides A, Ferreira G, Kakehas A, Lacerda M, Marques C, Paiva E et al. Impact of chronic use of antimalarials on SARS-COV-2 infection in patients with immune-mediated rheumatic diseases: protocol design for a multicentric observational cohort in Brazil. JMIR Research Protocols, 2020.PreprintTable 1.Univariate and multivariate analysis of predictors associated to the DASS-21 in undergraduate medical students during the COVID-19 pandemicUnivariate analysisMultivariate analysisVariableB95%CIp-ValueB95%CIp-ValueAge-0.32-0.61 to -0.030.03-0.47-0.81 to -0.130.008Female gender4.883.021 to 6.76<0.001---Stable love relationship-2.49-4.35 to -0.640.008-2.5-4.4 to -0.590.01Number of previous comorbidities reported4.693.71 to 5.68<0.0014.823.73 to 5.92<0.001MP-II volunteering-2.81-4.74 to -0.860.005---Worsening in sleep pattern6.414.62 to 8.20<0.0015.013.07 to 6.96<0.001Disclosure of Interests:None declared
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Salviato Pileggi G, Ferreira G, Gomides AP, Reis Neto E, Abreu M, Albuquerque C, Araújo N, Bacchiega AB, Bianchi D, Bica B, Bonfa E, Borba E, Brito D, Duarte A, Peixoto Gu e Silva de Souza M, Wagner Poti Gomes K, Maria Kakehasi A, Cavalheiro Do Espírito Santo R, Realle P, Klumb E, Lanna CC, Marques C, Monticielo O, Mota L, Munhoz G, Paiva E, Pereira H, Provenza JR, Ribeiro S, Rocha Jr L, Sampaio C, Sampaio V, Sato E, Laroca Skare T, De Souza V, Valim V, Lacerda M, Xavier R, Pinheiro M. POS1252 COVID-19 IN PATIENTS WITH RHEUMATIC DISEASES ON CHRONIC USE OF HYDROXYCHLOROQUINE IN A LARGE BRAZILIAN COHORT – A 24-WEEK PROSPECTIVE STUDY. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.3727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:The role of chronic use of hydroxychloroquine (HCQ) in rheumatic disease (RD) patients during the SARS-CoV-2 pandemic is still subject of discussion.Objectives:To compare the occurrence of COVID-19 and its outcomes between RD patients on HCQ use with individuals from the same household not taking the drug during community viral transmission in an observational prospective multicenter study in Brazil.Methods:Participants were enrolled and monitored through 24-week (From March 29th to Sep 30th, 2020) regularly scheduled phone calls performed by trained medical professionals. Epidemiological and demographic data, as well as RD disease activity status and current treatment data, specific information about COVID-19, hospitalization, need for intensive care, and death was recorded in both groups and stored in the Research Electronic Data Capture (REDCap) database. COVID-19 was defined according to the Brazilian Ministry of Health (BMH) criteria. The statistical analysis was performed using IBM-SPSS v.20.0 software. Group comparisons were made using the Man-Whitney, Chi-Square and Fisher Exact Test, as well as multivariate regression models adjusted to confounders. Survival curves were performed using Kaplan-Meier analysis.Results:A total of 10,427 participants mean age (SD) of 44.04 (14.98) years were enrolled, including 6004 (57.6%) rheumatic disease patients, of whom 70.8% had systemic lupus erythematosus (SLE), 6.7% rheumatoid arthritis (RA), 4% primary Sjögren’s syndrome (pSS), 1.8% mixed connective tissue disease (DMTC), 1% systemic sclerosis (SSc) and others (15.9), including overlap syndromes. In total, 1,132 (10.8%) participants fulfilled criteria for COVID-19, being 6.7% RD patients and 4.1% controls (p=0.002). A recent influenza vaccination had a protective role (p<0.001). Moderate and severe COVID-19 included the need for hospitalization, intensive care, mechanical ventilation or death. Infection severity was not different between groups (p=0.391) (Table 1). After adjustments for multiple confounders, the main risk factors significantly associated with COVID-19 were higher education level (OR=1.29 95%CI 1.05-1.59), being healthcare professionals (OR=1.91; 95%CI 1.45-2.53), presence of two comorbidities (OR=1.31; 95%CI 1.01-1.66) and three or more comorbidities associated (OR=1.69; 95%CI 1.23-2.32). Interestingly, age >=65 years (OR=0.20; 95%CI 0.11-0.34) was negatively associated. Regarding RD, the risk factors associated with COVID-19 diagnosys were SLE (OR= 2.37; 95%CI 1.92-293), SSc (OR=2.25; 95%CI 1.05-4.83) and rituximab use (OR=1.92; 95%CI 1.13-3.26). In addition, age >=65 years (OR=5.47; 95%CI 1.7-19.4) and heart disease (OR=2.60; 95%CI 1.06-6.38) were associated with hospitalization. Seven female RD patients died, six with SLE and one with pSS, and the presence of two or more comorbidities were associated with higher mortality rate.Conclusion:Chronic HCQ use did not prevent COVID-19 in RD compared to their household cohabitants. Health care profession, presence of comorbidities LES, SSc and rituximab were identified as main risk factors for COVID-19 and aging and heart disease as higher risk for hospitalization. Our data suggest these outcomes could be considered to manage them in clinical practice.Table 1.Frequency and severity of COVID-19 in patients with rheumatic diseases on chronic use of hydroxychloroquine compared to their household controlsCOVID-19 outcomesTotal(%)GroupsPPatients(%)Controls (%)DiagnosisNo9256 (89.1)5300 (88.3)3956 (90.2)0.002Yes1132 (10.9)704 (11.7)428 (9.8)SeverityMild1059 (93.6)662 (94.0)397 (92.8)0.391Moderate52 (4.6)32 (4.5)20 (4.7)Severe21 (1.9)10 (1.4)11 (2.6)HCQ: hydroxychloroquine.Moderate and severe COVID-19 included the need for any of the following: hospitalization, intensive care, mechanical ventilation or death.Acknowledgements:To the Brazilian Society of Rheumatology for technical support and rapid nationwide mobilization.To all the 395 interviewers (medical students and physicians) who collaborated in the study and the participantsTo CNPq (Number 403442/2020-6)Disclosure of Interests:None declared
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Rocha J, Soares P, Filipe C, Lopes S, Teixeira M, Fonseca I, Sousa J, Marquês D, Mestre R, Duarte A, Santana R. Inpatient Hospitalizations during the First Wave of COVID-19 in Portugal. Port J Public Health 2021. [PMCID: PMC8018194 DOI: 10.1159/000514163] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
The objective of this study was to analyze the impact of the pandemic on inpatient hospital admissions during the first wave in Portugal. Data from hospital admissions in mainland Portugal from 2008 to 2017 were used to forecast inpatient hospital admissions for March to May 2020. The observed number of hospitalizations and their characteristics were compared to forecasted values. Variations were compared by hospital and region. Statistical analysis was used to investigate whether patterns of variations existed according to hospital characteristics. There were 119,315 fewer hospitalizations than expected during March to May 2020 in Portugal, which represented a 57% reduction. Non-COVID-19 hospitalizations had a higher mean length of stay and proportion of inpatient deaths than forecasted values. Differences between observed and forecasted values varied greatly among regions and hospitals. These variations were not associated with COVID-19 hospital admissions, region, forecasted number of hospitalizations, type of hospital, or occupation rate. The impact on inpatient hospital admissions for each hospital was not consistent or proportional to the expected use across Portugal, as indicated by variations between forecasted and observed values. The appropriate planning of future responses may contribute to improving the necessary balance between the level of hospital admissions for usual health needs of the population and the response to COVID-19 patients.
