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Teixeira BL, Cunha PS, Jacinto AS, Portugal G, Laranjo S, Valente B, Lousinha A, Cruz MC, Delgado AS, Brás M, Paulo M, Guerra C, Ramos R, Fontes I, Ferreira RC, Oliveira MM. Epicardial adipose tissue volume assessed by cardiac CT as a predictor of atrial fibrillation recurrence following catheter ablation. Clin Imaging 2024; 110:110170. [PMID: 38696998 DOI: 10.1016/j.clinimag.2024.110170] [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] [Received: 01/23/2024] [Revised: 04/14/2024] [Accepted: 04/22/2024] [Indexed: 05/04/2024]
Abstract
INTRODUCTION In patients with atrial fibrillation (AF), up to one third have recurrence after a first catheter ablation (CA). Epicardial adipose tissue (EAT) has been considered to be closely related to AF, with a potential role in its recurrence. We aimed to evaluate the association between the volume of EAT measured by cardiac computed tomography (CT) and AF recurrence after CA. METHODS Consecutive AF patients underwent a standardized cardiac CT protocol for quantification of EAT, thoracic adipose volume (TAV) and left atrium (LA) volume before CA. An appropriate cut-off of EAT was determined and risk recurrence was estimated. RESULTS 305 patients (63.6 % male, mean age 57.5 years, 28.2 % persistent AF) were followed for 24 months; 23 % had AF recurrence at 2-year mark, which was associated with higher EAT (p = 0.037) and LAV (p < 0.001). Persistent AF was associated with higher EAT volumes (p = 0.010), TAV (p = 0.003) and LA volumes (p < 0.001). EAT was predictive of AF recurrence (p = 0.044). After determining a cut-off of 92 cm3, survival analysis revealed that EAT volumes > 92 cm3 showed higher recurrence rates at earlier time points after the index ablation procedure (p = 0.006), with a HR of 1.95 (p = 0.008) of AF recurrence at 2-year. After multivariate adjustment, EAT > 92 cm3 remained predictive of AF recurrence (p = 0.028). CONCLUSION The volume of EAT measured by cardiac CT can predict recurrence of AF after ablation, with a volume above 92 cm3 yielding almost twice the risk of arrhythmia recurrence in the first two years following CA. Higher EAT and TAV are also associated with persistent AF.
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Affiliation(s)
- Bárbara Lacerda Teixeira
- Arrhythmology, Pacing and Electrophysiology Unit, Cardiology Department, Santa Marta Hospital, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal; Clínica Universitária de Cardiologia, Centro Clínico Académico de Lisboa, Lisbon, Portugal. https://twitter.com/BarbaraLT94
| | - Pedro Silva Cunha
- Arrhythmology, Pacing and Electrophysiology Unit, Cardiology Department, Santa Marta Hospital, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal; Clínica Universitária de Cardiologia, Centro Clínico Académico de Lisboa, Lisbon, Portugal; Instituto de Fisiologia, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal; Comprehensive Health Research Center, NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Ana Sofia Jacinto
- Arrhythmology, Pacing and Electrophysiology Unit, Cardiology Department, Santa Marta Hospital, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal; Clínica Universitária de Cardiologia, Centro Clínico Académico de Lisboa, Lisbon, Portugal
| | - Guilherme Portugal
- Arrhythmology, Pacing and Electrophysiology Unit, Cardiology Department, Santa Marta Hospital, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal; Clínica Universitária de Cardiologia, Centro Clínico Académico de Lisboa, Lisbon, Portugal; Instituto de Fisiologia, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Sérgio Laranjo
- Arrhythmology, Pacing and Electrophysiology Unit, Cardiology Department, Santa Marta Hospital, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal; Clínica Universitária de Cardiologia, Centro Clínico Académico de Lisboa, Lisbon, Portugal; NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade NOVA de Lisboa, Lisbon, Portugal; Comprehensive Health Research Center, NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Bruno Valente
- Arrhythmology, Pacing and Electrophysiology Unit, Cardiology Department, Santa Marta Hospital, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal; Clínica Universitária de Cardiologia, Centro Clínico Académico de Lisboa, Lisbon, Portugal
| | - Ana Lousinha
- Arrhythmology, Pacing and Electrophysiology Unit, Cardiology Department, Santa Marta Hospital, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal; Clínica Universitária de Cardiologia, Centro Clínico Académico de Lisboa, Lisbon, Portugal; NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Madalena Coutinho Cruz
- Arrhythmology, Pacing and Electrophysiology Unit, Cardiology Department, Santa Marta Hospital, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal; Clínica Universitária de Cardiologia, Centro Clínico Académico de Lisboa, Lisbon, Portugal
| | - Ana Sofia Delgado
- Arrhythmology, Pacing and Electrophysiology Unit, Cardiology Department, Santa Marta Hospital, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal
| | - Manuel Brás
- Arrhythmology, Pacing and Electrophysiology Unit, Cardiology Department, Santa Marta Hospital, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal
| | - Margarida Paulo
- Arrhythmology, Pacing and Electrophysiology Unit, Cardiology Department, Santa Marta Hospital, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal
| | - Cátia Guerra
- Arrhythmology, Pacing and Electrophysiology Unit, Cardiology Department, Santa Marta Hospital, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal
| | - Ruben Ramos
- Arrhythmology, Pacing and Electrophysiology Unit, Cardiology Department, Santa Marta Hospital, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal; Clínica Universitária de Cardiologia, Centro Clínico Académico de Lisboa, Lisbon, Portugal
| | - Iládia Fontes
- Imagiology Department, Santa Marta Hospital, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal
| | - Rui Cruz Ferreira
- Arrhythmology, Pacing and Electrophysiology Unit, Cardiology Department, Santa Marta Hospital, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal; Clínica Universitária de Cardiologia, Centro Clínico Académico de Lisboa, Lisbon, Portugal
| | - Mário Martins Oliveira
- Arrhythmology, Pacing and Electrophysiology Unit, Cardiology Department, Santa Marta Hospital, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal; Clínica Universitária de Cardiologia, Centro Clínico Académico de Lisboa, Lisbon, Portugal; Instituto de Fisiologia, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal; Comprehensive Health Research Center, NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade NOVA de Lisboa, Lisbon, Portugal
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Marques Antunes M, Silva Cunha P, Lacerda Teixeira B, Portugal G, Valente B, Lousinha A, Delgado AS, Alves S, Guerra C, Cruz Ferreira R, Martins Oliveira M. Very-early detection of atrial fibrillation after ablation evaluated by a wearable ECG-patch predicts late blanking period recurrence: Preliminary data from a prospective registry. Int J Cardiol Heart Vasc 2024; 51:101369. [PMID: 38420510 PMCID: PMC10901076 DOI: 10.1016/j.ijcha.2024.101369] [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] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 01/23/2024] [Accepted: 02/18/2024] [Indexed: 03/02/2024]
Abstract
Introduction Atrial fibrillation (AF) ablation represents a safe and effective procedure to restore sinus rhythm. The idea that post-procedural AF episodes - during the blanking period - are not considered treatment failure has been increasingly challenged. The E-Patch, a single-use adhesive electrode, facilitates extended continuous ECG monitoring for 120 h. This pilot study aims to assess the effectiveness of this ambulatory monitoring device and investigate whether very-early AF recurrence correlates with delayed blanking period ablation outcomes. Methods We conducted a single-center, prospective, longitudinal study, including consecutive post-ablation patients monitored with the E-patch. The ability of the device to continuously record was analyzed, as well as the occurrence of AF episodes during external 7-day loop-recorder in the 2nd-month post-ablation. Results We included 40 patients, median age 62 years (IQR 56-70). E-Patch monitoring was obtained for a median of 118 h (IQR 112-120), with no discomfort nor interpretation artefacts. Very-early AF recurrence was detected in 11 (27.5 %) patients, with a median AF burden of 7 % (IQR 6 %-33 %). Late-blanking period AF was detected in 13 (33 %) of the external 7-day loop recordings. Of the 11 patients that had very-early AF recurrence, 10 (91 %) had late-blanking AF. Very-early AF detection showed 77 % (95 % CI 64 %-90 %) sensitivity and 96 % (95 % CI 90-100 %) specificity in predicting late-blanking AF, with a non-parametric ROC curve AUC of 0.903 (95 % 0.797--1.0). Conclusion The E-Patch was able to detect very-early AF during an extended period. Very-early AF detection emerges as a predictor of AF recurrence during the late blanking period post-ablation.
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Affiliation(s)
- Miguel Marques Antunes
- Cardiology Department, Hospital Santa Marta, Centro Hospitalar Universitário de Lisboa Central, Centro Clínico Académico de Lisboa (CCAL), Lisbon, Portugal
- Clinical Pharmacology and Therapeutics Unit - Centro Cardiovascular Da Universidade de Lisboa (CCUL@RISE), Faculdade de Medicina Da Universidade de Lisboa
| | - Pedro Silva Cunha
- Cardiology Department, Hospital Santa Marta, Centro Hospitalar Universitário de Lisboa Central, Centro Clínico Académico de Lisboa (CCAL), Lisbon, Portugal
- Faculdade de Medicina, CCUL, Universidade de Lisboa, Lisbon, Portugal
| | - Bárbara Lacerda Teixeira
- Cardiology Department, Hospital Santa Marta, Centro Hospitalar Universitário de Lisboa Central, Centro Clínico Académico de Lisboa (CCAL), Lisbon, Portugal
| | - Guilherme Portugal
- Cardiology Department, Hospital Santa Marta, Centro Hospitalar Universitário de Lisboa Central, Centro Clínico Académico de Lisboa (CCAL), Lisbon, Portugal
- Faculdade de Medicina, CCUL, Universidade de Lisboa, Lisbon, Portugal
| | - Bruno Valente
- Cardiology Department, Hospital Santa Marta, Centro Hospitalar Universitário de Lisboa Central, Centro Clínico Académico de Lisboa (CCAL), Lisbon, Portugal
| | - Ana Lousinha
- Cardiology Department, Hospital Santa Marta, Centro Hospitalar Universitário de Lisboa Central, Centro Clínico Académico de Lisboa (CCAL), Lisbon, Portugal
| | - Ana Sofia Delgado
- Cardiology Department, Hospital Santa Marta, Centro Hospitalar Universitário de Lisboa Central, Centro Clínico Académico de Lisboa (CCAL), Lisbon, Portugal
| | - Sandra Alves
- Cardiology Department, Hospital Santa Marta, Centro Hospitalar Universitário de Lisboa Central, Centro Clínico Académico de Lisboa (CCAL), Lisbon, Portugal
| | - Cátia Guerra
- Cardiology Department, Hospital Santa Marta, Centro Hospitalar Universitário de Lisboa Central, Centro Clínico Académico de Lisboa (CCAL), Lisbon, Portugal
| | - Rui Cruz Ferreira
- Cardiology Department, Hospital Santa Marta, Centro Hospitalar Universitário de Lisboa Central, Centro Clínico Académico de Lisboa (CCAL), Lisbon, Portugal
| | - Mário Martins Oliveira
- Cardiology Department, Hospital Santa Marta, Centro Hospitalar Universitário de Lisboa Central, Centro Clínico Académico de Lisboa (CCAL), Lisbon, Portugal
- Faculdade de Medicina, CCUL, Universidade de Lisboa, Lisbon, Portugal
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de Freixo Ferreira L, Guerra C, Vieira-Coelho MA. Predictors of psychotherapy dropout in patients with borderline personality disorder: A systematic review. Clin Psychol Psychother 2023; 30:1324-1337. [PMID: 37522280 DOI: 10.1002/cpp.2888] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 07/10/2023] [Accepted: 07/11/2023] [Indexed: 08/01/2023]
Abstract
INTRODUCTION Borderline personality disorder (BPD) is a highly debilitating psychiatric condition. Despite the expansion of new BPD specific forms of psychotherapy in the last few decades, high dropout rates have been reported in these treatments. Treatment discontinuation is associated with poor patient outcomes, inefficient resource utilization and the demoralization of healthcare providers. METHODS In order to identify predictors of psychotherapy dropout among patients with BPD, a systematic search of Medline, the Cochrane Library, PsycInfo and PsycArticles was conducted. Studies included were randomized-controlled trials in which patients diagnosed with BPD were exposed to a therapeutic intervention consisted of an evidence-based psychotherapy. The quality of evidence in the studies was assessed through the use of revised Cochrane risk of bias tool. RESULTS Six articles, incorporating four types of psychotherapy programmes, were included. Overall, the studies present low risk of attrition and reporting bias and unclear risk of selection, performance and detection bias. Patients with weaker therapeutic alliance scores and higher hostility presented with higher dropout rates. In contrast, better mindfulness skills and greater performance in specific neuropsychological domains, such as memory and executive control, were identified as predictive of lower risk of dropout. Sociodemographic variables and treatment history did not influence treatment retention. CONCLUSIONS Factors that influence discontinuation should be taken into consideration in future treatment programmes, in an effort to optimize retention. Qualitative assessments of patients' reasons for dropping out may also help guide adjustments.
