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Marques J, Duarte-Ramos F, Ferreira MB, Lima R, Lopes C, Sokolova A, Tonin FS, Loureiro CC. Optimizing the use of systemic corticosteroids in severe asthma (ROSA II project): a national Delphi consensus study. Pulmonology 2023; 29:555-563. [PMID: 37543525 DOI: 10.1016/j.pulmoe.2023.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 07/06/2023] [Accepted: 07/11/2023] [Indexed: 08/07/2023] Open
Affiliation(s)
- J Marques
- Immunology and Allergy Department, Centro Hospitalar e Universitário de Lisboa Central, EPE, Lisboa, Portugal; CEDOC, Integrated Pathophysiological Mechanisms Research Group, Lisboa, Portugal.
| | - F Duarte-Ramos
- Department of Pharmacy, Pharmacology and Health Technologies, Faculty of Pharmacy, University of Lisboa, Lisboa, Portugal; EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Portugal
| | - M B Ferreira
- Serviço de Imunoalergologia, Centro Hospitalar de Lisboa Norte, Lisboa, Portugal; Clínica Universitária de Imunoalergologia, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
| | - R Lima
- Pulmonology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, EPE, Vila Nova de Gaia, Portugal
| | - C Lopes
- Departamento do Tórax, Hospital de Santa Maria, Lisbon, Portugal
| | - A Sokolova
- Immunology and Allergy Department, Hospital Prof. Doutor Fernando Fonseca, EPE, Amadora, Portugal
| | - F S Tonin
- ESTeSL - Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Lisbon, Portugal; H&TRC - Health & Technology Research Center, Instituto Politécnico de Lisboa, Lisbon, Portugal
| | - C C Loureiro
- Pulmonology Unit, Hospitais da Universidade de Coimbra, Centro Hospitalar e Universitário de Coimbra, Portugal; Centre of Pulmonology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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Rodrigues HC, Martins C, Fragoso E, Lopes C, Azevedo P. Mepolizumab in severe asthma exacerbation in a respiratory ICU-a successful off-label use. Pulmonology 2023; 29:438-440. [PMID: 37031002 DOI: 10.1016/j.pulmoe.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 03/07/2023] [Accepted: 03/08/2023] [Indexed: 04/08/2023] Open
Affiliation(s)
- H C Rodrigues
- Unidade de Cuidados Intensivos Respiratórios, Serviço de Pneumologia, Centro Hospitalar Universitário Lisboa Norte, Portugal; Unidade Multidisciplinar de Asma Grave, Serviço de Pneumologia, Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal.
| | - C Martins
- Unidade de Cuidados Intensivos Respiratórios, Serviço de Pneumologia, Centro Hospitalar Universitário Lisboa Norte, Portugal
| | - E Fragoso
- Unidade de Cuidados Intensivos Respiratórios, Serviço de Pneumologia, Centro Hospitalar Universitário Lisboa Norte, Portugal
| | - C Lopes
- Unidade de Cuidados Intensivos Respiratórios, Serviço de Pneumologia, Centro Hospitalar Universitário Lisboa Norte, Portugal; Unidade Multidisciplinar de Asma Grave, Serviço de Pneumologia, Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal
| | - P Azevedo
- Unidade de Cuidados Intensivos Respiratórios, Serviço de Pneumologia, Centro Hospitalar Universitário Lisboa Norte, Portugal
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3
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Duerson W, Lopes C, Dumani D. Pregnancy and prophylactic red cell exchange in sickle cell disease. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00675-4] [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: 01/28/2023]
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Bouceiro-Mendes R, Soares-de-Almeida L, Lopes C. Eyelid Amyloid Deposition in Systemic Light Chain Amyloidosis. Actas Dermo-Sifiliográficas 2022; 113:305. [DOI: 10.1016/j.ad.2022.02.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 08/22/2020] [Indexed: 10/19/2022] Open
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5
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Bouceiro-Mendes R, Soares-de-Almeida L, Lopes C. [Artículo traducido] Depósito de amiloides en párpados en amiloidosis de cadena ligera sistémica. Actas Dermo-Sifiliográficas 2022; 113:T305. [DOI: 10.1016/j.ad.2020.08.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 08/22/2020] [Indexed: 11/30/2022] Open
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6
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Madeira T, Severo M, Correia D, Clara JG, Lopes C. Nutritional inadequacy and malnutrition in older adults. Clin Nutr ESPEN 2021. [DOI: 10.1016/j.clnesp.2021.09.234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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7
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Monteiro L, Silva P, Delgado L, Amaral B, Garcês F, Salazar F, Pacheco JJ, Lopes C, Bousbaa H, Warnakulasuriya S. Expression of spindle assembly checkpoint proteins BubR1 and Mad2 expression as potential biomarkers of malignant transformation of oral leukoplakia: an observational cohort study. Med Oral Patol Oral Cir Bucal 2021; 26:e719-e728. [PMID: 34704983 PMCID: PMC8601638 DOI: 10.4317/medoral.24511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 09/20/2021] [Indexed: 12/15/2022] Open
Abstract
Background The Spindle Assembly Checkpoint (SAC) is a surveillance mechanism essential to ensure the accuracy of chromosome segregation during mitosis. Our aim was to evaluate the expression of SAC proteins in oral carcinogenesis, and to assess their potential in predicting malignant transformation of oral leukoplakia. Material and Methods We analysed the immunoexpression of BubR1, Mad2, Bub3, and Spindly proteins in 64 oral biopsies from 52 oral leukoplakias and 12 normal tissues. Univariate and multivariate analysis were performed to evaluate predictive factors for malignant transformation (MT). Results We observed that BubR1 and Mad2 were more highly expressed in high dysplasia grade lesions than in low grade or normal tissues (P<0.05). High expression of Spindly was significantly correlated with a high Ki-67 score (P=0.004). Six (11.5%) oral leukoplakias underwent malignant transformation. In univariate analysis, the binary dysplasia grade (high grade) (P<0.001) was associated with a higher risk of malignant transformation as well as high BubR1 (P<0.001) and high Mad2 (P=0.013) expression. In multivariate analysis, high expression of BubR1 and Mad2 when combined showed an increased risk for malignant transformation (P=0.013; HR of 4.6, 95% CI of 1.4-15.1). Conclusions Our findings reveal that BubR1 and Mad2 were associated with an increased risk for malignant transformation independently of histological grade and could be potential and useful predictive risk markers of malignant transformation in oral leukoplakias. Key words:BubR1, Mad2, Spindly, Bub3, Oral Leukoplakia, epithelial dysplasia, Oral squamous cell carcinoma.
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Affiliation(s)
- L Monteiro
- Rua Central de Gandra, 1317 4585-116 Gandra PRD, Portugal
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8
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Markabawi D, Khan M, Alberti M, Tawagi K, Lopes C, Luk E, Satti S. P40.16 Real-World Data and Racial Outcomes for NSCLC in The Chemo-Immunotherapy Era. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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9
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Lopes C. Antipsychotics use in dementia: How safe are they? Eur Psychiatry 2021. [PMCID: PMC9475755 DOI: 10.1192/j.eurpsy.2021.1134] [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: 11/24/2022] Open
Abstract
Introduction Antipsychotics are frequently used for managing psychiatric and behavioral symptoms of dementia. However, it’s an off-label resource which remains controversial due to significant safety concerns in the elderly population, namely increasing cardiovascular adverse effects. Objectives To access antipsychotic safety and potential risks when used in dementia. Methods A non-systematic review was carefully conducted on PubMed using the following keywords: “dementia”, “antipsychotics” and “safety.” We selected clinical trials, meta-analysis, randomized controlled trials published in the last 10 years. Results A total of 43 articles was obtained, of which 22 were excluded because they didn’t meet our inclusion criteria. Regarding atypical antipsychotics, one study found an incidence of severe events in 23,7% of patients and a OR=2.5 for cerebrovascular side effects. Quetiapine was suspended midway given it had a higher incidence of adverse effects compared to others. There weren’t any significant statistic differences concerning serious events between classes of antipsychotics(p<0,01). No study was found comparing typical and atypical antipsychotics safety in dementia. Conclusions Overall, we can conclude that antipsychotics pose a risk of serious adverse effects when used in elderly patients, namely cerebrovascular events. Among atypical antipsychotics, quetiapine, used frequently for controlling neuropsychiatric symptoms in these patients appears a higher risk for severe adverse events compared with other drugs. Their use should be restricted after there aren’t any other options available. New protocols could be developed to control these symptoms, for example, environmental measures before resorting to antipsychotics.
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Lopes C, Cunha I, Camacho C, Vareda C, Lai A, Vilela M, Mendes F, Martins D. Twin-to-twin transfusion syndrome: new macroscopic and microscopic findings. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab120.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Twin-to-twin Transfusion Syndrome (TTTS) is a serious complication of monochorionic twin pregnancies. Affects about 10% to 15% of pregnancies and it is associated with high fetal and neonatal mortality, as well as cardiac and neurological morbidity in surviving fetuses. The main objective was to characterize a series of fetuses with TTTS since the pathophysiology of the syndrome is not fully understood and the clinical spectrum is broad.
Methods
Post-mortem macroscopic and microscopic examination of 26 fetuses (from 2010 to 2020) with TTTS syndrome.
Results
The most frequent macroscopic findings in placenta were discrepancy in size and pallor/placental congestion. Other macroscopic findings not described in the literature were calcifications, areas of infarction and hematomas. Infarction areas and villi heterogeneity growth were the most common microscopic findings, described in the literature. Regarding the fetus, the restriction of intrauterine growth, the alteration of anthropometric parameters and the presence of a plethoric/anemic fetus were the main characteristics associated with this syndrome. The most common microscopic findings were signs of anoxia and congestive organs, already described in the literature. We also found frequently pulmonary abnormalities as new findings in our study.
Conclusions
The results allowed the identification of TTTS aspects that can contribute to the characterization of this syndrome. Given that the progression of TTTS remains unpredictable and the mortality rate for both fetuses is 90%, it becomes increasingly important to identify strategies for diagnosing and characterizing the syndrome.
