1
|
Campagna J, Czyszczon K, Little J, Selby C, Wick L, Ferreira D, Oriel K. The physical and psychosocial impact of a school-based running programme for adolescents with disabilities. J Intellect Disabil Res 2024; 68:181-192. [PMID: 37984471 DOI: 10.1111/jir.13104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 09/28/2023] [Accepted: 10/11/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND Adolescents with disabilities have fewer opportunities to participate in community-based fitness programmes. The purpose of this study was to examine the impact of a school-based running programme at a local middle school in Lebanon, Pennsylvania, on fitness and quality of life (QoL) in children with physical and cognitive disabilities in a life-skills classroom. METHODS Nineteen adolescents with diagnosed disabilities including intellectual disability (ID), autism spectrum disorder and Down syndrome were recruited from three life-skills classrooms to participate in a school-based running programme. The programme was designed to be implemented two times/week for 6 weeks by classroom teachers/aides. Physical therapy faculty and students developed the programme and assisted with implementation. Each session lasted 30 min, consisting of a warm-up and cooldown, relay races, games and timed runs. Pre- and post-test measures included physiological cost index (PCI) and Paediatric Quality of Life Inventory™ (PedsQL™). Pre- and post-test data were compared using Wilcoxon signed rank tests. Each week participants also completed a training log to reflect on the activity for the day. RESULTS Participants demonstrated significant improvements in PCI (P = 0.028) and the PedsQL™ (P = 0.008) following the running programme. CONCLUSIONS Results of this study suggest that participation in a 6-week school-based running programme may improve fitness and QoL in adolescents with disabilities.
Collapse
Affiliation(s)
- J Campagna
- Student, Lebanon Valley College, Annville, PA, USA
| | - K Czyszczon
- Student, Lebanon Valley College, Annville, PA, USA
| | - J Little
- Student, Lebanon Valley College, Annville, PA, USA
| | - C Selby
- Student, Lebanon Valley College, Annville, PA, USA
| | - L Wick
- Student, Lebanon Valley College, Annville, PA, USA
| | - D Ferreira
- Department of Physical Education and Exercise Science, Lander University, Greenwood, SC, USA
| | - K Oriel
- Department of Physical Therapy, Lebanon Valley College, Annville, PA, USA
| |
Collapse
|
2
|
Nikolaou E, German EL, Howard A, Nabwera HM, Matope A, Robinson R, Shiham F, Liatsikos K, McNamara C, Kattera S, Carter K, Parry CM, Read JM, Allen SJ, Urban BC, Hawcutt DB, Hill H, Collins AM, Ferreira DM. Assessing the use of minimally invasive self-sampling at home for long-term monitoring of the microbiota within UK families. Sci Rep 2023; 13:18201. [PMID: 37875557 PMCID: PMC10598218 DOI: 10.1038/s41598-023-45574-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 10/21/2023] [Indexed: 10/26/2023] Open
Abstract
Monitoring the presence of commensal and pathogenic respiratory microorganisms is of critical global importance. However, community-based surveillance is difficult because nasopharyngeal swabs are uncomfortable and painful for a wide age range of participants. We designed a methodology for minimally invasive self-sampling at home and assessed its use for longitudinal monitoring of the oral, nasal and hand microbiota of adults and children within families. Healthy families with two adults and up to three children, living in and near Liverpool, United Kingdom, self-collected saliva, nasal lining fluid using synthetic absorptive matrices and hand swabs at home every two weeks for six months. Questionnaires were used to collect demographic and epidemiological data and assess feasibility and acceptability. Participants were invited to take part in an exit interview. Thirty-three families completed the study. Sampling using our approach was acceptable to 25/33 (76%) families, as sampling was fast (76%), easy (76%) and painless (60%). Saliva and hand sampling was acceptable to all participants of any age, whereas nasal sampling was accepted mostly by adults and children older than 5 years. Multi-niche self-sampling at home can be used by adults and children for longitudinal surveillance of respiratory microorganisms, providing key data for design of future studies.
Collapse
Affiliation(s)
- E Nikolaou
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.
- Infection and Immunity, Murdoch Children's Research Institute, Parkville, VIC, 3050, Australia.
- Microbiology and Immunology Department, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Parkville, VIC, Australia.
| | - E L German
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - A Howard
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - H M Nabwera
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
- Alder Hey Children's Hospital, Liverpool, UK
- Centre of Excellence in Women and Child Health, Aga Khan University, Nairobi, Kenya
| | - A Matope
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - R Robinson
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - F Shiham
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - K Liatsikos
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - C McNamara
- Alder Hey Children's Hospital, Liverpool, UK
| | - S Kattera
- Alder Hey Children's Hospital, Liverpool, UK
| | - K Carter
- Alder Hey Children's Hospital, Liverpool, UK
| | - C M Parry
- Alder Hey Children's Hospital, Liverpool, UK
| | - J M Read
- Lancaster Medical School, Lancaster University, Lancaster, UK
| | - S J Allen
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
- Edward Francis Small Teaching Hospital, Banjul, The Gambia
| | - B C Urban
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, OX3 7LE, UK
| | - D B Hawcutt
- Alder Hey Children's Hospital, Liverpool, UK
- University of Liverpool, Liverpool, UK
| | - H Hill
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - A M Collins
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - D M Ferreira
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, OX3 7LE, UK.
| |
Collapse
|
3
|
Sallée JB, Abrahamsen EP, Allaigre C, Auger M, Ayres H, Badhe R, Boutin J, Brearley JA, de Lavergne C, ten Doeschate AMM, Droste ES, du Plessis MD, Ferreira D, Giddy IS, Gülk B, Gruber N, Hague M, Hoppema M, Josey SA, Kanzow T, Kimmritz M, Lindeman MR, Llanillo PJ, Lucas NS, Madec G, Marshall DP, Meijers AJS, Meredith MP, Mohrmann M, Monteiro PMS, Mosneron Dupin C, Naeck K, Narayanan A, Naveira Garabato AC, Nicholson SA, Novellino A, Ödalen M, Østerhus S, Park W, Patmore RD, Piedagnel E, Roquet F, Rosenthal HS, Roy T, Saurabh R, Silvy Y, Spira T, Steiger N, Styles AF, Swart S, Vogt L, Ward B, Zhou S. Southern ocean carbon and heat impact on climate. Philos Trans A Math Phys Eng Sci 2023; 381:20220056. [PMID: 37150205 PMCID: PMC10164461 DOI: 10.1098/rsta.2022.0056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 02/24/2023] [Indexed: 05/09/2023]
Abstract
The Southern Ocean greatly contributes to the regulation of the global climate by controlling important heat and carbon exchanges between the atmosphere and the ocean. Rates of climate change on decadal timescales are therefore impacted by oceanic processes taking place in the Southern Ocean, yet too little is known about these processes. Limitations come both from the lack of observations in this extreme environment and its inherent sensitivity to intermittent processes at scales that are not well captured in current Earth system models. The Southern Ocean Carbon and Heat Impact on Climate programme was launched to address this knowledge gap, with the overall objective to understand and quantify variability of heat and carbon budgets in the Southern Ocean through an investigation of the key physical processes controlling exchanges between the atmosphere, ocean and sea ice using a combination of observational and modelling approaches. Here, we provide a brief overview of the programme, as well as a summary of some of the scientific progress achieved during its first half. Advances range from new evidence of the importance of specific processes in Southern Ocean ventilation rate (e.g. storm-induced turbulence, sea-ice meltwater fronts, wind-induced gyre circulation, dense shelf water formation and abyssal mixing) to refined descriptions of the physical changes currently ongoing in the Southern Ocean and of their link with global climate. This article is part of a discussion meeting issue 'Heat and carbon uptake in the Southern Ocean: the state of the art and future priorities'.
Collapse
Affiliation(s)
- The SO-CHIC consortium
- Laboratoire d’Océanographie et du Climat Expérimentations et Approches Numériques (LOCEAN), Sorbonne Université, CNRS/IRD/MNHN, Paris, France
| | - J. B. Sallée
- Laboratoire d’Océanographie et du Climat Expérimentations et Approches Numériques (LOCEAN), Sorbonne Université, CNRS/IRD/MNHN, Paris, France
| | | | - C. Allaigre
- Laboratoire d’Océanographie et du Climat Expérimentations et Approches Numériques (LOCEAN), Sorbonne Université, CNRS/IRD/MNHN, Paris, France
| | - M. Auger
- Laboratoire d’Océanographie et du Climat Expérimentations et Approches Numériques (LOCEAN), Sorbonne Université, CNRS/IRD/MNHN, Paris, France
| | - H. Ayres
- University of Reading, Reading, UK
| | - R. Badhe
- European Polar Board, Den Haag, The Netherlands
| | - J. Boutin
- Laboratoire d’Océanographie et du Climat Expérimentations et Approches Numériques (LOCEAN), Sorbonne Université, CNRS/IRD/MNHN, Paris, France
| | | | - C. de Lavergne
- Laboratoire d’Océanographie et du Climat Expérimentations et Approches Numériques (LOCEAN), Sorbonne Université, CNRS/IRD/MNHN, Paris, France
| | - A. M. M. ten Doeschate
- AirSea Laboratory and Ryan Institute, School of Natural Sciences, University of Galway, Galway, Ireland
- Department of Oceanography, Dalhousie University, Halifax, Canada
| | - E. S. Droste
- Alfred Wegener Institute Helmholtz Centre for Polar and Marine Research, Bremerhaven, Germany
| | - M. D. du Plessis
- Department of Marine Sciences, University of Gothenburg, Gothenburg, Sweden
| | | | - I. S. Giddy
- Department of Oceanography, University of Cape Town, Rondebosch, South Africa
| | - B. Gülk
- Department of Marine Sciences, University of Gothenburg, Gothenburg, Sweden
| | | | | | - M. Hoppema
- Alfred Wegener Institute Helmholtz Centre for Polar and Marine Research, Bremerhaven, Germany
| | - S. A. Josey
- National Oceanography Centre, Southampton, UK
| | - T. Kanzow
- Alfred Wegener Institute Helmholtz Centre for Polar and Marine Research, Bremerhaven, Germany
| | - M. Kimmritz
- Alfred Wegener Institute Helmholtz Centre for Polar and Marine Research, Bremerhaven, Germany
| | | | - P. J. Llanillo
- Alfred Wegener Institute Helmholtz Centre for Polar and Marine Research, Bremerhaven, Germany
| | | | - G. Madec
- Laboratoire d’Océanographie et du Climat Expérimentations et Approches Numériques (LOCEAN), Sorbonne Université, CNRS/IRD/MNHN, Paris, France
| | | | | | | | - M. Mohrmann
- Department of Marine Sciences, University of Gothenburg, Gothenburg, Sweden
| | - P. M. S. Monteiro
- Southern Ocean Carbon-Climate Observatory (SOCCO), CSIR, Cape Town, South Africa
| | - C. Mosneron Dupin
- Laboratoire d’Océanographie et du Climat Expérimentations et Approches Numériques (LOCEAN), Sorbonne Université, CNRS/IRD/MNHN, Paris, France
| | - K. Naeck
- Laboratoire d’Océanographie et du Climat Expérimentations et Approches Numériques (LOCEAN), Sorbonne Université, CNRS/IRD/MNHN, Paris, France
| | - A. Narayanan
- Department of Marine Sciences, University of Gothenburg, Gothenburg, Sweden
| | | | - S-A. Nicholson
- Southern Ocean Carbon-Climate Observatory (SOCCO), CSIR, Cape Town, South Africa
| | | | - M. Ödalen
- GEOMAR Helmholtz Centre for Ocean Research Kiel, Kiel, Germany
| | - S. Østerhus
- Norwegian Research Centre (NORCE), Bergen, Norway
| | - W. Park
- GEOMAR Helmholtz Centre for Ocean Research Kiel, Kiel, Germany
- IBS Center for Climate Physics and Department of Climate System, Pusan National University, Busan, Republic of Korea
| | | | - E. Piedagnel
- Laboratoire d’Océanographie et du Climat Expérimentations et Approches Numériques (LOCEAN), Sorbonne Université, CNRS/IRD/MNHN, Paris, France
| | - F. Roquet
- Department of Marine Sciences, University of Gothenburg, Gothenburg, Sweden
| | - H. S. Rosenthal
- Department of Marine Sciences, University of Gothenburg, Gothenburg, Sweden
| | | | - R. Saurabh
- Laboratoire d’Océanographie et du Climat Expérimentations et Approches Numériques (LOCEAN), Sorbonne Université, CNRS/IRD/MNHN, Paris, France
| | - Y. Silvy
- Laboratoire d’Océanographie et du Climat Expérimentations et Approches Numériques (LOCEAN), Sorbonne Université, CNRS/IRD/MNHN, Paris, France
| | - T. Spira
- Department of Marine Sciences, University of Gothenburg, Gothenburg, Sweden
| | - N. Steiger
- Laboratoire d’Océanographie et du Climat Expérimentations et Approches Numériques (LOCEAN), Sorbonne Université, CNRS/IRD/MNHN, Paris, France
| | | | - S. Swart
- Department of Marine Sciences, University of Gothenburg, Gothenburg, Sweden
- Department of Oceanography, University of Cape Town, Rondebosch, South Africa
| | - L. Vogt
- Laboratoire d’Océanographie et du Climat Expérimentations et Approches Numériques (LOCEAN), Sorbonne Université, CNRS/IRD/MNHN, Paris, France
| | - B. Ward
- AirSea Laboratory and Ryan Institute, School of Natural Sciences, University of Galway, Galway, Ireland
| | - S. Zhou
- British Antarctic Survey, Cambridge, UK
| |
Collapse
|
4
|
De Almeida Fernandes D, Camoes G, Ferreira D, Queijo C, Guimaraes JM, Ribeiro C, Goncalves L, Pina R, Antonio N. Prevalence and predictors of acquired long QT syndrome in the ER department. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Long QT syndrome (LQTS) is a rare heterogeneous syndrome that may be congenital or acquired, the latter being more common. Its real-world prevalence remains to be determined. We aimed to determine the prevalence of this syndrome in patients admitted to the emergency room (ER) and characterize the subset of patients with severely prolonged QT.