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Affiliation(s)
- Leonor de Freixo Ferreira
- Department of Biomedicine, Pharmacology and Therapeutics Unit, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Cátia Guerra
- Department of Psychiatry and Mental Health, University Hospital Centre of São João, Porto, Portugal
| | - M A Vieira-Coelho
- Department of Biomedicine, Pharmacology and Therapeutics Unit, Faculty of Medicine, University of Porto, Porto, Portugal
- Department of Psychiatry and Mental Health, University Hospital Centre of São João, Porto, Portugal
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Santos Martins F, Feldens T, Guerra C, Santos JV. Long-term mental health care in Portugal: A portrait of the first years of activity. Int J Soc Psychiatry 2023; 69:1605-1616. [PMID: 37092774 DOI: 10.1177/00207640231168026] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
INTRODUCTION In Portugal, a reform to implement Long-term mental health care (LTMHC) started in 2017 allowing patients with severe mental illness receiving psychosocial rehabilitation to regain their autonomy and be reintegrated into their communities. AIM To describe the first steps of the Portuguese LTMHC implementation and to assess the relationship between the LTMHC's demand (referrals) and supply (vacancies and occupancy). METHODS We conducted a national retrospective observational study to analyse the LTMHC referrals, vacancies and occupancy between mid-2017 (LTMHC establishment) and December 2022. We described and analysed the associated indicators through time and geography, as well as performed a simultaneous regression model to evaluate the relationship between supply and demand. RESULTS There were 1,192 referrals to the LTMHC, of which 99 (8.3%) were made for childhood and adolescence structures. The maximum support residence (RAMa, 'Residência de apoio máximo'), designed for patients with higher disabilities, had the highest number of referrals. Additionally, since the opening of vacancies in different institutions, residential structures became quickly saturated. On the other hand, domiciliary services were those with the lowest occupancy. Our estimates support that the vacancies (supply) are induced by the referrals (demand), and referrals are also related to the location of LTMHC facilities. CONCLUSION LTMHC is still in the initial stage of development in Portugal, and it is expected to receive financial support through the Recovery and Resilience Programme. According to the occupancy rates and referrals made, residential structures seem to be a priority, being also important to explore the partial use of domiciliary services. The geographical distribution of vacancies can also be a concern, considering the important proximity to the community in LTMHC.
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Affiliation(s)
- Filipa Santos Martins
- Psychiatry and Mental Health Department, Centro Hospitalar Universitário de São João (CHUSJ), Porto, Portugal
- CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal
| | - Tallys Feldens
- CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal
- Federal University of Paraná, Paraná, Brazil
| | - Cátia Guerra
- Psychiatry and Mental Health Department, Centro Hospitalar Universitário de São João (CHUSJ), Porto, Portugal
- Clinical Neurosciences and Mental Health Department, Faculty of Medicine, University of Porto (FMUP), Porto, Portugal
| | - João Vasco Santos
- CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
- Public Health Unit, ACES Grande Porto V - Porto Ocidental, Porto, Portugal
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Gazzanelli S, Cavallaro G, Miccini M, Crocetti D, Tarallo M, Accarpio F, Fanello G, Biacchi D, Guerra C, Ranieri MV. Total intravenous anesthesia (TIVA) with propofool and remifentanil during operative endoscopy tracheobronchial laser therapy. Clin Ter 2023; 174:331-335. [PMID: 37378502 DOI: 10.7417/ct.2023.2446] [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] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Abstract
Background The aim of our study was to assess how total intra-venous anaesthesia (TIVA) achieved by propofol and remifentanil continuous infusion could ensure proper success of the endobronchial laser therapy, in optimal conditions for the endoscopist, determining at the same time an adequate hypnosis and a good analgesia. Methods We studied 50 patients (28M - 22F), ASA class I-IV, mean age 42 ± 32.5 years , subjected to laser endoscopy to repair tracheal stenosis. TIVA was performed in all patients, and spontaneous breathing was maintained. Results 10.2% of patients experienced episodes of coughing during induction. The depth of the anaesthesia plan, monitored by BIS, was 55 ± 5. The awakening was fast in all patients, with an Aldrete score of 7.71 ± 1.14 at 1 minute and 9.31 ± 1.12 at 10 minutes. Conclusion The results of this study allow us to state that the continuous infusion of propofol and remifentanil proved to be the gold standard in patients ASA I-II-III undergoing endobronchial laser therapy. The use of TIVA has also allowed to perform endoscopic intervention on patients who suffered from a significant decrease of both cardiac and respiratory functions.
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Affiliation(s)
- S Gazzanelli
- Department of Anesthesiology, Critical Care and Pain Medicine, "Sapienza" University of Rome, Rome, Italy
| | - G Cavallaro
- Department of Surgery, "Sapienza" University of Rome, Rome, Italy
| | - M Miccini
- Department of Surgery, "Sapienza" University of Rome, Rome, Italy
| | - D Crocetti
- Department of Surgery, "Sapienza" University of Rome, Rome, Italy
| | - M Tarallo
- Department of Surgery, "Sapienza" University of Rome, Rome, Italy
| | - F Accarpio
- Department of Surgery, "Sapienza" University of Rome, Rome, Italy
| | - G Fanello
- Department of Surgery, "Sapienza" University of Rome, Rome, Italy
| | - D Biacchi
- Department of Surgery, "Sapienza" University of Rome, Rome, Italy
| | - C Guerra
- Department of Anesthesiology, Critical Care and Pain Medicine, "Sapienza" University of Rome, Rome, Italy
| | - M V Ranieri
- Department of Anesthesiology, Critical Care and Pain Medicine, "Sapienza" University of Rome, Rome, Italy
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Silva Cunha P, Portugal G, Laranjo S, Alves M, Luísa Papoila A, Valente B, Sofia Delgado A, Lousinha A, Paulo M, Brás M, Guerra C, Cruz Ferreira R, Martins Oliveira M. The atrial fibrillation burden during the blanking period is predictive of time to recurrence after catheter ablation. Int J Cardiol Heart Vasc 2022; 43:101138. [PMID: 36275421 PMCID: PMC9579489 DOI: 10.1016/j.ijcha.2022.101138] [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: 07/31/2022] [Revised: 09/22/2022] [Accepted: 10/11/2022] [Indexed: 11/05/2022]
Abstract
Objective This study aimed to assess whether atrial fibrillation (AF) occurrence or its corresponding daily mean burden (in minutes/day) during the mid to late blanking period after pulmonary vein isolation (PVI), predicts AF recurrence. Methods Analysis of consecutive first PVI ablation patients undergoing prolonged electrocardiogram (ECG) monitoring during the second and third months after PVI. The clinical variables, total AF burden, and their relationship with time to recurrence were studied. Results 477 patients with a mean age of 56.9 (SD = 12.3) years (63.7 % male; 71.7 % paroxysmal AF), from which 317 (66.5 %) had an external event recorder between 30 and 90 days after ablation. Median follow-up of 16.0 (P 25:12.0: P 75:33.0) months, 177 (37 %) patients had an AF recurrence, with 106 (22.2 %) having the first episode after 12 months of follow-up. In the group of patients with an event recorder, 80 (25.2 %) had AF documented during the blanking period. Multivariable analysis showed that AF during the blanking period was associated with a 4-fold higher risk of recurrence (HR: 3.98; 95 %CI: 2.95–5.37), and, compared to patients in sinus rhythm, those with an AF burden ≥ 23 min/day had an approximately 7-fold higher risk of recurrence (HR estimate: 6.79; 95 %CI: 4.56–10.10). Conclusions The probability of experiencing AF recurrence can be predicted by atrial tachyarrhythmia episodes during the second and third months after PVI. Atrial arrhythmias burden > 23 min/day has a high predictive ability for recurrence.
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Affiliation(s)
- Pedro Silva Cunha
- Arrhythmology, Pacing and Electrophysiology Unit, Cardiology Service, Santa Marta Hospital, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal,LisbonSchool of Medicine, Universidade de Lisboa, Lisbon, Portugal,Corresponding author at: Santa Marta Hospital, Cardiology Service, Arrhythmology, Pacing, and Electrophysiology Unit, R. de Santa Marta 50, 1169-024 Lisboa, Portugal.
| | - Guilherme Portugal
- Arrhythmology, Pacing and Electrophysiology Unit, Cardiology Service, Santa Marta Hospital, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal,LisbonSchool of Medicine, Universidade de Lisboa, Lisbon, Portugal
| | - Sérgio Laranjo
- Arrhythmology, Pacing and Electrophysiology Unit, Cardiology Service, Santa Marta Hospital, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal,NOVAMedical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa and CEAUL (Center of Statistics and Its Applications), Lisbon, Portugal,ComprehensiveHealth Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Marta Alves
- NOVAMedical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa and CEAUL (Center of Statistics and Its Applications), Lisbon, Portugal,Epidemiology and Statistics Unit, Research Centre, Centro Hospitalar de Lisboa Central, Lisbon, Portugal
| | - Ana Luísa Papoila
- NOVAMedical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa and CEAUL (Center of Statistics and Its Applications), Lisbon, Portugal,Epidemiology and Statistics Unit, Research Centre, Centro Hospitalar de Lisboa Central, Lisbon, Portugal
| | - Bruno Valente
- Arrhythmology, Pacing and Electrophysiology Unit, Cardiology Service, Santa Marta Hospital, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal
| | - Ana Sofia Delgado
- Arrhythmology, Pacing and Electrophysiology Unit, Cardiology Service, Santa Marta Hospital, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal
| | - Ana Lousinha
- Arrhythmology, Pacing and Electrophysiology Unit, Cardiology Service, Santa Marta Hospital, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal
| | - Margarida Paulo
- Arrhythmology, Pacing and Electrophysiology Unit, Cardiology Service, Santa Marta Hospital, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal
| | - Manuel Brás
- Arrhythmology, Pacing and Electrophysiology Unit, Cardiology Service, Santa Marta Hospital, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal
| | - Cátia Guerra
- Arrhythmology, Pacing and Electrophysiology Unit, Cardiology Service, Santa Marta Hospital, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal
| | - Rui Cruz Ferreira
- Arrhythmology, Pacing and Electrophysiology Unit, Cardiology Service, Santa Marta Hospital, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal
| | - Mário Martins Oliveira
- Arrhythmology, Pacing and Electrophysiology Unit, Cardiology Service, Santa Marta Hospital, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal,LisbonSchool of Medicine, Universidade de Lisboa, Lisbon, Portugal
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Santos Martins F, Guerra C. 22q11.2 deletion syndrome and psychosis – regarding a clinical case. Eur Psychiatry 2022. [PMCID: PMC9567216 DOI: 10.1192/j.eurpsy.2022.1980] [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
22q11.2 deletion syndrome is the most common microdeletion syndrome. Its clinical presentation varies and it may present several medical complications, namely heart defects, cleft palate, autoimmune diseases, delayed development, and psychiatric disorders. In these patients, psychiatric disorders are frequent and may include attention-deficit hyperactivity disorder, anxiety disorders, autism spectrum disorder, and schizophrenia spectrum disorders.
Objectives
We aim to characterize psychosis in patients diagnosed with 2q11.2 deletion syndrome, which is one of the most frequent psychiatric presentations.
Methods
To introduce the topic of 22q11.2 psychiatric symptoms, we will start by presenting a clinical case. Then, a review of the related literature using the Pubmed database using the following expression “22q11.2 deletion syndrome”; “DiGeorge syndrome”; “velocardiofacial syndrome”; “psychosis”; “psychiatric disorders”.
Results
Patients diagnosed with 22q11.2 deletion syndrome are considered high-risk for psychosis. In this clinical case, we present a 19-year old man diagnosed with 22q11.2 deletion syndrome who was admitted to a psychiatric ward for psychosis. The knowledge of the increased risk for psychosis in these patients should be taken into account in the face of behavioral changes de novo to assure a timely therapeutic approach. Currently, the treatment does not differ from other patients, but this is mainly due to the lack of knowledge on the best therapeutic approach in this specific diagnosis.
Conclusions
Genetic syndromes are often associated with psychiatric disorders. Patients diagnosed with 22q11.2 deletion syndrome are at high risk for psychosis and should deserve a multidisciplinary approach so that their diagnosis and treatment are established as early as possible.
Disclosure
No significant relationships.