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Affiliation(s)
- Cátia Lopes
- Politécnico de Coimbra, ESTeSC, DCBL, Rua 5 de Outubro - SM Bispo, Apartado 7006, 3046-854 Coimbra, Portugal
| | - Inês Cunha
- Politécnico de Coimbra, ESTeSC, DCBL, Rua 5 de Outubro - SM Bispo, Apartado 7006, 3046-854 Coimbra, Portugal
| | - Catarina Camacho
- Politécnico de Coimbra, ESTeSC, DCBL, Rua 5 de Outubro - SM Bispo, Apartado 7006, 3046-854 Coimbra, Portugal
| | - Catarina Vareda
- Politécnico de Coimbra, ESTeSC, DCBL, Rua 5 de Outubro - SM Bispo, Apartado 7006, 3046-854 Coimbra, Portugal
| | - Ana Lai
- Centro Hospitalar e Universitário de Coimbra, Serviço de Anatomia Patológica, Coimbra, Portugal
| | - Marisa Vilela
- Centro Hospitalar e Universitário de Coimbra, Serviço de Anatomia Patológica, Coimbra, Portugal
| | - Fernando Mendes
- Politécnico de Coimbra, ESTeSC, DCBL, Rua 5 de Outubro - SM Bispo, Apartado 7006, 3046-854 Coimbra, Portugal
- Biophysics Institute, Coimbra Institute for Clinical and Biomedical Research (iCBR) Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, Azinhaga de Santa Comba, Celas, 3000-548 Coimbra, Portugal
- CNC.IBILI Consortium/Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Azinhaga de Santa Comba, Celas, 3000-548 Coimbra, Portugal
| | - Diana Martins
- Politécnico de Coimbra, ESTeSC, DCBL, Rua 5 de Outubro - SM Bispo, Apartado 7006, 3046-854 Coimbra, Portugal
- Biophysics Institute, Coimbra Institute for Clinical and Biomedical Research (iCBR) Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, Azinhaga de Santa Comba, Celas, 3000-548 Coimbra, Portugal
- CNC.IBILI Consortium/Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Azinhaga de Santa Comba, Celas, 3000-548 Coimbra, Portugal
- I3S, Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal
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11
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Vareda C, Camacho C, Cunha I, Lopes C, Pina R, Lai A, Vilela M, Mendes F, Martins D. Foetal hydrops: new challenges. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab120.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Foetal Hydrops (FH) is an abnormal accumulation of fluid inside two or more serous cavities and may be linked with polyhydramnios and/or placental oedema. It has been correlated with several causes such foetal anaemia, chromosomal anomalies, congenital abnormalities, infections, twin-to-twin transfusion syndrome and maternal causes such as diabetes. Regardless the advances in diagnosis and therapy, the overall perinatal mortality rate remains high. Thereby, the main goal is to evaluate the autopsy findings including between 2010 and 2019.
Methods
105 cases including perinatal and new-born autopsies with different gestation stages were studied, in order to understand the macroscopic and microscopic events that can elucidate FH.
Results
Macroscopically, a large number of foetuses demonstrated oedema effusions and intrauterine growth restriction. Regarding placenta, the most common macroscopic finding is oedema, such as described in the literature. Nodules and hemorrhagic areas are the new findings observed. Oedema remains the most relevant microscopic finding, whereas unspecified villi alterations and trophoblast pseudoinclusions were the new findings.
Conclusions
The results allowed the identification of new characteristics that can contribute to the knowledge of this foetal condition that remains a challenge. Future studies need to focus on identifying strategies for diagnosis and treatment is critical for foetal hydrops.
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Affiliation(s)
- Catarina Vareda
- Politécnico de Coimbra, ESTeSC, DCBL, Rua 5 de Outubro - SM Bispo, Apartado 7006, 3046-854 Coimbra, Portugal
| | - Catarina Camacho
- Politécnico de Coimbra, ESTeSC, DCBL, Rua 5 de Outubro - SM Bispo, Apartado 7006, 3046-854 Coimbra, Portugal
| | - Inês Cunha
- Politécnico de Coimbra, ESTeSC, DCBL, Rua 5 de Outubro - SM Bispo, Apartado 7006, 3046-854 Coimbra, Portugal
| | - Cátia Lopes
- Politécnico de Coimbra, ESTeSC, DCBL, Rua 5 de Outubro - SM Bispo, Apartado 7006, 3046-854 Coimbra, Portugal
| | - Raquel Pina
- Centro Hospitalar e Universitário de Coimbra, Serviço de Anatomia Patológica, Coimbra, Portugal
| | - Ana Lai
- Centro Hospitalar e Universitário de Coimbra, Serviço de Anatomia Patológica, Coimbra, Portugal
| | - Marisa Vilela
- Centro Hospitalar e Universitário de Coimbra, Serviço de Anatomia Patológica, Coimbra, Portugal
| | - Fernando Mendes
- Politécnico de Coimbra, ESTeSC, DCBL, Rua 5 de Outubro - SM Bispo, Apartado 7006, 3046-854 Coimbra, Portugal
- Politécnico de Coimbra, ESTeSC, DCBL, Rua 5 de Outubro - SM Bispo, Apartado 7006, 3046-854 Coimbra, Portugal
- Biophysics Institute, Coimbra Institute for Clinical and Biomedical Research (iCBR) Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, Azinhaga de Santa Comba, Celas, 3000-548 Coimbra, Portugal
| | - Diana Martins
- Politécnico de Coimbra, ESTeSC, DCBL, Rua 5 de Outubro - SM Bispo, Apartado 7006, 3046-854 Coimbra, Portugal
- Politécnico de Coimbra, ESTeSC, DCBL, Rua 5 de Outubro - SM Bispo, Apartado 7006, 3046-854 Coimbra, Portugal
- Biophysics Institute, Coimbra Institute for Clinical and Biomedical Research (iCBR) Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, Azinhaga de Santa Comba, Celas, 3000-548 Coimbra, Portugal
- CNC.IBILI Consortium/Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Azinhaga de Santa Comba, Celas, 3000-548 Coimbra, Portugal
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12
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Pereira MF, Amaral IM, Lopes C, Leitão C, Madeira D, Lopes JP, Gonçalves FQ, Canas PM, Cunha RA, Agostinho P. l-α-aminoadipate causes astrocyte pathology with negative impact on mouse hippocampal synaptic plasticity and memory. FASEB J 2021; 35:e21726. [PMID: 34196433 DOI: 10.1096/fj.202100336r] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 05/12/2021] [Accepted: 05/24/2021] [Indexed: 12/26/2022]
Abstract
Increasing evidence shows that astrocytes, by releasing and uptaking neuroactive molecules, regulate synaptic plasticity, considered the neurophysiological basis of memory. This study investigated the impact of l-α-aminoadipate (l-AA) on astrocytes which sense and respond to stimuli at the synaptic level and modulate hippocampal long-term potentiation (LTP) and memory. l-AA selectivity toward astrocytes was proposed in the early 70's and further tested in different systems. Although it has been used for impairing the astrocytic function, its effects appear to be variable in different brain regions. To test the effects of l-AA in the hippocampus of male C57Bl/6 mice we performed two different treatments (ex vivo and in vivo) and took advantage of other compounds that were reported to affect astrocytes. l-AA superfusion did not affect the basal synaptic transmission but decreased LTP magnitude. Likewise, trifluoroacetate and dihydrokainate decreased LTP magnitude and occluded the effect of l-AA on synaptic plasticity, confirming l-AA selectivity. l-AA superfusion altered astrocyte morphology, increasing the length and complexity of their processes. In vivo, l-AA intracerebroventricular injection not only reduced the astrocytic markers but also LTP magnitude and impaired hippocampal-dependent memory in mice. Interestingly, d-serine administration recovered hippocampal LTP reduction triggered by l-AA (2 h exposure in hippocampal slices), whereas in mice injected with l-AA, the superfusion of d-serine did not fully rescue LTP magnitude. Overall, these data show that both l-AA treatments affect astrocytes differently, astrocytic activation or loss, with similar negative outcomes on hippocampal LTP, implying that opposite astrocytic adaptive alterations are equally detrimental for synaptic plasticity.
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Affiliation(s)
| | - Inês M Amaral
- Center for Neuroscience and Cell Biology, CNC, Coimbra, Portugal
| | - Cátia Lopes
- Center for Neuroscience and Cell Biology, CNC, Coimbra, Portugal
| | - Catarina Leitão
- Center for Neuroscience and Cell Biology, CNC, Coimbra, Portugal
| | - Daniela Madeira
- Center for Neuroscience and Cell Biology, CNC, Coimbra, Portugal.,Faculty of Medicine, University of Coimbra, FMUC, Coimbra, Portugal
| | - João P Lopes
- Center for Neuroscience and Cell Biology, CNC, Coimbra, Portugal
| | | | - Paula M Canas
- Center for Neuroscience and Cell Biology, CNC, Coimbra, Portugal
| | - Rodrigo A Cunha
- Center for Neuroscience and Cell Biology, CNC, Coimbra, Portugal.,Faculty of Medicine, University of Coimbra, FMUC, Coimbra, Portugal
| | - Paula Agostinho
- Center for Neuroscience and Cell Biology, CNC, Coimbra, Portugal.,Faculty of Medicine, University of Coimbra, FMUC, Coimbra, Portugal
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Monteiro L, Santiago C, Amaral BD, Al-Mossallami A, Albuquerque R, Lopes C. An observational retrospective study of odontogenic cyst´s and tumours over an 18-year period in a Portuguese population according to the new WHO Head and Neck Tumour classification. Med Oral Patol Oral Cir Bucal 2021; 26:e482-e493. [PMID: 33340074 PMCID: PMC8254885 DOI: 10.4317/medoral.24337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 11/23/2020] [Indexed: 11/17/2022] Open
Abstract
Background Odontogenic cysts and tumours of the jaws represent one of the most prevalent groups of oral-maxillofacial lesions. We aimed to evaluate the clinical and pathological characteristics of a cohort of odontogenic cysts (OC) and odontogenic tumours (OT) of the jaws in a Portuguese population.
Material and Methods This observational retrospective study analysed patients diagnosed with either an OC or OT of the jaws at a central hospital of Oporto, Portugal, between 1988 and 2006. Data collected from patients’ files included demographic, clinical, radiological and histopathological information. Recurrence was evaluated using univariate and multivariate analysis.
Results The sample consisted of 397 patients, 231 males (58.2%) and 166 females (41.8%), with a mean-age of 36.7±17 years. Twenty-seven patients (6.8%) presented with more than one lesion providing a total of 433 lesions. There were 396 (91.5%) OC, mostly represented by radicular cysts (n=257;59.4%), dentigerous cysts (n=79;18.2%), or odontogenic keratocysts (n=50;11.5%). There were 37 (8.5%) OT, mostly represented by ameloblastomas (n=16;3.7%), and odontomas (n=9;2.1%). The most common initial clinical manifestation was swelling (n=224;51.7%). Recurrence was observed in 30 cases (6.9%), mostly in ameloblastomas (n=6;37.5%) and odontogenic keratocysts (n=12;24%). In the multivariate analysis the diagnosis classification of the lesion was the only independent and significant variable related with the recurrence (P=0.04).
Conclusions Radicular cysts were the most commonly occurring type of OC and ameloblastomas the most commonly occurring OT. Amelobastomas and odontogenic keratocysts were the lesions with the highest rates of recurrence. This large sample provides useful information about the frequency profile and characteristics of OC and OT over a period of 18 years, allowing valuable comparison with data from other countries. Key words:Odontogenic cysts and tumours, radicular cyst, dentigerous cyst, odontogenic keratocyst, ameloblastoma, recurrence.