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Affiliation(s)
- João Rocha
- National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
- *João Rocha, Escola Nacional de Saúde Pública, Avenida Padre Cruz, PT–1600-560 Lisbon (Portugal),
| | - Patrícia Soares
- National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Catarina Filipe
- National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Sílvia Lopes
- National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Mário Teixeira
- National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Inês Fonseca
- National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Joana Sousa
- National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Diana Marquês
- National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Ricardo Mestre
- Administração Central do Sistema de Saúde, Ministério da Saúde, Lisbon, Portugal
| | - António Duarte
- Administração Central do Sistema de Saúde, Ministério da Saúde, Lisbon, Portugal
| | - Rui Santana
- National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
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Duarte A, Gouveia E Melo R, Lopes A, Rato JP, Valente J, Pedro LM. Lessons Learned from the Impact of the COVID-19 Pandemic in a Vascular Surgery Department and Preparation for Future Outbreaks. Ann Vasc Surg 2021; 73:97-106. [PMID: 33493593 PMCID: PMC7825916 DOI: 10.1016/j.avsg.2021.01.060] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 01/01/2021] [Accepted: 01/03/2021] [Indexed: 02/07/2023]
Abstract
Objectives This study aims to report the changes and adaptations of a vascular tertiary center during a global pandemic and the impact on its activity and patients. Methods We conducted a retrospective cohort study within the Vascular Surgery ward in Centro Hospitalar Universitário Lisboa Norte, Portugal. All data from surgical, inpatient and outpatient activity were collected from February to June 2020 and compared to the same 5-month period in 2018 and 2019. We ran a descriptive analysis of all data and performed statistical tests for the variation of procedures and admissions between February and June 2018 and the same time period in 2020. Results During the outbreak, our staff had to be readapted. Six nurses were transferred to COVID-19 units (out of a total of 33 nurses) while 1 of the 7 residents was transferred to an intensive care unit and 1 senior surgeon was put on prophylactic leave. In the outpatient clinic, there was an increase in the number of telemedicine consultations with a greater focus on first-time referrals and urgent cases. There was a significant increase in the total number of elective admissions whereas there were significantly less admissions from an emergency setting (+57% and −54%, respectively, P < 0.001). The vascular surgery team performed a total number of 584 procedures between February and June 2020 (−17.8% compared to 2018 and 2019), with a significant increase in the number of endovascular procedures (P < 0.001) and in the use of local and regional anesthesia (P < 0.001), especially in the Angio Suite (+600%, P < 0.001). Comparing with 2018 and 2019, the surgical team performed less outpatient procedures in early 2020. We reported a significant increase in the total number of procedures for patients with a chronic limb-threatening ischemia (CLTI) diagnosis (+21%, P < 0.001). We did not report significant changes in the proportion of other vascular conditions. Regarding mortality, we observed a 16% decrease in the intraoperative mortality (P 0.67). Conclusions In this study, we assessed the impact of the COVID-19 outbreak in daily activity during the contingency period. During the outbreak, there was an overall decline in outpatient clinics and inpatient admissions. Nevertheless, and despite the restrictions imposed by the pandemic and health authorities, we managed to maintain most procedures for most vascular diseases, particularly for CLTI urgent cases, without a significant increase in the mortality rate. Stringent protective measures for patient and staff or higher use of endovascular techniques and local anesthesia are some of the successful changes implemented in the department. These learned lessons are to be pursued as the pandemic evolves with future outbreaks of COVID-19, such as the current second outbreak currently spreading through Europe.
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Affiliation(s)
- António Duarte
- Vascular Surgery Department, Hospital Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), Lisboa, Portugal; Cardiovascular Center of the University of Lisbon (CCUL), Lisboa, Portugal.
| | - Ryan Gouveia E Melo
- Vascular Surgery Department, Hospital Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), Lisboa, Portugal; Cardiovascular Center of the University of Lisbon (CCUL), Lisboa, Portugal; Faculty of Medicine, University of Lisbon, Lisboa, Portugal
| | - Alice Lopes
- Vascular Surgery Department, Hospital Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), Lisboa, Portugal; Cardiovascular Center of the University of Lisbon (CCUL), Lisboa, Portugal
| | - João Pedro Rato
- Vascular Surgery Department, Hospital Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), Lisboa, Portugal; Cardiovascular Center of the University of Lisbon (CCUL), Lisboa, Portugal
| | - João Valente
- Anesthesiology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), Lisboa, Portugal
| | - Luís Mendes Pedro
- Vascular Surgery Department, Hospital Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), Lisboa, Portugal; Cardiovascular Center of the University of Lisbon (CCUL), Lisboa, Portugal; Faculty of Medicine, University of Lisbon, Lisboa, Portugal
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Gouveia E Melo R, Martins B, Pedro DM, Santos CM, Duarte A, Fernandes E Fernandes R, Garrido P, Mendes Pedro L. Microbial evolution of vascular graft infections in a tertiary hospital based on positive graft cultures. J Vasc Surg 2020; 74:276-284.e4. [PMID: 33348004 DOI: 10.1016/j.jvs.2020.12.071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 12/09/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Vascular graft infections are a serious complication in vascular surgery. Correct antibiotic therapy targeted to the most likely infecting species is essential to treat these patients, although the bacterial epidemiology and pathogenesis are still not completely understood. We analyzed the behavior of vascular graft infections and the microbiologic patterns of resistance. METHODS A 10-year (2008-2018), single-center, retrospective cohort study was performed of all patients admitted with vascular graft infection identified by positive direct graft cultures. An extensive microbiologic study was performed to analyze the bacterial strains, antibiotic resistance and sensitivity, and prevalence stratified by the year. RESULTS A total of 72 vascular graft infections with positive graft cultures occurring in 65 patients were found. Their mean age was 67 ± 9.6 years, and 85% were men. Infection-related mortality was 11%. Of the 65 patients, 14 had undergone aortobifemoral bypass, 13 axillofemoral bypass, 5 femorofemoral bypass, 27 femoropopliteal bypass, and 4 femoral endarterectomy with synthetic patch angioplasty. The median interval from the index procedure to infection was longer for intracavitary than for extracavitary grafts (P = .011). Of the 72 infections, 48 were monomicrobial and 24 were polymicrobial. Gram-negative bacteria were predominantly identified in intracavitary graft infections (54%). In contrast, gram-positive bacteria were most frequent in the extracavitary graft group (58%). Multidrug-resistant bacterial species occurred more frequently in early graft infections (P = .002). Throughout the study duration, an overall decrease in gram-positive infections and an increase in gram-negative infections was observed, especially in extensively drug-resistant strains. A similar progression was found in all nosocomial infections. CONCLUSIONS The present study has shown that vascular graft infection microbiology changed in accordance with graft location and interval to infection from revascularization surgery and had also evolved over the study period with patterns similar to those for all nosocomial infections. This highlights the importance of studying the specific microbiology of each healthcare center and its relationship to vascular graft infections to achieve the best treatment possible.