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Gazzanelli S, Miccini M, Sapienza P, Cavallaro G, Biacchi D, Crocetti D, Fiori E, Sammartino P, Guerra C, Ranieri MV. Fracture and migration in right atrium of a permanent venous central access system in a elderly patient: case report and literature review. Clin Ter 2022; 173:207-213. [PMID: 35612331 DOI: 10.7417/ct.2022.2419] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Catheter dislocation and fracture with migration of central venous lines have been reported in the International literature. Catheter fracture with consequent migration has been observed in 0.5-3.0% and may either be consequent to catheter removal or it can occur spontane-ously. Our case report concerns the migration of a Hickman catheter connected to a venous port to the right atrium in a 61-year old patient. A literature up-to-date has been performed to assess the risk of port-a-cath positioning. The position of catheter tip is considered critical for the risk of migration, that is greater as higher the tip localization respect to the carina. The aim of our study is to underline the critical role of X-ray to visualize the exact location of the catheter tip, regard-less of the approach used for catheter positioning.
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Affiliation(s)
- S Gazzanelli
- Department of Anesthesiology and Palliative Care, Sapienza University, Rome, Italy
| | - M Miccini
- Department of Surgery P. Valdoni, Sapienza University, Rome, Italy
| | - P Sapienza
- Department of Surgery P. Valdoni, Sapienza University, Rome, Italy
| | - G Cavallaro
- Department of Surgery P. Valdoni, Sapienza University, Rome, Italy
| | - D Biacchi
- Department of Surgery P. Valdoni, Sapienza University, Rome, Italy
| | - D Crocetti
- Department of Surgery P. Valdoni, Sapienza University, Rome, Italy
| | - E Fiori
- Department of Surgery P. Valdoni, Sapienza University, Rome, Italy
| | - P Sammartino
- Department of Surgery P. Valdoni, Sapienza University, Rome, Italy
| | - C Guerra
- Department of Anesthesiology and Palliative Care, Sapienza University, Rome, Italy
| | - M V Ranieri
- Department of Anesthesiology and Palliative Care, Sapienza University, Rome, Italy
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9
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Jacinto S, Silva Cunha P, Portugal G, Valente B, Coutinho Cruz M, Lousinha A, Veiga J, Delgado AS, Bras M, Paulo M, Guerra C, Teixeira AR, Lacerda Teixeira B, Cruz Ferreira R, Martins Oliveira M. Fluoroless cavotricuspid isthmus radiofrequency ablation of typical atrial flutter achieves success with zero radiation and shorter procedural duration. Europace 2022. [DOI: 10.1093/europace/euac053.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Cavotricuspid isthmus (CTI) ablation in patients with typical atrial flutter (AFL) has improved in the past years, especially by the use of threedimensional (3D) electroanatomic mapping systems. These mapping tools contributed to reduce radiation exposure, but most ablation procedures still require varying amounts of fluoroscopy.
Purpose
We aim to examine whether fluoroless CTI ablation is effective and safe in reducing AFL recurrence, compared with CTI ablation using fluoroscopy and a 3D mapping system.
Methods
A retrospective analysis of CTI ablation procedures performed at a tertiary center between December 2008 and December 2020 was conducted. Cases were divided in two groups: fluoroless and fluoroscopic, according to the use of radiation. Procedural duration, fluoroscopy time (FT), use of 3D mapping system, complications and recurrence rate at one year were analyzed.
Results
A total of 324 CTI ablations performed on patients with documented typical AFL were included. Mean age was 62.3±14.0, with 78.1% male patients. Fluoroless ablations were performed based on a 3D mapping system, and all fluoroscopic procedures also used 3D electroanatomic mapping. The FT was zero in the fluoroless group - 31 cases (9.6%), and 7.0±4.4 minutes in the fluoroscopic group - 291 cases (90.4%) (p<0.001). There was no statistically significant difference between the two groups, regarding AFL recurrence at one year (21.7% in the fluoroless group versus 13% in the fluoroscopic group; odds ratio [OD] 0.54; 95% confidence interval [CI] 0.18-1.62; p=0.27). Total procedure duration was significantly shorter in the fluoroless group (1h07m versus 1h40m; t-test 4.261, p<0.001, CI 0h16m-0h50m). There were no acute complications for both groups.
Conclusion
Fluoroless CTI ablation avoids radiation exposure to the patient and operator and can be performed in patients with typical AFL, without compromising duration, safety or efficacy of the procedure.
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Affiliation(s)
- S Jacinto
- Hospital de Santa Marta, Lisbon, Portugal
| | | | - G Portugal
- Hospital de Santa Marta, Lisbon, Portugal
| | - B Valente
- Hospital de Santa Marta, Lisbon, Portugal
| | | | - A Lousinha
- Hospital de Santa Marta, Lisbon, Portugal
| | - J Veiga
- Hospital de Santa Marta, Lisbon, Portugal
| | - AS Delgado
- Hospital de Santa Marta, Lisbon, Portugal
| | - M Bras
- Hospital de Santa Marta, Lisbon, Portugal
| | - M Paulo
- Hospital de Santa Marta, Lisbon, Portugal
| | - C Guerra
- Hospital de Santa Marta, Lisbon, Portugal
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10
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Jacinto S, Silva Cunha P, Portugal G, Valente B, Coutinho Cruz M, Lousinha A, Bras P, Delgado AS, Bras M, Paulo M, Guerra C, Teixeira AR, Lacerda Teixeira B, Martins Oliveira M. Combined pulmonary vein isolation and cavotricuspid isthmus ablation shows no benefit in recurrence of atrial fibrillation. Europace 2022. [DOI: 10.1093/europace/euac053.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Pulmonary vein isolation (PVI) is the mainstay of catheter ablation (CA) for atrial fibrillation (AF). Strategies have been proposed to improve the success rate of CA, such as prophylactic cavotricuspid isthmus (CTI) ablation. Despite some studies providing no, or limited, incremental benefit of CTI ablation in patients with AF, it is still frequently performed worldwide.
Purpose
The aim of this study is to examine whether CTI ablation, combined with PVI, is associated with improvement in recurrence of AF, compared with PVI alone in AF patients with or without atrial flutter (AFL).
Methods
We conducted a retrospective analysis of CA for AF performed at a tertiary center between September 2004 and December 2020. The procedures were divided in two groups: "PVI alone" and "PVI plus CTI ablation". Demographic, clinical, and procedure related data was retrieved. Atrial fibrillation recurrence rate at one year was analyzed for both groups and compared using logistic regression.
Results
A total of 453 procedures were analyzed: PVI alone (n=378; 83.4%) and PVI with CTI ablation (n=75; 16.6%). In the PVI alone group, 12.9% of the patients had concomitant typical AFL and in the PVI plus CTI ablation, 45.8% had typical AFL. Mean age was 57.3±12.1 years, with 63.6% male patients. At one year, AF recurrence rate was higher in the combined PVI with CTI ablation group (30.4%; n=21), compared with the PVI alone group (28.4%; n=97), with no statistical difference between the two groups (Odds Ratio [OD] 1.10; 95% confidence interval [CI] 0.62-1.94; p=0.73). In the subgroup analysis, there was no difference in recurrence between patients with AF without AFL (OR: 1.9; 95% CI: 0.39-9.36; p=0.43), and in patients with AF with concomitant AFL (OR: 10.0; 95% CI: 0.9-110.3; p=0.06).
Conclusion
In AF patients, irrespective of the presence of typical AFL, additional CTI ablation, compared with PVI alone, was not associated with improvement in recurrence of AF.
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Affiliation(s)
- S Jacinto
- Hospital de Santa Marta, Lisbon, Portugal
| | | | - G Portugal
- Hospital de Santa Marta, Lisbon, Portugal
| | - B Valente
- Hospital de Santa Marta, Lisbon, Portugal
| | | | - A Lousinha
- Hospital de Santa Marta, Lisbon, Portugal
| | - P Bras
- Hospital de Santa Marta, Lisbon, Portugal
| | - AS Delgado
- Hospital de Santa Marta, Lisbon, Portugal
| | - M Bras
- Hospital de Santa Marta, Lisbon, Portugal
| | - M Paulo
- Hospital de Santa Marta, Lisbon, Portugal
| | - C Guerra
- Hospital de Santa Marta, Lisbon, Portugal
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11
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Castelo A, Portugal G, Vaz Ferreira V, Garcia Bras P, Teixeira B, Valente B, Cunha P, Guerra C, Delgado A, Cruz Ferreira R, Oliveira M. Radiofrequency catheter ablation of focal atrial tachycardia: characteristics and results of a series in a tertiary hospital. Europace 2021. [DOI: 10.1093/europace/euab116.090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Focal atrial tachycardia (AT) is a relatively uncommon arrhythmia with poor response to medical treatment. Radiofrequency (RF) ablation appears to be a good option for treatment of symptomatic patients (P).
Purpose
To describe the clinical characteristics, electrophysiological (EP) findings, safety and short-term efficacy of catheter ablation in P with AT.
Methods
Retrospective analysis of consecutive P submitted to AT ablation using electroanatomical mapping between 2015 and 2020. If the AT was not present spontaneously, pacing maneuvers (atrial drive or burst pacing with up to 3 extra-stimuli) and isoprenaline was employed until reproducible induction of an ectopic atrial rhythm. Radiofrequency (RF) ablation was delivered at the site of earliest activation after validation of local electrograms until non-inducibility.
Results
A total of 46P (61% female) were included, with a mean age of 48 ± 23 years (minimum 8 months, maximum 86 years). Idiopathic AT was observed in 47,8%, while 52.2% had other relevant comorbidities (chronic pulmonary disease 17.4%; previous cardiac surgery 8,7%; congenital heart disease 10.9%; coronary artery disease 6.5%). Despite anti-arrhythmic therapy, daily palpitations were present in 87% of the cases and dizziness or syncope occurred in 22%). Nearly half (47.8%) had previously sought urgent medical care and 30.4% had a hospital admission due to arrhythmia. The clinical arrhythmia was documented in 34P (47.8% by 12-lead electrocardiography and 26.1% in 24h Holter monitoring). During the EP study a focal AT was documented in all P (spontaneously in 54.3% and induced with pacing maneuvers in 45.7%). AT origin after electroanatomical activation mapping is depicted in figure 1. After focal RF ablation, a second AT was induced in 16P (34.8%) and a new ablation was performed in 15 cases (93.8%). Total RF time was 508 ± 386 sec. One P developed right phrenic nerve palsy after ablation on the lateral wall of the right atrium. No other complications were noted. On follow-up (mean 320 ± 92 days), symptoms improved in 88.1% of the P, with a 3-fold decrease in urgent medical care visits and hospital admission for arrhythmia. Three P (8.7%) were submitted to a new EP study, in which an AT was documented and ablated in 2P.
Conclusion
AT is a very symptomatic arrhythmia, associated with increased usage of hospital resources and poor response to antiarrhythmic therapy. Ablation is an efficient treatment option, with a high success rate, low rate of complications and short-term clinical benefits. Abstract Figure. Distribution of focal atrial tachycardia
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Affiliation(s)
- A Castelo
- Hospital de Santa Marta, Lisbon, Portugal
| | - G Portugal
- Hospital de Santa Marta, Lisbon, Portugal
| | | | | | - B Teixeira
- Hospital de Santa Marta, Lisbon, Portugal
| | - B Valente
- Hospital de Santa Marta, Lisbon, Portugal
| | - P Cunha
- Hospital de Santa Marta, Lisbon, Portugal
| | - C Guerra
- Hospital de Santa Marta, Lisbon, Portugal
| | - A Delgado
- Hospital de Santa Marta, Lisbon, Portugal
| | | | - M Oliveira
- Hospital de Santa Marta, Lisbon, Portugal
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12
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Ferreira V, Portugal G, Cruz Coutinho M, Silva Cunha P, Valente B, Lousinha A, Castelo A, Garcia Bras P, Grazina A, Guerra C, Delgado A, Paulo M, Cruz Ferreira R, Oliveira M. Low-fluoro workflows and impact in radiation exposure in the electrophysiology lab. Europace 2021. [DOI: 10.1093/europace/euab116.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
During electrophysiology (EP) procedures, fluoroscopy imaging is employed to visualise catheters position in real-time. However, ionizing radiation is a health hazard to both the patient and operator. In recent years, the use of electroanatomical mapping systems and operator adoption of low-fluoro workflows has allowed a reduction of radiation exposure. The aim of this study was to assess the evolution of fluoroscopy time (FT) in EP procedures, using conventional technique or an electroanatomical mapping system (EMS).
Methods
A retrospective analysis of consecutive EP procedures performed at a tertiary centre between September 2018 and October 2020 was conducted. The procedures were divided in 3 tertiles according to date (T1, T2 and T3), with T3 corresponding to the most recent interventions. Procedural duration, FT, use of EMS, radiofrequency time (RT), acute ablation success and procedural complications were examined.