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Affiliation(s)
- L Monteiro
- Rua Central de Gandra 1317, 4585-116 Gandra PRD, Portugal
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Mata AV, Mesquita IP, Alves D, Medeiros J, Polo B, Lopes C, Costa MJ, Martins C, Esteves G, Lacerda JF, Raposo J. TIME TO HEMATOLOGIC RECOVERY PREDICTS SURVIVAL IN CHRONIC LYMPHOCYTIC LEUKEMIA PATIENTS TREATED WITH FLUDARABIN, CYCLOPHOSPHAMIDE AND RITUXIMAB – 11 YEARS OF REAL‐WORLD EXPERIENCE. Hematol Oncol 2021. [DOI: 10.1002/hon.17_2881] [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: 11/06/2022]
Affiliation(s)
- A. V Mata
- Hospital Santa Maria Centro Hospitalar Universitário Lisboa Norte Hematology and Bone Marrow Transplant Department Lisbon Portugal
| | - I. P Mesquita
- Hospital Santa Maria Centro Hospitalar Universitário Lisboa Norte Hematology and Bone Marrow Transplant Department Lisbon Portugal
| | - D Alves
- Hospital Santa Maria Centro Hospitalar Universitário Lisboa Norte Hematology and Bone Marrow Transplant Department Lisbon Portugal
| | - J Medeiros
- Hospital Santa Maria Centro Hospitalar Universitário Lisboa Norte Hematology and Bone Marrow Transplant Department Lisbon Portugal
| | - B Polo
- Hospital Santa Maria Centro Hospitalar Universitário Lisboa Norte Hematology and Bone Marrow Transplant Department Lisbon Portugal
| | - C Lopes
- Hospital Santa Maria Centro Hospitalar Universitário Lisboa Norte Hematology and Bone Marrow Transplant Department Lisbon Portugal
| | - M. J Costa
- Hospital Santa Maria Centro Hospitalar Universitário Lisboa Norte Hematology and Bone Marrow Transplant Department Lisbon Portugal
| | - C Martins
- Hospital Santa Maria Centro Hospitalar Universitário Lisboa Norte Hematology and Bone Marrow Transplant Department Lisbon Portugal
| | - G Esteves
- Hospital Santa Maria Centro Hospitalar Universitário Lisboa Norte Hematology and Bone Marrow Transplant Department Lisbon Portugal
| | - J. F Lacerda
- Hospital Santa Maria Centro Hospitalar Universitário Lisboa Norte Hematology and Bone Marrow Transplant Department Lisbon Portugal
| | - J Raposo
- Hospital Santa Maria Centro Hospitalar Universitário Lisboa Norte Hematology and Bone Marrow Transplant Department Lisbon Portugal
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Valbom Mesquita D, Parreira L, Esteves A, Farinha J, Marinheiro R, Amador P, Fonseca M, Lopes C, Chambel D, Goncalves A, Caria R. Echocardiographic but not clinical response to CRT is an independent predictor of a better survival free from arrhythmic events. Europace 2021. [DOI: 10.1093/europace/euab116.467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Cardiac resynchronization therapy (CRT) is of proven benefit in heart failure patients, improving mortality and reducing hospital admissions. There is however uncertainty if the arrhythmic risk is reduced in responders.
Purpose
We aimed to assess if patients with a CRT implanted for primary prevention had less arrhythmic episodes if they responded to this therapy and if echocardiographic and clinical responses to CRT differ regarding the occurrence of ventricular arrhythmias.
Methods
We prospectively enrolled patients that underwent CRT implant for primary prevention according to ESC guidelines. Patients were classified as responders if they fulfilled one of four criteria (echocardiographic or clinical) at six months after implant: a 5% absolute improvement in LV ejection fraction (LVEF), a 15% improvement in LVEF, a 15% decrease in LV end-diastolic volume or a decrease in NYHA class. During follow-up with device interrogation, arrhythmic ventricular events (AVE) were classified as appropriate ICD therapies or sustained ventricular tachycardia either occurring in ICD monitoring zones or undetected by the device due to a slower rare, but clinically documented. All patients were further classified according to type of pacing, biventricular or LV only. Demographic characteristics of patients were also assessed.
Results
We enrolled 73 patients, 58 (79.5%) male, median age of 72 (65-77) years. Median LVEF was 28 (22-35) % (p = 0.95 between groups), ischemic etiology in 36 (46.6%, p = 1.00). The two groups with and without AVE did not differ significantly regarding clinical, echocardiographic, and electrocardiographic characteristics (table). CRT echocardiographic response criteria were met by 50 (68.5%) of patients and clinical criteria by 53 (72.6%) patients. AVE occurred in 15 (20.5%) patients. In univariate regression analysis, echocardiographic response was associated with reduced AVE (OR 0,14; p = 0,005). Clinical response to CRT was not associated with AVE (p = 0.07). LV only pacing was associated with a higher probability of AVE (OR 5.1; p = 0.038). In Cox regression multivariate analysis, response to CRT was the only independent predictor of better survival free from AVE (HR 0.28;CI 95%, p = 0.044) and LV only pacing was not associated with more episodes of ventricular arrhythmias (p = 0.17). Conclusions: Echocardiographic, but not clinical response to CRT therapy, is the only independent predictor of a higher survival free from arrhythmic events. In spite controversies regarding the arrhythmogenic role of LV pacing, this was not associated with higher ventricular arrhythmic events. Abstract Figure.
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Affiliation(s)
| | - L Parreira
- Hospital Center of Setubal, Setubal, Portugal
| | - A Esteves
- Hospital Center of Setubal, Setubal, Portugal
| | - J Farinha
- Hospital Center of Setubal, Setubal, Portugal
| | | | - P Amador
- Hospital Center of Setubal, Setubal, Portugal
| | - M Fonseca
- Hospital Center of Setubal, Setubal, Portugal
| | - C Lopes
- Hospital Center of Setubal, Setubal, Portugal
| | - D Chambel
- Hospital Center of Setubal, Setubal, Portugal
| | - A Goncalves
- Hospital Center of Setubal, Setubal, Portugal
| | - R Caria
- Hospital Center of Setubal, Setubal, Portugal
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16
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Jácome C, Almeida R, Pereira AM, Araújo L, Correia MA, Pereira M, Couto M, Lopes C, Chaves Loureiro C, Catarata MJ, Santos LM, Ramos B, Mendes A, Pedro E, Cidrais Rodrigues JC, Oliveira G, Aguiar AP, Arrobas AM, Costa J, Dias J, Todo Bom A, Azevedo J, Ribeiro C, Alves M, Pinto PL, Neuparth N, Palhinha A, Marques JG, Martins P, Trincão D, Neves A, Todo Bom F, Santos MA, Branco J, Loyoza C, Costa A, Silva Neto A, Silva D, Vasconcelos MJ, Teixeira MF, Ferreira-Magalhães M, Taborda Barata L, Carvalhal C, Santos N, Sofia Pinto C, Rodrigues Alves R, Moreira AS, Morais Silva P, Fernandes R, Ferreira R, Alves C, Câmara R, Ferraz de Oliveira J, Bordalo D, Calix MJ, Marques A, Nunes C, Menezes F, Gomes R, Almeida Fonseca J. Asthma App Use and Interest Among Patients With Asthma: A Multicenter Study. J Investig Allergol Clin Immunol 2021; 30:137-140. [PMID: 32327403 DOI: 10.18176/jiaci.0456] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- C Jácome
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto (FMUP), Porto, Portugal
| | - R Almeida
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto (FMUP), Porto, Portugal
| | - A M Pereira
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto (FMUP), Porto, Portugal.,Allergy Unit, Instituto and Hospital CUF, Porto, Portugal
| | - L Araújo
- Allergy Unit, Instituto and Hospital CUF, Porto, Portugal
| | - M A Correia
- Allergy Unit, Instituto and Hospital CUF, Porto, Portugal
| | - M Pereira
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto (FMUP), Porto, Portugal.,MEDIDA - Medicina, Educação, Investigação, Desenvolvimento e Avaliação, Porto, Portugal
| | - M Couto
- Allergy Unit, Instituto and Hospital CUF, Porto, Portugal
| | - C Lopes
- Unidade de Imunoalergologia, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal.,Imunologia Básica e Clínica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - C Chaves Loureiro
- Serviço de Pneumologia A, Hospital Universitário de Coimbra, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - M J Catarata
- Serviço de Pneumologia A, Hospital Universitário de Coimbra, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - L M Santos
- Serviço de Pneumologia A, Hospital Universitário de Coimbra, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - B Ramos
- Serviço de Pneumologia A, Hospital Universitário de Coimbra, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - A Mendes
- Serviço de Imunoalergologia, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisboa, Portugal
| | - E Pedro
- Serviço de Imunoalergologia, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisboa, Portugal
| | - J C Cidrais Rodrigues
- Serviço de Pediatria, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal
| | - G Oliveira
- Serviço de Pediatria, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal
| | - A P Aguiar
- Serviço de Pediatria, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal
| | - A M Arrobas
- Serviço de Pneumologia B, Hospital Geral, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - J Costa
- Serviço de Pneumologia B, Hospital Geral, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - J Dias
- Serviço de Pneumologia B, Hospital Geral, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - A Todo Bom
- Serviço de Imunoalergologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - J Azevedo
- Serviço de Imunoalergologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - C Ribeiro
- Serviço de Imunoalergologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - M Alves
- Serviço de Imunoalergologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - P L Pinto
- Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
| | - N Neuparth
- Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal.,Pathophysiology, CEDOC, Integrated Pathophysiological Mechanisms Research Group, Nova Medical School, Lisboa, Portugal
| | - A Palhinha
- Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
| | - J G Marques
- Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
| | - P Martins
- Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal.,Pathophysiology, CEDOC, Integrated Pathophysiological Mechanisms Research Group, Nova Medical School, Lisboa, Portugal
| | - D Trincão
- Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
| | - A Neves
- Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
| | - F Todo Bom
- Serviço de Pneumologia, Hospital Beatriz Ângelo, Loures, Portugal
| | - M A Santos
- Serviço de Pneumologia, Hospital Beatriz Ângelo, Loures, Portugal
| | - J Branco
- Serviço de Pneumologia, Hospital Beatriz Ângelo, Loures, Portugal
| | - C Loyoza
- Serviço de Imunoalergologia, Hospital Amato Lusitano, Unidade Local de Saúde de Castelo Branco, Castelo Branco, Portugal
| | - A Costa
- Serviço de Pediatria, Hospital da Senhora da Oliveira, Guimarães, Portugal
| | - A Silva Neto
- Serviço de Pediatria, Hospital da Senhora da Oliveira, Guimarães, Portugal
| | - D Silva
- Serviço de Imunoalergologia, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - M J Vasconcelos
- Serviço de Imunoalergologia, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - M F Teixeira
- Serviço de Pediatria, Centro Materno Infantil do Norte, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - M Ferreira-Magalhães
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto (FMUP), Porto, Portugal.,Serviço de Pediatria, Centro Materno Infantil do Norte, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - L Taborda Barata
- Serviço de Imunoalergologia, Hospital Pêro da Covilhã, Centro Hospitalar Universitário Cova da Beira, Covilhã, Portugal
| | - C Carvalhal
- Serviço de Imunoalergologia, Hospital Pêro da Covilhã, Centro Hospitalar Universitário Cova da Beira, Covilhã, Portugal
| | - N Santos
- Serviço de Imunoalergologia, Centro Hospitalar Universitário do Algarve, Portimão, Portugal
| | - C Sofia Pinto
- Serviço de Pneumologia, Hospital São Pedro de Vila Real, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - R Rodrigues Alves
- Unidade de Imunoalergologia, Hospital do Divino Espirito Santo, Ponta Delgada, Portugal
| | - A S Moreira
- Unidade de Imunoalergologia, Hospital do Divino Espirito Santo, Ponta Delgada, Portugal
| | | | - R Fernandes
- Serviço de Pediatria, Departamento de Pediatria, Hospital de Santa Maria, Centro Hospitalar Universitário de Lisboa Norte, Lisboa, Portugal.,Laboratório de Farmacologia Clínica e Terapêutica, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Portugal
| | - R Ferreira
- Serviço de Pediatria, Departamento de Pediatria, Hospital de Santa Maria, Centro Hospitalar Universitário de Lisboa Norte, Lisboa, Portugal
| | - C Alves
- Serviço de Pneumologia, Hospital Nossa Senhora do Rosário, Centro Hospitalar Barreiro Montijo, Barreiro, Portugal
| | - R Câmara
- Serviço de Pneumologia, Hospital Nossa Senhora do Rosário, Centro Hospitalar Barreiro Montijo, Barreiro, Portugal
| | | | - D Bordalo
- Serviço de Pediatria, Unidade Hospitalar de Famalicão, Centro Hospitalar do Médio Ave, Vila Nova de Famalicão, Portugal
| | - M J Calix
- Serviço de Pediatria, Hospital de São Teotónio, Centro Hospitalar Tondela-Viseu, Viseu, Portugal
| | - A Marques
- Serviço de Pediatria, Hospital de São Teotónio, Centro Hospitalar Tondela-Viseu, Viseu, Portugal
| | - C Nunes
- Imunoalergologia, Centro de Imunoalergologia do Algarve, Portimão, Portugal
| | - F Menezes
- Serviço de Pneumologia, Hospital Garcia de Orta, Almada, Portugal
| | - R Gomes
- Serviço de Pneumologia, Hospital Garcia de Orta, Almada, Portugal
| | - J Almeida Fonseca
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto (FMUP), Porto, Portugal.,Allergy Unit, Instituto and Hospital CUF, Porto, Portugal.,MEDIDA - Medicina, Educação, Investigação, Desenvolvimento e Avaliação, Porto, Portugal.,Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
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Xirou S, Lopes C, Bolano C, Manera JD, Straub V, Marini-Bettolo C. MUSCLE IMAGING – MRI. Neuromuscul Disord 2020. [DOI: 10.1016/j.nmd.2020.08.164] [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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Costa de Miranda R, Rauber F, Moraes M, Torres D, Lopes C, Rodrigues S, Bertazzi Levy R. Consumption of ultra-processed foods on free sugar intake of Portuguese infants: The Upper Project. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.439] [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
Background
The dietary share of ultra-processed foods (UPF) has been associated with low diet quality, including high content of free sugar, mainly in adults' populations. We aim to assess the influence of UPF consumption on free sugar intake of Portuguese infants.