Methods
A retrospective analysis of ECG of all consecutively admitted patients in the ER of a tertiary hospital between the 28th of January and the 17th of March 2020 was made. All patients with Bazzett corrected QT interval greater than 470ms in men and 480ms in women were included. Repeated ECGs or with bad electrocardiographic quality, congenital LQTS, atrial fibrillation and pacemaker rhythm were excluded. Clinical data with a special focus on QT prolonging drugs and clinical factors were recorded. Statistical comparison was made between the groups with and without QT interval greater than 500ms.
Results
A total of 6280 ECGs of 5056 patients were analysed. After evaluation, 390 ECGs from 387 different patients were considered. Prevalence of LQTS at admission was 7.95%. Patients were more commonly men (53.1%) with an average age of 73.6±14.7 years old and mean QTc interval of 502.14±32.2ms. Only 20% of the patients were symptomatic, with the most common form of presentation being syncope (50%). No ventricular arrhythmias were recorded.
Regarding patients with a QT interval greater than 500ms, these were more frequently female (59.9% vs 37.2%, p<0.001), were more frequently on QT prolonging drugs (77.8% vs 67.3%; p=0.002). Presence of clinical risk factors was not a risk factor per se (p=0.811) but a greater number of risk factors was linked to more severely prolonged QT (p=0.040). The main contributing factor was intake of antibiotics (odds ratio (OR) 3.497; CI 95% 1.074–11.321; p=0.038) followed by female gender (OR 2.518; CI 95% 1.668–3.800; p<0.001) and use of antipsychotics (OR 1.960; CI 95% 1.159–3.316; p=0.012).
Conclusions
Acquired LQTS is particularly prevalent in the ER setting. The complex interaction of clinical factors and drug iatrogenesis and the unpredictability of its manifestations render its management and recognition difficult but essential. Female patients on antibiotics and antipsychotics are at particularly high risk. Efforts must be made in order to avoid, detect and treat acquired LQTS as early as possible.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
| | - G Camoes
- Coimbra Hospital and University Center, Internal Medicine , Coimbra , Portugal
| | - D Ferreira
- Coimbra Hospital and University Center, Internal Medicine , Coimbra , Portugal
| | - C Queijo
- Coimbra University, Faculty of Medicine , Coimbra , Portugal
| | - J M Guimaraes
- Coimbra Hospital and University Center, Cardiology , Coimbra , Portugal
| | - C Ribeiro
- Coimbra Hospital and University Center, Pharmacology , Coimbra , Portugal
| | - L Goncalves
- Coimbra Hospital and University Center, Cardiology , Coimbra , Portugal
| | - R Pina
- Coimbra Hospital and University Center, Internal Medicine , Coimbra , Portugal
| | - N Antonio
- Coimbra Hospital and University Center, Cardiology , Coimbra , Portugal
| |
Collapse
|
5
|
Mendes S, Ferreira D, Bernardo M. Parent-reported toothbrushing behaviour in the Portuguese preschool population. Eur Arch Paediatr Dent 2022; 23:961-968. [PMID: 36083464 DOI: 10.1007/s40368-022-00749-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 08/28/2022] [Indexed: 10/14/2022]
Abstract
PURPOSE Study toothbrushing behaviours and associated factors in a Portuguese preschool population. METHODS The study population was the parents of children attending Portuguese kindergartens. The data on sociodemographic and toothbrushing behaviours, at home and at school, were collected by an online questionnaire. The data analysis was performed using Chi-square, Fisher, Mann-Whitney and Kruskal-Wallis tests (α = 0.05). RESULTS The sample included 711 parents. Most of the children brushed their teeth at home at least twice-a-day (65.3%), with the help of an adult (62.9%). The majority of the children did not brush their teeth at school (71.2%); however, only 9.9% of the parents reported that they don't/wouldn't authorise it. Considering both toothbrushing, at home and at school, 75% of the children brushed their teeth twice-a-day. However, only 7.8% of the children performed all the correct toothbrushing related procedures. Toothbrushing at school was more frequent in private kindergartens (p < 0.001). A higher level of education was associated with non-authorisation of toothbrushing at school (p = 0.019) and with performing the correct toothbrushing related procedures (p = 0.007). Attending an oral health professional appointment was also associated with performing the correct toothbrushing related procedures (p = 0.005). CONCLUSION Toothbrushing twice-a-day was frequent in the studied population, however, the percentage of children who brushed at school was low, as well as the percentage of children who performed all the correct toothbrushing related procedures. Toothbrushing at school was more likely in private kindergartens. Performing correct toothbrushing related procedures was more frequent in children who had a previous oral health appointment and whose parents had a higher education level.
Collapse
Affiliation(s)
- S Mendes
- Faculdade de Medicina Dentária da Universidade de Lisboa, Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Rua Prof. Teresa Ambrósio, Cidade Universitária, 1600-277, Lisbon, Portugal.
| | - D Ferreira
- Faculdade de Medicina Dentária da Universidade de Lisboa, Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Rua Prof. Teresa Ambrósio, Cidade Universitária, 1600-277, Lisbon, Portugal
| | - M Bernardo
- Faculdade de Medicina Dentária da Universidade de Lisboa, Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Rua Prof. Teresa Ambrósio, Cidade Universitária, 1600-277, Lisbon, Portugal
| |
Collapse
|
6
|
Ferreira D, Dwivedi J, Brienesse S, Leitch J, Sy R, Chan K, Thomas S, Singarayar S, Morris G, Jackson N. The Progression of Atrial Substrate in Patients with Recurrent Left Atrial Ablation Procedures. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.201] [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]
|
7
|
Porwal K, Porwal M, Gadre P, Ferreira D, Butel-Simoes L, Turner S. Mechanical Mitral Valve Thrombosis – A Twenty-Five-Hour Alteplase Protocol. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.102] [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]
|
8
|
Ferreira D, Vivot A, Berthier F. Comment on: Application of a new serratus anterior plane block in modified radical mastectomy under ultrasound guidance: A prospective, randomized controlled trial. J Clin Anesth 2021; 75:110477. [PMID: 34358852 DOI: 10.1016/j.jclinane.2021.110477] [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: 07/02/2021] [Revised: 07/23/2021] [Accepted: 07/27/2021] [Indexed: 11/27/2022]
Affiliation(s)
- D Ferreira
- Anesthesiology and Intensive Care Department, CHU Besançon, F-25000 Besançon, France.
| | - A Vivot
- Service de biostatistique et information médicale, Hôpital Saint Louis, AP-HP, Paris, France
| | - F Berthier
- Anesthesiology and Intensive Care Department, CHU Besançon, F-25000 Besançon, France
| |
Collapse
|
9
|
Silva G, Sampaio F, Espada Guerreiro C, Goncalves Teixeira P, Ribeiro Queiros P, Ribeiro Da Silva M, Brandao M, Ferreira D, Fontes-Carvalho R. Staging cardiac damage in aortic valve disease: one size fits all? Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Nowadays, in patients with aortic regurgitation (AR), aortic valve surgery is indicated when severe and symptomatic or those with depressed LVEF. However, clinical outcomes of patients with significant aortic regurgitation are not influenced by these factors only. Recently, a new staging system for severe aortic stenosis has been proposed by Généreux on the basis of the extent of anatomic and functional cardiac damage. If this model could be applicable to an unselected significant AR population has not been tested.
Purpose
The aim of our study was to evaluate the prevalence of the different stages of extra-aortic valvular cardiac damage by the application of Généreux staging and its impact on prognosis in a large, real world cohort of significant AR patients.
Methods
This study retrospectively analysed the clinical, Doppler echocardiographic and outcome data in patients with grade III or greater AR between January 2014 and September 2019. According to the extent of cardiac damage on echocardiography, patients were classified as Stage 0 (no cardiac damage), Stage 1 (left ventricular damage), Stage 2 (mitral valve or left atrial damage), Stage 3 (tricuspid valve or pulmonary artery vasculature damage) or Stage 4 (right ventricular damage). Exclusion criteria were severe aortic stenosis and previous valve repair or replacement. The primary end-point was all-cause mortality.
Results
A total of 572 patients, aged 70.1±13.9 years, 294 (51.3%) men were enrolled. One third of patients were in NYHA I. Based on the proposed classification, 82 patients (14.3%) were classified in stage 0, 130 (22.7%) in stage 1, 276 (48.2%) in stage 2, 68 (11.8%) in stage 3 and 17 (3.0%) in stage 4. Median follow-up time was 3.3±1.9 years. There was a progressive increase in mortality rates according to staging: 8.5% in stage 0, 10.8% in stage 1, 24.9% in stage 2, 42.6% in stage 3 and 52.9% in stage 4 (p<0.001). On multivariable analysis, the extent of cardiac damage was independently associated with excess mortality (HR 1.69, 95% CI 1.29 to 2.21)
Conclusion
Our study demonstrated that this new staging system studied for aortic stenosis also provides increased prognostic value to patients with significant aortic regurgitation. This staging system can be helpful to identify the degree of extra-aortic valvular cardiac damage and to optimize the time of valvular intervention. Further prospective studies are needed to confirm the benefit of the applicability of this model in clinical practice.