Results
A total of 615 procedures were analysed: atrioventricular node reentry tachycardia (AVNRT) – n = 144, accessory pathways (AP) – n = 83, typical atrial flutter – n = 106, atrial fibrillation (AF) ablation with radiofrequency (RF) – n = 61, AF ablation with cryoballoon – n = 92, ablation of ventricular arrhythmias – n = 53, and 75 miscellaneous procedures (including atrioventricular node ablation, left atrial flutter ablation and cardioneuroablation). Mean age was 54.6 ± 18.2 years with 59.4% male sex patients. An EMS was used in 75% of the procedures, without significant differences between tertiles. A progressive reduction in median FT was observed over the tertiles (T1 6.3 min, interquartile range [IQR] 2.9-13.6; T2 5.4 min, IQR 2.1-12.0, and T3 3.1 min, IQR 1.2-7.2, Figure 1), and a statistical significant difference was found when comparing T1 to T3 (p < 0.001) and T2 to T3 (p < 0.001). The decrease in FT was observed throughout the study period for all different EP procedures (Figure 2). The number of procedures with zero fluoroscopy had gradually increased (T1 6.1%, T2 8.5% and T3 14.1%; T1 vs. T3 p <0.01). Younger patients (<20 years) were submitted to low fluoroscopy doses with a significant decrease over tertiles (T1 1.2 min, IQR 0.0-4.3; T2 0.9 min, IQR 0.0-2.5; T3 0.0, IQR 0.0-2.2, T1 vs.T3 p < 0.001). No significant difference in procedural duration, RT, acute procedural success or complication rate were noted between tertiles.
Conclusion
Reduction in radiation exposure can be achieved without compromising duration, safety and effectiveness of the procedure. The commitment of operators to reduce radiation exposure using 3D mapping technology can lead to a significant decrease in the use of fluoroscopy. Abstract Figure. Fluoroscopic time analysis
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Affiliation(s)
- V Ferreira
- Hospital de Santa Marta, Lisbon, Portugal
| | - G Portugal
- Hospital de Santa Marta, Lisbon, Portugal
| | | | | | - B Valente
- Hospital de Santa Marta, Lisbon, Portugal
| | - A Lousinha
- Hospital de Santa Marta, Lisbon, Portugal
| | - A Castelo
- Hospital de Santa Marta, Lisbon, Portugal
| | | | - A Grazina
- Hospital de Santa Marta, Lisbon, Portugal
| | - C Guerra
- Hospital de Santa Marta, Lisbon, Portugal
| | - A Delgado
- Hospital de Santa Marta, Lisbon, Portugal
| | - M Paulo
- Hospital de Santa Marta, Lisbon, Portugal
| | | | - M Oliveira
- Hospital de Santa Marta, Lisbon, Portugal
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13
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Oreto L, Manuri L, Calvaruso D, Guerra C, Ferro G, Campanella I, Nicita G, Grasso N, Zanai R, Trombetta B, Sturiale M, Fonte A, Iorio F, Reali S, Agati S. RF25 HYBRID PALLIATION ALLOWS THE HYPOPLASTIC LEFT VENTRICLE FOR A CHANCE OF BIVENTRICULAR REPAIR. J Cardiovasc Med (Hagerstown) 2018. [DOI: 10.2459/01.jcm.0000550031.82141.6c] [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: 11/05/2022]
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14
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Oreto L, Manuri L, Calvaruso D, Guerra C, Ferro G, Campanella I, Nicita G, Grasso N, Zanai R, Trombetta B, Sturiale M, Fonte A, Iorio F, Reali S, Agati S. OC32 HYBRID PALLIATION FOR HYPOPLASTIC LEFT HEART SYNDROME AND VARIANTS. J Cardiovasc Med (Hagerstown) 2018. [DOI: 10.2459/01.jcm.0000549870.57072.d7] [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: 11/05/2022]
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15
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Manuri L, Calvaruso D, Guerra C, Ferro G, Campanella I, Nicita G, Grasso N, Zanai R, Trombetta B, Sturiale M, Fonte A, Iorio F, Reali S, Agati S. RF58 PATENT DUCTUS ARTERIOSUS IN EARLY PRETERMS. J Cardiovasc Med (Hagerstown) 2018. [DOI: 10.2459/01.jcm.0000550030.74517.d8] [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: 11/05/2022]
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16
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Álvarez-Rodriguez M, Álvarez M, Anel-López L, Guerra C, Chamorro CA, Anel L, de Paz P, Martínez-Pastor F. Effect of length of time post-mortem on quality and freezing capacity of Cantabric chamois (Rupicapra pyrenaica parva) epididymal spermatozoa. Anim Reprod Sci 2018; 198:184-192. [PMID: 30301620 DOI: 10.1016/j.anireprosci.2018.09.018] [Citation(s) in RCA: 3] [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: 06/18/2018] [Revised: 09/17/2018] [Accepted: 09/27/2018] [Indexed: 12/17/2022]
Abstract
Genome Resource Banks are keystones in the ex-situ conservation of wild species. Post-mortem (PM) collection of epididymal spermatozoa is an opportunistic and valuable source of germplasm, the time from the death of the animal limits its use. Seeking to improve germplasm preservation strategies for the chamois (Rupicapra sp.), the effect of PM time on epididymal sperm quality and freezability was studied using the Cantabrian chamois. Samples were classified according to PM collection time, up to 216 h (refrigerated), and cryopreserved (Tris-citric acid-fructose, 430 mOsm/kg, 15% egg yolk, 8% glycerol; freezing at -20 °C/min). Sperm quality was assessed after recovery and post-thawing (motility by CASA, HOS test, abnormal forms, cytoplasmic droplets, and viability and acrosomal damage by flow cytometry). The sperm mass pH and osmolality showed a positive correlation with time. Total sperm motility dropped after 2 days PM, with progressivity and sperm velocities remained similar up to 3 days PM. Sperm freezability was acceptable, with the post-thawing HOST, motility, progressivity, VAP, VCL, VSL and BCF negatively correlating with PM time. Overall, chamois epidydimal samples were not adequate for preservation after 6 days PM. Freezability capacity could make these spermatozoa suitable for specific ART even if kept refrigerated for several days PM.
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Affiliation(s)
- M Álvarez-Rodriguez
- Department of Clinical and Experimental Medicine (IKE), BKH, Obstetrics and Gynecology, Linköping University, Linköping, Sweden; Department of Animal Health and Anatomy, Veterinary Faculty, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M Álvarez
- Department of Medicine, Surgery and Veterinary Anatomy, Universidad de León, León, Spain; INDEGSAL, Universidad de León, 24071 León, Spain
| | - L Anel-López
- Department of Medicine, Surgery and Veterinary Anatomy, Universidad de León, León, Spain; INDEGSAL, Universidad de León, 24071 León, Spain
| | - C Guerra
- Department of Medicine, Surgery and Veterinary Anatomy, Universidad de León, León, Spain
| | - C A Chamorro
- Department of Medicine, Surgery and Veterinary Anatomy, Universidad de León, León, Spain; INDEGSAL, Universidad de León, 24071 León, Spain
| | - L Anel
- Department of Medicine, Surgery and Veterinary Anatomy, Universidad de León, León, Spain; INDEGSAL, Universidad de León, 24071 León, Spain
| | - P de Paz
- INDEGSAL, Universidad de León, 24071 León, Spain; Department of Molecular Biology (Cell Biology), Universidad de León, Spain
| | - F Martínez-Pastor
- INDEGSAL, Universidad de León, 24071 León, Spain; Department of Molecular Biology (Cell Biology), Universidad de León, Spain.
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Bruyneel A, Guerra C, Tack J, Droguet M, Maes J, Miranda DR. Traduction sémantique en français et implémentation du Nursing Activities Score en Belgique. Méd Intensive Réa 2018. [DOI: 10.3166/rea-2018-0029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Introduction : L’évaluation du temps de travail en soins infirmiers est une pratique courante aux soins intensifs. Elle permet de calculer un ratio infirmière/patient optimal qui est un enjeu majeur pour assurer la qualité des soins et maîtriser les coûts des soins de santé. Le Nursing Activities Score (NAS) permet de calculer ce ratio, mais l’outil n’a jamais été traduit en français et adapté à la Belgique.
Objectif : Traduire et adapter le NAS à la Belgique francophone.
Méthodes: L’échelle a été traduite par deux traducteurs indépendants de l’anglais vers le français. Ensuite, une traduction rétrograde du français à l’anglais a été réalisée. Une adaptation culturelle a été effectuée en réunissant un groupe de 13 infirmiers belges. Enfin, l’échelle traduite a été validée et implémentée dans deux unités de soins intensifs (USI) distinctes en Belgique francophone.
Résultats : La traduction rétrograde était similaire à la première traduction. La réunion avec le groupe d’experts a permis de trouver un consensus sur l’adaptation de l’échelle et le tutoriel adaptés au contexte des soins en Belgique. Pour la validation, le NAS a été encodé chez 113 patients et avec 981 NAS encodés dans deux USI, la médiane de NAS/patient était respectivement de 69 et 76 %. Le temps médian d’encodage du NAS était de trois minutes par patient. Nous avons observé une compliance élevée de l’encodage du NAS (respectivement 99 et 76 %).
Conclusions : Nous avons validé une échelle traduite en français conforme à la version originale et adaptée au contexte des soins en Belgique.
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Joseph G, Nickell A, Cohen E, Burke NJ, Colen S, Lawlor K, Guerra C, Stewart SL. Abstract P4-10-05: Engaging linguistically and ethnically diverse low income women in health research: A randomized controlled trial. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p4-10-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Underserved breast cancer survivors are typically offered fewer opportunities to participate in cancer research. To address this disparity, a community based navigator program, Shanti's Margot Murphy Breast Cancer Program (Shanti) initiated a collaboration with UCSF researchers and BreastCancerTrials.org (BCT), a nonprofit clinical trials matching service to explore the potential role of a trusted community-based organization as a source of culturally appropriate education and access to clinical trial information. Through formative research, we developed the Health Research Engagement Intervention (HREI), a one-on-one navigator-client education session emphasizing the range of treatment and non-treatment quality-of-life and observational studies, conducted at a time when the participant is not in the initial crisis of diagnosis. The HREI ends by providing participants with an information card listing BCT and other organizations that provide information about health research for breast cancer patients and survivors.
Methods: We tested the HREI in a randomized controlled trial, comparing the HREI to simply providing the information card. Pre and post intervention surveys one month apart measured our primary outcome of health research information-seeking behavior. Secondary outcomes include health research knowledge, attitudes towards research participation, and health empowerment. All Shanti clients who spoke English, Cantonese or Spanish and had “low care navigation needs” (either completed treatment or no longer in the crisis of initial diagnosis and/or burdened by treatment protocols) were eligible.
Results: We recruited 133 Shanti Clients, including 59 who spoke English, 48 Cantonese, and 26 Spanish; 66 were randomized to the intervention arm and 67 to the control arm, and 130 completed both pre- and post-test surveys. Almost one-third of participants in both the intervention and control arms reported having talked to someone about health research or having called a telephone number or visited a website listed on the card (30% vs. 30%, p=0.94); a smaller proportion of participants confirmed that their information-seeking was related to the content of the educational materials (17% vs. 9%, p=0.22). On average the change from pre- to post-test in a 5-item knowledge score, adjusted for pre-test knowledge, was greater in the intervention group than in the control group (p=0.028), but the proportion of participants who were very confident that they could find health research information (had health empowerment) remained essentially unchanged in both study arms (intervention: 20% post vs. 21% pre, p=0.76; control: 25% post vs. 25% pre, p=1.00). Women were more likely to seek information if they had higher pre-test knowledge scores (odds ratio [OR]=3.5 per item, 95% confidence interval [CI] 1.5-8.4) or a greater increase in knowledge from pre- to post-test (OR=2.2 per item, 95% CI 1.1-4.7); there was no association between information-seeking and health empowerment (OR=0.6, 95% CI 0.2-2.5) or study arm (OR=1.6, 95% CI 0.5-4.9).
Conclusion: The HREI had a positive impact on knowledge of health research but did not significantly affect health empowerment or health research information-seeking behavior.
Citation Format: Joseph G, Nickell A, Cohen E, Burke NJ, Colen S, Lawlor K, Guerra C, Stewart SL. Engaging linguistically and ethnically diverse low income women in health research: A randomized controlled trial [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P4-10-05.