Methods
Cross-sectional representative study including 573 infants (6-23 months old) who participated in the 2015-2016 National Food, Nutrition and Physical Activity Survey. Dietary intake was collected by two non-consecutive food diaries (time interval 8-15 days). Food items were classified according food processing degree by the NOVA system. Total energy intake and percentage provided by each NOVA food groups as well as the free sugar content of the overall diet were assessed. Mean free sugar intake was evaluated across quintiles (Q) of UPF consumption by linear regression adjusted for socioeconomic covariates.
Results
Mean energy intake was 935 kcal/day, in which 49.1% was derived from unprocessed/minimally processed foods, 7.2% from processed culinary ingredients, 7.0% from processed foods and 36.6% from UPF. The mean dietary share of UPF ranged from 12.5% (Q1) to 65.5% (Q5) of total energy. Within UPF, infant formulas (19.3%), milk-based drinks (6.7%) and sweet snacks (4.8%) contributed the most to energy intake. Mean free sugar intake in the overall diet accounted for 8.1% of total energy intake, in which 92.5% came from UPF. As the UPF consumption increased, the dietary content of free sugar increased significantly (β = 0.77; p < 0.001). Contribution of free sugar in total energy intake raised from 2.9% to 12.7%, representing an increment of 338% from the lower to the upper quintile of the dietary share of UPF.
Conclusions
Portuguese infants had an important intake of free sugar. Nearly all of this intake came from UPF, which calls for public health efforts to avoid UPF consumption by this population group.
Funding
FAPESP 2018/07391-9, 2019/05972-7 (MCR), 2016/14302-7 (FR); POCI-01-0145-FEDER-032090.
Key messages
Ultra-processed foods contributed with 36.6% of total energy intake and 92.5% of free sugar in the diets of Portuguese infants. As the ultra-processed foods consumption increased, the dietary content of free sugar increased significantly from 2.9% (Q1) to 12.7% (Q5), representing an increment of 338%.
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Affiliation(s)
- R Costa de Miranda
- Faculty of Medicine/Department of Preventative Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - F Rauber
- Faculty of Medicine/Department of Preventative Medicine, University of Sao Paulo, Sao Paulo, Brazil
- School of Public Health/ Department of Nutrition, University of Sao Paulo, Sao Paulo, Brazil
| | - M Moraes
- Faculty of Nutrition and Food Science, University of Porto, Porto, Portugal
| | - D Torres
- Faculty of Nutrition and Food Science, University of Porto, Porto, Portugal
- EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal
| | - C Lopes
- EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal
- Department of Public Health and Forensic Sciences, University of Porto, Porto, Portugal
| | - S Rodrigues
- Faculty of Nutrition and Food Science, University of Porto, Porto, Portugal
- EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal
| | - R Bertazzi Levy
- Faculty of Medicine/Department of Preventative Medicine, University of Sao Paulo, Sao Paulo, Brazil
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Viney K, Amaral S, Marques EB, Siroka A, Lopes C, Nery SV. Four of five tuberculosis patients experience catastrophic costs related to TB diagnosis and care in Timor-Leste. Int J Tuberc Lung Dis 2020; 23:1191-1197. [PMID: 31718755 DOI: 10.5588/ijtld.18.0765] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING: Seventeen health care facilities that report to the national tuberculosis (TB) programme in Timor-Leste. Participants were TB patients.OBJECTIVE: To determine the proportion of TB patients who experienced catastrophic costs due to their TB diagnosis and care, and the magnitude and composition of these costs.DESIGN: This was a cross-sectional health facility-based survey, conducted in 17 DOTS centres between October 2016 and March 2017. TB patients were interviewed by trained nurses using a standardised questionnaire.RESULTS: Among the 457 TB patients who participated (response rate 96.6%), the median age was 32 years; 39.2% were from the capital, Dili. The patient was the main income earner in 26.3% of households. Annual individual and household incomes before and after TB diagnosis decreased by respectively 30.4% and 31.1%. Using a cut-off of 20% of annual household income, 83.0% of patients experienced catastrophic costs related to their TB diagnosis and care. Income loss and nutritional supplementation accounted for respectively 40.7% and 37.9% of these costs.CONCLUSION: Four of five TB patients in Timor-Leste experienced catastrophic costs related to TB diagnosis and care. Financial and social protection to mitigate against these costs are urgently needed, in addition to universal health coverage.
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Affiliation(s)
- K Viney
- Department of Global Health, Research School of Population Health, Australian National University, Canberra, ACT, Australia, Centre of Global Health, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - S Amaral
- Department of Global Health, Research School of Population Health, Australian National University, Canberra, ACT, Australia
| | - E Baptista Marques
- Department of Global Health, Research School of Population Health, Australian National University, Canberra, ACT, Australia
| | - A Siroka
- Centre of Global Health, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden, Tuberculosis Monitoring and Evaluation Unit, Global Tuberculosis Programme, World Health Organization, Geneva, Switzerland
| | - C Lopes
- Communicable Disease Control, Ministry of Health, Dili, Timor-Leste
| | - S Vaz Nery
- Department of Global Health, Research School of Population Health, Australian National University, Canberra, ACT, Australia, Kirby Institute, University of New South Wales, Sydney, NSW, Australia
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Marinheiro R, Parreira L, Amador P, Mesquita D, Farinha J, Fonseca M, Esteves A, Ferreira J, Lopes C, Duarte C, Venancio J, Santos B, Caria R. P1393Prolonged atrial electrical conduction as a predictor of atrial fibrillation after atrioventricular nodal reentrant tachycardia ablation. Europace 2020. [DOI: 10.1093/europace/euaa162.040] [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
BACKGROUND
Patients (pts) with atrioventricular nodal reentrant tachycardia (AVNRT) have a higher incidence of atrial fibrillation (AF) during follow-up. Conventional risk factors can play a role in AF development, however atrial electrical conduction properties may be implicated in AF pathogenesis.
AIMS
to evaluate atrial conduction times and assess its effect on AF development during follow-up.
METHODS
We studied AVNRT pts who performed EPS and catheter ablation of the slow pathway between 2013 and 2016 in a single center. Pts with AF or valvular disease were excluded. We evaluated duration of symptoms due to AVNRT, conventional risk factors for AF (age, gender, obesity, hypertension, diabetes and structural heart disease (SHD)), left atrium (LA) enlargement and electrophysiologic study (EPS) time intervals related with atrial electrical conduction properties. We measured the time interval between: (1) the beginning of the P wave on the ECG to the A deflection in His-bundle electrogram (P-AHis); (2) the beginning of the P wave to the mid-distal coronary sinus (CS) atrial electrogram (P-CS) and (3) the beginning of the P wave to the H deflection in His-bundle electrogram (P-HHis).
RESULTS
Fifty-two pts were evaluated during a median follow-up of 63 months (IQR 51-69): 22% male, median age 55 years (IQR 42-67). AF occurred in 9 patients (17%) (39 cases per 1000 person-years). Patients with AF were older (67 vs 53 years, p= 0.005) and had more frequently LA enlargement (33% vs 7%, p= 0.024) but they did not differ in hypertension, obesity, diabetes, SHD and duration of symptoms. EPS measured intervals P-AHis and P-HHis interval were not different between the groups (26.0 vs 22.8 ms, p = 0.89 and 151 vs 106 ms, p= 0.56, respectively) but P-CS were prolonged in patients with AF (70 vs 55 ms, p = 0.02) (figure 1). Univariate logistic analysis for AF is presented in table 1. There was no interaction between P-CS and LA enlargement (p = 0.87). In multiavariate analysis, only P-CS was independently associated with AF (table).
CONCLUSIONS
In this group of patients with AVNRT, P-CS, but not other atrial conduction intervals, was independently associated with AF development. The possible role of LA electrical conduction impairment in AVNRT pts for AF development needs further studies.
Univariate and multivariate analysis Univariate analysis Multivariate analysis OR 95% CI p-value OR 95% CI p-value Age (years) 1.10 1.02-1.19 0.016 1.10 1.00-1.21 0.051 LA enlargement 7.00 1.10-44.71 0.040 3.42 0.41-28.03 0.255 P-CS 1.07 1.021.14 0.013 1.06 1.01-1.12 0.044 OR Odds ratio. CI: confidence interval
Abstract Figure. Box-plot for the studied intervals
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Affiliation(s)
| | - L Parreira
- Hospital Center of Setubal, Setubal, Portugal
| | - P Amador
- Hospital Center of Setubal, Setubal, Portugal
| | - D Mesquita
- Hospital Center of Setubal, Setubal, Portugal
| | - J Farinha
- Hospital Center of Setubal, Setubal, Portugal
| | - M Fonseca
- Hospital Center of Setubal, Setubal, Portugal
| | - A Esteves
- Hospital Center of Setubal, Setubal, Portugal
| | - J Ferreira
- Hospital Center of Setubal, Setubal, Portugal
| | - C Lopes
- Hospital Center of Setubal, Setubal, Portugal
| | - C Duarte
- Hospital Center of Setubal, Setubal, Portugal
| | - J Venancio
- Hospital Center of Setubal, Setubal, Portugal
| | - B Santos
- Hospital Center of Setubal, Setubal, Portugal
| | - R Caria
- Hospital Center of Setubal, Setubal, Portugal
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Marinheiro R, Parreira L, Amador P, Mesquita D, Farinha J, Fonseca M, Esteves A, Ferreira J, Lopes C, Caria R. P518Inappropriate shocks in atrial fibrillation patients: are they really deleterious? Europace 2020. [DOI: 10.1093/europace/euaa162.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Data suggest inappropriate defibrillator shocks are associated with a higher risk of all-cause mortality, particularly those delivered for atrial fibrillation (AF). However, the impact of inappropriate shocks has not been studied specifically in a population with AF.