Funding Acknowledgement
Type of funding sources: Public hospital(s). Main funding source(s): Centro Hospitalar Vila Nova de Gaia / Espinho Distribution of stages of cardiac damageSurvival analysis according to stage
Collapse
Affiliation(s)
- G Silva
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - F Sampaio
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - C Espada Guerreiro
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | | | - P Ribeiro Queiros
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - M Ribeiro Da Silva
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - M Brandao
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - D Ferreira
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - R Fontes-Carvalho
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| |
Collapse
|
10
|
Silva G, Espada Guerreiro C, Goncalves Teixeira P, Queiros P, Ribeiro Da Silva M, Ferreira D, Brandao M, Sampaio F, Rodrigues A, Braga P, Fontes-Carvalho R. Prognostic impact of coronary artery disease severity and revascularization in TAVI patients. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Coronary artery disease (CAD) is highly prevalent in patients with severe aortic stenosis. In patients who undergo surgical aortic valve replacement, the presence of CAD and the need for CABG adversely influences short- and long-term outcomes. However, the impact of concomitant CAD and its revascularization in patients undergoing transcatheter aortic valve implantation (TAVI) is still a matter of debate.
Purpose
The aim of this study was to evaluate the prognostic impact of CAD severity in 1-year all-cause mortality of patients undergoing TAVI and whether prior complete or incomplete reasonable revascularization can improve prognosis after TAVI.
Methods and results
Retrospective analysis of a total of 575 patients (51,3% female, mean age 79,7±7,7 years) who underwent TAVI from August 2007 to November 2018. 50,3% of patients had significant CAD (at least one stenosis >50%) which 54,2% of these had history of prior revascularization (64,8% complete or incomplete reasonable revascularization and 35,2% incomplete revascularization).
Pre-TAVI CAD severity was defined by the SYNTAX Score (SS) and reasonable revascularization by the residual SYNTAX Score (rSS). Patients without history of revascularization were stratified into 3 groups: no CAD (SS=0); nonsevere CAD (SS between 1 and 22); and severe CAD (SS ≥23); Patients who had undergone revascularization prior to TAVI were separated into 2 categories based on their residual SS: complete or incomplete reasonable revascularization (rSS<8) and incomplete revascularization (rSS≥8). The primary end point was an all-cause mortality. 1 year, patients with severe CAD had significantly higher rates of mortality (no CAD: 9,8%, nonsevere CAD: 12,6%, severe CAD: 38,9%; P=0.001) without significant differences between patients with no CAD and nonsevere CAD (p=1,00). Patients with high rSS had significantly higher rates of mortality comparing to no CAD or rSS<8 (no CAD: 9,8%, rSS<8: 8,6%; rSS≥8: 28,0%, p=0.001).
Conclusions
In our study, only the presence of severe CAD (SS≥23) prior to TAVI was associated with increased 1-year all-cause mortality. In patients with previous history of revascularization, a complete/reasonable revascularization (lower rSS) was associated with lower long-term mortality, which may attenuate the association of severe CAD and mortality and therefore improve the prognosis of these patients.
Funding Acknowledgement
Type of funding sources: Public hospital(s). Main funding source(s): Centro Hospitalar Vila Nova de Gaia / Espinho Figure 1. Prognostic Impact of CAD severityFigure 2. Prognostic Impact of Revascularization
Collapse
Affiliation(s)
- G Silva
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - C Espada Guerreiro
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | | | - P Queiros
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - M Ribeiro Da Silva
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - D Ferreira
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - M Brandao
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - F Sampaio
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - A Rodrigues
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - P Braga
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - R Fontes-Carvalho
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| |
Collapse
|
11
|
Silva G, Espada Guerreiro C, Goncalves Teixeira P, Ribeiro Queiros P, Ribeiro Da Silva M, Brandao M, Ferreira D, Pires-Morais G, Santos L, Melica B, Rodrigues A, Braga P, Sampaio F, Fontes-Carvalho R. Feasibility of coronary angiography after TAVR. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2082] [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
Background
The prevalence of coronary artery disease (CAD) is high among patients with severe aortic stenosis who undergo transcatheter aortic valve replacement (TAVR).
Indications for TAVR are now expanding to younger and lower risk patients. During their lifetime, these patients will be at risk of developing CAD and it is expected an increase in coronary angiography and percutaneous coronary intervention (PCI). Aortic prosthesis, particularly if in supra-annular position, may pose important technical difficulties in coronary re-engagement after TAVR.
Purpose
To evaluate the feasibility to reengage the coronary ostia after TAVR, describe complications and compare technical differences between coronary procedures performed before and after TAVR.
Methods
Retrospective analysis of 714 patients submitted to TAVR from August 2007 to December 2019. Patients who needed coronary angiography after TAVR were selected.
The primary endpoint was the rate of successful coronary ostia cannulation after TAVR, defined by the possibility to selectively cannulate and inject both coronary ostia.
Secondary endpoint was complications associated with coronary catheterization after TAVR.
Results
Among 714 patients, 25 (3.5%) patients were submitted to a total of 28 coronary angiography after TAVR. 14 patients were male (56%), mean age 78.2±6.2 years and 9 (36%) had history of previous coronary revascularization.
From the 28 coronary angiographies (balloon-expandable Edwards-Sapien n=11, 44%; self-expandable CoreValve n=10, 40%; Portico n=2, 8%; Symetis n=2, 8%), 25 (89%) met the primary endpoint. Only three was semiselective (Symetis, CoreValve Evolut R and CoreValve TAVR in TAVR), with impossibility to cannulate both coronary arteries, right coronary artery and left coronary artery, respectively. 13 (46%) patients had also indication for PCI and all were successfully performed (Edwards-Sapien n=4, 31%; CoreValve n=6, 46%; Portico n=2, 15%; Symetis n=1, 8%). The main indications for coronary angiography was chronic coronary syndrome (n=12, 43%) and acute coronary syndrome without ST segment elevation (n=7, 25%). Circumflex artery was the most frequently treated vessel (n=6), followed by left anterior descending artery (n=4), right coronary artery (n=3) and left main (n=2).
There were no complications reported during or post-procedure. Comparing coronary angiographies before and after TAVR, there were no significant differences regarding arterial access site, catheter diameter, fluoroscopy time and quantity of contrast used in coronary angiography.
Conclusion
Although the need for coronary angiography was rare in patients after TAVR, selective diagnostic coronary angiographies were possible in 89% (25/28) and PCI was feasible in all patients in whom it was indicated, without any reported complications.
Further prospective studies are needed to confirm the great feasibility of performing coronary angiography after TAVR.
Funding Acknowledgement
Type of funding sources: Public hospital(s). Main funding source(s): Centro Hospitalar Vila Nova de Gaia / Espinho
Collapse
Affiliation(s)
- G Silva
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - C Espada Guerreiro
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | | | - P Ribeiro Queiros
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - M Ribeiro Da Silva
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - M Brandao
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - D Ferreira
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - G Pires-Morais
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - L Santos
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - B Melica
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - A Rodrigues
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - P Braga
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - F Sampaio
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - R Fontes-Carvalho
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| |
Collapse
|
12
|
Ineichen BV, Moridi T, Ewing E, Ouellette R, Manouchehrinia A, Stawiarz L, Ferreira D, Muehlboeck SJ, Kuhle J, Westman E, Leppert D, Hillert J, Olsson T, Kockum I, Piehl F, Granberg T. Neurofilament light chain as a marker for cortical atrophy in multiple sclerosis without radiological signs of disease activity. J Intern Med 2021; 290:473-476. [PMID: 33871105 DOI: 10.1111/joim.13286] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/11/2021] [Accepted: 03/12/2021] [Indexed: 11/27/2022]
Affiliation(s)
- B V Ineichen
- From the, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden
| | - T Moridi
- From the, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Center of Neurology, Academic Specialist Center, Stockholm Health Services, Stockholm, Sweden
| | - E Ewing
- From the, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - R Ouellette
- From the, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden
| | - A Manouchehrinia
- From the, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - L Stawiarz
- From the, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - D Ferreira
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - S J Muehlboeck
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - J Kuhle
- Neurologic Clinic and Policlinic, Departments of Medicine, University Hospital Basel and University of Basel, Basel, Switzerland
| | - E Westman
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Department of Neuroimaging, Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - D Leppert
- Neurologic Clinic and Policlinic, Departments of Medicine, University Hospital Basel and University of Basel, Basel, Switzerland
| | - J Hillert
- From the, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Department of Neurology, Karolinska University Hospital, Stockholm, Sweden
| | - T Olsson
- From the, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - I Kockum
- From the, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - F Piehl
- From the, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Center of Neurology, Academic Specialist Center, Stockholm Health Services, Stockholm, Sweden
| | - T Granberg
- From the, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden
| |
Collapse
|
13
|
Sugito S, Ferreira D, Hardy J, Turner S, Boyle A, Cooke H. Global longitudinal strain and mechanical dispersion at rest in exercise stress echocardiography for detecting obstructive coronary artery disease: a pilot study. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
BACKGROUND
Exercise stress echocardiography (ESE) is a commonly used investigation for risk stratification in coronary artery disease (CAD). The added value of resting indices such as Global Longitudinal Strain (GLS) and Mechanical Dispersion (MD) to detect obstructive CAD is not well established and would be of significant clinical benefit.
PURPOSE
To evaluate the diagnostic value of GLS and MD at rest and post-exercise during ESE to detect obstructive CAD, defined by angiographic stenosis >70% in any major coronary artery.
METHODS
Retrospective cohort study of 80 consecutive patients who underwent ESE and had coronary angiography (invasive or CT) within 6 months. Retrospective speckle tracking strain analysis was performed on digitally archived video-loops, using vendor independent software. Data on demographics, medications, outcomes and ESE characteristics were collected and analysed.
RESULTS
In 49 (61.3%) patients with any CAD >70%, GLS at rest was lower (-13.9% ± 4.2 vs -16.1% ± 5.2, p-value = 0.04), and MD at rest was higher (81ms ± 43 vs 58ms ± 28, p-value = 0.008), when compared to patients without CAD >70%. GLS and MD measured post-exercise were not significantly different between groups. Ejection fraction (EF) and Wall Motion Score Index (WMSI) at rest and post-exercise were not significantly different between groups. A resting GLS cutpoint of -14% had a sensitivity and specificity of 57/68%, comparable to the development of new regional wall motion abnormalities (71/39%) and peak WMSI >1.2 (59/48%). Additionally, in 39 (48.8%) patients who had >70% stenosis in the left anterior descending (LAD) artery, LS in the LAD territory segments was lower (-16.2% ± 4.4 vs -18.3% ± 4.7, p-value = 0.04), when compared to patients without >70% stenosis in the LAD artery.
CONCLUSION
Resting GLS was lower and MD higher in patients undergoing ESE, who have any CAD >70% compared to patients who do not have any CAD >70%. Resting GLS and MD may increase diagnostic accuracy during ESE to predict obstructive CAD. Further prospective studies evaluating the utility of resting indices to predict functionally significant CAD are required.