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Affiliation(s)
- G Joseph
- University of California, San Francisco, San Francisco, CA; The Shanti Project, San Francisco, CA; University of California, Merced, Merced, CA; University of California, Davis, Davis, CA; BreastCancerTrials.org, San Francisco, CA
| | - A Nickell
- University of California, San Francisco, San Francisco, CA; The Shanti Project, San Francisco, CA; University of California, Merced, Merced, CA; University of California, Davis, Davis, CA; BreastCancerTrials.org, San Francisco, CA
| | - E Cohen
- University of California, San Francisco, San Francisco, CA; The Shanti Project, San Francisco, CA; University of California, Merced, Merced, CA; University of California, Davis, Davis, CA; BreastCancerTrials.org, San Francisco, CA
| | - NJ Burke
- University of California, San Francisco, San Francisco, CA; The Shanti Project, San Francisco, CA; University of California, Merced, Merced, CA; University of California, Davis, Davis, CA; BreastCancerTrials.org, San Francisco, CA
| | - S Colen
- University of California, San Francisco, San Francisco, CA; The Shanti Project, San Francisco, CA; University of California, Merced, Merced, CA; University of California, Davis, Davis, CA; BreastCancerTrials.org, San Francisco, CA
| | - K Lawlor
- University of California, San Francisco, San Francisco, CA; The Shanti Project, San Francisco, CA; University of California, Merced, Merced, CA; University of California, Davis, Davis, CA; BreastCancerTrials.org, San Francisco, CA
| | - C Guerra
- University of California, San Francisco, San Francisco, CA; The Shanti Project, San Francisco, CA; University of California, Merced, Merced, CA; University of California, Davis, Davis, CA; BreastCancerTrials.org, San Francisco, CA
| | - SL Stewart
- University of California, San Francisco, San Francisco, CA; The Shanti Project, San Francisco, CA; University of California, Merced, Merced, CA; University of California, Davis, Davis, CA; BreastCancerTrials.org, San Francisco, CA
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Napoles TM, Guerra C, Orenstein F, Luce JA, Merritt S, Burke NJ. Abstract P6-12-19: Healing art: Breast cancer survivor experiences with nipple-areola tattoo procedures during breast reconstruction. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p6-12-19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Nipple-areola tattoos can provide restoration of a natural looking breast that more closely resembles its pre-surgical appearance while avoiding additional surgeries. To date, the majority of nipple-areola tattoo procedures are performed by healthcare providers with minimal training in tattoo procedures. Substandard results explain the high rates of dissatisfaction among women who receive nipple-areola tattoos. In response, professional tattoo artists have emerged as an alternative provider for women seeking reconstruction. However, few studies have examined expectations and experiences of women undergoing nipple-areola tattoo procedures provided by a professional tattoo artist outside of the traditional healthcare setting. Methods: In-depth interviews were conducted with a racially/ethnically diverse group of 30 women who had undergone nipple-areola tattooing in the past 0-2 years. Interviews were conducted in English, Spanish, Chinese, and Arabic, recorded, and translated and transcribed into English for analysis. A team of three researchers conducted iterative reviews of the data which included closely reading each transcript, coding, running queries of codes, and developing summary documents to highlight recurrent concepts and patterns which were shared and discussed in group meetings. Results: Interview narratives addressed the often unexpected impact nipple-areola tattooing had on body image, self-esteem, emotional well-being, and interpersonal relationships. Women described their decision-making processes as weighing concern about the needle, the pain, and uncertainty about the tattoo artist, setting for the procedure, and outcome with the opportunity to return to a more “normal” appearance without further surgeries. Women discussed how their initial preconceptions of tattoos and tattoo parlors were ameliorated by the spa-like setting and the tattoo artist's anticipation of such concerns which enhanced her ability to put them at ease and provide professional and compassionate care. Participants noted the integral role the tattoo artist played in their positive experiences, describing her as both an “artist” and “caregiver.” The manner in which she guided them through the decision-making process regarding the color, size, shape, and placement of their nipple-areola tattoo was noted as particularly significant and empowering. Conclusions: Nipple-areola tattooing is an acceptable and meaningful reconstruction process for medically underserved public hospital patients. Our results indicate that women should be informed of nipple-areola tattooing as an alternative to more invasive, surgical reconstruction options. Results also illustrate how the healthcare system can extend beyond the traditional healthcare setting to include and leverage non-clinical and non-traditional specialists to provide appropriate care and positive breast health outcomes for women. In order to increase access and legitimacy to these services, additional research is needed to understand how to bring tattoo artists “in-house” (i.e., into the medical setting) and how to incorporate tattoo artists into breast health teams.
Citation Format: Napoles TM, Guerra C, Orenstein F, Luce JA, Merritt S, Burke NJ. Healing art: Breast cancer survivor experiences with nipple-areola tattoo procedures during breast reconstruction [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P6-12-19.
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Affiliation(s)
- TM Napoles
- University of California, San Francisco, San Francisco, CA; Avon Breast Care Program, San Francisco General Hospital (SFGH), San Francisco, CA; Department of Medicine (Hematology/Oncology), San Francisco, CA; Dragonfly Ink Studio, San Francisco, CA; Public Health, School of Social Sciences, Humanities, & Arts, University of California, Merced, Merced, CA
| | - C Guerra
- University of California, San Francisco, San Francisco, CA; Avon Breast Care Program, San Francisco General Hospital (SFGH), San Francisco, CA; Department of Medicine (Hematology/Oncology), San Francisco, CA; Dragonfly Ink Studio, San Francisco, CA; Public Health, School of Social Sciences, Humanities, & Arts, University of California, Merced, Merced, CA
| | - F Orenstein
- University of California, San Francisco, San Francisco, CA; Avon Breast Care Program, San Francisco General Hospital (SFGH), San Francisco, CA; Department of Medicine (Hematology/Oncology), San Francisco, CA; Dragonfly Ink Studio, San Francisco, CA; Public Health, School of Social Sciences, Humanities, & Arts, University of California, Merced, Merced, CA
| | - JA Luce
- University of California, San Francisco, San Francisco, CA; Avon Breast Care Program, San Francisco General Hospital (SFGH), San Francisco, CA; Department of Medicine (Hematology/Oncology), San Francisco, CA; Dragonfly Ink Studio, San Francisco, CA; Public Health, School of Social Sciences, Humanities, & Arts, University of California, Merced, Merced, CA
| | - S Merritt
- University of California, San Francisco, San Francisco, CA; Avon Breast Care Program, San Francisco General Hospital (SFGH), San Francisco, CA; Department of Medicine (Hematology/Oncology), San Francisco, CA; Dragonfly Ink Studio, San Francisco, CA; Public Health, School of Social Sciences, Humanities, & Arts, University of California, Merced, Merced, CA
| | - NJ Burke
- University of California, San Francisco, San Francisco, CA; Avon Breast Care Program, San Francisco General Hospital (SFGH), San Francisco, CA; Department of Medicine (Hematology/Oncology), San Francisco, CA; Dragonfly Ink Studio, San Francisco, CA; Public Health, School of Social Sciences, Humanities, & Arts, University of California, Merced, Merced, CA
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Baldwin MK, Alvarez C, Rincon M, Quintero A, Urrego M, Guerra C, Edna F, Taborda N, Hersh AR, Muñoz LF, Moreno DJ, Rubio ML, Vargas JC, Tolosa JE. An implementation strategy to increase uptake of immediate postpartum contraception: the COMSE trial. Contraception 2017. [DOI: 10.1016/j.contraception.2017.07.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Joseph G, Pasick RJ, Schillinger D, Luce J, Cheng JKY, Guerra C. Effective Cancer Risk Communication to Prevent Disparities in the Era of Precision Medicine. Cancer Epidemiol Biomarkers Prev 2017. [DOI: 10.1158/1055-9965.epi-17-0028] [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: 11/16/2022] Open
Abstract
Abstract
As genetics and genomics become part of mainstream Medicine, these advances have the potential to reduce or exacerbate health disparities. Gaps in effective communication (where all parties share the same meaning) are widely recognized as a major contributor to health disparities. The purpose of this study was to examine cancer genetic counselor-patient communication, to assess its effectiveness from the patient perspective, and to pilot intervention strategies to improve it. We used multiple inductive methods, including standard ethnographic techniques to systematically observe and audio-record genetic counseling sessions, and qualitative interviews with observed patients using the audio recordings to stimulate recall and probe specific aspects of the communication. Data analyses were conducted using grounded theory. We observed 64 English-, 35 Spanish- and 25 Cantonese- speaking public hospital patients (n = 124) and 10 Genetic Counselors in 170 appointments, and interviewed 49 patients who had been offered testing. We identified a fundamental mismatch between the information provided by genetic counselors and the information desired and meaningful to patients. Several components of the communication that contributed to this mismatch and often resulted in ineffective communication included: (1) too much information; (2) complex terminology and conceptually difficult presentation of information; (3) information perceived as not relevant by the patient; (4) unintentional inhibition of patient engagement and question-asking; (5) vague discussions of screening and prevention recommendations. To address these communication barriers, we adapted from other fields of Medicine to the genetic counseling context and pilot tested evidence-based strategies for effective communication with limited literacy patients. Our findings indicate a need to transform the standard model of hereditary cancer risk communication. The increasing access of diverse populations to genetic services, high rates of limited health literacy in the US, and growing complexity of genetic information have created a perfect storm. If not directly addressed, this convergence can be expected to exacerbate health disparities in the genomic age.
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Joseph G, Guerra C, Cheng JKY, Lee R. Abstract P3-11-04: Adapting evidenced based strategies for effective communication in cancer genetic counseling. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p3-11-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
This abstract was withdrawn by the authors.
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Affiliation(s)
- G Joseph
- University of California, San Francisco, San Francisco, CA
| | - C Guerra
- University of California, San Francisco, San Francisco, CA
| | - JKY Cheng
- University of California, San Francisco, San Francisco, CA
| | - R Lee
- University of California, San Francisco, San Francisco, CA
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23
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Trotter LA, Patel D, Dubin S, Guerra C, McCloud V, Lockwood P, Messer R, Wataha JC, Lewis JB. Violet/blue light activates Nrf2 signaling and modulates the inflammatory response of THP-1 monocytes. Photochem Photobiol Sci 2017; 16:883-889. [DOI: 10.1039/c6pp00299d] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Several studies suggest that light in the UVA range (320–400 nm) activates signaling pathways that are anti-inflammatory and antioxidative.
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Affiliation(s)
| | - D. Patel
- Augusta University
- Dept. of Oral Biology
- Augusta
- USA
- University of Kentucky
| | - S. Dubin
- Western University of Health Sciences
- College of Dental Medicine
- Pomona
- USA
| | - C. Guerra
- Western University of Health Sciences
- College of Dental Medicine
- Pomona
- USA
| | - V. McCloud
- Augusta University
- Dept. of Oral Biology
- Augusta
- USA
| | - P. Lockwood
- Augusta University
- Dept. of Oral Biology
- Augusta
- USA
| | - R. Messer
- Augusta University
- Dept. of Oral Biology
- Augusta
- USA
| | - J. C. Wataha
- Augusta University
- Dept. of Oral Biology
- Augusta
- USA
- University of Washington
| | - J. B. Lewis
- Augusta University
- Dept. of Oral Biology
- Augusta
- USA
- Western University of Health Sciences
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24
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Bertaglia E, Guerra C, Vertolli U, Varchetta V, Azzurro M, Belmonte P. Thrombogenesis and fibrinolysis: Risk in systemic lupus erythematosus (SLE) patients? Clin Hemorheol Microcirc 2016. [DOI: 10.3233/ch-1982-2413] [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: 11/15/2022]
Affiliation(s)
- E. Bertaglia
- Clinica Medica I Policlinico Universitario, Padova, Italia
| | - C. Guerra
- Clinica Medica I Policlinico Universitario, Padova, Italia
| | - U. Vertolli
- Clinica Medica I Policlinico Universitario, Padova, Italia
| | - V. Varchetta
- Clinica Medica I Policlinico Universitario, Padova, Italia
| | - M. Azzurro
- Clinica Medica I Policlinico Universitario, Padova, Italia
| | - P. Belmonte
- Clinica Medica I Policlinico Universitario, Padova, Italia
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25
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D Agostino MC, Frairia R, Romeo P, Amelio E, Berta L, Bosco V, Gigliotti S, Guerra C, Messina S, Messuri L, Moretti B, Notarnicola A, Maccagnano G, Russo S, Saggini R, Vulpiani MC, Buselli P. Extracorporeal shockwaves as regenerative therapy in orthopedic traumatology: a narrative review from basic research to clinical practice. J BIOL REG HOMEOS AG 2016; 30:323-332. [PMID: 27358117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Extracorporeal Shock Wave Therapy (ESWT), after its first medical application in the urological field for lithotripsy, nowadays represents a valid therapeutical tool also for many musculoskeletal diseases, as well as for regenerative medicine applications. This is possible thanks to its mechanisms of action, which in the non-urological field are not related to mechanical disruption (as for renal stones), but rather to the capacity, by mechanotransduction, to induce neoangiogenesis, osteogenesis and to improve local tissue trophism, regeneration and remodeling, through stem cell stimulation. On the basis of these biological assumptions, it becomes clear that ESWT can represent a valid therapeutic tool also for all those pathological conditions that derive from musculoskeletal trauma, and are characterized by tissue loss and/or delayed healing and regeneration (mainly bone and skin, but not only). As a safe, repeatable and noninvasive therapy, in many cases it can represent a firstline therapeutic option, as an alternative to surgery (for example, in bone and skin healing disorders), or in combination with some other treatment options. It is hoped that with its use in daily practice also the muscleskeletal field will grow, not only for standard indications, but also in posttraumatic sequelae, in order to improve recovery and shorten healing time, with undoubted advantages for the patients and lower health service expenses.