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Affiliation(s)
- Ryan Gouveia E Melo
- Faculty of Medicine, University of Lisbon, Hospital Santa Maria (Centro Hospitalar Universitário Lisboa Norte), Lisbon, Portugal; Division of Vascular Surgery, Heart and Vessels Department, Hospital Santa Maria (Centro Hospitalar Universitário Lisboa Norte), Lisbon, Portugal; Lisbon Academic Medical Centre, Lisbon, Portugal.
| | - Beatriz Martins
- Faculty of Medicine, University of Lisbon, Hospital Santa Maria (Centro Hospitalar Universitário Lisboa Norte), Lisbon, Portugal
| | - Diogo Mendes Pedro
- Faculty of Medicine, University of Lisbon, Hospital Santa Maria (Centro Hospitalar Universitário Lisboa Norte), Lisbon, Portugal; Lisbon Academic Medical Centre, Lisbon, Portugal; Infectious Disease Department, Hospital Santa Maria (Centro Hospitalar Universitário Lisboa Norte), Lisbon, Portugal
| | - Carla Mimoso Santos
- Faculty of Medicine, University of Lisbon, Hospital Santa Maria (Centro Hospitalar Universitário Lisboa Norte), Lisbon, Portugal; Lisbon Academic Medical Centre, Lisbon, Portugal; Grupo de Coordenação Local do Programa de Prevenção e Controlo de Infeção e Resistência aos Antimicrobianos do Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal; Infectious Disease Department, Hospital Santa Maria (Centro Hospitalar Universitário Lisboa Norte), Lisbon, Portugal
| | - António Duarte
- Division of Vascular Surgery, Heart and Vessels Department, Hospital Santa Maria (Centro Hospitalar Universitário Lisboa Norte), Lisbon, Portugal; Lisbon Academic Medical Centre, Lisbon, Portugal
| | - Ruy Fernandes E Fernandes
- Faculty of Medicine, University of Lisbon, Hospital Santa Maria (Centro Hospitalar Universitário Lisboa Norte), Lisbon, Portugal; Division of Vascular Surgery, Heart and Vessels Department, Hospital Santa Maria (Centro Hospitalar Universitário Lisboa Norte), Lisbon, Portugal; Lisbon Academic Medical Centre, Lisbon, Portugal
| | - Pedro Garrido
- Division of Vascular Surgery, Heart and Vessels Department, Hospital Santa Maria (Centro Hospitalar Universitário Lisboa Norte), Lisbon, Portugal; Lisbon Academic Medical Centre, Lisbon, Portugal
| | - Luís Mendes Pedro
- Faculty of Medicine, University of Lisbon, Hospital Santa Maria (Centro Hospitalar Universitário Lisboa Norte), Lisbon, Portugal; Division of Vascular Surgery, Heart and Vessels Department, Hospital Santa Maria (Centro Hospitalar Universitário Lisboa Norte), Lisbon, Portugal; Lisbon Academic Medical Centre, Lisbon, Portugal
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Ramos D, Mancuso R, Paiva L, Duarte A, Ferro K, Contieri B, Saad S, Lazarini M. A SUBFAMÍLIA RAC DE RHO GTPASES REPRESENTA UM POTENCIAL ALVO TERAPÊUTICO NA LEUCEMIA MIELOIDE AGUDA. Hematol Transfus Cell Ther 2020. [DOI: 10.1016/j.htct.2020.10.232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Moretti K, Aluisio A, Chen J, Aguiar Martinez L, Vallejo J, Carranza H, Gallo Marin B, Duarte A, Clark M, Beaudoin F, Arbelaez C. 43 Knowledge and Confidence in the Treatment of Emergent Conditions among Graduating Medical Students Across Colombia. Ann Emerg Med 2020. [DOI: 10.1016/j.annemergmed.2020.09.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Mendonça L, Trindade A, Carvalho C, Correia J, Badenes M, Gigante J, Duarte A. Metastasis is impaired by endothelial-specific Dll4 loss-of-function through inhibition of epithelial-to-mesenchymal transition and reduction of cancer stem cells and circulating tumour cells. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz269.005] [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: 11/14/2022] Open
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Fiedler IAK, Zeveleva S, Duarte A, Zhao X, Depalle B, Cardoso L, Jin S, Berteau JP. Microstructure, mineral and mechanical properties of teleost intermuscular bones. J Biomech 2019; 94:59-66. [PMID: 31427091 DOI: 10.1016/j.jbiomech.2019.07.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 06/12/2019] [Accepted: 07/09/2019] [Indexed: 12/12/2022]
Abstract
There is an increasing interest in understanding teleost bone biomechanics in several scientific communities, for instance as interesting biomaterials with specific structure-function relationships. Intermuscular bones of teleost fish have previously been described to play a role in the mechanical force transmission between muscle and bone, but their biomechanical properties are not yet fully described. Here, we have investigated intermuscular bones (IBs) of the North Atlantic Herring with regard to their structure and micro-architecture, mineral-related properties, and micro-mechanical tensile properties. A total of 115 IBs from 18 fish were investigated. One cohort of IBs, containing 20 bones from 2 smaller fish and 23 bones of 3 larger fish, was used for mechanical testing, wide-angle X-ray scattering, and scanning electron microscopy. Another cohort, containing 36 bones from 7 smaller fish and 36 bones from 6 larger fish, was used for microCT. Results show some astonishing properties of the IBs: (i) IBs present higher ductility, lower Young's modulus but similar strength and TMD (Tissue Mineral Density) compared to mammalian bone, and (ii) IBs from small fish were 49% higher in Young's modulus than fish bones from larger fish while their TMD was not statistically different and crystal length was 8% higher in large fish bones. Our results revealed that teleost IB presents a hybrid nature of soft and hard tissue that differs from other bone types, which might be associated with their evolution from mineralized tendons. This study provides new data regarding teleost fish bone biomechanical and micro-structural properties.