Collapse
Affiliation(s)
- S Sugito
- John Hunter Hospital, Newcastle, Australia
| | - D Ferreira
- John Hunter Hospital, Newcastle, Australia
| | - J Hardy
- John Hunter Hospital, Newcastle, Australia
| | - S Turner
- John Hunter Hospital, Newcastle, Australia
| | - A Boyle
- John Hunter Hospital, Newcastle, Australia
| | - H Cooke
- John Hunter Hospital, Newcastle, Australia
| |
Collapse
|
14
|
Soomro A, Ferreira D, Elashri I, McGee M. The Use of PCSK9 Inhibitors in Treating Statin Induced Necrotising Myositis. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.398] [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]
|
15
|
Ribeiro C, Conde S, Oliveira P, Nogueira C, Ferreira D, Adler D, Windisch W, Nunes R. Portuguese adaptation of the S3-non-invasive ventilation (S3-NIV) questionnaire for home mechanically ventilated patients. Pulmonology 2020; 28:262-267. [PMID: 33388296 DOI: 10.1016/j.pulmoe.2020.11.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 10/31/2020] [Accepted: 11/01/2020] [Indexed: 10/22/2022] Open
Abstract
Short, valid and easy to use tools are needed to monitor non-invasive ventilation in clinical practice and for organization of home mechanical ventilation services. The aim of this study was to develop a professional translation and cultural adaptation of the Portuguese S3 non-invasive ventilation questionnaire. 234 stable patients (128 male patients, 53.8%) with a mean age of 69.3 years under long-term home non-invasive ventilation were recruited from a single-center outpatient clinic. The most frequent diagnostic groups were obesity hypoventilation syndrome, chronic obstructive pulmonary disease and restrictive chest wall disorders. The Portuguese version of the questionnaire was obtained using translation back-translation process with two professional translators. Internal consistency for the total score was good (Cronbach's α coefficient of 0.76) as well as for the "respiratory symptoms" and the "sleep and side effects" domains (Cronbach's α coefficient=0.68 and Cronbach's α coefficient=0.72, respectively). An exploratory factor analysis was performed leading to an explained variance of 54.6%, and resulted in 3 components. The Portuguese version of the S3-NIV questionnaire is a simple and valid tool for the routine clinical assessment of patients receiving home NIV.
Collapse
Affiliation(s)
- C Ribeiro
- Serviço de Pneumologia - Centro Hospitalar de Vila Nova de Gaia/Espinho, Portugal.
| | - S Conde
- Serviço de Pneumologia - Centro Hospitalar de Vila Nova de Gaia/Espinho, Portugal
| | - P Oliveira
- ISPUP-EPIUnit, Instituto de Ciências Biomédicas de Abel Salazar, Universidade do Porto, Portugal
| | - C Nogueira
- Serviço de Pneumologia - Centro Hospitalar de Vila Nova de Gaia/Espinho, Portugal
| | - D Ferreira
- Serviço de Pneumologia - Centro Hospitalar de Vila Nova de Gaia/Espinho, Portugal
| | - D Adler
- Division of Lung Diseases, Geneva University Hospitals, Geneva, Switzerland; University of Geneva Medical School, Geneva, Switzerland
| | - W Windisch
- Department of Pneumology, Cologne Merheim Hospital, Kliniken der Stadt Köln gGmbH, Witten/Herdecke University, Faculty of Health/School of Medicine, Cologne, Germany
| | - R Nunes
- Faculdade de Medicina da Universidade do Porto, Portugal
| |
Collapse
|
16
|
Ribeiro Da Silva M, Rodrigues A, Guerreiro C, Mosalina Manuel A, Santos Silva G, Teixeira P, Ribeiro Queiros P, Brandao M, Ferreira D, Caeiro D, Dias A, Sousa O, Oliveira M, Primo J, Braga P. Early discharge after TAVI: should we still be afraid of conduction disturbances? Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2603] [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
Conduction disturbances (CD) after TAVI remains the most frequent complication of the procedure, frequently increasing the length of hospital stay. A lack of consensus exists regarding in-hospital management of CD post-TAVI.
Purpose
To evaluate if an early discharge (ED) protocol could be safely implemented in patients (pts) with CD post-TAVI.
Methods
Retrospective study of all pts submitted to TAVI between 2016 and 2018. Pts with prior permanent pacemaker (PP) and non-transfemoral approach were excluded. ECG data before, immediately after the procedure and at day 3 post-TAVI were collected, and continuous telemetry monitoring was recorded. We applied a recently proposed ED algorithm (adapted from Management of Conduction Disturbances Associated With Transcatheter Aortic Valve Replacement - JACC Scientific Expert Panel; JACC 2019; 74(8):1086–106) to identify which pts could have been candidates for ED. ED was defined as discharge in the first 72 hours (h) after the procedure. We evaluated if an ED strategy would have been safe at 1-year follow-up (FUP), as defined by the absence of need for PP, syncope and mortality.
Results
242 pts were included, 44,8% males, mean age 80,4 years, mean Euroscore II 5,4 and the majority implanted a self-expandable prosthesis (64,1%). Mean hospital stay after TAVI was 7,7 days. The most frequent CD after TAVI were: new onset left bundle brunch block (36%) and high degree atrioventricular block (HAVB) (16,3%). During hospital stay 21,6% needed PP, mainly because of HAVB (mainly implanted in the first 72h).
According to the proposed algorithm, 70,7% of our pts were ED-candidates. ED-candidates had lower prevalence of predilation (18,5% vs 36,8%, p=0,008) with no significant differences between type of prosthesis or baseline ECG. ED-candidates had smaller PR interval post-TAVI (184,5 vs 202,5 ms, p=0,044) and smaller PR and QRS at 72h (p<0,001 in both).
At 1-year FUP, only 2,3% of ED-candidates needed a PP (vs 37,7% non-ED, p<0,001). It is noteworthy that in those ED-candidates who needed a PP during FUP, the percentage of ventricular pacing was less than 2% at 6 months. In the FUP period, 3,2% of ED candidates presented at the ER because of syncope, with no significant differences to non-ED pts. No differences between groups were found in 30-days and 1-year ER presentation because of syncope or all-cause mortality.
Conclusions
According to the proposed algorithm for ED in pts with CD post-TAVI, pts with specific ECG characteristics and without rhythm events during continuous telemetry monitoring can be early discharged with long-term safety.
Funding Acknowledgement
Type of funding source: None
Collapse
Affiliation(s)
- M Ribeiro Da Silva
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - A Rodrigues
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - C Guerreiro
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - A Mosalina Manuel
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - G Santos Silva
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - P Teixeira
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - P Ribeiro Queiros
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - M Brandao
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - D Ferreira
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - D Caeiro
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - A Dias
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - O Sousa
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - M Oliveira
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - J Primo
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - P Braga
- Hospital Center of Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| |
Collapse
|
17
|
Ourô S, Albergaria D, Ferreira MP, Costeira B, Roquete P, Ferreira D, Maio R. Transanal total mesorectal excision: 3-year oncological outcomes. Tech Coloproctol 2020; 25:205-213. [PMID: 33113009 DOI: 10.1007/s10151-020-02362-y] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 10/16/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Rectal cancer treatment has evolved with the implementation of new surgical techniques. Transanal total mesorectal excision (TaTME) is the most recent approach developed to facilitate pelvic dissection of mid- and distal rectal tumours. The purpose of this study was to analyse the short- and mid-term oncological outcomes of TaTME. METHODS A study was conducted on patients treated with TaTME for rectal cancer at two colorectal units in Portugal between March 2016 and December 2018. Clinical, pathological and oncological data were retrospectively analysed. Primary endpoints were 3-year overall survival, disease-free survival and local recurrence. Secondary endpoints were clinical and pathological outcomes. RESULTS Fifty patients (31 males, [62%], median age 66 years [range 40-85 years]) underwent TaTME, 49 (98%) for malignant and 1 (2%) for benign disease. There were no cases of conversion, 49 (98%) patients had complete or near-complete mesorectum, all the resections were R0 with adequate distal and circumferential margins. With a median follow-up of 36 months, there were 2 cases (4%) of local recurrence and 3-year estimated overall survival and disease-free survival were 90% and 79%, respectively. CONCLUSIONS TaTME can provide safe mid-term oncological outcomes, similar to what has been published for classic and laparoscopic TME. Our results also show how demanding this novel approach can be and the consequent need for audited data and standardized implementation.
Collapse
Affiliation(s)
- S Ourô
- Surgical Department of Hospital Beatriz Ângelo, Loures, Portugal.
- NOVA Medical School, Lisbon, Portugal.
- Surgical Department, Hospital Beatriz Ângelo, Avenida Carlos Teixeira 514, Loures, Portugal.
| | - D Albergaria
- Surgical Department of Hospital Beatriz Ângelo, Loures, Portugal
- NOVA Medical School, Lisbon, Portugal
| | - M P Ferreira
- Surgical Department of Hospital Beatriz Ângelo, Loures, Portugal
| | - B Costeira
- Surgical Department of Hospital Beatriz Ângelo, Loures, Portugal
| | - P Roquete
- Surgical Department of Hospital da Luz, Lisbon, Portugal
| | - D Ferreira
- Surgical Department of Hospital da Luz, Lisbon, Portugal
| | - R Maio
- Surgical Department of Hospital Beatriz Ângelo, Loures, Portugal
- NOVA Medical School, Lisbon, Portugal
| |
Collapse
|
18
|
Soares C, Ferreira D, Araújo R. Gender analysis of 'man-in-the-barrel' syndrome: is 'person-in-the-barrel' a more adequate term? Eur J Neurol 2020; 28:341-343. [PMID: 32961582 DOI: 10.1111/ene.14551] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 09/15/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND PURPOSE Gender bias is a known issue in healthcare and academia. We analysed the gender of patients reported in the literature with 'man-in-the-barrel' syndrome or equivalent semiological terms. METHODS A search in the PubMed database was conducted using the terms 'man-in-the-barrel', 'person-in-the-barrel', 'woman-in-the-barrel', 'brachial diplegia', 'flail arm' and 'cruciate paralysis'. All articles published between 1969 and 2020 containing a detailed description compatible with the original description of man-in-the-barrel syndrome were included. RESULTS Ninety-five patients with a clinical picture compatible with man-in-the-barrel syndrome were included. Up to 33% of patients were female. Overall, the proportion of female patients with man-in-the-barrel syndrome was 25%. DISCUSSION AND CONCLUSIONS The term man-in-the-barrel may disenfranchise up to a third of women presenting with brachial diplegia with undesirable consequences. We propose a gender-neutral alternative such as 'person-in-the-barrel'.