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Affiliation(s)
- M C D Agostino
- Humanitas Research Hospital and Humanitas University, Rozzano, Milano, Italy
| | - R Frairia
- Department of Medical Sciences, University of Torino, Turin, Italy
| | - P Romeo
- Orthopedic Clinic of the University of Milan, Galeazzi Orthopedic Institute, Milan, Italy
| | - E Amelio
- University Hospital, Verona, Italy
| | - L Berta
- Med and Sport 2000, Turin, Italy
| | - V Bosco
- Private Clinic Madre Fortunata Toniolo, Bologna, Italy
| | | | - C Guerra
- University Hospital, Verona, Italy
| | | | | | - B Moretti
- Department of Medical Sciences of Basis, Neurosciences and Organs of Sense, Faculty of Medicine and Surgery, University of Bari, Bari, Italy
| | - A Notarnicola
- Department of Medical Sciences of Basis, Neurosciences and Organs of Sense, Faculty of Medicine and Surgery, University of Bari, Bari, Italy
| | - G Maccagnano
- Department of Medical Sciences of Basis, Neurosciences and Organs of Sense, Faculty of Medicine and Surgery, University of Bari, Bari, Italy
| | - S Russo
- Department of Surgery, Orthopedic, University Federico II, Napoli, Italy
| | - R Saggini
- Department of Medical, Oral and Biotechnological Sciences, University G. DAnnunzio, Chieti, Italy
| | - M C Vulpiani
- Physical Medicine and Rehabilitation Unit, St. Andrea Hospital, University La Sapienza, Roma, Italy
| | - P Buselli
- Department of Neuro Ostheo Articular Sciences, Cremona Hospital, Cremona, Italy
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26
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Aguilar C, Guerra C, Lascano S, Guzman D, Rojas P, Thirumurugan M, Bejar L, Medina A. Synthesis and characterization of Ti–Ta–Nb–Mn foams. Materials Science and Engineering: C 2016; 58:420-31. [DOI: 10.1016/j.msec.2015.08.053] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Revised: 08/06/2015] [Accepted: 08/25/2015] [Indexed: 12/01/2022]
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Miñambres E, Suberviola B, Guerra C, Lavid N, Lassalle M, González-Castro A, Ballesteros M. Experiencia de un programa de donación en asistolia Maastricht II en una ciudad de pequeño tamaño: resultados preliminares. Med Intensiva 2015; 39:433-41. [DOI: 10.1016/j.medin.2014.09.007] [Citation(s) in RCA: 18] [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] [Received: 06/30/2014] [Revised: 08/13/2014] [Accepted: 09/04/2014] [Indexed: 11/28/2022]
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Gama Marques J, Roberto A, Guerra C, Pinto da Costa M, Podlesek A, Beezhold J, Jovanovic N, Moscoso A. Comportamento Suicidário nos Internos de Psiquiatria em Portugal: Comparação com a Realidade Europeia. ACTA MEDICA PORT 2015. [DOI: 10.20344/amp.6038] [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: 11/20/2022]
Abstract
<strong>Introduction:</strong> The aim of this paper was to assess the prevalence of suicide ideation and attempts in Portuguese psychiatry trainees (adult and child and adolescence), and compare the data with the general population and other European countries.<br /><strong>Material and Methods:</strong> A structured and anonymous questionnaire was sent by email to 159 portuguese trainees of adult psychiatry and child and adolescence psychiatry with questions about personal history of suicidal ideation and suicide attempts, as well as family history of suicide attempts and completed suicides. This is part of the BoSS Study (Burnout Syndrome Study) performed in 21 countries worldwide. Data was analysed in SPSS v.19.<br /><strong>Results:</strong> From the inquired population, 62 trainees (40,3%) partially responded, and 46 (29%) were complete responders - these entered the final analysis. There was a ratio of 2:1 (female:male) and a mean age of 29 years. The suicidal ideation was present in passive form in 44% and in active form in 33%; also, 4.3% of respondents had previous suicide attempts. In first degree relatives, 22% had attempted suicide and 13% completed suicide.<br /><strong>Discussion:</strong> The results are worriying and may be associated with some factors to which this population is exposed.<br /><strong>Conclusion:</strong> It is necessary further research to better understand this phenomenon, its causes and potential modifiers.
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29
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Gama Marques J, Roberto A, Guerra C, Pinto da Costa M, Podlesek A, Beezhold J, Jovanovic N, Moscoso A. [Suicidal Behavior among Portuguese Psychiatry Trainees: Comparison with the European Situation]. ACTA MEDICA PORT 2015; 28:608-612. [PMID: 26667864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Accepted: 07/27/2015] [Indexed: 06/05/2023]
Abstract
INTRODUCTION The aim of this paper was to assess the prevalence of suicide ideation and attempts in Portuguese psychiatry trainees (adult and child and adolescence), and compare the data with the general population and other European countries. MATERIAL AND METHODS A structured and anonymous questionnaire was sent by email to 159 portuguese trainees of adult psychiatry and child and adolescence psychiatry with questions about personal history of suicidal ideation and suicide attempts, as well as family history of suicide attempts and completed suicides. This is part of the BoSS Study (Burnout Syndrome Study) performed in 21 countries worldwide. Data was analysed in SPSS v.19. RESULTS From the inquired population, 62 trainees (40,3%) partially responded, and 46 (29%) were complete responders - these entered the final analysis. There was a ratio of 2:1 (female:male) and a mean age of 29 years. The suicidal ideation was present in passive form in 44% and in active form in 33%; also, 4.3% of respondents had previous suicide attempts. In first degree relatives, 22% had attempted suicide and 13% completed suicide. DISCUSSION The results are worriying and may be associated with some factors to which this population is exposed. CONCLUSION It is necessary further research to better understand this phenomenon, its causes and potential modifiers.
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Affiliation(s)
- João Gama Marques
- Clínica de Psicoses Esquizofrénicas. Centro Hospitalar Psiquiátrico de Lisboa. Lisboa. Portugal. Clínica Universitária de Psiquiatria e Psicologia Médica. Faculdade de Medicina. Universidade de Lisboa. Lisboa. Portugal
| | - Alice Roberto
- Departamento de Psiquiatria. Hospital Garcia de Orta. Almada. Portugal
| | - Cátia Guerra
- Departamento de Psiquiatria. Centro Hospitalar de S. João. Porto. Portugal
| | | | - Anja Podlesek
- Department of Psychology. University of Ljubljana. Ljubljana. Slovenia
| | - Julian Beezhold
- Department of Psychiatry. Hellesdon Hospital. Norwich. Norfolk. United Kingdom. University of East Anglia. Norwich. United Kingdom
| | - Nikolina Jovanovic
- Psychiatric Clinic. University Hospital Centre and School of Medicine. Zagreb. Croatia
| | - Ana Moscoso
- Departamento de Pedopsiquiatra. Hospital de D. Estefânia. Centro Hospitalar de Lisboa Central. Lisboa. Portugal
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Camargo LFA, Marra AR, Pignatari ACC, Sukiennik T, Behar PPP, Medeiros EAS, Ribeiro J, Girão E, Correa L, Guerra C, Brites C, Pereira CAP, Carneiro I, Reis M, Souza MA, Barata CU, Edmond MB. Nosocomial bloodstream infections in a nationwide study: comparison between solid organ transplant patients and the general population. Transpl Infect Dis 2015; 17:308-13. [PMID: 25726707 DOI: 10.1111/tid.12356] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Revised: 07/04/2014] [Accepted: 12/11/2014] [Indexed: 12/29/2022]
Abstract
BACKGROUND The incidence of bloodstream infection (BSI) varies according to the transplanted organ. Mortality can be as high as 24%, with a significant impact on graft survival. Transplantation is a risk factor for multidrug-resistant (MDR) organisms, but comparison with a non-transplanted population in a single large cohort has not been described. METHODS This is a prospective nationwide study (16 centers) reporting data on 2364 monomicrobial nosocomial BSIs, comparing 83 episodes in solid organ transplant patients with 2447 BSIs occurring in the general hospital population. RESULTS The prevalence of groups of infecting organisms (gram-positive, gram-negative, and fungi) was similar between transplant patients and the general population and a similar crude mortality rate was observed (34.9% in transplant vs. 43.3% in non-transplant patients). Staphylococcus aureus was the single most frequently isolated organism in both groups, and Acinetobacter species was more frequently isolated in the general population. Regarding MDR organisms, Klebsiella species, and Enterobacter species resistant to cefepime, as well as Acinetobacter species resistant to meropenem, were significantly more frequent in transplant patients. CONCLUSION Antimicrobial resistance is higher, particularly among gram-negative bacteria in the transplant population, although the overall mortality rate between transplant and non-transplant patients with nosocomial BSI is similar.
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Affiliation(s)
- L F A Camargo
- Hospital Israelita Albert Einstein, São Paulo, Brazil; Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
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Luna-Jorquera G, Wilson RP, Culik BM, Aguilar R, Guerra C. Observations on the thermal conductance of Adélie (Pygoscelis adeliae) and Humboldt (Spheniscus humboldti) penguins. Polar Biol 2014. [DOI: 10.1007/s003000050106] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Zapata H, Bustince H, De Miguel L, Guerra C. Some properties of implications via aggregation functions and overlap functions. INT J COMPUT INT SYS 2014. [DOI: 10.1080/18756891.2014.967005] [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: 10/24/2022] Open
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Guerra C, Coelho T, Melo R, Guimarães R, Moura M. EPA-0602 – Donors motivation and altruism narratives in living kidney transplantation. Eur Psychiatry 2014. [DOI: 10.1016/s0924-9338(14)77987-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Guerra C, Jurio A, Bustince H, Lopez-Molina C. Multichannel generalization of the Upper-Lower Edge Detector using ordered weighted averaging operators. Journal of Intelligent & Fuzzy Systems 2014. [DOI: 10.3233/ifs-131110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- C. Guerra
- Department Automatica y Computacion, Universidad Publica de Navarra, Pamplona, Spain
| | - A. Jurio
- Department Automatica y Computacion, Universidad Publica de Navarra, Pamplona, Spain
| | - H. Bustince
- Department Automatica y Computacion, Universidad Publica de Navarra, Pamplona, Spain
| | - C. Lopez-Molina
- Department Automatica y Computacion, Universidad Publica de Navarra, Pamplona, Spain
- Department of Mathematical Modelling, Statistics and Bioinformatics, Ghent University, Gent, Belgium
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Guerra C, Coelho T, Torres C, Correia R, Moreira R, Silva A, Mota M. EPA-0596 – Catatonia and electroconvulsive therapy: are there patients that need a higher number of sessions? Eur Psychiatry 2014. [DOI: 10.1016/s0924-9338(14)77983-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Pinto da Costa M, Guerra C, Malta R, Moura M, Carvalho S, Mendonça D. Psychiatry Training Towards a Global Future: Trainees’ Perspective in Portugal. ACTA MEDICA PORT 2013. [DOI: 10.20344/amp.319] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
Abstract
Introduction: Psychiatry is influenced by society changes, so it should be permanently updating itself, foreseeing future behaviours and pathologies. This study aims to describe psychiatry trainee’s opinion in Portugal concerning their training and the modifications they would want to witness in the near future.Material and Methods: A structured questionnaire of 26 questions was developed by the Portuguese Association of Psychiatry Trainees and sent via email.Results: The percentage of responses was 41.5%. The majority of the trainees were satisfied with their formation. However, some changes were pointed out concerning obligatory and optional placements. Most trainees claimed psychotherapy should be included in their training, along with an easier access to investigational procedures and clinical training opportunities abroad.Discussion and Conclusion: This detailed perspective can facilitate the transformation of the curricula throughout Portugal and Europe, allowing the improvement of psychiatry training, as well as the enhancement of mental health care.