Aims
to determine if AF-triggered inappropriate shocks are associated with long- term mortality in patients with AF and defibrillators implanted for primary prevention.
Methods
Retrospective single-center study. We analyzed all patients with defibrillators implanted for primary prevention in whom AF was diagnosed until the end of 2017. The cause of inappropriate shocks was evaluated by analysis of the stored intracardiac electrogram. Basal characteristics, cardiovascular risk factors, left ventricle ejection fraction, heart failure etiology (ischemic and non-ischemic), kidney function (creatinine) and medication were evaluated. Death was assessed during the follow-up.
Results
We studied 177 patients [median age 66 years (IQR 59-71); 82% male], with defibrillators and AF. AF was diagnosed before defibrillator implantation in 131 patients (74%) and after the implantation in the remaining 46 (26%). Inappropriate shocks occurred in 31 patients and 24 (14%) were caused by AF with rapid ventricular response: 13 patients with previously diagnosed AF and 11 with new-onset AF. During a median follow-up of 65 (IQR: 36-104) months, 74 patients died. Multivariate Cox-regression analysis demonstrated inappropriate shocks caused by AF were not independently related with death (adjusted HR 0.53; CI 0.23-1.23, p = 0.14). Kaplan-Meier survival curve demonstrated patients with AF-triggered inappropriate shocks had a better survival comparing to those with AF but without inappropriate shocks (logrank, p = 0.03) (figure).
Conclusions
In this group of AF patients, inappropriate shocks caused by AF did not increase the risk of death. Instead, these patients had a better survival comparing to those with AF but no shocks, probably due to a re-evaluation of the patient´s status and subsequent closer medical monitoring, strictly control of symptoms and optimization of drug treatment. These results demonstrate that inappropriate shocks are probably not deleterious per si through a direct mechanism.
Abstract Figure. Kaplan-Meier survival curve
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Affiliation(s)
| | - L Parreira
- Hospital Center of Setubal, Setubal, Portugal
| | - P Amador
- Hospital Center of Setubal, Setubal, Portugal
| | - D Mesquita
- Hospital Center of Setubal, Setubal, Portugal
| | - J Farinha
- Hospital Center of Setubal, Setubal, Portugal
| | - M Fonseca
- Hospital Center of Setubal, Setubal, Portugal
| | - A Esteves
- Hospital Center of Setubal, Setubal, Portugal
| | - J Ferreira
- Hospital Center of Setubal, Setubal, Portugal
| | - C Lopes
- Hospital Center of Setubal, Setubal, Portugal
| | - R Caria
- Hospital Center of Setubal, Setubal, Portugal
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22
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Martins C, Vidal A, De Boevre M, De Saeger S, Nunes C, Torres D, Goios A, Lopes C, Alvito P, Assunção R. Burden of disease associated with dietary exposure to carcinogenic aflatoxins in Portugal using human biomonitoring approach. Food Res Int 2020; 134:109210. [PMID: 32517894 DOI: 10.1016/j.foodres.2020.109210] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 03/27/2020] [Accepted: 03/29/2020] [Indexed: 12/11/2022]
Abstract
Human biomonitoring is an important tool to assess human exposure to chemicals, contributing to describe trends of exposure over time and to identify population groups that could be under risk. Aflatoxins are genotoxic and carcinogenic food contaminants causing hepatocellular carcinoma, the third leading cause of cancer deaths worldwide. In Portugal, scarce data are available regarding exposure to aflatoxins and no previous study used human biomonitoring data to comprehensively characterize the associated burden of disease. 24 h urine and first-morning urine paired samples were collected by 94 participants and were analyzed by liquid chromatography-tandem mass spectrometry for the quantitative determination of aflatoxins (B1, B2, G1, G2 and M1). Deterministic and probabilistic models were developed to assess the Portuguese exposure to aflatoxins and to estimate the health impact of this exposure, estimating the attributed Disability-Adjusted Life Years (DALYs). Aflatoxins were detected in a maximum of 13% (AFB1), 16% (AFB2), 1% (AFG1), 2% (AFG2) and 19% (AFM1) of the urine samples. Data obtained through the probabilistic approach revealed an estimated mean probable daily intake of 13.43 ng/kg body weight per day resulting in 0.13 extra cases of hepatocellular carcinoma, corresponding to mean annual DALYs of 172.8 for the Portuguese population (10291027 inhabitants). The present study generated for the first time and within a human biomonitoring study, reliable and crucial data to characterize the burden associated to the exposure to aflatoxins of the Portuguese population. The obtained results constitute an imperative support to risk managers in the establishment of preventive policy measures that contribute to ensure public health protection.
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Affiliation(s)
- C Martins
- Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, Avenida Padre Cruz, 1649-016 Lisboa, Portugal; NOVA National School of Public Health, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560 Lisboa, Portugal; CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal; Public Health Research Centre, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560 Lisboa, Portugal.
| | - A Vidal
- Centre of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, B-9000 Ghent, Belgium
| | - M De Boevre
- Centre of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, B-9000 Ghent, Belgium
| | - S De Saeger
- Centre of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, B-9000 Ghent, Belgium
| | - C Nunes
- NOVA National School of Public Health, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560 Lisboa, Portugal; Public Health Research Centre, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560 Lisboa, Portugal
| | - D Torres
- Epidemiology Research Unit, Institute of Public Health, University of Porto, Rua das Taipas 135, 4050-091 Porto, Portugal; Faculty of Nutrition and Food Sciences, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal
| | - A Goios
- Epidemiology Research Unit, Institute of Public Health, University of Porto, Rua das Taipas 135, 4050-091 Porto, Portugal; Faculty of Nutrition and Food Sciences, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal
| | - C Lopes
- Epidemiology Research Unit, Institute of Public Health, University of Porto, Rua das Taipas 135, 4050-091 Porto, Portugal; Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - P Alvito
- Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, Avenida Padre Cruz, 1649-016 Lisboa, Portugal; CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal
| | - R Assunção
- Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, Avenida Padre Cruz, 1649-016 Lisboa, Portugal; CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal
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Abstract
Summary Atopic Dermatitis affects both children and adults and is a serious health concern in many countries. AD is a complex disease with host and environmental factors underlying its pathology. Its treatment is multidimensional reflecting the diverse nature of its triggers and includes emollients, topical steroids and calcineurin inhibitors among others. Immunological dysfunction can be addressed broadly with systemic immunosupressors and specifically with monoclonal antibodies. Dupilumab, which targets IL-4 and IL-13 was granted approval for treatment of moderate-to-severe AD. Biologics targeting IgE/Th2 pathways may have its role in patients with overlapping AD and asthma. Psychological distress can exacerbate symptoms and is associated with increased severity of AD. Environmental triggers, such as, allergens can be addressed in selected cases with allergic immunotherapy. In this paper, we discuss AD treatment and propose a new step-by-step approach aiming at maintaining disease control and improving quality of life.
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Affiliation(s)
- A Lopes
- Immunoallergology Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte (CHLN), Lisbon, Portugal
| | - A Sokolova
- Immunoallergology Department, Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal
| | - C Abreu
- Immunoallergology Department, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - C Lopes
- Allergy Unit, Pedro Hispano Hospital, Matosinhos, Portugal.,Basic and Clinical Immunology Laboratory, Medical School, Porto University, Portugal
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Gassner A, Harris D, Mausch K, Terheggen A, Lopes C, Finlayson RF, Dobie P. Poverty eradication and food security through agriculture in Africa: Rethinking objectives and entry points. Outlook Agric 2019; 48:309-315. [PMID: 33281227 PMCID: PMC7684531 DOI: 10.1177/0030727019888513] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Agriculture in Africa is expected to meet the dual objectives of providing food and helping people to escape poverty. African agriculture is dominated by smallholdings and donors generally target their agricultural support at the smallholder sector. The expectation is that if the gap between actual and potential yields can be closed, smallholders will grow sufficient crops to feed their families, with a surplus to sell, thus meeting food security needs and bringing in an income to move them out of poverty. In practice, this is often not possible. While technologies already exist that can raise smallholder farmers' yields 3 or 4 times, even under rainfed conditions, the small size of land available to them limits how much can be grown and the per capita income from agriculture is insufficient to allow people to move above the current World Bank-defined poverty line of US$1.90 per day. We link this finding with farmer typologies to further explain that there are large differences between individual farming households themselves in terms of their investment incentives and capability to benefit from field-level technologies that are aimed at increasing farm productivity. We argue for more differentiated policies for agricultural development in Africa and suggest that policymakers should be much more aware of the heterogeneity of farms and target interventions accordingly. It is important to understand where and for whom agriculture will have the main purpose of ensuring food and nutritional security and where and for whom there is the potential for significant increases in incomes and a contribution to wider economic growth. Let us recognize the distinctiveness of these targets and underlying target groups and work towards solutions that address the underlying needs.
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Affiliation(s)
- A Gassner
- World Agroforestry (ICRAF), 2/F Khush Hall, International Rice Research
Institute (IRRI), Los Baños, Laguna, Philippines
| | - D Harris
- International Crops Research Institute for the Semi-Arid Tropics (ICRISAT),
Nairobi, Kenya
- School of Natural Sciences, Bangor University, Bangor, UK
| | - K Mausch
- World Agroforestry (ICRAF), Nairobi, Kenya
| | | | - C Lopes
- Oxford Martin School, Oxford, UK
| | | | - P Dobie
- World Agroforestry (ICRAF), Nairobi, Kenya
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Martins C, Vidal A, De Boevre M, De Saeger S, Nunes C, Torres D, Goios A, Lopes C, Alvito P, Assunção R. Burden of disease attributable to exposure to aflatoxins in Portugal using Human biomonitoring data. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Human biomonitoring (HBM) is recognized as an important tool to assess the Human exposure to chemicals, contributing to describe trends and patterns of exposure over time and to identify population groups that could be under risk. Natural chemicals as mycotoxins, fungi metabolites that produce toxic effects in humans, are important compounds that could be found in foods usually consumed worldwide in a daily basis. Mycotoxins as aflatoxins (AFTs) are genotoxic, carcinogenic and immunosuppressive compounds. Hepatocellular carcinoma (HCC) is one of their main health toxic effects and is the third leading cause of cancer deaths worldwide. In Portugal, scarce data are available regarding exposure to AFTs and none previous study used HBM data to characterize comprehensively the burden associated to this exposure.
In the scope of the National Food, Nutrition, and Physical Activity Survey of the Portuguese General Population (2015-2016), 24h-urine samples from 94 participants were analyzed by liquid chromatography-mass spectrometry (LC-MS/MS) for the simultaneous determination of AFTs (B1, B2, G1, G2, M1). A model was developed to estimate the health impact of the exposure of Portuguese population to aflatoxins, estimating the number of cases of HCC and DALYs attributed to AFTs exposure.
AFTs were detected in 12.8% (AFB1), 16.0% (AFB2) and 19.1% (AFM1) of the 24h-urine samples. The estimated number of extra cases of HCC attributed to this exposure ranged from 17 to 65 cases/year; the associated DALYs for the Portuguese population ranged from 284 to 1802 years.
The present study generated, for the first time and within a HBM study, reliable data regarding the exposure of the Portuguese population to AFTs. These data were crucial to characterize the health impact associated to AFTs exposure and to support risk managers to establish preventive policy measures that contribute to ensure the public health protection.