Collapse
Affiliation(s)
- C Soares
- Department of Neurology, Centro Hospitalar Universitário São João, EPE, Porto, Portugal.,Department of Clinic Neurosciences and Mental Health, Faculty of Medicine of University of Porto, Porto, Portugal
| | - D Ferreira
- Department of Neurology, Centro Hospitalar Universitário São João, EPE, Porto, Portugal.,Department of Clinic Neurosciences and Mental Health, Faculty of Medicine of University of Porto, Porto, Portugal
| | - R Araújo
- Department of Neurology, Centro Hospitalar Universitário São João, EPE, Porto, Portugal.,Department of Clinic Neurosciences and Mental Health, Faculty of Medicine of University of Porto, Porto, Portugal
| |
Collapse
|
19
|
Sá R, Pinho-Bandeira T, Queiroz G, Ferreira D, Lopes P, Leitão R, Pedroso MJ. Food safety in canteens: a public health programme in Aveiro region (Portugal) in 2018 and 2019. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.187] [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
Each year, 23 million people get ill from unsafe food in Europe. Food safety refers to the absence or safe acceptable levels of hazards in food that may harm the health of consumers. The Public Health Unit of Baixo Vouga Primary Healthcare Cluster (Aveiro region) developed a programme to identify hazards and promote implementation of corrective measures in community canteens that serve children and elderly. It has three fields of action: qualitative evaluation of the installation and operating conditions, based on the legislation; microbiological surveillance of food and utensils; training of food handlers and managers. This study aims to describe the results of such programme in 2018 and 2019.
Methods
This cross-sectional study used data from qualitative evaluation and microbiological results for a descriptive analysis. Additionally, an assess of the compliance of the critical points was performed to identify the main barriers in achieving the proposed targets.
Results
From a total of 420 registered canteens, 211 and 294 were evaluated in 2018 and 2019, respectively. For these years, only 87 (41.2%) and 124 (33.3%) fully complied with all critical points. The main problems were the lack of non-manual activation system in wash basins and faucets and inadequately instructed food handlers about required hygiene measures. Microbiological surveillance results of 371 and 393 samples had a proportion of satisfactory or acceptable results of: 93.5% and 91.3% for the main dish; 56.1% and 46.6% for the salads and 82.4% and 79.8% for the utensils. Coliform bacteria were the most common agent.
Conclusions
The compliances with critical points were low, accounting for the fact they are legislation-based. The microbiological results were worst for the salads' samples. Deviations give us hints of what should be reinforced. Education of the food handlers and consulting with companies to improve procedures and equipment could be of great use.
Key messages
Community canteens’ compliances with legislated criteria were low. This programme is useful in identifying vulnerabilities and may lead to the implementation of corrective measures.
Collapse
Affiliation(s)
- R Sá
- Public Health Unit, Baixo Vouga Primary Healthcare Cluster, Aveiro Region, Portugal
| | - T Pinho-Bandeira
- Public Health Unit, Baixo Vouga Primary Healthcare Cluster, Aveiro Region, Portugal
| | - G Queiroz
- Public Health Unit, Baixo Vouga Primary Healthcare Cluster, Aveiro Region, Portugal
| | - D Ferreira
- Public Health Unit, Baixo Vouga Primary Healthcare Cluster, Aveiro Region, Portugal
| | - P Lopes
- Public Health Unit, Baixo Vouga Primary Healthcare Cluster, Aveiro Region, Portugal
| | - R Leitão
- Public Health Unit, Baixo Vouga Primary Healthcare Cluster, Aveiro Region, Portugal
| | - M J Pedroso
- Public Health Unit, Baixo Vouga Primary Healthcare Cluster, Aveiro Region, Portugal
| |
Collapse
|
20
|
Reiné J, Cooper K, Sewell A, Lyall J, Thorbinson C, Hincks E, Ferreira DM, Pizer B, Morton B. Neutrophil function is impaired in paediatric patients with malignancy and may be a useful clinical marker. Clin Transl Oncol 2020; 22:2121-2125. [PMID: 32410117 DOI: 10.1007/s12094-020-02362-2] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 04/28/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE Patients treated with cytotoxic chemotherapy are at risk of neutropenia, neutropenic fever and neutropenic sepsis. We hypothesised that pre-existing neutrophil function dysfunction may increase susceptibility to neutropenic fever in paediatric patients receiving cytotoxic chemotherapy. METHODS Prospective cohort study recruited patients at Alder Hey Children's NHS Foundation Trust, United Kingdom. We measured neutrophil phagocytic function using a validated flow cytometric whole blood phagocytosis assay in paediatric patients (n = 16) with oncological disease before and after chemotherapy in a prospective cohort study. We recruited healthy children as a control comparator (n = 10). RESULTS We found significantly decreased phagocytic function in oncology patients compared to healthy participants. In five patients who developed neutropenic fever, we observed increased pre-dose neutrophil respiratory burst. CONCLUSION With further validation, measurement of neutrophil function could potentially be used to personalise appropriate prophylactic antimicrobial administration for patients receiving cytotoxic chemotherapy.
Collapse
Affiliation(s)
- J Reiné
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - K Cooper
- Department of Paediatric Oncology, Alder Hey Children's Hospital, Liverpool, UK
| | - A Sewell
- Department of Paediatric Oncology, Alder Hey Children's Hospital, Liverpool, UK
| | - J Lyall
- Department of Paediatric Oncology, Alder Hey Children's Hospital, Liverpool, UK
| | - C Thorbinson
- Department of Paediatric Oncology, Alder Hey Children's Hospital, Liverpool, UK
| | - E Hincks
- Department of Paediatric Oncology, Alder Hey Children's Hospital, Liverpool, UK
| | - D M Ferreira
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - B Pizer
- Department of Paediatric Oncology, Alder Hey Children's Hospital, Liverpool, UK
| | - B Morton
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.
- Lung Health Group, Malawi-Liverpool Wellcome Trust Clinical Research Programme, Blantyre, Malawi.
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK.
| |
Collapse
|
21
|
Reiné J, Rylance J, Ferreira DM, Pennington SH, Welters ID, Parker R, Morton B. The whole blood phagocytosis assay: a clinically relevant test of neutrophil function and dysfunction in community-acquired pneumonia. BMC Res Notes 2020; 13:203. [PMID: 32268927 PMCID: PMC7140487 DOI: 10.1186/s13104-020-05034-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 03/19/2020] [Indexed: 01/01/2023] Open
Abstract
Objective To refine and validate a neutrophil function assay with clinical relevance for patients with community-acquired pneumonia (CAP). Design Two phase cross-sectional study to standardise and refine the assay in blood from healthy volunteers and test neutrophil phagocytic function in hospital patients with CAP. Participants Phase one: Healthy adult volunteers (n = 30). Phase two: Critical care patients with severe CAP (n = 16), ward-level patients with moderate CAP (n = 15) and respiratory outpatients (no acute disease, n = 15). Results Our full standard operating procedure for the assay is provided. Patients with severe CAP had significantly decreased neutrophil function compared to moderate severity disease (median phagocytic index 2.8 vs. 18.0, p = 0.014). Moderate severity pneumonia neutrophil function was significantly higher than control samples (median 18.0 vs. 1.6, p = 0.015). There was no significant difference between critical care and control neutrophil function (median 2.8 vs. 1.6, p = 0.752). Conclusions Our whole blood neutrophil assay is simple, reproducible and clinically relevant. Changes in neutrophil function measured in this pneumonia cohort is in agreement with previous studies. The assay has potential to be used to identify individuals for clinical trials of immunomodulatory therapies, to risk-stratify patients with pneumonia, and to refine our understanding of ‘normal’ neutrophil function in infection.
Collapse
Affiliation(s)
- J Reiné
- Clinical Sciences Department, Liverpool School of Tropical Medicine (LSTM), Liverpool, UK.
| | - J Rylance
- Clinical Sciences Department, Liverpool School of Tropical Medicine (LSTM), Liverpool, UK.,Lung Health Group, Malawi Liverpool Wellcome Trust Clinical Research Programme, Queen Elizabeth Central Hospital, College of Medicine, P.O. BOX 30096, Chichiri, Blantyre, Malawi
| | - D M Ferreira
- Clinical Sciences Department, Liverpool School of Tropical Medicine (LSTM), Liverpool, UK
| | - S H Pennington
- Clinical Sciences Department, Liverpool School of Tropical Medicine (LSTM), Liverpool, UK
| | - I D Welters
- Critical Care Department, Royal Liverpool University Hospital, Liverpool, UK
| | - R Parker
- Critical Care Department, Aintree University Hospital NHS Foundation Trust, Liverpool, UK
| | - B Morton
- Clinical Sciences Department, Liverpool School of Tropical Medicine (LSTM), Liverpool, UK.,Critical Care Department, Aintree University Hospital NHS Foundation Trust, Liverpool, UK.,Lung Health Group, Malawi Liverpool Wellcome Trust Clinical Research Programme, Queen Elizabeth Central Hospital, College of Medicine, P.O. BOX 30096, Chichiri, Blantyre, Malawi
| |
Collapse
|
22
|
De Ste Croix M, Mitsi E, Morozov A, Glenn S, Andrew PW, Ferreira DM, Oggioni MR. Phase variation in pneumococcal populations during carriage in the human nasopharynx. Sci Rep 2020; 10:1803. [PMID: 32019989 PMCID: PMC7000782 DOI: 10.1038/s41598-020-58684-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 12/28/2019] [Indexed: 11/10/2022] Open
Abstract
Streptococcus pneumoniae is one of the world's leading bacterial pathogens, responsible for pneumonia, septicaemia and meningitis. Asymptomatic colonisation of the nasopharynx is considered to be a prerequisite for these severe infections, however little is understood about the biological changes that permit the pneumococcus to switch from asymptomatic coloniser to invasive pathogen. A phase variable type I restriction-modification (R-M) system (SpnIII) has been linked to a change in capsule expression and to the ability to successfully colonise the murine nasopharynx. Using our laboratory data, we have developed a Markov change model that allows prediction of the expected level of phase variation within a population, and as a result measures when populations deviate from those expected at random. Using this model, we have analysed samples from the Experimental Human Pneumococcal Carriage (EHPC) project. Here we show, through mathematical modelling, that the patterns of dominant SpnIII alleles expressed in the human nasopharynx are significantly different than those predicted by stochastic switching alone. Our inter-disciplinary work demonstrates that the expression of alternative methylation patterns should be an important consideration in studies of pneumococcal colonisation.