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Alvarez R, Musteanu M, Garcia-Garcia E, Lopez-Casas PP, Megias D, Guerra C, Muñoz M, Quijano Y, Cubillo A, Rodriguez-Pascual J, Plaza C, de Vicente E, Prados S, Tabernero S, Barbacid M, Lopez-Rios F, Hidalgo M. Stromal disrupting effects of nab-paclitaxel in pancreatic cancer. Br J Cancer 2013; 109:926-33. [PMID: 23907428 PMCID: PMC3749580 DOI: 10.1038/bjc.2013.415] [Citation(s) in RCA: 252] [Impact Index Per Article: 22.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Revised: 06/26/2013] [Accepted: 07/01/2013] [Indexed: 12/12/2022] Open
Abstract
Background: Nab-paclitaxel and gemcitabine have demonstrated a survival benefit over gemcitabine alone in advanced pancreatic cancer (PDA). This study aimed to investigate the clinical, biological, and imaging effects of the regimen in patients with operable PDA. Methods: Patients with operable PDA received two cycles of nab-paclitaxel and gemcitabine before surgical resection. FDG-PET and CA19.9 tumour marker levels were used to measure clinical activity. Effects on tumour stroma were determined by endoscopic ultrasound (EUS) elastography. The collagen content and architecture as well as density of cancer-associated fibroblasts (CAFs) were determined in the resected surgical specimen and compared with a group of untreated and treated with conventional chemoradiation therapy controls. A co-clinical study in a mouse model of PDA was conducted to differentiate between the effects of nab-paclitaxel and gemcitabine. Results: A total of 16 patients were enrolled. Treatment resulted in significant antitumour effects with 50% of patients achieving a >75% decrease in circulating CA19.9 tumour marker and a response by FDG-PET. There was also a significant decrement in tumour stiffness as measured by EUS elastography. Seven of 12 patients who completed treatment and were operated had major pathological regressions. Analysis of residual tumours showed a marked disorganised collagen with a very low density of CAF, which was not observed in the untreated or conventionally treated control groups. The preclinical co-clinical study showed that these effects were specific of nab-paclitaxel and not gemcitabine. Conclusion: These data suggest that nab-paclitaxel and gemcitabine decreases CAF content inducing a marked alteration in cancer stroma that results in tumour softening. This regimen should be studied in patients with operable PDA.
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Affiliation(s)
- R Alvarez
- Centro Integral Oncológico Clara Campal, Oña 10, 28050 Madrid, Spain
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Pinto da Costa M, Guerra C, Malta R, Moura M, Carvalho S, Mendonça D. Psychiatry training towards a global future: trainees' perspective in Portugal. ACTA MEDICA PORT 2013; 26:357-360. [PMID: 24016644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Accepted: 05/09/2013] [Indexed: 06/02/2023]
Abstract
INTRODUCTION Psychiatry is influenced by society changes, so it should be permanently updating itself, foreseeing future behaviours and pathologies. This study aims to describe psychiatry trainee's opinion in Portugal concerning their training and the modifications they would want to witness in the near future. MATERIAL AND METHODS A structured questionnaire of 26 questions was developed by the Portuguese Association of Psychiatry Trainees and sent via email. RESULTS The percentage of responses was 41.5%. The majority of the trainees were satisfied with their formation. However, some changes were pointed out concerning obligatory and optional placements. Most trainees claimed psychotherapy should be included in their training, along with an easier access to investigational procedures and clinical training opportunities abroad. DISCUSSION AND CONCLUSION This detailed perspective can facilitate the transformation of the curricula throughout Portugal and Europe, allowing the improvement of psychiatry training, as well as the enhancement of mental health care.
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Guerra C, Zenteno-Savín T, Maeda-Martínez A, Abele D, Philipp E. The effect of predator exposure and reproduction on oxidative stress parameters in the Catarina scallop Argopecten ventricosus. Comp Biochem Physiol A Mol Integr Physiol 2013; 165:89-96. [DOI: 10.1016/j.cbpa.2013.02.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Revised: 02/07/2013] [Accepted: 02/08/2013] [Indexed: 01/05/2023]
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Guerra C, Ferreira P, Moura M, Silva A. 1064 – Does internet promote self-harm behavior? Eur Psychiatry 2013. [DOI: 10.1016/s0924-9338(13)76181-9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Guerra C, Rendeiro P, Pereira E, Rosmaninho A, Nogueira R, Pereira S, Tavares P. Microarray for skeletal dysplasias: thanatophoric dysplasia diagnosed in utero using microarray technology. Ultrasound Obstet Gynecol 2013; 41:95-96. [PMID: 22744731 DOI: 10.1002/uog.11217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Guerra C, Johal K, Morris D, Moreno S, Alvarado O, Gray D, Tanzil M, Pearce D, Venketaraman V. Control of Mycobacterium tuberculosis growth by activated natural killer cells. Clin Exp Immunol 2012; 168:142-52. [PMID: 22385249 DOI: 10.1111/j.1365-2249.2011.04552.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
We characterized the underlying mechanisms by which glutathione (GSH)-enhanced natural killer (NK) cells inhibit the growth of Mycobacterium tuberculosis (M. tb) inside human monocytes. We observed that in healthy individuals, treatment of NK cells with N-acetyl cysteine (NAC), a GSH prodrug in conjunction with cytokines such as interleukin (IL)-2 + IL-12, resulted in enhanced expression of NK cytotoxic ligands (FasL and CD40L) with concomitant stasis in the intracellular growth of M. tb. Neutralization of FasL and CD40L in IL-2 + IL-12 + NAC-treated NK cells resulted in abrogation in the growth inhibition of M. tb inside monocytes. Importantly, we observed that the levels of GSH are decreased significantly in NK cells derived from individuals with HIV infection compared to healthy subjects, and this decrease correlated with a several-fold increase in the growth of M. tb inside monocytes. This study describes a novel innate defence mechanism adopted by NK cells to control M. tb infection.
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Affiliation(s)
- C Guerra
- College of Osteopathic Medicine of the Pacific Graduate of College of Biomedical Sciences Western University of Health Sciences, 309 East SecondStreet, Pomona, CA 91766, USA
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Joseph G, Kaplan C, Luce J, Lee R, Stewart S, Guerra C, Pasick R. Efficient identification and referral of low-income women at high risk for hereditary breast cancer: a practice-based approach. Public Health Genomics 2012; 15:172-80. [PMID: 22488460 DOI: 10.1159/000336419] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Identification of low-income women with the rare but serious risk of hereditary cancer and their referral to appropriate services presents an important public health challenge. We report the results of formative research to reach thousands of women for efficient identification of those at high risk and expedient access to free genetic services. External validity is maximized by emphasizing intervention fit with the two end-user organizations who must connect to make this possible. This study phase informed the design of a subsequent randomized controlled trial. METHODS We conducted a randomized controlled pilot study (n = 38) to compare two intervention models for feasibility and impact. The main outcome was receipt of genetic counseling during a two-month intervention period. Model 1 was based on the usual outcall protocol of an academic hospital genetic risk program, and Model 2 drew on the screening and referral procedures of a statewide toll-free phone line through which large numbers of high-risk women can be identified. In Model 1, the risk program proactively calls patients to schedule genetic counseling; for Model 2, women are notified of their eligibility for counseling and make the call themselves. We also developed and pretested a family history screener for administration by phone to identify women appropriate for genetic counseling. RESULTS There was no statistically significant difference in receipt of genetic counseling between women randomized to Model 1 (3/18) compared with Model 2 (3/20) during the intervention period. However, when unresponsive women in Model 2 were called after 2 months, 7 more obtained counseling; 4 women from Model 1 were also counseled after the intervention. Thus, the intervention model that closely aligned with the risk program's outcall to high-risk women was found to be feasible and brought more low-income women to free genetic counseling. Our screener was easy to administer by phone and appeared to identify high-risk callers effectively. The model and screener are now in use in the main trial to test the effectiveness of this screening and referral intervention. A validation analysis of the screener is also underway. CONCLUSION Identification of intervention strategies and tools, and their systematic comparison for impact and efficiency in the context where they will ultimately be used are critical elements of practice-based research.
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Affiliation(s)
- G Joseph
- Departments of Anthropology, History and Social Medicine, University of California-San Francisco, 1450 3rd Street, San Francisco, CA 94158, USA.
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Guerra C, Leite S, Reis C, Moura M, Esteves M. P-752 - Psychosomatic factors in alopecia areata. Eur Psychiatry 2012. [DOI: 10.1016/s0924-9338(12)74919-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Guerra C, Schwartz CJ. Investigation of the influence of textiles and surface treatments on blistering using a novel simulant. Skin Res Technol 2011; 18:94-100. [DOI: 10.1111/j.1600-0846.2011.00538.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Guerra C, Azevedo J, Massano J, Fernandes L. Delirium and parkinsonic syndrome in elderly. Eur Psychiatry 2011. [DOI: 10.1016/s0924-9338(11)72540-8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Delirium is an acute or subacute syndrome characterized by a fluctuating global disorder of cognition, impairment of attention and awareness, disorganization of thought and speech, perceptual disturbances, hallucinations, as well as hypo or hyperactivity.We present a case report of a 76-year-old woman who developed disorientation, lack of familiar recognition and functional impairment, three days before admission. She was admitted to a Medicine Department and submitted to several laboratory and imaging studies.During this period she presented attention, consciousness fluctuations and agitation that required several treatments, including neuroleptics. Like these symptoms were linked to an important life even that triggered reactive depression, she was transferred to a psychiatric ward. Progressively her clinical state worsened, she became permanently bedridden and was observed by Neurology. She presented moderate to severe parkinsonian signs, namely akinesia and rigidity, predominantly on her left side. Reviewing her clinical past, she had suffered these symptoms during the two years before this episode (apathy, small stepped gait, flexed posture, and left hand rest tremor). Treatment with antiparkinsonic drugs produced a dramatic improvement in the patient’s mental and physical status. A I-Ioflupane-SPECT (DaTscan) confirmed striatal presynaptic dopaminergic degeneration, more on the right side, which was the proof of the presence of a degenerative parkinsonian syndrome.The present clinical case shows Delirium with degenerative Parkinsonism comorbidity, worsened by the use of neuroleptics. We emphasize the importance previously undiagnosed Parkinsonism in old age which is highlighted by usefulness of dopamine transporter imaging in this scenery.
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Frezzetti D, De Menna M, Zoppoli P, Guerra C, Ferraro A, Bello AM, De Luca P, Calabrese C, Fusco A, Ceccarelli M, Zollo M, Barbacid M, Di Lauro R, De Vita G. Upregulation of miR-21 by Ras in vivo and its role in tumor growth. Oncogene 2010; 30:275-86. [PMID: 20956945 DOI: 10.1038/onc.2010.416] [Citation(s) in RCA: 109] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
miR-21 is a microRNA (miRNA) frequently overexpressed in human cancers. Here we show that miR-21 is upregulated both in vitro and in vivo by oncogenic Ras, thus linking this miRNA to one of the most frequently activated oncogenes in human cancers. Ras regulation of miR-21 occurs with a delayed kinetic and requires at least two Ras downstream pathways. A screen of human thyroid cancers and non-small-cell lung cancers for the expression of miR-21 reveals that it is overexpressed mainly in anaplastic thyroid carcinomas, the most aggressive form of thyroid cancer, whereas in lung its overexpression appears to be inversely correlated with tumor progression. We also show that a LNA directed against miR-21 slows down tumor growth in mice. Consistently, a search for mRNAs downregulated by miR-21 shows an enrichment for mRNAs encoding cell cycle checkpoints regulators, suggesting an important role for miR-21 in oncogenic Ras-induced cell proliferation.