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Affiliation(s)
- I A K Fiedler
- Department of Physical Therapy, City University of New York - College of Staten Island, USA; Department of Osteology and Biomechanics, University Medical Center Hamburg Eppendorf, DE, Germany
| | - S Zeveleva
- Department of Physical Therapy, City University of New York - College of Staten Island, USA
| | - A Duarte
- Department of Physical Therapy, City University of New York - College of Staten Island, USA
| | - X Zhao
- Department of Chemistry, City University of New York - College of Staten Island, USA
| | - B Depalle
- Department of Materials, Imperial College London, UK
| | - L Cardoso
- Department of Biomedical Engineering, City University of New York - City College of New York, USA
| | - S Jin
- Department of Chemistry, City University of New York - College of Staten Island, USA
| | - J P Berteau
- Department of Physical Therapy, City University of New York - College of Staten Island, USA; New York Center for Biomedical Engineering, City University of New York - City College of New York, USA; Nanoscience Initiative, Advanced Science Research Center, City University of New York, USA.
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Abstract
Although oncogynaecological management of bulky vulvar tumors tends to minimally-invasive approaches preceded by neoadjuvant therapies, ultra-radical surgery with curative intent may still have an important role. These procedures remain associated with significant short and long-term complications, imposing the need for novel reconstructive techniques [Brown et al., 2017, Di Donato et al., 2017, Moreno-Palacios et al., 2015, Oonk et al., 2017]. We present a video highlighting the crucial surgical steps of a successful pelvic exenterative procedure followed by perineal reconstruction with a muscle-sparing flap technique. A 72-year woman with history of stage II vulvar epidermoid carcinoma, treated with radical surgery and adjuvant radiotherapy. At two-year follow-up local recurrence was diagnosed, handled with large excisional surgical treatment. Within four years a second local recurrence occurred, with infiltrative and bulky dimensions extending to perianal region and vaginal wall. A multidisciplinary surgical approach with curative intent was performed, involving gynecologists, colorectal and plastic surgeons: radical bilateral vulvectomy with distal colpectomy, abdominoperineal resection with colostomy, perineal reconstruction with deep inferior epigastric perforators (DIEP) flap. No major intraoperative or postoperative complications occurred, and the patient was discharged within two weeks with no readmissions for wound care. At two-year follow up she remains in complete remission of the disease. No flap complications occurred during this period. In highly selected patients with recurrent vulvar cancer previously submitted to multiple surgeries and radiotherapy, pelvic exenterative procedures followed by reconstructive techniques allow free surgical margins minimizing morbidity and pelvic disfiguring surgery. Association of reconstructive techniques to radical vulvo-vaginal surgery can shift the paradigm of oncological treatment approach, improving outcomes and quality-of-life. In selected cases of recurrent vulvar cancer, radical procedures still play a role. A multidisciplinary surgical approach is crucial for better outcomes. Novel reconstructive techniques improve patient satisfaction and quality-of-life. The DIEP flap is a complex but feasible option for large perineal defects.
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Affiliation(s)
- M Rei
- Department of Obstetrics and Gynecology, Centro Hospitalar de São João, Porto, Portugal.,Medical School, University of Porto, Portugal
| | - R Mota
- Department of Obstetrics and Gynecology, Centro Hospitalar de São João, Porto, Portugal
| | - V Paiva
- Department of Obstetrics and Gynecology, Centro Hospitalar de São João, Porto, Portugal
| | - A Duarte
- Department of General Surgery, Centro Hospitalar de São João, Porto, Portugal
| | - J Costa
- Department of Plastic Surgery, Centro Hospitalar de São João, Porto, Portugal
| | - A Costa
- Department of Obstetrics and Gynecology, Centro Hospitalar de São João, Porto, Portugal.,Medical School, University of Porto, Portugal
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Figueiredo MC, Dias H, Amendoeira J, Spínola A, André C, Godinho C, Duarte A, Pintor M, Ferreira M. O8 Impact evaluation of literacy on health in school from the third cycle of basic education: a scoping review. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz098.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M C Figueiredo
- Health Higher School of Santarém, Monitoring Unity of Health Indicators (UMIS), IPSantarém Research Unit, Polytechnic Institute of Santarém, Santarém, PORTUGAL
| | - H Dias
- Health Higher School of Santarém, Monitoring Unity of Health Indicators (UMIS), IPSantarém Research Unit, Polytechnic Institute of Santarém, Santarém, PORTUGAL
- Centre for Health Technology and Services Research (CINTESIS), University of Porto, Porto, PORTUGAL
| | - J Amendoeira
- Health Higher School of Santarém, Monitoring Unity of Health Indicators (UMIS), IPSantarém Research Unit, Polytechnic Institute of Santarém, Santarém, PORTUGAL
- Center for Interdisciplinary Research in Health (CIIS), Universidade Católica Portuguesa, Lisbon, PORTUGAL
| | - A Spínola
- Health Higher School of Santarém, Monitoring Unity of Health Indicators (UMIS), IPSantarém Research Unit, Polytechnic Institute of Santarém, Santarém, PORTUGAL
- Centre for Health Technology and Services Research (CINTESIS), University of Porto, Porto, PORTUGAL
| | - C André
- Health Higher School of Santarém, Monitoring Unity of Health Indicators (UMIS), IPSantarém Research Unit, Polytechnic Institute of Santarém, Santarém, PORTUGAL
| | - C Godinho
- Health Higher School of Santarém, Monitoring Unity of Health Indicators (UMIS), IPSantarém Research Unit, Polytechnic Institute of Santarém, Santarém, PORTUGAL
| | - A Duarte
- Health Higher School of Santarém, Monitoring Unity of Health Indicators (UMIS), Polytechnic Institute of Santarém, Santarém, PORTUGAL
| | - M Pintor
- Health Higher School of Santarém, Monitoring Unity of Health Indicators (UMIS), Polytechnic Institute of Santarém, Santarém, PORTUGAL
| | - M Ferreira