Collapse
Affiliation(s)
- M De Ste Croix
- Department of Genetics and Genome Biology, University of Leicester, University Rd, Leicester, LE1 7RH, United Kingdom
| | - E Mitsi
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Pl, Liverpool, L3 5QA, United Kingdom
| | - A Morozov
- Department of Mathematics, University of Leicester, University Rd, Leicester, LE1 7RH, United Kingdom
- Institute of Ecology and Evolution, Russian Academy of Sciences, 33 Leninskii pr., Moscow, 119071, Russia
| | - S Glenn
- Department of Respiratory Sciences, University of Leicester, University Rd, Leicester, LE1 7RH, United Kingdom
| | - P W Andrew
- Department of Respiratory Sciences, University of Leicester, University Rd, Leicester, LE1 7RH, United Kingdom
| | - D M Ferreira
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Pl, Liverpool, L3 5QA, United Kingdom
| | - M R Oggioni
- Department of Genetics and Genome Biology, University of Leicester, University Rd, Leicester, LE1 7RH, United Kingdom.
| |
Collapse
|
23
|
Ferreira D, Ng R, Lai E, Collins N, Thompson-Bowe K, Kehr J, Singh D. 668 Kawasaki Disease in the Australian Population: The John Hunter Hospital Experience. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.675] [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]
|
24
|
Ferreira D, Le A, Khoo J, Nguyen P, Juergens C, Spicer T, Jain M. 624 Surgical Management of Right Atrial Mass Associated With a Vascular Access Catheter. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.631] [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: 11/26/2022]
|
25
|
Sugito S, Ferreira D, Hardy J, Cooke H. 418 The Role of Global Longitudinal Strain at Rest During Exercise Stress Echocardiography to Predict Significant Coronary Artery Disease. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.425] [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]
|
26
|
Alen Coutinho I, Ferreira D, Regateiro FS, Pita J, Ferreira M, Martins JF, Fonseca IA, Loureiro C, Todo-Bom A. Anaphylaxis in an emergency department: a retrospective 10-year study in a tertiary hospital. Eur Ann Allergy Clin Immunol 2019; 52:23-34. [PMID: 31287264 DOI: 10.23822/eurannaci.1764-1489.98] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 11/17/2022]
Abstract
Summary Background. Anaphylaxis is a potentially fatal medical emergency. The frequency of hospital admissions for anaphylaxis seems to be increasing in the recent decades. Objective. Characterize the patients admitted for anaphylaxis to the adult emergency department (ED) of a tertiary care hospital over a 10-year period, discriminating aetiologies, clinical features and therapy administered. Methods. Retrospective, descriptive and inferential study, evaluating age, sex, Manchester triage system, suspected allergen, site of allergen exposure, comorbidities, cofactors, clinical findings and symptoms, treatment and management. Patients admitted between January 2007 and December 2016 were included. Results. Forty-three patients were enrolled: 23 males, mean age 54.3 ± 16.2 years, n = 22 had history of allergic disease. Two patients were triaged as non-urgent. The most frequently suspected causes of anaphylaxis were: drugs (33%, n = 14), Hymenoptera venoms (23%, n = 10), foods (21%, n = 9) and iodinated contrast products (12%, n = 5). Adrenaline was used in 88% of the episodes (n = 38), 55% of which (n = 21) intramuscularly. Mortality was registered in one case. At discharge, adrenaline auto-injector was prescribed in 7% (n = 3) of the patients, and Allergy and Clinical Immunology consultation (ACIC) was requested in 65% of the episodes (n = 28). Statistically significant associations (p minor 0.05) were established: a, anaphylaxis to drugs associated with a low intramuscular adrenaline use and with frequent oxygen therapy; b, anaphylaxis to food associated with intramuscular adrenaline administration; c, anaphylaxis to Hymenoptera venom associated with male sex; and d, anaphylaxis to iodinated contrasts associated with referral to ACIC and with shock. All obese patients developed shock. Conclusions. Anaphylaxis is a life-threatening condition that requires early recognition. Although most patients received adrenaline, administration was not always performed by the recommended route and only a few patients were prescribed adrenaline auto-injector.
Collapse
Affiliation(s)
- I Alen Coutinho
- Serviço de Imunoalergologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - D Ferreira
- Serviço de Medicina Interna, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - F S Regateiro
- Serviço de Imunoalergologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - J Pita
- Serviço de Imunoalergologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - M Ferreira
- Serviço de Medicina Interna, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - J F Martins
- Serviço de Medicina Intensiva, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - I A Fonseca
- Serviço de Urgência, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - C Loureiro
- Serviço de Imunoalergologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - A Todo-Bom
- Serviço de Imunoalergologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| |
Collapse
|
27
|
Gao M, Vilayur E, Ferreira D. SAT-319 ESTIMATING GFR IN PREGNANCY: COMPARISON BETWEEN 24-HOUR CREATININE CLEARANCE RATE AND NANRA EQUATION. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.362] [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: 10/26/2022] Open
|
28
|
German EL, Solórzano C, Sunny S, Dunne F, Gritzfeld JF, Mitsi E, Nikolaou E, Hyder-Wright AD, Collins AM, Gordon SB, Ferreira DM. Protective effect of PCV vaccine against experimental pneumococcal challenge in adults is primarily mediated by controlling colonisation density. Vaccine 2019; 37:3953-3956. [PMID: 31176540 PMCID: PMC6611220 DOI: 10.1016/j.vaccine.2019.05.080] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 05/20/2019] [Accepted: 05/28/2019] [Indexed: 11/03/2022]
Abstract
Widespread use of Pneumococcal Conjugate Vaccines (PCV) has reduced vaccine-type nasopharyngeal colonisation and invasive pneumococcal disease. In a double-blind, randomised controlled trial using the Experimental Human Pneumococcal Challenge (EHPC) model, PCV-13 (Prevenar-13) conferred 78% protection against colonisation acquisition and reduced bacterial intensity (AUC) as measured by classical culture. We used a multiplex qPCR assay targeting lytA and pneumococcal serotype 6A/B cpsA genes to re-assess the colonisation status of the same volunteers. Increase in detection of low-density colonisation resulted in reduced PCV efficacy against colonisation acquisition (29%), compared to classical culture (83%). For experimentally colonised volunteers, PCV had a pronounced effect on decreasing colonisation density. These results obtained in adults suggest that the success of PCV vaccination could primarily be mediated by the control of colonisation density. Studies assessing the impact of pneumococcal vaccines should allow for density measurements in their design.
Collapse
Affiliation(s)
- E L German
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
| | - C Solórzano
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
| | - S Sunny
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
| | - F Dunne
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
| | - J F Gritzfeld
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
| | - E Mitsi
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
| | - E Nikolaou
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
| | | | - A M Collins
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
| | - S B Gordon
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
| | - D M Ferreira
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
| |
Collapse
|
29
|
Ferreira D, Vivot A, Meyer N. Méthodes bayésiennes dans les essais contrôlés randomisés de phase III : une revue systématique. Rev Epidemiol Sante Publique 2019. [DOI: 10.1016/j.respe.2019.03.011] [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] Open
|
30
|
Ferreira D, Barthoulot M, Pottecher J, Diemunsch P, Meyer N. Une checklist pour les essais cliniques analysés en Bayésien. Rev Epidemiol Sante Publique 2019. [DOI: 10.1016/j.respe.2019.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
31
|
Marcos-Figueiredo P, Ferreira D, Ferreira C, Pereira E, Branco M. Fetal anaemia: two clinical cases with fetal blood transfusion. CLIN EXP OBSTET GYN 2019. [DOI: 10.12891/ceog4415.2019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
|
32
|
Escudeiro A, Ferreira D, Mendes-da-Silva A, Heslop-Harrison JS, Adega F, Chaves R. Bovine satellite DNAs – a history of the evolution of complexity and its impact in the Bovidae family. The European Zoological Journal 2019. [DOI: 10.1080/24750263.2018.1558294] [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: 10/27/2022] Open
Affiliation(s)
- A. Escudeiro
- Department of Genetics and Biotechnology (DGB), CAG – Laboratory of Cytogenomics and Animal Genomics (CAG), University of Trás-os-Montes e Alto Douro (UTAD), Vila Real, Portugal
- Biosystems & Integrative Sciences Institute (BioISI), Faculty of Sciences, University of Lisboa, Lisboa, Portugal
| | - D. Ferreira
- Department of Genetics and Biotechnology (DGB), CAG – Laboratory of Cytogenomics and Animal Genomics (CAG), University of Trás-os-Montes e Alto Douro (UTAD), Vila Real, Portugal
- Biosystems & Integrative Sciences Institute (BioISI), Faculty of Sciences, University of Lisboa, Lisboa, Portugal
| | - A. Mendes-da-Silva
- Department of Genetics and Biotechnology (DGB), CAG – Laboratory of Cytogenomics and Animal Genomics (CAG), University of Trás-os-Montes e Alto Douro (UTAD), Vila Real, Portugal
- Biosystems & Integrative Sciences Institute (BioISI), Faculty of Sciences, University of Lisboa, Lisboa, Portugal
| | | | - F. Adega
- Department of Genetics and Biotechnology (DGB), CAG – Laboratory of Cytogenomics and Animal Genomics (CAG), University of Trás-os-Montes e Alto Douro (UTAD), Vila Real, Portugal
- Biosystems & Integrative Sciences Institute (BioISI), Faculty of Sciences, University of Lisboa, Lisboa, Portugal
| | - R. Chaves
- Department of Genetics and Biotechnology (DGB), CAG – Laboratory of Cytogenomics and Animal Genomics (CAG), University of Trás-os-Montes e Alto Douro (UTAD), Vila Real, Portugal
- Biosystems & Integrative Sciences Institute (BioISI), Faculty of Sciences, University of Lisboa, Lisboa, Portugal
| |
Collapse
|
33
|
Ferreira M, Pinto M, Ferreira D, Esperto H, Verissimo M, Carvalho A. Statin therapy in very frail older adults. Atherosclerosis 2018. [DOI: 10.1016/j.atherosclerosis.2018.06.235] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
34
|
Pessoa T, Pessoa A, Aguiar P, Pessoa R, Moura A, Ferreira D, Távora F, Pessoa F, Pessoa R. Analysis of echoendoscopic punctures of a solid pancreatic lesions in a private institution in Brazil. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy151.170] [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
|
35
|
Pereira C, Ferreira D, Granja P, Almeida G, Oliveira C. PO-501 Deconstructing the role of CD44 in gastric cancer resistance to cisplatin. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.517] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
36
|
Carrascal MA, Silva M, Ferreira JA, Azevedo R, Ferreira D, Silva AMN, Ligeiro D, Santos LL, Sackstein R, Videira PA. A functional glycoproteomics approach identifies CD13 as a novel E-selectin ligand in breast cancer. Biochim Biophys Acta Gen Subj 2018; 1862:2069-2080. [PMID: 29777742 DOI: 10.1016/j.bbagen.2018.05.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 05/12/2018] [Accepted: 05/15/2018] [Indexed: 01/02/2023]
Abstract
BACKGROUND The glycan moieties sialyl-Lewis-X and/or -A (sLeX/A) are the primary ligands for E-selectin, regulating subsequent tumor cell extravasation into distant organs. However, the nature of the glycoprotein scaffolds displaying these glycans in breast cancer remains unclear and constitutes the focus of the present investigation. METHODS We isolated glycoproteins that bind E-selectin from the CF1_T breast cancer cell line, derived from a patient with ductal carcinoma. Proteins were identified using bottom-up proteomics approach by nanoLC-orbitrap LTQ-MS/MS. Data were curated using bioinformatics tools to highlight clinically relevant glycoproteins, which were validated by flow cytometry, Western blot, immunohistochemistry and in-situ proximity ligation assays in clinical samples. RESULTS We observed that the CF1_T cell line expressed sLeX, but not sLeA and the E-selectin reactivity was mainly on N-glycans. MS and bioinformatics analysis of the targeted glycoproteins, when narrowed down to the most clinically relevant species in breast cancer, identified CD44 glycoprotein (HCELL) and CD13 as key E-selectin ligands. Additionally, the co-expression of sLeX-CD44 and sLeX-CD13 was confirmed in clinical breast cancer tissue samples. CONCLUSIONS Both CD44 and CD13 glycoforms display sLeX in breast cancer and bind E-selectin, suggesting a key role in metastasis development. Such observations provide a novel molecular rationale for developing targeted therapeutics. GENERAL SIGNIFICANCE While HCELL expression in breast cancer has been previously reported, this is the first study indicating that CD13 functions as an E-selectin ligand in breast cancer. This observation supports previous associations of CD13 with metastasis and draws attention to this glycoprotein as an anti-cancer target.