Key messages
Portuguese population is exposed to aflatoxins, chemical food contaminants that may be harmful (carcinogenic, immunotoxic, mutagenic, teratogenic, hepatotoxic) to humans. Human biomonitoring studies provide realistic data on internal exposure at individual level, contributing to a more accurate estimation of the burden derived from this exposure.
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Affiliation(s)
- C Martins
- National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
- National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
- CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Aveiro, Portugal
| | - A Vidal
- Centre of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Portugal
| | - M De Boevre
- Centre of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Portugal
| | - S De Saeger
- Centre of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Portugal
| | - C Nunes
- National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
- Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - D Torres
- Epidemiology Research Unit, Institute of Public Health, University of Porto, Porto, Portugal
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - A Goios
- Epidemiology Research Unit, Institute of Public Health, University of Porto, Porto, Portugal
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - C Lopes
- Epidemiology Research Unit, Institute of Public Health, University of Porto, Porto, Portugal
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal
| | - P Alvito
- National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
- CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Aveiro, Portugal
| | - R Assunção
- National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
- CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Aveiro, Portugal
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Martins C, Vidal A, De Saeger S, Nunes C, Torres D, Goios A, Lopes C, Assunção R, Alvito P, De Boevre M. Risk assessment of Portuguese population to multiple mycotoxins: the human biomonitoring approach. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Mycotoxins constitute a relevant group of food contaminants with several associated health outcomes such as estrogenic, immunotoxic, nephrotoxic and teratogenic effects. Although scarce data are available in Portugal, human biomonitoring studies have been globally developed to assess the exposure to mycotoxins at individual level.
The present study concerned the analysis of mycotoxins in 24h urine and first-morning urine paired samples from 94 participants enrolled within the scope of the National Food, Nutrition, and Physical Activity Survey of the Portuguese General Population (2015-2016). Following a salt-assisted matrix extraction, urine samples were analyzed by liquid chromatography-mass spectrometry for the simultaneous determination of 37 urinary mycotoxins’ biomarkers and data obtained used to estimate the probable daily intake as well as the risk characterization applying the Hazard Quotient approach.
Results revealed the exposure of Portuguese population to zearalenone, deoxynivalenol, ochratoxin A, alternariol, citrinin and fumonisin B1 through the quantification in 24h urine and first-morning urine paired samples. Risk characterization data revealed a potential concern to some reported mycotoxins since the reference intake values were exceeded by some of the considered participants. Alternariol was identified for the first time in urine samples from a European country; however, risk characterization was not performed due to lack of reference intake value.
The present study contributed with reliable and evidence-based results, and confirmed that mycotoxins represent a burden and are part of the human exposome of the Portuguese population. Further studies are needed to shed a light on the determinants of exposure in order to contribute for the promotion of public health measures to reduce the mycotoxins’ exposure in Portugal.
Key messages
Portuguese population is exposed to mycotoxins, chemical food contaminants that may be harmful (carcinogenic, immunotoxic, mutagenic, teratogenic, hepatotoxic) for human health. Human biomonitoring studies provide realistic data on internal exposure at individual level, allowing a more accurate knowledge of the determinants of exposure to these contaminants.
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Affiliation(s)
- C Martins
- National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
- National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
- CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Aveiro, Portugal
| | - A Vidal
- Centre of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - S De Saeger
- Centre of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - C Nunes
- National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
- Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - D Torres
- Epidemiology Research Unit, Institute of Public Health, University of Porto, Porto, Portugal
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - A Goios
- Epidemiology Research Unit, Institute of Public Health, University of Porto, Porto, Portugal
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - C Lopes
- Epidemiology Research Unit, Institute of Public Health, University of Porto, Porto, Portugal
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal
| | - R Assunção
- National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
- CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Aveiro, Portugal
| | - P Alvito
- National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
- CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Aveiro, Portugal
| | - M De Boevre
- Centre of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
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Marinheiro R, Parreira L, Amador P, Mesquita D, Farinha J, Fonseca M, Esteves A, Pinheiro A, Sousa S, Silva M, Lopes C, Fernandes A, Guerreiro A, Chambel D, Caria R. P3563The influence of circadian patterand obstructive sleep apnean of blood pressure in nocturnal arrhythmias in hypertensive patients. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
There is growing evidence suggesting hypertension is related to the occurrence of arrhythmias. When occurring predominantly during the night, two potential entities commonly present in hypertensive patients could be related with increased arrhythmogenesis: (1) the lack of normal nocturnal dipping of blood pressure (BP) (non-dipping pattern of hypertension) or (2) obstructive sleep apnea (OSA). Thus, nocturnal arrhythmias (NAs) can identify hypertensive patients with OSA and/or non-dipping pattern, both related with adverse outcomes.
Aims
To determine if NAs are related with non-dipping hypertension, OSA or both.
Methods
We studied hypertensive patients who performed ambulatory blood pressure monitoring (ABPM) and also polysomnography and 24-hour Holter monitoring. Non-dipping pattern was considered when nocturnal BP reduction was inferior to 10%. Based on Holter monitoring, NAs were present when atrial fibrillation, frequent premature atrial contractions (PACs) (>30 PACs/hour), runs of >4 consecutive PACs, frequent premature ventricular contractions (PVCs) (>30PVCs/hour) or runs of >4 consecutive PVCs were present predominantly during sleeping hours. During polyssonography, apnoea/hypopnoea index (AHI) and oxygen saturation (SaO2) were analysed. Moderate to severe OSA was considered when AHI >15.
Results
We studied 104 patients [median age 62 (54–70) years, 65% male): 42 (40%) had moderate to severe OSA (median AHI=11 (6–26), mean SaO2=94% (92–95)] and 64 (61%) were non-dippers. NAs occurred in 18 patients (17%) and they were independently associated with AHI (Odds Ratio (OR) for a one unit increase 1.04, 95% confidence interval (CI) 1.01–1.07, p=0.03) but not with SaO2 (OR 0.96, CI 0.78–1.19, p=0.73) nor non-dipping pattern (OR 1.23, CI 0.38–3.98, p=0.72). No interaction was found between OSA and non-dipping hypertension (p=0.35). In patients with dipping pattern (n=40), AHI was higher in NAs patients comparing with no NAs patients (median AHI 29 versus 10, p=0.04), while in those with non-dipping pattern (n=64), AHI was not statistically different between patients with and without NAs (21 versus 11, p=0.12) (figure).
Figure 1
Conclusion
In this population of hypertensive patients, the presence of NAs was associated with OSA severity (i.e AHI), but not with the non-dipping pattern of hypertension. The importance of obstructive events in arrhythmogenesis seemed to be more pronounced in dipping patients, suggesting the abnormal high blood pressure during the night may also have some impact on NAs in non-dipping patients. Overall, our results suggest that OSA screening should be considered when nocturnal arrhythmias are detected in hypertensive patients, but ABPM should not be forgotten since multiple mechanisms can be involved in nocturnal arrhythmogenesis.
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Affiliation(s)
| | - L Parreira
- Hospital Center of Setubal, Setubal, Portugal
| | - P Amador
- Hospital Center of Setubal, Setubal, Portugal
| | - D Mesquita
- Hospital Center of Setubal, Setubal, Portugal
| | - J Farinha
- Hospital Center of Setubal, Setubal, Portugal
| | - M Fonseca
- Hospital Center of Setubal, Setubal, Portugal
| | - A Esteves
- Hospital Center of Setubal, Setubal, Portugal
| | - A Pinheiro
- Hospital Center of Setubal, Setubal, Portugal
| | - S Sousa
- Hospital Center of Setubal, Setubal, Portugal
| | - M Silva
- Hospital Center of Setubal, Setubal, Portugal
| | - C Lopes
- Hospital Center of Setubal, Setubal, Portugal
| | - A Fernandes
- Hospital Center of Setubal, Setubal, Portugal
| | - A Guerreiro
- Hospital Center of Setubal, Setubal, Portugal
| | - D Chambel
- Hospital Center of Setubal, Setubal, Portugal
| | - R Caria
- Hospital Center of Setubal, Setubal, Portugal
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Marinheiro R, Parreira L, Amador P, Mesquita D, Farinha J, Fonseca M, Esteves A, Pinheiro A, Sousa S, Silva M, Lopes C, Chambel D, Santos B, Carradas C, Caria R. P3795Should we also screen for obstructive sleep apnea in patients presenting with excessive supraventricular ectopic activity? Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
It is recommended to consider obstructive sleep apnoea (OSA) screening in atrial fibrillation (AF) patients with risk factors, due to the strong evidence of an association between these two entities. Excessive supraventricular ectopic activity (ESVEA) has been proposed to be a risk factor for AF. However, strong evidence between ESVEA and OSA has not been established.
Objective
We aimed to determine if ESVEA is associated with moderate to severe OSA since its treatment may prevent AF.
Methods
We studied patients who performed polysomnography and 24-hour Holter monitoring. Patients with atrial fibrillation were excluded. ESVEA was defined as more than 30 PACs per hour (frequent PACs) or runs of >4 consecutive PACs. The circadian pattern of PACs was also evaluated. Sleeping hours were used to define “nocturnal”. Moderate to severe OSA was defined when polyssonography demonstrated a apnoea/hypopnoea index (AHI) >15. We examined the association between ESVEA and moderate to severe OSA during wakefulness and sleep.
Results
We studied 290 patients [median age 65 (55–72) years, 62% males, body mass index (BMI) 30 (27–34)]. 112 (38%) had moderate to severe OSA. Median AHI was 11 (5–24) and mean oxygen saturation was 94% (92–95). Median PACs was 35 (9–117) and 29 patients (10%) had frequent PACs. Runs of >4PACs occurred in 114 patients (39%). Forty-three patients (15%) had predominant nocturnal PACs and 42 (14%) had nocturnal runs of PACs. Multivariate logistic regression analysis demonstrated only nocturnal PACs were associated with moderate to severe OSA (p=0.027) (table 1).
Multivariate logistic regression Odds Ratio 95% Confidence Interval p-value Male gender 4.49 2.48–8.17 <0.001 Body mass index (kg/m2) 1.09 1.03–1.15 0.002 Nocturnal PACs 4.12 1.17–14.46 0.027 Variables not included in the model: age, number of PACs/h, frequent PACs (>30 PAcs/hour), runs of PACs (>4 consecutive PACs), nocturnal frequent PACs and nocturnal runs of PACs.
Conclusion
OSA screening in patients presenting with nocturnal PACs should be routinely considered, especially in male and obese. Treating moderate to severe OSA patients with CPAP has a potential benefit in preventing ESVEA and consequently AF.