- Health Higher School of Santarém, Monitoring Unity of Health Indicators (UMIS), Polytechnic Institute of Santarém, Santarém, PORTUGAL
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Duarte A, Castro M, Fernandes O. What is the influence of the use of headphones on balance, assessed by the distance of postural oscillations, in young adults? Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz035.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A Duarte
- RoboCorp, ESTeSC - Coimbra Health School, Instituto Politécnico de Coimbra, Portugal
| | - M Castro
- RoboCorp, ESTeSC - Coimbra Health School, Instituto Politécnico de Coimbra, Portugal
- CEMMPRE, Universidade de Coimbra, Portugal
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Sigmund EE, Baete SH, Luo T, Patel K, Wang D, Rossi I, Duarte A, Bruno M, Mossa D, Femia A, Ramachandran S, Stoffel D, Babb JS, Franks AG, Bencardino J. Correction to: MRI assessment of the thigh musculature in dermatomyositis and healthy subjects using diffusion tensor imaging, intravoxel incoherent motion and dynamic DTI. Eur Radiol 2019; 29:1061. [DOI: 10.1007/s00330-018-5606-9] [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: 10/28/2022]
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Rottenberg S, Duarte A, Duarte E, Francica P, Mutlu M, Blatter S, Sachs N, Clevers H, Jonkers J. BRCA-deficient mouse mammary tumour organoids as a rapid tool to study anti-cancer drug resistance. J Comp Pathol 2019. [DOI: 10.1016/j.jcpa.2018.10.065] [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]
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Chevallier J, Duarte A, Löcherbach E, Ost G. Mean field limits for nonlinear spatially extended Hawkes processes with exponential memory kernels. Stoch Process Their Appl 2019. [DOI: 10.1016/j.spa.2018.02.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Duarte A, Botteldoorn N, Miller W, Coucke W, Martiny D, Hallin M, Seliwiorstow T, De Zutter L, Uyttendaele M, Vandenberg O, Dierick K. Relation between broiler and humanCampylobacter jejunistrains isolated in Belgium from 2011 to 2013. J Appl Microbiol 2018; 126:277-287. [DOI: 10.1111/jam.14132] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 09/05/2018] [Accepted: 09/06/2018] [Indexed: 12/31/2022]
Affiliation(s)
- A. Duarte
- Laboratory of Food Microbiology and Food Preservation; Department of Food Safety and Food Quality; Faculty of Bioscience Engineering; Ghent University; Gent Belgium
- National Reference Laboratory for Campylobacter; Sciensano; Scientific Service Foodborne Pathogens; Brussels Belgium
| | - N. Botteldoorn
- National Reference Laboratory for Campylobacter; Sciensano; Scientific Service Foodborne Pathogens; Brussels Belgium
| | - W.G. Miller
- USDA, ARS, WRRC, Produce Safety and Microbiology; Albany CA USA
| | - W. Coucke
- Section Quality of Laboratories; Sciensano; Brussels Belgium
| | - D. Martiny
- National Reference Center for Campylobacter; Saint Pierre University Hospital; Brussels Belgium
- Department of Microbiology; LHUB-ULB; Pôle Hospitalier Universitaire de Bruxelles; Brussels Belgium
| | - M. Hallin
- National Reference Center for Campylobacter; Saint Pierre University Hospital; Brussels Belgium
- Department of Molecular Diagnosis; LHUB-ULB; Pôle Hospitalier Universitaire de Bruxelles; Brussels Belgium
| | - T. Seliwiorstow
- Laboratory of Food Microbiology and Food Preservation; Department of Food Safety and Food Quality; Faculty of Bioscience Engineering; Ghent University; Gent Belgium
- Department of Veterinary Public Health and Food Safety; Faculty of Veterinary Medicine; Ghent University; Merelbeke Belgium
| | - L. De Zutter
- Department of Veterinary Public Health and Food Safety; Faculty of Veterinary Medicine; Ghent University; Merelbeke Belgium
| | - M. Uyttendaele
- Laboratory of Food Microbiology and Food Preservation; Department of Food Safety and Food Quality; Faculty of Bioscience Engineering; Ghent University; Gent Belgium
| | - O. Vandenberg
- National Reference Center for Campylobacter; Saint Pierre University Hospital; Brussels Belgium
- Department of Microbiology; LHUB-ULB; Pôle Hospitalier Universitaire de Bruxelles; Brussels Belgium
- Center for Environmental Health and Occupational Health; School of Public Health; Université Libre de Bruxelles; Brussels Belgium
| | - K. Dierick
- National Reference Laboratory for Campylobacter; Sciensano; Scientific Service Foodborne Pathogens; Brussels Belgium
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Bento MC, Canha R, Eira C, Vingada J, Nicolau L, Ferreira M, Domingo M, Tavares L, Duarte A. Herpesvirus infection in marine mammals: A retrospective molecular survey of stranded cetaceans in the Portuguese coastline. Infect Genet Evol 2018; 67:222-233. [PMID: 30445114 DOI: 10.1016/j.meegid.2018.11.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 11/12/2018] [Accepted: 11/12/2018] [Indexed: 10/27/2022]
Abstract
Herpesvirus (HVs) infection has already been reported in cetaceans, but available information on its epidemiology is scarce. In this study we surveyed a total of 179 cetaceans belonging to 6 different species. Samples were obtained from cetaceans stranded along the Portuguese coastline, belonging to populations that roam the north-east region of the Atlantic Ocean. Detection of HVs was performed by conventional nested PCR. Amplicons were sequenced by Sanger's method and sequences used to construct phylogenetic trees by Maximum Likelihood method. Our results show that prevalence of positive samples, among fresh carcasses, reached 14.3% (10/70) and both alpha and gammaherpesvirus were detected. Histopathology showed that herpesvirus infection varied from absence of signs compatible with disease, localized genital lesions and systemic disease. Phylogenetic analysis revealed three clusters within the alphaherpesvirus family; within the gammaherpesvirus no subdivision was detected. All clusters included animals from different species and geographic origins. In seven of the positive HVs samples, co-infections with other agents such as morbillivirus and toxoplasma gondii were detected. The viral nucleotide sequences were not assigned to a specific animal species, nor presented a given geographic distribution, which may imply a wider distribution of herpesvirus in these animal populations. Our results are also the first report of herpesvirus infection in common dolphins (Delphinus delphis), with both alpha and gammaherpesvirus detected.