Collapse
Affiliation(s)
- M A Carrascal
- UCIBIO, Departamento Ciências da Vida, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, Portugal; CEDOC, Chronic Diseases Research Center, NOVA Medical School/Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - M Silva
- CEDOC, Chronic Diseases Research Center, NOVA Medical School/Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, Lisbon, Portugal; Departments of Dermatology and Medicine, Brigham & Women's Hospital, and Program of Excellence in Glycosciences, Harvard Medical School, USA
| | - J A Ferreira
- Experimental Pathology and Therapeutics Group, Portuguese Institute of Oncology, Porto, Portugal; Glycobiology in Cancer, Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), Porto, Portugal; Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Portugal; International Iberian Nanotechnology Laboratory, Braga, Portugal; Department of Pathology and Immunology, ICBAS-UP, Porto, Portugal
| | - R Azevedo
- Experimental Pathology and Therapeutics Group, Portuguese Institute of Oncology, Porto, Portugal
| | - D Ferreira
- Experimental Pathology and Therapeutics Group, Portuguese Institute of Oncology, Porto, Portugal
| | - A M N Silva
- REQUIMTE-LAQV/Departamento de Química e Bioquímica, Faculdade de Ciências, Universidade do Porto, Portugal
| | - D Ligeiro
- Centro de Sangue e Transplantação de Lisboa, Instituto Português de Sangue e Transplantação, IP, Lisboa, Portugal
| | - L L Santos
- Experimental Pathology and Therapeutics Group, Portuguese Institute of Oncology, Porto, Portugal
| | - R Sackstein
- Departments of Dermatology and Medicine, Brigham & Women's Hospital, and Program of Excellence in Glycosciences, Harvard Medical School, USA
| | - P A Videira
- UCIBIO, Departamento Ciências da Vida, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, Portugal; CEDOC, Chronic Diseases Research Center, NOVA Medical School/Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, Lisbon, Portugal; Professionals and Patient Associations International Network (CDG & Allies-PPAIN), Departamento Ciências da Vida, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, 2820-287 Lisboa, Portugal.
| |
Collapse
|
37
|
McGee M, Ferreira D, Davies A, Tvedten O, Turner S, Boyle A. Specificity of Myocardial Perfusion Imaging. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
38
|
Vala H, Pina R, Cruz R, Venancio C, Esteves F, Silva A, Mesquita J, Ortiz A, Ferreira D. Hepatic Histopathological Lesions in Acute Controlled Haemorrhage Followed by Volume Replacement With A Crystalloid or Colloid Solution. J Comp Pathol 2018. [DOI: 10.1016/j.jcpa.2017.10.119] [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: 10/18/2022]
|
39
|
Vecino X, Rodríguez-López L, Ferreira D, Cruz JM, Moldes AB, Rodrigues LR. Bioactivity of glycolipopeptide cell-bound biosurfactants against skin pathogens. Int J Biol Macromol 2017; 109:971-979. [PMID: 29162463 DOI: 10.1016/j.ijbiomac.2017.11.088] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [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: 10/09/2017] [Revised: 11/04/2017] [Accepted: 11/13/2017] [Indexed: 01/23/2023]
Abstract
The antimicrobial and anti-adhesive activities of the cell-bound biosurfactants, produced by Lactobacillus pentosus (PEB), characterized as glycolipopeptide macromolecules, were evaluated against several microorganisms present in the skin microflora, envisaging its potential use as a "natural" ingredient in cosmetic and personal care formulations. Their performance was compared with another cell-bound biosurfactants also characterized as glycolipopeptides produced by Lactobacillus paracasei (PAB). At concentrations of 50mg/mL, the PEB showed an important antimicrobial activity against Pseudomonas aeruginosa (85% when extracted with phosphate buffer (PB) and 100% when extracted with phosphate buffer saline (PBS)), Streptococcus agalactiae (100% for both extracts), Staphylococcus aureus (67% when extracted with PBS and 100% when extracted with PB), Escherichia coli (72% when extracted with PB and 89% when extracted with PBS), Streptococcus pyogenes (about 85% for both extracts) and Candida albicans (around 70% for both extracts), comparable with that obtained for the PAB. However, at lower concentrations the PAB exhibited in general higher antimicrobial activities. Biosurfactants produced by both microorganisms also showed significant anti-adhesive properties against all the microorganisms under study, except for E. coli and C. albicans (less than 30%). Overall, these cell-bound biosurfactants could be used as potential antimicrobial and anti-adhesive agents in cosmetic and pharmaceutical formulations.
Collapse
Affiliation(s)
- X Vecino
- CEB-Centre of Biological Engineering, University of Minho, 4710-057 Braga, Portugal; Chemical Engineering Department, School of Industrial Engineering (EEI)- Módulo Tecnológico Industrial (MTI), University of Vigo, Campus As Lagoas-Marcosende, 36310 Vigo, Spain.
| | - L Rodríguez-López
- Chemical Engineering Department, School of Industrial Engineering (EEI)- Módulo Tecnológico Industrial (MTI), University of Vigo, Campus As Lagoas-Marcosende, 36310 Vigo, Spain
| | - D Ferreira
- CEB-Centre of Biological Engineering, University of Minho, 4710-057 Braga, Portugal
| | - J M Cruz
- Chemical Engineering Department, School of Industrial Engineering (EEI)- Módulo Tecnológico Industrial (MTI), University of Vigo, Campus As Lagoas-Marcosende, 36310 Vigo, Spain
| | - A B Moldes
- Chemical Engineering Department, School of Industrial Engineering (EEI)- Módulo Tecnológico Industrial (MTI), University of Vigo, Campus As Lagoas-Marcosende, 36310 Vigo, Spain
| | - L R Rodrigues
- CEB-Centre of Biological Engineering, University of Minho, 4710-057 Braga, Portugal
| |
Collapse
|
40
|
Marqueze A, Garbino CF, Trapp M, Kucharski LC, Fagundes M, Ferreira D, Koakoski G, Rosa JGS. Protein and lipid metabolism adjustments in silver catfish (Rhamdia quelen) during different periods of fasting and refeeding. BRAZ J BIOL 2017; 78:464-471. [PMID: 29091116 DOI: 10.1590/1519-6984.169333] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 02/21/2017] [Indexed: 11/21/2022] Open
Abstract
The fish may experience periods of food deprivation or starvation which produce metabolic changes. In this study, adult Rhamdia quelen males were subjected to fasting periods of 1, 7, 14, and 21 days and of refeeding 2, 4, 6, and 12 days. The results demonstrated that liver protein was depleted after 1 day of fasting, but recovered after 6 days of refeeding. After 14 days of fasting, mobilization in the lipids of the muscular tissue took place, and these reserves began to re-establish themselves after 4 days of refeeding. Plasmatic triglycerides increased after 1 day of fasting, and decreased following 2 days of refeeding. The glycerol in the plasma oscillated constantly during the different periods of fasting and refeeding. Changes in the metabolism of both protein and lipids during these periods can be considered as survival strategies used by R. quelen. The difference in the metabolic profile of the tissues, the influence of the period of fasting, and the type of reserves mobilized were all in evidence.
Collapse
Affiliation(s)
- A Marqueze
- Mestrado de Avaliação em Impactos Ambientais, Centro Universitário Lassalle - Unilasalle, Av. Victor Barreto, 2288, CEP 92010-000, Canoas, RS, Brazil
| | - C F Garbino
- Mestrado de Avaliação em Impactos Ambientais, Centro Universitário Lassalle - Unilasalle, Av. Victor Barreto, 2288, CEP 92010-000, Canoas, RS, Brazil
| | - M Trapp
- Departamento de Fisiologia, Universidade Federal do Rio Grande do Sul - UFRGS, Rua Sarmento Leite, 500, CEP 90050-170, Porto Alegre, RS, Brazil
| | - L C Kucharski
- Departamento de Fisiologia, Universidade Federal do Rio Grande do Sul - UFRGS, Rua Sarmento Leite, 500, CEP 90050-170, Porto Alegre, RS, Brazil
| | - M Fagundes
- Curso de Medicina Veterinária, Universidade de Passo Fundo - UPF, Campus I, São José, CP 611, CEP 99001-970, Passo Fundo, RS, Brazil
| | - D Ferreira
- Curso de Medicina Veterinária, Universidade de Passo Fundo - UPF, Campus I, São José, CP 611, CEP 99001-970, Passo Fundo, RS, Brazil
| | - G Koakoski
- Programa de Pós-graduação em Farmacologia, Universidade Federal de Santa Maria - UFSM, Avenida Roraima, 1000, Cidade Universitária, Camobi, CEP 97105-900, Santa Maria, RS, Brazil
| | - J G S Rosa
- Programa de Pós-graduação em Farmacologia, Universidade Federal de Santa Maria - UFSM, Avenida Roraima, 1000, Cidade Universitária, Camobi, CEP 97105-900, Santa Maria, RS, Brazil
| |
Collapse
|
41
|
Nikolaou E, Mitsi E, Ferreira DM, Bartolo A, Leong SC. Assessing the ideal microwave duration for disinfection of sinus irrigation bottles-A quantitative study. Clin Otolaryngol 2017; 43:261-266. [PMID: 28815972 DOI: 10.1111/coa.12956] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Saline irrigation of the nasal cavity and paranasal sinuses has a recognised role in the management of chronic rhinosinusitis. However, bacterial recontamination of irrigation bottles through backflow from the sinonasal cavity is a concern in recurrent sinus cavity infections. While patients are encouraged to clean the irrigation bottles regularly, there remains significant concern that the use of contaminated bottles may perpetuate chronic rhinosinusitis. This study assesses the optimal microwave duration to achieve decontamination for each irrigation bottle component part (reservoir, tube and nozzle) using a standard, commercially available microwave. In addition, the irrigation fluid was also tested for contamination after each microwave cycle. STUDY DESIGN Laboratory-based experimental study. PARTICIPANTS No patients were involved in this study. MAIN OUTCOME MEASURES The percentage in vitro decontamination of the bottles' components was determined following 30, 60, 90, 120, 150 seconds of microwave cycles. RESULTS Complete decontamination of the bottles was not achieved at any of the tested microwave cycles. Levels of decontamination differed for the different bottle components, and the greatest degree of decontamination for all bottle components occurred at 90 seconds. Although higher levels of decontamination were observed at microwave durations exceeding 90 seconds, this was at the expense of thermal degradation and deformation of the reservoir plastic component of the irrigation bottle. Similarly, lowest contamination of irrigation fluid was observed at 120 seconds. CONCLUSIONS This study highlights the importance of establishing precise decontamination procedures and recommends a microwave cycle of 90 seconds for optimal decontamination.