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Affiliation(s)
| | - L Parreira
- Hospital Center of Setubal, Setubal, Portugal
| | - P Amador
- Hospital Center of Setubal, Setubal, Portugal
| | - D Mesquita
- Hospital Center of Setubal, Setubal, Portugal
| | - J Farinha
- Hospital Center of Setubal, Setubal, Portugal
| | - M Fonseca
- Hospital Center of Setubal, Setubal, Portugal
| | - A Esteves
- Hospital Center of Setubal, Setubal, Portugal
| | - A Pinheiro
- Hospital Center of Setubal, Setubal, Portugal
| | - S Sousa
- Hospital Center of Setubal, Setubal, Portugal
| | - M Silva
- Hospital Center of Setubal, Setubal, Portugal
| | - C Lopes
- Hospital Center of Setubal, Setubal, Portugal
| | - D Chambel
- Hospital Center of Setubal, Setubal, Portugal
| | - B Santos
- Hospital Center of Setubal, Setubal, Portugal
| | - C Carradas
- Hospital Center of Setubal, Setubal, Portugal
| | - R Caria
- Hospital Center of Setubal, Setubal, Portugal
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Mendes F, Paciência I, Lopes C, Santos A, Barros H, Moreira A, Moreira P. OR56: Pregnancy Exposure to Maternal Smoking and High Caffeine Intake is Associated with Increased Childhood Asthma Risk: Evidence from a Birth Cohort. Clin Nutr 2019. [DOI: 10.1016/s0261-5614(19)32528-2] [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] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Martins C, Vidal A, De Boevre M, De Saeger S, Nunes C, Torres D, Goios A, Lopes C, Assunção R, Alvito P. Exposure assessment of Portuguese population to multiple mycotoxins: The human biomonitoring approach. Int J Hyg Environ Health 2019; 222:913-925. [DOI: 10.1016/j.ijheh.2019.06.010] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 04/18/2019] [Accepted: 06/24/2019] [Indexed: 12/11/2022]
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Martins T, Vaz A, Asseiceira I, Mexia S, Pereira L, Lopes C, Azevedo P, Barreto C, Sampaio D. P317 Nutritional status and body composition in a cystic fibrosis population: comparison with a healthy population. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30610-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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32
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Martins C, De Boevre M, De Saeger S, Assunção R, Nunes C, Torres D, Goios A, Lopes C, Alvito P, Vidal A. Exposure of Portuguese population to mycotoxins: the contribution of human biomonitoring studies. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky214.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- C Martins
- National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
- NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
- CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Lisbon, Portugal
| | - M De Boevre
- Laboratory of Food Analysis, Department of Bioanalysis, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - S De Saeger
- Laboratory of Food Analysis, Department of Bioanalysis, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - R Assunção
- National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
- CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Lisbon, Portugal
| | - C Nunes
- NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
- Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - D Torres
- Faculty of Nutrition and Food Sciences, University of Porto; Epidemiology Research Unit, Institute of Public Health, University of Porto, Porto, Portugal
| | - A Goios
- Faculty of Nutrition and Food Sciences, University of Porto; Epidemiology Research Unit, Institute of Public Health, University of Porto, Porto, Portugal
| | - C Lopes
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto; Epidemiology Research Unit, Institute of Public Health, University of Porto, Porto, Portugal
| | - P Alvito
- National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
- CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Lisbon, Portugal
| | - A Vidal
- Laboratory of Food Analysis, Department of Bioanalysis, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
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Cabral M, Araújo J, Lopes C, Ramos E. Food intake and high-sensitivity C-reactive protein levels in adolescents. Nutr Metab Cardiovasc Dis 2018; 28:1067-1074. [PMID: 30031673 DOI: 10.1016/j.numecd.2018.06.003] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 06/04/2018] [Accepted: 06/05/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND AIMS Diet comprises factors with anti and pro-inflammatory potential that can contribute to modulate obesity-induced inflammation. We aimed to assess the association between food intake and high-sensitivity C-reactive protein (hsCRP) levels in adolescents. METHODS AND RESULTS A cross-sectional analysis of 991 adolescents aged 13 years old was conducted as part of the EPITeen cohort, Porto, Portugal. Food intake was assessed by a food frequency questionnaire and thirteen food groups were defined. Anthropometric assessment was performed and serum hsCRP was measured in a fasting blood sample. hsCRP concentrations above the 75th percentile were considered high. Logistic regression was fitted to estimate the association between the intake frequency of the food groups and hsCRP, stratified by BMI and adjusted for sex, parental education and total energy intake. Median (25-75th percentiles) hsCRP concentrations increased with increasing values of BMI [normal weight: 0.20 (0.10-0.50); overweight: 0.40 (0.20-0.80); obese: 1.10 (0.40-2.15) mg/l, p < 0.001]. After adjustment for sex, parental education and total energy intake, no statistically significant associations were found amongst normal weight and overweight participants. However, among obese individuals, having as reference the first frequency category (<1 per day), a higher frequency of vegetables/legumes intake showed a decreased odds of high hsCRP levels (OR: 0.10, 95%CI 0.03-0.38, 1-3 per day; and OR: 0.14, 95%CI 0.04-0.52, >3 per day). CONCLUSION Among participants with obesity-induced higher hsCRP levels, a higher frequency of vegetable/legume intake was inversely related to hsCRP.
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Affiliation(s)
- M Cabral
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Portugal, Rua das Taipas, nº 135, 4050-600, Porto, Portugal.
| | - J Araújo
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Portugal, Rua das Taipas, nº 135, 4050-600, Porto, Portugal
| | - C Lopes
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Portugal, Rua das Taipas, nº 135, 4050-600, Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Al. Prof. Hernâni Monteiro, 4200 - 319, Porto, Portugal
| | - E Ramos
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Portugal, Rua das Taipas, nº 135, 4050-600, Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Al. Prof. Hernâni Monteiro, 4200 - 319, Porto, Portugal
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Pascoal P, Rosa P, Lopes C. 112 The impact of expression of feelings on sexual satisfaction: testing the mediating role of sexual self-disclosure in a sample of cisgendered heterosexual adults in a monogamous relationship. J Sex Med 2018. [DOI: 10.1016/j.jsxm.2018.04.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Martins T, Vaz A, Asseiceira I, Mexia S, Pereira L, Lopes C, Almeida Nunes P, Azevedo P, Barreto C, Sampaio D. P199 Nutritional status and eating behaviour in a CF population. J Cyst Fibros 2018. [DOI: 10.1016/s1569-1993(18)30494-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Marinheiro AR, Parreira L, Amador P, Lopes C, Fernandes A, Duarte T, Farinha J, Sa C, Fonseca M, Caria R. P1198Clinical impact of oral anticoagulation in patients with atrial high rates episodes. Europace 2018. [DOI: 10.1093/europace/euy015.680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - L Parreira
- Hospital Center of Setubal, Setubal, Portugal
| | - P Amador
- Hospital Center of Setubal, Setubal, Portugal
| | - C Lopes
- Hospital Center of Setubal, Setubal, Portugal
| | - A Fernandes
- Hospital Center of Setubal, Setubal, Portugal
| | - T Duarte
- Hospital Center of Setubal, Setubal, Portugal
| | - J Farinha
- Hospital Center of Setubal, Setubal, Portugal
| | - C Sa
- Hospital Center of Setubal, Setubal, Portugal
| | - M Fonseca
- Hospital Center of Setubal, Setubal, Portugal
| | - R Caria
- Hospital Center of Setubal, Setubal, Portugal
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Marinheiro AR, Parreira L, Amador P, Farinha J, Duarte T, Sa C, Fonseca M, Lopes C, Fernandes A, Santos B, Chambel D, Caria R. P1123Long-term prognosis of excessive premature ventricular contractions is determined by the presence and etiology of structural heart disease. Europace 2018. [DOI: 10.1093/europace/euy015.609] [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: 11/12/2022] Open
Affiliation(s)
| | - L Parreira
- Hospital Center of Setubal, Setubal, Portugal
| | - P Amador
- Hospital Center of Setubal, Setubal, Portugal
| | - J Farinha
- Hospital Center of Setubal, Setubal, Portugal
| | - T Duarte
- Hospital Center of Setubal, Setubal, Portugal
| | - C Sa
- Hospital Center of Setubal, Setubal, Portugal
| | - M Fonseca
- Hospital Center of Setubal, Setubal, Portugal
| | - C Lopes
- Hospital Center of Setubal, Setubal, Portugal
| | - A Fernandes
- Hospital Center of Setubal, Setubal, Portugal
| | - B Santos
- Hospital Center of Setubal, Setubal, Portugal
| | - D Chambel
- Hospital Center of Setubal, Setubal, Portugal
| | - R Caria
- Hospital Center of Setubal, Setubal, Portugal
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Mateus J, Cerquido M, Lopes C, Leitão D, Cardoso S, Ventura J, Aguiar P. A novel 3D-microstructured multielectrode array configuration for high-yield and high-fidelity electrophysiological recordings. Front Cell Neurosci 2018. [DOI: 10.3389/conf.fncel.2018.38.00028] [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: 11/13/2022] Open
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Rodrigues AM, Canhão H, Marques A, Ambrósio C, Borges J, Coelho P, Costa L, Fernandes S, Gonçalves I, Gonçalves M, Guerra M, Marques ML, Pimenta S, Pinto P, Sequeira G, Simões E, Teixeira L, Vaz C, Vieira-Sousa E, Vieira R, Alvarenga F, Araújo F, Barcelos A, Barcelos F, Barros R, Bernardes M, Canas da Silva J, Cordeiro A, Costa M, Cunha-Miranda L, Cruz M, Duarte AC, Duarte C, Faustino A, Figueiredo G, Fonseca JE, Furtado C, Gomes J, Lopes C, Mourão AF, Oliveira M, Pimentel-Santos FM, Ribeiro A, Sampaio da Nóvoa T, Santiago M, Silva C, Silva-Dinis A, Sousa S, Tavares-Costa J, Terroso G, Vilar A, Branco JC, Tavares V, Romeu JC, da Silva J. Portuguese recommendations for the prevention, diagnosis and management of primary osteoporosis - 2018 update. Acta Reumatol Port 2018; 43:10-31. [PMID: 29602163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND Advances in osteoporosis (OP)case definition, treatment options, optimal therapy duration and pharmacoeconomic evidence in the national context motivated the Portuguese Society of Rheumatology (SPR) to update the Portuguese recommendations for the diagnosis and management of osteoporosis published in 2007. METHODS SPR bone diseases' working group organized meetings involving 55 participants (rheumatologists, rheumatology fellows and one OP specialist nurse) to debate and develop the document. First, the working group selected 11 pertinent clinical questions for the diagnosis and management of osteoporosis in standard clinical practice. Then, each question was investigated through literature review and draft recommendations were built through consensus. When insufficient evidence was available, recommendations were based on experts' opinion and on good clinical practice. At two national meetings, the recommendations were discussed and updated. A draft of the recommendations full text was submitted to critical review among the working group and suggestions were incorporated. A final version was circulated among all Portuguese rheumatologists before publication and the level of agreement was anonymously assessed using an online survey. RESULTS The 2018 SPR recommendations provide comprehensive guidance on osteoporosis prevention, diagnosis, fracture risk assessment, pharmacological treatment initiation, therapy options and duration of treatment, based on the best available evidence. They attained desirable agreement among Portuguese rheumatologists. As more evidence becomes available, periodic revisions will be performed. Target audience and patient population: The target audience for these guidelines includes all clinicians. The target patient population includes adult Portuguese people. Intended use: These recommendations provide general guidance for typical cases. They may not be appropriate in all situations - clinicians are encouraged to consider this information together with updated evidence and their best clinical judgment in individual cases.