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Affiliation(s)
- M C Bento
- CIISA Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, 1300-477 Lisbon, Portugal.
| | - R Canha
- CIISA Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, 1300-477 Lisbon, Portugal
| | - C Eira
- Department of Biology and CESAM, University of Aveiro, 3810-193 Aveiro, Portugal; Portuguese Wildlife Society, Department of Biology, Minho University, 4710-057 Braga, Portugal
| | - J Vingada
- Portuguese Wildlife Society, Department of Biology, Minho University, 4710-057 Braga, Portugal; Department of Biology and CESAM, Minho University, 4710-057 Braga, Portugal
| | - L Nicolau
- Department of Biology and CESAM, University of Aveiro, 3810-193 Aveiro, Portugal; Portuguese Wildlife Society, Department of Biology, Minho University, 4710-057 Braga, Portugal
| | - M Ferreira
- Portuguese Wildlife Society, Department of Biology, Minho University, 4710-057 Braga, Portugal; Department of Biology and CBMA, Minho University, 4710-057 Braga, Portugal
| | - M Domingo
- Departament de Sanitat i Anatomia Animals, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
| | - L Tavares
- CIISA Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, 1300-477 Lisbon, Portugal
| | - A Duarte
- CIISA Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, 1300-477 Lisbon, Portugal
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Duarte A, Bojke C, Cayton W, Salawu A, Case B, Bojke L, Richardson G. Impact of specialist rehabilitation services on hospital length of stay and associated costs. Eur J Health Econ 2018; 19:1027-1034. [PMID: 29282588 PMCID: PMC6105206 DOI: 10.1007/s10198-017-0952-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Accepted: 12/14/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Provision of specialist rehabilitation services in North Yorkshire and Humberside may be suboptimal. Local commissioning bodies need to prioritise investments in health care, but previous studies provide limited evidence to inform the decision to expand existing services on the basis of cost-effectiveness. We examine the impact of specialist rehabilitation services in the subregion on hospital length of stay (LoS) and associated costs compared to routine care. METHODS Comparison of hospital LoS and associated costs in centres with greater access (Hull) and limited access (i.e. routine care, York and Northern Lincolnshire), to specialist rehabilitation services for patients with complex disabilities following illness or injury, using Hospital Episodes Statistics data. RESULTS Average LoS and duration costs by Healthcare Resource Group (HRG) were lower for the majority of patients with greater access to specialist rehabilitation compared to routine care. Difference in LoS between groups widened with level of complexity within each HRG. For the more frequent HRG codes, the LoS difference was as high as 34 days longer for York compared to Hull and £7900 more costly. CONCLUSION Rehabilitation patients within York and Northern Lincolnshire areas appear to have longer LoS and higher associated costs compared to those admitted to the Hull Trust. This analysis suggests that specialist rehabilitation may be cost saving compared to routine care and supports the case for expansion of the existing services to improve coverage in the area.
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Affiliation(s)
- A Duarte
- Centre for Health Economics, University of York, Heslington, York, YO10 5DD, UK.
| | - C Bojke
- Faculty of Medicine and Health, Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds, LS2 9NL, UK
| | - W Cayton
- Hull and East Yorkshire Hospitals NHS Trust, Hull, HU3 2JZ, UK
| | - A Salawu
- Hull and East Yorkshire Hospitals NHS Trust, Hull, HU3 2JZ, UK
- Hull York Medical School, Hull, HU6 7RX, UK
- Department of Health, Sports and Exercise Science, University of Hull, Hull, HU6 7RX, UK
| | - B Case
- NHS Vale of York Clinical Commissioning Group, York, YO1 6GA, UK
| | - L Bojke
- Centre for Health Economics, University of York, Heslington, York, YO10 5DD, UK
| | - G Richardson
- Centre for Health Economics, University of York, Heslington, York, YO10 5DD, UK
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Oliveira J, Duarte A, Santos C, Pessoa L, Filho CM, Lima J, Carvalho D, Xavier T, Figueiredo E, Giovanetti M, Almeida B, Goes J, Lima F, Alcantara L, Siqueira I. Prevalence of Zika, dengue and Chikungunya virus infection in pregnant women and surveillance of congenital Zika infection in Salvador, Brazil. Int J Infect Dis 2018. [DOI: 10.1016/j.ijid.2018.04.3826] [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] [Indexed: 10/28/2022] Open
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Almeida B, Cabral J, Faiçal A, Oliveira J, Souza M, Salles C, Vianna M, D’Agostino E, Ferreira N, Reis L, Embiruçu E, Santos C, Duarte A, Acosta A, Siqueira I. Discordant congenital Zika virus infection in dizygotic twins: a case report. Int J Infect Dis 2018. [DOI: 10.1016/j.ijid.2018.04.3662] [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] Open
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Duarte A, Lopes de Almeida J, Martins Ú, Magro C, Lima C, Araújo S, Pereira N, Coutinho M, Marques H. Epiglottic kinematics alterations and risk of laryngeal penetration-aspiration. Ann Phys Rehabil Med 2018. [DOI: 10.1016/j.rehab.2018.05.434] [Citation(s) in RCA: 2] [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: 12/01/2022]
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Weckerly F, Bhaskar G, Duarte A, Luna R, Starns H. Heavier rumen–reticulum organs in white-tailed deer ( Odocoileus virginianus) is consistent with dietary bulk not quality. CAN J ZOOL 2018. [DOI: 10.1139/cjz-2017-0036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The organs that make up the gastrointestinal tract have high energy demands. Therefore, when these organs vary in mass, they should impact metabolic requirements. Mass of the rumen–reticulum organs, the organs that comprise the largest part of the gastrointestinal tract of ruminants, might vary from bulk or nutrient availability of the diet. We examined differences in mass of the rumen–reticulum organs in white-tailed deer (Odocoileus virginianus (Zimmermann, 1780)) from two sites in Texas, USA, with different diet types. Specifically, at one site deer were fed a pelleted ration and at the other site deer consumed a natural browse diet. Accounting for body mass, deer consuming the browse diet had rumen–reticulum organ masses that were about 1.7 times heavier than deer consuming the pelleted diet. Deer consuming the browse diet also had lower diet quality, as indexed by crude protein concentration, than deer consuming the pelleted diet. The digesta loads of deer, however, were similar for the two types of diet. Our study findings are consistent with increased mass of rumen–reticulum organs from greater bulk, not diet quality. Understanding variation in rumen–reticulum organ mass has implications for understanding energy conservation in white-tailed deer.