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Dubus P, Puyol M, Martin A, Mulero F, Canamero M, Guerra C, Santamaria D, Barbacid M. R164 - Oral, Club Mex-H Cdk4, une cible thérapeutique des carcinomes pulmonaires K-Ras mutées ? Analyse d’un modèle préclinique de tumorigenèse pulmonaire. Bull Cancer 2010. [DOI: 10.1016/s0007-4551(15)31085-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Aamodt K, Abel N, Abeysekara U, Abrahantes Quintana A, Abramyan A, Adamová D, Aggarwal MM, Aglieri Rinella G, Agocs AG, Aguilar Salazar S, Ahammed Z, Ahmad A, Ahmad N, Ahn SU, Akimoto R, Akindinov A, Aleksandrov D, Alessandro B, Alfaro Molina R, Alici A, Almaráz Aviña E, Alme J, Alt T, Altini V, Altinpinar S, Andrei C, Andronic A, Anelli G, Angelov V, Anson C, Anticić T, Antinori F, Antinori S, Antipin K, Antończyk D, Antonioli P, Anzo A, Aphecetche L, Appelshäuser H, Arcelli S, Arceo R, Arend A, Armesto N, Arnaldi R, Aronsson T, Arsene IC, Asryan A, Augustinus A, Averbeck R, Awes TC, Aystö J, Azmi MD, Bablok S, Bach M, Badalà A, Baek YW, Bagnasco S, Bailhache R, Bala R, Baldisseri A, Baldit A, Bán J, Barbera R, Barnaföldi GG, Barnby LS, Barret V, Bartke J, Barile F, Basile M, Basmanov V, Bastid N, Bathen B, Batigne G, Batyunya B, Baumann C, Bearden IG, Becker B, Belikov I, Bellwied R, Belmont-Moreno E, Belogianni A, Benhabib L, Beole S, Berceanu I, Bercuci A, Berdermann E, Berdnikov Y, Betev L, Bhasin A, Bhati AK, Bianchi L, Bianchi N, Bianchin C, Bielcík J, Bielcíková J, Bilandzic A, Bimbot L, Biolcati E, Blanc A, Blanco F, Blanco F, Blau D, Blume C, Boccioli M, Bock N, Bogdanov A, Bøggild H, Bogolyubsky M, Bohm J, Boldizsár L, Bombara M, Bombonati C, Bondila M, Borel H, Borisov A, Bortolin C, Bose S, Bosisio L, Bossú F, Botje M, Böttger S, Bourdaud G, Boyer B, Braun M, Braun-Munzinger P, Bravina L, Bregant M, Breitner T, Bruckner G, Brun R, Bruna E, Bruno GE, Budnikov D, Buesching H, Buncic P, Busch O, Buthelezi Z, Caffarri D, Cai X, Caines H, Calvo E, Camacho E, Camerini P, Campbell M, Canoa Roman V, Capitani GP, Cara Romeo G, Carena F, Carena W, Carminati F, Casanova Díaz A, Caselle M, Castillo Castellanos J, Castillo Hernandez JF, Catanescu V, Cattaruzza E, Cavicchioli C, Cerello P, Chambert V, Chang B, Chapeland S, Charpy A, Charvet JL, Chattopadhyay S, Chattopadhyay S, Cherney M, Cheshkov C, Cheynis B, Chiavassa E, Chibante Barroso V, Chinellato DD, Chochula P, Choi K, Chojnacki M, Christakoglou P, Christensen CH, Christiansen P, Chujo T, Chuman F, Cicalo C, Cifarelli L, Cindolo F, Cleymans J, Cobanoglu O, Coffin JP, Coli S, Colla A, Conesa Balbastre G, Conesa Del Valle Z, Conner ES, Constantin P, Contin G, Contreras JG, Corrales Morales Y, Cormier TM, Cortese P, Cortés Maldonado I, Cosentino MR, Costa F, Cotallo ME, Crescio E, Crochet P, Cuautle E, Cunqueiro L, Cussonneau J, Dainese A, Dalsgaard HH, Danu A, Das I, Dash A, Dash S, de Barros GOV, De Caro A, de Cataldo G, de Cuveland J, De Falco A, De Gaspari M, de Groot J, De Gruttola D, De Marco N, De Pasquale S, De Remigis R, de Rooij R, de Vaux G, Delagrange H, Delgado Y, Dellacasa G, Deloff A, Demanov V, Dénes E, Deppman A, D'Erasmo G, Derkach D, Devaux A, Di Bari D, Di Giglio C, Di Liberto S, Di Mauro A, Di Nezza P, Dialinas M, Díaz L, Díaz R, Dietel T, Divià R, Djuvsland O, Dobretsov V, Dobrin A, Dobrowolski T, Dönigus B, Domínguez I, Don DMM, Dordic O, Dubey AK, Dubuisson J, Ducroux L, Dupieux P, Dutta Majumdar AK, Dutta Majumdar MR, Elia D, Emschermann D, Enokizono A, Espagnon B, Estienne M, Esumi S, Evans D, Evrard S, Eyyubova G, Fabjan CW, Fabris D, Faivre J, Falchieri D, Fantoni A, Fasel M, Fateev O, Fearick R, Fedunov A, Fehlker D, Fekete V, Felea D, Fenton-Olsen B, Feofilov G, Fernández Téllez A, Ferreiro EG, Ferretti A, Ferretti R, Figueredo MAS, Filchagin S, Fini R, Fionda FM, Fiore EM, Floris M, Fodor Z, Foertsch S, Foka P, Fokin S, Formenti F, Fragiacomo E, Fragkiadakis M, Frankenfeld U, Frolov A, Fuchs U, Furano F, Furget C, Fusco Girard M, Gaardhøje JJ, Gadrat S, Gagliardi M, Gago A, Gallio M, Ganoti P, Ganti MS, Garabatos C, García Trapaga C, Gebelein J, Gemme R, Germain M, Gheata A, Gheata M, Ghidini B, Ghosh P, Giraudo G, Giubellino P, Gladysz-Dziadus E, Glasow R, Glässel P, Glenn A, Gómez Jiménez R, González Santos H, González-Trueba LH, González-Zamora P, Gorbunov S, Gorbunov Y, Gotovac S, Gottschlag H, Grabski V, Grajcarek R, Grelli A, Grigoras A, Grigoras C, Grigoriev V, Grigoryan A, Grigoryan S, Grinyov B, Grion N, Gros P, Grosse-Oetringhaus JF, Grossiord JY, Grosso R, Guber F, Guernane R, Guerra C, Guerzoni B, Gulbrandsen K, Gulkanyan H, Gunji T, Gupta A, Gupta R, Gustafsson HA, Gutbrod H, Haaland O, Hadjidakis C, Haiduc M, Hamagaki H, Hamar G, Hamblen J, Han BH, Harris JW, Hartig M, Harutyunyan A, Hasch D, Hasegan D, Hatzifotiadou D, Hayrapetyan A, Heide M, Heinz M, Helstrup H, Herghelegiu A, Hernández C, Herrera Corral G, Herrmann N, Hetland KF, Hicks B, Hiei A, Hille PT, Hippolyte B, Horaguchi T, Hori Y, Hristov P, Hrivnácová I, Hu S, Huang M, Huber S, Humanic TJ, Hutter D, Hwang DS, Ichou R, Ilkaev R, Ilkiv I, Inaba M, Innocenti PG, Ippolitov M, Irfan M, Ivan C, Ivanov A, Ivanov M, Ivanov V, Iwasaki T, Jachołkowski A, Jacobs P, Jancurová L, Jangal S, Janik R, Jena C, Jena S, Jirden L, Jones GT, Jones PG, Jovanović P, Jung H, Jung W, Jusko A, Kaidalov AB, Kalcher S, Kalinák P, Kalisky M, Kalliokoski T, Kalweit A, Kamal A, Kamermans R, Kanaki K, Kang E, Kang JH, Kapitan J, Kaplin V, Kapusta S, Karavichev O, Karavicheva T, Karpechev E, Kazantsev A, Kebschull U, Keidel R, Khan MM, Khan SA, Khanzadeev A, Kharlov Y, Kikola D, Kileng B, Kim DJ, Kim DS, Kim DW, Kim HN, Kim J, Kim JH, Kim JS, Kim M, Kim M, Kim SH, Kim S, Kim Y, Kirsch S, Kisel I, Kiselev S, Kisiel A, Klay JL, Klein J, Klein-Bösing C, Kliemant M, Klovning A, Kluge A, Knichel ML, Kniege S, Koch K, Kolevatov R, Kolojvari A, Kondratiev V, Kondratyeva N, Konevskih A, Kornaś E, Kour R, Kowalski M, Kox S, Kozlov K, Kral J, Králik I, Kramer F, Kraus I, Kravcáková A, Krawutschke T, Krivda M, Krumbhorn D, Krus M, Kryshen E, Krzewicki M, Kucheriaev Y, Kuhn C, Kuijer PG, Kumar L, Kumar N, Kupczak R, Kurashvili P, Kurepin A, Kurepin AN, Kuryakin A, Kushpil S, Kushpil V, Kutouski M, Kvaerno H, Kweon MJ, Kwon Y, La Rocca P, Lackner F, Ladrón de Guevara P, Lafage V, Lal C, Lara C, Larsen DT, Laurenti G, Lazzeroni C, Le Bornec Y, Le Bris N, Lee H, Lee KS, Lee SC, Lefèvre F, Lenhardt M, Leistam L, Lehnert J, Lenti V, León H, León Monzón I, León Vargas H, Lévai P, Li X, Li Y, Lietava R, Lindal S, Lindenstruth V, Lippmann C, Lisa MA, Liu L, Loginov V, Lohn S, Lopez X, López Noriega M, López-Ramírez R, López Torres E, Løvhøiden G, Lozea Feijo Soares A, Lu S, Lunardon M, Luparello G, Luquin L, Lutz JR, Ma K, Ma R, Madagodahettige-Don DM, Maevskaya A, Mager M, Mahapatra DP, Maire A, Makhlyueva I, Mal'kevich D, Malaev M, Malagalage KJ, Maldonado Cervantes I, Malek M, Malkiewicz T, Malzacher P, Mamonov A, Manceau L, Mangotra L, Manko V, Manso F, Manzari V, Mao Y, Mares J, Margagliotti GV, Margotti A, Marín A, Martashvili I, Martinengo P, Martínez Hernández MI, Martínez Davalos A, Martínez García G, Maruyama Y, Marzari Chiesa A, Masciocchi S, Masera M, Masetti M, Masoni A, Massacrier L, Mastromarco M, Mastroserio A, Matthews ZL, Matyja A, Mayani D, Mazza G, Mazzoni MA, Meddi F, Menchaca-Rocha A, Mendez Lorenzo P, Meoni M, Mercado Pérez J, Mereu P, Miake Y, Michalon A, Miftakhov N, Milano L, Milosevic J, Minafra F, Mischke A, Miśkowiec D, Mitu C, Mizoguchi K, Mlynarz J, Mohanty B, Molnar L, Mondal MM, Montaño Zetina L, Monteno M, Montes E, Morando M, Moretto S, Morsch A, Moukhanova T, Muccifora V, Mudnic E, Muhuri S, Müller H, Munhoz MG, Munoz J, Musa L, Musso A, Nandi BK, Nania R, Nappi E, Navach F, Navin S, Nayak TK, Nazarenko S, Nazarov G, Nedosekin A, Nendaz F, Newby J, Nianine A, Nicassio M, Nielsen BS, Nikolaev S, Nikolic V, Nikulin S, Nikulin V, Nilsen BS, Nilsson MS, Noferini F, Nomokonov P, Nooren G, Novitzky N, Nyatha A, Nygaard C, Nyiri A, Nystrand J, Ochirov A, Odyniec G, Oeschler H, Oinonen M, Okada K, Okada Y, Oldenburg M, Oleniacz J, Oppedisano C, Orsini F, Ortiz Velasquez A, Ortona G, Oskarsson A, Osmic F, Osterman L, Ostrowski P, Otterlund I, Otwinowski J, Ovrebekk G, Oyama K, Ozawa K, Pachmayer Y, Pachr M, Padilla F, Pagano P, Paić G, Painke F, Pajares C, Pal S, Pal SK, Palaha A, Palmeri A, Panse R, Papikyan V, Pappalardo GS, Park WJ, Pastircák B, Pastore C, Paticchio V, Pavlinov A, Pawlak T, Peitzmann T, Pepato A, Pereira H, Peressounko D, Pérez C, Perini D, Perrino D, Peryt W, Peschek J, Pesci A, Peskov V, Pestov Y, Peters AJ, Petrácek V, Petridis A, Petris M, Petrov P, Petrovici M, Petta C, Peyré J, Piano S, Piccotti A, Pikna M, Pillot P, Pinazza O, Pinsky L, Pitz N, Piuz F, Platt R, Płoskoń M, Pluta J, Pocheptsov T, Pochybova S, Podesta Lerma PLM, Poggio F, Poghosyan MG, Polák K, Polichtchouk B, Polozov P, Polyakov V, Pommeresch B, Pop A, Posa F, Pospísil V, Potukuchi B, Pouthas J, Prasad SK, Preghenella R, Prino F, Pruneau CA, Pshenichnov I, Puddu G, Pujahari P, Pulvirenti A, Punin A, Punin V, Putis M, Putschke J, Quercigh E, Rachevski A, Rademakers A, Radomski S, Räihä TS, Rak J, Rakotozafindrabe A, Ramello L, Ramírez Reyes A, Rammler M, Raniwala R, Raniwala S, Räsänen SS, Rashevskaya I, Rath S, Read KF, Real JS, Redlich K, Renfordt R, Reolon AR, Reshetin A, Rettig F, Revol 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Zbroszczyk H, Zelnicek P, Zenin A, Zepeda A, Zgura I, Zhalov M, Zhang X, Zhou D, Zhou S, Zhu J, Zichichi A, Zinchenko A, Zinovjev G, Zoccarato Y, Zychácek V, Zynovyev M. Midrapidity antiproton-to-proton ratio in pp collisons at sqrt[s]=0.9 and 7 TeV measured by the ALICE experiment. Phys Rev Lett 2010; 105:072002. [PMID: 20868032 DOI: 10.1103/physrevlett.105.072002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2010] [Indexed: 05/29/2023]
Abstract
The ratio of the yields of antiprotons to protons in pp collisions has been measured by the ALICE experiment at sqrt[s]=0.9 and 7 TeV during the initial running periods of the Large Hadron Collider. The measurement covers the transverse momentum interval 0.45<p_{t}<1.05 GeV/c and rapidity |y|<0.5. The ratio is measured to be R_{|y|<0.5}=0.957±0.006(stat)±0.014(syst) at 0.9 TeV and R_{|y|<0.5}=0.991±0.005(stat)±0.014(syst) at 7 TeV and it is independent of both rapidity and transverse momentum. The results are consistent with the conventional model of baryon-number transport and set stringent limits on any additional contributions to baryon-number transfer over very large rapidity intervals in pp collisions.
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Affiliation(s)
- K Aamodt
- Department of Physics, University of Oslo, Oslo, Norway
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