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Marques O, Canadas A, Faria F, Oliveira E, Amorim I, Seixas F, Gama A, Lobo-da-Cunha A, Silva BMD, Porto G, Lopes C. Expression of iron-related proteins in feline and canine mammary gland reveals unexpected accumulation of iron. Biotech Histochem 2017; 92:584-594. [PMID: 29172705 DOI: 10.1080/10520295.2017.1369160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Dysregulation of cellular iron homeostasis in human breast cancer is reflected by the altered expression of regulatory proteins. The expressions of iron-related proteins in the mammary glands of cats and dogs have not been assessed. We evaluated the expressions of ferritin, ferroportin, hepcidin and transferrin receptor 1 in benign and malignant mammary gland lesions in cats and dogs. Iron deposition was detected using Perls' Prussian blue staining. We found no major differences in the expression of iron-related proteins between benign and malignant mammary gland lesions in either cats or dogs; however, these species exhibited accumulation of iron in benign lesions. Our findings provide an explanation for the absence of higher iron requirements by tumor cells in these animals. Further investigation of local iron homeostasis in cats and dogs and differences in their physiology compared to human breast cancer is required.
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Affiliation(s)
- O Marques
- a Unit for Multidisciplinary Biomedical Research (UMIB), Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto , Porto.,b Pathology and Molecular Immunology Department , Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto , Porto.,c Basic and Clinical Research on Iron Biology, Molecular and Cell Biology Institute (IBMC) University of Porto , Porto.,d Institute for Research and Innovation in Health Sciences (i3S), University of Porto , Porto
| | - A Canadas
- b Pathology and Molecular Immunology Department , Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto , Porto
| | - F Faria
- b Pathology and Molecular Immunology Department , Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto , Porto
| | - E Oliveira
- a Unit for Multidisciplinary Biomedical Research (UMIB), Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto , Porto.,e Laboratory of Cell Biology, Department of Microscopy , Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto , Porto
| | - I Amorim
- b Pathology and Molecular Immunology Department , Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto , Porto.,d Institute for Research and Innovation in Health Sciences (i3S), University of Porto , Porto.,f Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), University of Porto , Porto
| | - F Seixas
- g Centre of Animal and Veterinary Sciences, University of Trás-os-Montes e Alto Douro (CECAV-UTAD) , Vila Real
| | - A Gama
- g Centre of Animal and Veterinary Sciences, University of Trás-os-Montes e Alto Douro (CECAV-UTAD) , Vila Real
| | - A Lobo-da-Cunha
- a Unit for Multidisciplinary Biomedical Research (UMIB), Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto , Porto.,e Laboratory of Cell Biology, Department of Microscopy , Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto , Porto
| | - B Martins da Silva
- a Unit for Multidisciplinary Biomedical Research (UMIB), Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto , Porto.,b Pathology and Molecular Immunology Department , Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto , Porto
| | - G Porto
- b Pathology and Molecular Immunology Department , Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto , Porto.,c Basic and Clinical Research on Iron Biology, Molecular and Cell Biology Institute (IBMC) University of Porto , Porto.,d Institute for Research and Innovation in Health Sciences (i3S), University of Porto , Porto.,e Laboratory of Cell Biology, Department of Microscopy , Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto , Porto.,f Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), University of Porto , Porto.,g Centre of Animal and Veterinary Sciences, University of Trás-os-Montes e Alto Douro (CECAV-UTAD) , Vila Real.,h Hematology Service, Santo António Hospital, Porto Hospital Centre
| | - C Lopes
- b Pathology and Molecular Immunology Department , Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto , Porto.,i Department of Pathology , Portuguese Oncology Institute (IPO) , Porto , Portugal
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Lopes C, Torres D, Oliveira A, Severo M, Lobato L, Correia D, Guiomar S, Alarcao V, Oliveira L. Nutritional intake and contribution of foods to nutrient inadequacy – the Portuguese Dietary Survey. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx187.319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- C Lopes
- Institute of Public Health, Faculty of Medicine, University of Porto, Porto, Portugal
| | - D Torres
- Institute of Public Health, Faculty of Medicine, University of Porto, Porto, Portugal
| | - A Oliveira
- Institute of Public Health, Faculty of Medicine, University of Porto, Porto, Portugal
| | - M Severo
- Institute of Public Health, Faculty of Medicine, University of Porto, Porto, Portugal
| | - L Lobato
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - D Correia
- Institute of Public Health, Faculty of Medicine, University of Porto, Porto, Portugal
| | - S Guiomar
- National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal
| | - V Alarcao
- Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - L Oliveira
- National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal
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Santos E, Gabriel D, Braga A, Duarte S, Martins Silva A, Matos I, Freijo M, Martins J, Nadais G, Silveira F, Sousa F, Fraga C, Santos Silva R, Lopes C, Gonçalves G, Pinto C, Sousa Braga J, Leite M. MuSK myasthenia gravis and pregnancy. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.3027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Martino-Costa A, Malhão F, Lopes C, Dias-Pereira P. Renal Interstitial Lipid Accumulation in Cats with Chronic Kidney Disease. J Comp Pathol 2017; 157:75-79. [DOI: 10.1016/j.jcpa.2017.06.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2017] [Revised: 06/08/2017] [Accepted: 06/13/2017] [Indexed: 02/04/2023]
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Marinheiro A, Amador P, Parreira L, Lopes C, Fernandes A, Venancio J, Sa C, Duarte T, Fonseca M, Farinha J, Caria R. P1680New-onset atrial fibrillation after pacemaker implantation. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p1680] [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: 11/13/2022] Open
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Aguiar R, Fernandes NP, Lopes A, Lopes C. Allergic bronchopulmonary aspergillosis treated successfully with omalizumab. Rev Port Pneumol (2006) 2017; 23:304-306. [PMID: 28705584 DOI: 10.1016/j.rppnen.2017.05.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 05/12/2017] [Accepted: 05/16/2017] [Indexed: 10/19/2022] Open
Affiliation(s)
- R Aguiar
- Immunoallergology Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal.
| | - N P Fernandes
- Immunoallergology Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal
| | - A Lopes
- Immunoallergology Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal
| | - C Lopes
- Pneumology Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal
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Marinheiro AR, Parreira L, Amador P, Sa C, Duarte T, Fonseca M, Lopes C, Venancio J, Chambel D, Caria R. P397Are implantable defibrillators less useful in patients with non-ischemic heart disease? Europace 2017. [DOI: 10.1093/ehjci/eux141.122] [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: 11/13/2022] Open
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Marinheiro AR, Amador P, Parreira L, Sa C, Duarte T, Fonseca M, Chambel D, Santos B, Fernandes A, Lopes C, Carradas C, Caria R. P1609Sheldon score - a simple questionnaire that identifies patients with a positive tilt test. Europace 2017. [DOI: 10.1093/ehjci/eux158.235] [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: 11/13/2022] Open
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Marinheiro AR, Amador P, Parreira L, Sa C, Duarte T, Fonseca M, Lopes C, Fernandes A, Venancio J, Caria R. P276Preditors of new-onset atrial fibrillation after pacemaker implantation. Europace 2017. [DOI: 10.1093/ehjci/eux141.004] [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: 11/13/2022] Open
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Orfanos P, Naska A, Rodrigues S, Lopes C, Freisling H, Rohrmann S, Sieri S, Elmadfa I, Lachat C, Gedrich K, Boeing H, Katzke V, Turrini A, Tumino R, Ricceri F, Mattiello A, Palli D, Ocké M, Engeset D, Oltarzewski M, Nilsson LM, Key T, Trichopoulou A. Eating at restaurants, at work or at home. Is there a difference? A study among adults of 11 European countries in the context of the HECTOR* project. Eur J Clin Nutr 2017; 71:407-419. [PMID: 27966568 DOI: 10.1038/ejcn.2016.219] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 10/11/2016] [Accepted: 10/12/2016] [Indexed: 01/07/2023]
Abstract
BACKGROUND/OBJECTIVES To compare macronutrient intakes out of home-by location-to those at home and to investigate differences in total daily intakes between individuals consuming more than half of their daily energy out of home and those eating only at home. SUBJECTS/METHODS Data collected through 24-h recalls or diaries among 23 766 European adults. Participants were grouped as 'non-substantial', 'intermediate' and 'very substantial out-of-home' eaters based on energy intake out of home. Mean macronutrient intakes were estimated at home and out of home (overall, at restaurants, at work). Study/cohort-specific mean differences in total intakes between the 'very substantial out-of-home' and the 'at-home' eaters were estimated through linear regression and pooled estimates were derived. RESULTS At restaurants, men consumed 29% of their energy as fat, 15% as protein, 45% as carbohydrates and 11% as alcohol. Among women, fat contributed 33% of energy intake at restaurants, protein 16%, carbohydrates 45% and alcohol 6%. When eating at work, both sexes reported 30% of energy from fat and 55% from carbohydrates. Intakes at home were higher in fat and lower in carbohydrates and alcohol. Total daily intakes of the 'very substantial out-of-home' eaters were generally similar to those of individuals eating only at home, apart from lower carbohydrate and higher alcohol intakes among individuals eating at restaurants. CONCLUSIONS In a large population of adults from 11 European countries, eating at work was generally similar to eating at home. Alcoholic drinks were the primary contributors of higher daily energy intakes among individuals eating substantially at restaurants.
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Affiliation(s)
- P Orfanos
- WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - A Naska
- WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - S Rodrigues
- Faculty of Nutrition and Food Sciences, University of Porto, and Institute of Public Health, Porto, Portugal
| | - C Lopes
- Department of Clinical Epidemiology, Preventive Medicine and Public Health, University of Porto Medical School/Institute of Public Health, Porto, Portugal
| | - H Freisling
- International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - S Rohrmann
- Division of Chronic Disease Epidemiology, Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
| | - S Sieri
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - I Elmadfa
- Department of Nutritional Sciences, University of Vienna, Vienna, Austria
| | - C Lachat
- Department of Food Safety and Food Quality, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
- Nutrition and Child Health Unit, Institute of Tropical Medicine, Antwerp, Belgium
| | - K Gedrich
- Department of Nutritional Physiology, TUM Technical University of Munich, Freising, Germany
| | - H Boeing
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - V Katzke
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - A Turrini
- Council for Agricultural Research and Economics-Research Center for Food and Nutrition (CREA-Alimenti e Nutrizione), Rome, Italy
| | - R Tumino
- Cancer Registry and Histopathology Unit, 'Civic M.P.Arezzo' Hospital, ASP Ragusa, Italy
| | - F Ricceri
- Department of Economics and Statistics, 'Cognetti de Martiis' University of Turin, Turin, Italy
- Unit of Epidemiology, Regional Health Service ASL TO3, Turin, Italy
- Unit of Cancer Epidemiology, Department of Medical Sciences, University of Turin, Turin, Italy
| | - A Mattiello
- Dipartimento di Medicina Clinica e Chirurgia Federico II University, Naples, Italy
| | - D Palli
- Cancer Research and Prevention Institute (ISPO), Florence, Italy
| | - M Ocké
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - D Engeset
- Department of Public Health, Sport and Nutrition, University of Agder, Kristiansand, Norway
| | | | - L M Nilsson
- Public Health and Clinical Medicine, Nutritional research, Umeå University, Umeå, Sweden
- Arcum, Arctic Research Centre at Umeå University, Umeå, Sweden
| | - T Key
- Cancer Epidemiology Unit, University of Oxford, Oxford, UK
| | - A Trichopoulou
- WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- Hellenic Health Foundation, Athens, Greece
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Gil da Costa R, Aragão S, Moutinho M, Alvarado A, Neto T, Santos C, Ferreirinha P, Carmo D, Casaca F, Silva S, Ribeiro J, Sousa H, Medeiros R, Lopes C, Vilanova M, Oliveira P, Bastos M. Bracken and Papillomavirus-induced Cancers: Which Toxin is the Main Viral Co-factor? J Comp Pathol 2017. [DOI: 10.1016/j.jcpa.2016.11.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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