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Affiliation(s)
- F.W. Weckerly
- Department of Biology, Texas State University, San Marcos, TX 78666, USA
- Department of Biology, Texas State University, San Marcos, TX 78666, USA
| | - G. Bhaskar
- Department of Biology, Texas State University, San Marcos, TX 78666, USA
- Department of Biology, Texas State University, San Marcos, TX 78666, USA
| | - A. Duarte
- Department of Biology, Texas State University, San Marcos, TX 78666, USA
- Department of Biology, Texas State University, San Marcos, TX 78666, USA
| | - R.S. Luna
- Department of Biology, Texas State University, San Marcos, TX 78666, USA
- Department of Biology, Texas State University, San Marcos, TX 78666, USA
| | - H.D. Starns
- Department of Biology, Texas State University, San Marcos, TX 78666, USA
- Department of Biology, Texas State University, San Marcos, TX 78666, USA
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Sigmund EE, Baete SH, Luo T, Patel K, Wang D, Rossi I, Duarte A, Bruno M, Mossa D, Femia A, Ramachandran S, Stoffel D, Babb JS, Franks AG, Bencardino J. MRI assessment of the thigh musculature in dermatomyositis and healthy subjects using diffusion tensor imaging, intravoxel incoherent motion and dynamic DTI. Eur Radiol 2018; 28:5304-5315. [DOI: 10.1007/s00330-018-5458-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 03/23/2018] [Accepted: 04/03/2018] [Indexed: 12/20/2022]
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Duarte A, Graça S, Salvada A, Teixeira P, Pires Lourenço A, Costa E, Ribeiro J, Lima C, Abrantes A, Botelho M. PO-275 Effect of ionising radiation in FaDu cell line- preliminary results. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Caballero A, Palma E, Ruiz-Esteban P, Vazquez T, Sola E, Torio A, Cabello M, Lopez V, Jironda C, Duarte A, Alonso-Titos J, Hernández D. CXCR3 + Monocytes Increase Significantly in Graft Blood Compared to Peripheral Blood in Patients With Stable Kidney Graft Function. Transplant Proc 2018; 50:555-559. [PMID: 29579851 DOI: 10.1016/j.transproceed.2017.11.055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Revised: 10/20/2017] [Accepted: 11/11/2017] [Indexed: 12/29/2022]
Abstract
INTRODUCTION We have recently reported that some lymphocyte populations do not maintain the same proportion in kidney graft blood as in peripheral blood, despite a stable function of the transplanted kidney. These results suggest that a comparative study between leukocyte cells from graft blood and those obtained from peripheral blood could provide information about the inflammatory state of the transplanted organ. In this work we selected the population of CD4+ lymphocytes and monocytes expressing CXCR3 to test this hypothesis. MATERIAL AND METHODS The study was performed by flow cytometry during month 3, 6, and 12 after transplantation in 58 patients who received an isolated kidney transplant and the same immunosuppressive regimen. The peripheral blood sample was obtained by venipuncture and the graft blood by fine needle aspiration. RESULTS We found a significant percentage decrease in CXCR3+ monocytes throughout the first year of transplantation in peripheral blood (15.9 ± 20.7 vs. 12.6 ± 12.4 vs. 6.3 ± 9.0, at 3, 6, and 12 months, respectively; P = .001), whereas the percentage of CXCR3+ monocytes in graft blood did not change over this period. This situation resulted in a significant percentage difference between the CXCR3+ monocytes from the graft blood and those from the peripheral blood at the sixth (15.8 ± 8.1 vs. 12.6 ± 12.4, respectively; P = .008) and 12th months (12.9 ± 8.1 vs. 6.3 ± 9.0, respectively; P < .001). CONCLUSIONS Therefore, we can conclude that the significant percentage increase of CXCR3+ monocytes in graft blood with respect to peripheral blood suggests the presence of inflammatory activity despite renal function being stable during the second half of the first year post-transplantation.
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Affiliation(s)
- A Caballero
- Immunology Department, Regional University Hospital of Malaga and University of Malaga, IBIMA, REDINREN (RD16/0009/0006), Malaga, Spain
| | - E Palma
- Nephrology Department, Regional University Hospital of Malaga and University of Malaga, IBIMA, REDINREN (RD16/0009/0006), Malaga, Spain
| | - P Ruiz-Esteban
- Immunology Department, Complejo Hospitalario General Universitario de Albacete, Albacete, Spain
| | - T Vazquez
- Nephrology Department, Regional University Hospital of Malaga and University of Malaga, IBIMA, REDINREN (RD16/0009/0006), Malaga, Spain
| | - E Sola
- Nephrology Department, Regional University Hospital of Malaga and University of Malaga, IBIMA, REDINREN (RD16/0009/0006), Malaga, Spain
| | - A Torio
- Immunology Department, Complejo Hospitalario General Universitario de Albacete, Albacete, Spain
| | - M Cabello
- Nephrology Department, Regional University Hospital of Malaga and University of Malaga, IBIMA, REDINREN (RD16/0009/0006), Malaga, Spain
| | - V Lopez
- Nephrology Department, Regional University Hospital of Malaga and University of Malaga, IBIMA, REDINREN (RD16/0009/0006), Malaga, Spain
| | - C Jironda
- Nephrology Department, Regional University Hospital of Malaga and University of Malaga, IBIMA, REDINREN (RD16/0009/0006), Malaga, Spain
| | - A Duarte
- Nephrology Department, Regional University Hospital of Malaga and University of Malaga, IBIMA, REDINREN (RD16/0009/0006), Malaga, Spain
| | - J Alonso-Titos
- Nephrology Department, Regional University Hospital of Malaga and University of Malaga, IBIMA, REDINREN (RD16/0009/0006), Malaga, Spain
| | - D Hernández
- Nephrology Department, Regional University Hospital of Malaga and University of Malaga, IBIMA, REDINREN (RD16/0009/0006), Malaga, Spain.
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Marin GH, Rebollo A, Bruzzoni-Giovanelli H, Schinella G, Piazzon I, Duarte A, Errecalde J. Correction to: T cell leukemia control via Ras-Raf pathway inhibition with peptides. J Med Life 2018; 11:83. [PMID: 29697701 PMCID: PMC5909951] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
[This corrects the article on p. 172 in vol. 10, PMID: 29075346.].