Collapse
Affiliation(s)
- E Nikolaou
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - E Mitsi
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - D M Ferreira
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - A Bartolo
- Department of Otorhinolaryngology, Aintree University Hospital, Liverpool, UK
| | - S C Leong
- Department of Otorhinolaryngology, Aintree University Hospital, Liverpool, UK.,Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| |
Collapse
|
42
|
Rocha De Sousa A, Ferreira D, Tavares-Silva M, Raimundo A, Barbosa-Breda J, Leite-Moreira A. Modulation of iris sphincter and ciliary muscles by Urocortin 2. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.0f085] [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: 11/28/2022]
Affiliation(s)
- A. Rocha De Sousa
- Unit of Ophthalmology; Department of Surgery and Physiology; Faculty of Medicine University Porto; Porto Portugal
| | - D. Ferreira
- Department of Surgery and Physiology; Faculty of Medicine University Porto; Porto Portugal
| | - M. Tavares-Silva
- Department of Surgery and Physiology; Faculty of Medicine University Porto; Porto Portugal
| | - A.R. Raimundo
- Department of Surgery and Physiology; Faculty of Medicine University Porto; Porto Portugal
| | - J. Barbosa-Breda
- Unit of Ophthalmology; Department of Surgery and Physiology; Faculty of Medicine University Porto; Porto Portugal
| | - A. Leite-Moreira
- Department of Surgery and Physiology; Faculty of Medicine University Porto; Porto Portugal
| |
Collapse
|
43
|
Ferreira A, Vecino X, Ferreira D, Cruz JM, Moldes AB, Rodrigues LR. Novel cosmetic formulations containing a biosurfactant from Lactobacillus paracasei. Colloids Surf B Biointerfaces 2017; 155:522-529. [PMID: 28494430 DOI: 10.1016/j.colsurfb.2017.04.026] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [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: 01/10/2017] [Revised: 03/29/2017] [Accepted: 04/04/2017] [Indexed: 01/30/2023]
Abstract
Cosmetic and personal care products including toothpaste, shampoo, creams, makeup, among others, are usually formulated with petroleum-based surfactants, although in the last years the consume trend for "green" products is inducing the replacement of surface-active agents in these formulations by natural surfactants, so-called biosurfactants. In addition to their surfactant capacity, many biosurfactants can act as good emulsifiers, which is an extra advantage in the preparation of green cosmetic products. In this work, a biosurfactant obtained from Lactobacillus paracasei was used as a stabilizing agent in oil-in-water emulsions containing essential oils and natural antioxidant extract. In the presence of biosurfactant, maximum percentages of emulsion volumes (EV=100%) were observed, with droplets sizes about 199nm. These results were comparable with the ones obtained using sodium dodecyl sulfate (SDS), a synthetic well known surfactant with high emulsify capacity. Moreover, the biosurfactant and emulsions cytotoxicity was evaluated using a mouse fibroblast cell line. Solutions containing 5g/L of biosurfactant presented cell proliferation values of 97%, whereas 0.5g/L of SDS showed a strong inhibitory effect. Overall, the results herein gathered are very promising towards the development of new green cosmetic formulations.
Collapse
Affiliation(s)
- A Ferreira
- Faculty of Science and Technology, University of La Rochelle, 17042 La Rochelle, France; CEB-Centre of Biological Engineering, University of Minho, 4710-057 Braga, Portugal
| | - X Vecino
- CEB-Centre of Biological Engineering, University of Minho, 4710-057 Braga, Portugal; Chemical Engineering Department, School of Industrial Engineering (EEI), University of Vigo, Campus As Lagoas-Marcosende, 36310 Vigo-Pontevedra, Spain.
| | - D Ferreira
- CEB-Centre of Biological Engineering, University of Minho, 4710-057 Braga, Portugal
| | - J M Cruz
- Chemical Engineering Department, School of Industrial Engineering (EEI), University of Vigo, Campus As Lagoas-Marcosende, 36310 Vigo-Pontevedra, Spain
| | - A B Moldes
- Chemical Engineering Department, School of Industrial Engineering (EEI), University of Vigo, Campus As Lagoas-Marcosende, 36310 Vigo-Pontevedra, Spain
| | - L R Rodrigues
- CEB-Centre of Biological Engineering, University of Minho, 4710-057 Braga, Portugal
| |
Collapse
|
44
|
Currow DC, Dal Grande E, Ferreira D, Johnson MJ, McCaffrey N, Ekström M. Chronic breathlessness associated with poorer physical and mental health-related quality of life (SF-12) across all adult age groups. Thorax 2017; 72:1151-1153. [PMID: 28356419 DOI: 10.1136/thoraxjnl-2016-209908] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 02/16/2017] [Accepted: 03/02/2017] [Indexed: 11/03/2022]
Abstract
Little is known about the impact of chronic breathlessness (modified Medical Research Council (mMRC) score ≥2 for most days, at least three of the last six months) on health-related quality of life (Short Form-12 (SF-12)). 3005 adults from randomly selected households were interviewed face-to-face in South Australia. mMRC ≥2 community prevalence was 2.9%. Adjusted analyses showed clinically meaningful and statistically significant decrements of physical and mental components of SF-12 (mean SF-12 summary scores in physical (-13.0 (-16.0 to -10.2)) and mental (-10.7 (-13.7 to -7.8)) components compared with people with mMRC=0) as chronic breathlessness severity increased, across five age groupings.
Collapse
Affiliation(s)
- D C Currow
- Discipline, Palliative and Supportive Services, Flinders University, Adelaide, Australia.,Southern Adelaide Palliative Services, Adelaide, South Australia, Australia.,Hull York Medical School, University of Hull, Hull, UK
| | - E Dal Grande
- Population Research and Outcomes Studies Unit, Discipline of Medicine, Health Services Faculty, Adelaide University, Adelaide, Australia
| | - D Ferreira
- Discipline, Palliative and Supportive Services, Flinders University, Adelaide, Australia
| | - M J Johnson
- Hull York Medical School, University of Hull, Hull, UK
| | - N McCaffrey
- Discipline, Palliative and Supportive Services, Flinders University, Adelaide, Australia
| | - M Ekström
- Department of Respiratory Medicine and Allergology, Lund University, Lund, Sweden
| |
Collapse
|
45
|
Mitsi E, Roche AM, Reiné J, Zangari T, Owugha JT, Pennington SH, Gritzfeld JF, Wright AD, Collins AM, van Selm S, de Jonge MI, Gordon SB, Weiser JN, Ferreira DM. Agglutination by anti-capsular polysaccharide antibody is associated with protection against experimental human pneumococcal carriage. Mucosal Immunol 2017; 10:385-394. [PMID: 27579859 PMCID: PMC5332540 DOI: 10.1038/mi.2016.71] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 07/12/2016] [Indexed: 02/04/2023]
Abstract
The ability of pneumococcal conjugate vaccine (PCV) to decrease transmission by blocking the acquisition of colonization has been attributed to herd immunity. We describe the role of mucosal immunoglobulin G (IgG) to capsular polysaccharide (CPS) in mediating protection from carriage, translating our findings from a murine model to humans. We used a flow cytometric assay to quantify antibody-mediated agglutination demonstrating that hyperimmune sera generated against an unencapsulated mutant was poorly agglutinating. Passive immunization with this antiserum was ineffective to block acquisition of colonization compared to agglutinating antisera raised against the encapsulated parent strain. In the human challenge model, samples were collected from PCV and control-vaccinated adults. In PCV-vaccinated subjects, IgG levels to CPS were increased in serum and nasal wash (NW). IgG to the inoculated strain CPS dropped in NW samples after inoculation suggesting its sequestration by colonizing pneumococci. In post-vaccination NW samples pneumococci were heavily agglutinated compared with pre-vaccination samples in subjects protected against carriage. Our results indicate that pneumococcal agglutination mediated by CPS-specific antibodies is a key mechanism of protection against acquisition of carriage. Capsule may be the only vaccine target that can elicit strong agglutinating antibody responses, leading to protection against carriage acquisition and generation of herd immunity.
Collapse
Affiliation(s)
- E Mitsi
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - AM Roche
- Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - J Reiné
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - T Zangari
- Department of Microbiology, New York University School of Medicine, New York, NY 10016, USA
| | - JT Owugha
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - SH Pennington
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - JF Gritzfeld
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - AD Wright
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - AM Collins
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - S van Selm
- Department of Pediatrics, Radboud University Medical Center, Nijmegen, the Netherlands
| | - MI de Jonge
- Department of Pediatrics, Radboud University Medical Center, Nijmegen, the Netherlands
| | - SB Gordon
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK,The Malawi Liverpool Wellcome Trust Clinical Research Programme, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | - JN Weiser
- Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA, Department of Microbiology, New York University School of Medicine, New York, NY 10016, USA
| | - DM Ferreira
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK, Corresponding Author: Daniela M. Ferreira, , Department of Clinical Sciences, Liverpool School of Tropical Medicine, UK, phone 0151 705 3711
| |
Collapse
|
46
|
Ribeiro C, Ferreira D, Conde S, Oliveira P, Windisch W. Validation of the Portuguese Severe Respiratory Insufficiency Questionnaire for home mechanically ventilated patients. Rev Port Pneumol (2006) 2017; 23:139-145. [PMID: 28238622 DOI: 10.1016/j.rppnen.2017.01.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Revised: 12/30/2016] [Accepted: 01/05/2017] [Indexed: 10/20/2022] Open
Abstract
The aim of this study was to develop and validate the professional translation and cultural adaptation of the Portuguese Severe Respiratory Insufficiency (SRI) Questionnaire. The sample was composed of 93 patients (50 male patients, 53.8%) with a mean age of 66.3 years. The most frequent diagnostic groups were chronic obstructive pulmonary disease, obesity hypoventilation syndrome and restrictive chest wall disorders. The patients were asked to fill in both the SRI and SF-36 questionnaires. Factor analysis of the SRI questionnaire was performed leading to an explained variance of 73%, and resulted in 13 components. When analyzing the reliability, we obtained values for Cronbach's alpha above 0.70 for most subscales with the reliability of the summary scale being even higher (0.84). This professional translation and cultural adaptation of the Portuguese SRI Questionnaire has good psychometric properties which are similar, not only to the original, but also to other translations. These characteristics make this questionnaire applicable to the Portuguese population receiving home mechanical ventilation for severe respiratory insufficiency.
Collapse
Affiliation(s)
- C Ribeiro
- Pneumology Department - Centro Hospitalar de Vila Nova de Gaia/Espinho, Portugal.
| | - D Ferreira
- Pneumology Department - Centro Hospitalar de Vila Nova de Gaia/Espinho, Portugal
| | - S Conde
- Pneumology Department - Centro Hospitalar de Vila Nova de Gaia/Espinho, Portugal
| | - P Oliveira
- ISPUP-EPIUnit, Instituto de Ciências Biomédicas de Abel Salazar, Universidade do Porto, Portugal
| | - W Windisch
- Department of Pneumology, Cologne Merheim Hospital, Kliniken der Stadt Köln gGmbH, Witten/Herdecke University, Faculty of Health/School of Medicine, Cologne, Germany
| |
Collapse
|
47
|
Zaidi S, Collins A, Davies K, Wright A, Ganguli A, Mitsi E, Reine J, Owugha J, Gordon S, Ferreira D, Rylance J. P48 Research BAL using single use disposable bronchoscope. Thorax 2016. [DOI: 10.1136/thoraxjnl-2016-209333.191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
48
|
Silva J, Alexandre M, Ferreira D, Ramos M, Pereira P, Ferreira N, Sargento I, Netto E, Magalhaes M, Ferreira M, Moreira A. Cercival lymph node metastasis of squamous cell carcinoma of an unknown primary (SCCUP): a single institutional review. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw376.65] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
49
|
Rodriguez J, Pierre N, Naslain D, Bontemps F, Ferreira D, Priem F, Deldicque L, Francaux M. Identification de l’urolithine B comme un nouveau régulateur de la masse musculaire. NUTR CLIN METAB 2016. [DOI: 10.1016/j.nupar.2016.09.068] [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]
|
50
|
Alvarado A, Bernal L, Ferreira D, Paige C, Romero-Sandoval A. (279) Increase of anti-inflammatory cytokines in human macrophages that overexpress CD163 under different pro-inflammatory conditions. The Journal of Pain 2016. [DOI: 10.1016/j.jpain.2016.01.185] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|