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Affiliation(s)
- GH Marin
- National University of La Plata - Pharmacology Department-CONICET
| | - A Rebollo
- CIMI, Inserm/UPMC/CNRS- Université Pierre et Marie Curie, Paris 6, France; Centre d’Immunologie et des Maladies Infectieuses
| | - H Bruzzoni-Giovanelli
- Université Paris 7- Hôpital Saint Louis, Pharmacology - Centre d’Investigations Cliniques
| | - G Schinella
- National University of La Plata - Pharmacology Department-CONICET
| | - I Piazzon
- National Academy of Medicine, Argentina, Experimental Immunology Laboratory
| | - A Duarte
- National Academy of Medicine, Argentina, Experimental Immunology Laboratory
| | - J Errecalde
- National University of La Plata - Pharmacology Department-CONICET
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Burress ED, Alda F, Duarte A, Loureiro M, Armbruster JW, Chakrabarty P. Phylogenomics of pike cichlids (Cichlidae: Crenicichla): the rapid ecological speciation of an incipient species flock. J Evol Biol 2017; 31:14-30. [PMID: 29044782 DOI: 10.1111/jeb.13196] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [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: 05/17/2017] [Revised: 08/13/2017] [Accepted: 10/12/2017] [Indexed: 12/18/2022]
Abstract
The rapid rise of phenotypic and ecological diversity in independent lake-dwelling groups of cichlids is emblematic of the East African Great Lakes. In this study, we show that similar ecologically based diversification has occurred in pike cichlids (Crenicichla) throughout the Uruguay River drainage of South America. We collected genomic data from nearly 500 ultraconserved element (UCEs) loci and >260 000 base pairs across 33 species, to obtain a phylogenetic hypothesis for the major species groups and to evaluate the relationships and genetic structure among five closely related, endemic, co-occurring species (the Uruguay River species flock; URSF). Additionally, we evaluated ecological divergence of the URSF based on body and lower pharyngeal jaw (LPJ) shape and gut contents. Across the genus, we recovered novel relationships among the species groups. We found strong support for the monophyly of the URSF; however, relationships among these species remain problematic, likely because of the rapid and recent evolution of this clade. Clustered co-ancestry analysis recovered most species as well delimited genetic groups. The URSF species exhibit species-specific body and LPJ shapes associated with specialized trophic roles. Collectively, our results suggest that the URSF consists of incipient species that arose via ecological speciation associated with the exploration of novel trophic roles.
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Affiliation(s)
- E D Burress
- Department of Biological Sciences and Auburn University Museum of Natural History, Auburn University, Auburn, AL, USA
| | - F Alda
- Museum of Natural Science, Department of Biological Sciences, Louisiana State University, Baton Rouge, LA, USA
| | - A Duarte
- Sección Zoología Vertebrados, Departmento de Ecología y Evolución, Facultad de Ciencias, Universidad de la República, Montevideo, Uruguay
| | - M Loureiro
- Sección Zoología Vertebrados, Departmento de Ecología y Evolución, Facultad de Ciencias, Universidad de la República, Montevideo, Uruguay.,Sección Ictología, Departmento de Zoología, Museo Nacional de Historia Natural, Montevideo, Uruguay
| | - J W Armbruster
- Department of Biological Sciences and Auburn University Museum of Natural History, Auburn University, Auburn, AL, USA
| | - P Chakrabarty
- Museum of Natural Science, Department of Biological Sciences, Louisiana State University, Baton Rouge, LA, USA
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Duarte A, Walker S, Littlewood E, Brabyn S, Hewitt C, Gilbody S, Palmer S. Cost-effectiveness of computerized cognitive-behavioural therapy for the treatment of depression in primary care: findings from the Randomised Evaluation of the Effectiveness and Acceptability of Computerised Therapy (REEACT) trial. Psychol Med 2017; 47:1825-1835. [PMID: 28228182 DOI: 10.1017/s0033291717000289] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Computerized cognitive-behavioural therapy (cCBT) forms a core component of stepped psychological care for depression. Existing evidence for cCBT has been informed by developer-led trials. This is the first study based on a large independent pragmatic trial to assess the cost-effectiveness of cCBT as an adjunct to usual general practitioner (GP) care compared with usual GP care alone and to establish the differential cost-effectiveness of a free-to-use cCBT programme (MoodGYM) in comparison with a commercial programme (Beating the Blues) in primary care. METHOD Costs were estimated from a healthcare perspective and outcomes measured using quality-adjusted life years (QALYs) over 2 years. The incremental cost-effectiveness of each cCBT programme was compared with usual GP care. Uncertainty was estimated using probabilistic sensitivity analysis and scenario analyses were performed to assess the robustness of results. RESULTS Neither cCBT programme was found to be cost-effective compared with usual GP care alone. At a £20 000 per QALY threshold, usual GP care alone had the highest probability of being cost-effective (0.55) followed by MoodGYM (0.42) and Beating the Blues (0.04). Usual GP care alone was also the cost-effective intervention in the majority of scenario analyses. However, the magnitude of the differences in costs and QALYs between all groups appeared minor (and non-significant). CONCLUSIONS Technically supported cCBT programmes do not appear any more cost-effective than usual GP care alone. No cost-effective advantage of the commercially developed cCBT programme was evident compared with the free-to-use cCBT programme. Current UK practice recommendations for cCBT may need to be reconsidered in the light of the results.
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Affiliation(s)
- A Duarte
- Centre for Health Economics, University of York,Heslington,York YO10 5DD,UK
| | - S Walker
- Centre for Health Economics, University of York,Heslington,York YO10 5DD,UK
| | - E Littlewood
- Department of Health Sciences,University of York,Heslington,York YO10 5DD,UK
| | - S Brabyn
- Department of Health Sciences,University of York,Heslington,York YO10 5DD,UK
| | - C Hewitt
- Department of Health Sciences,University of York,Heslington,York YO10 5DD,UK
| | - S Gilbody
- Department of Health Sciences,University of York,Heslington,York YO10 5DD,UK
| | - S Palmer
- Centre for Health Economics, University of York,Heslington,York YO10 5DD,UK
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Neves A, Marto J, Duarte A, Gonçalves LM, Pinto P, Figueiredo AC, Ribeiro HM. Characterization of Portuguese Thymbra capitata
, Thymus caespititius
and Myrtus communis
essential oils in topical formulations. FLAVOUR FRAG J 2017. [DOI: 10.1002/ffj.3393] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- A. Neves
- Research Institute for Medicines and Pharmaceutical Sciences (iMed.ULisboa), Faculty of Pharmacy; Universidade de Lisboa; Portugal
| | - J. Marto
- Research Institute for Medicines and Pharmaceutical Sciences (iMed.ULisboa), Faculty of Pharmacy; Universidade de Lisboa; Portugal
| | - A. Duarte
- Research Institute for Medicines and Pharmaceutical Sciences (iMed.ULisboa), Faculty of Pharmacy; Universidade de Lisboa; Portugal
| | - L. M. Gonçalves
- Research Institute for Medicines and Pharmaceutical Sciences (iMed.ULisboa), Faculty of Pharmacy; Universidade de Lisboa; Portugal
| | - P. Pinto
- Research Institute for Medicines and Pharmaceutical Sciences (iMed.ULisboa), Faculty of Pharmacy; Universidade de Lisboa; Portugal
- PhD Trials, Rua das Murtas; Lisbon Portugal
| | - A. C. Figueiredo
- Centro de Estudos do Ambiente e do Mar (CESAM Lisboa); Faculdade de Ciências da Universidade de Lisboa, Centro de Biotecnologia Vegetal (CBV); Lisbon Portugal
| | - H. M. Ribeiro
- Research Institute for Medicines and Pharmaceutical Sciences (iMed.ULisboa), Faculty of Pharmacy; Universidade de Lisboa; Portugal
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