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Zecchin Ferrara V, Martinino A, Toti F, Schilirò D, Pinto F, Giovinazzo F. Robotic Vascular Resection in Pancreatic Ductal Adenocarcinoma: A Systematic Review. J Clin Med 2024; 13:2000. [PMID: 38610766 PMCID: PMC11012275 DOI: 10.3390/jcm13072000] [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: 02/27/2024] [Revised: 03/25/2024] [Accepted: 03/26/2024] [Indexed: 04/14/2024] Open
Abstract
(1) Background: This study comprehensively compared robotic pancreatic surgery with vascular resection (RPS-VR) to other surgical procedures in the treatment of pancreatic ductal adenocarcinoma (PDAC). (2) Methods: A systematic review of relevant literature was conducted to assess a range of crucial surgical and oncological outcomes. (3) Results: Findings indicate that robotic surgery with vascular resections (VRs) significantly prolongs the duration of surgery compared to other surgical procedures, and they notably demonstrate an equal hospital stay. While some studies reported a lower conversion rate and a higher rate of blood loss and blood transfusion in the RPS-VR group, others found no significant disparity. Furthermore, RPS-VR consistently correlated with comparable recurrence rates, free margins R0, postoperative mortality, and complication rates. Concerning the last one, certain reviews reported a higher rate of major complications. Overall survival and disease-free survival remained comparable between the RPS-VR and other surgical techniques in treating PDAC. (4) Conclusions: The analysis emphasizes how RPS-VR is a resembling approach in terms of surgical outcomes and aligns with existing literature findings in this field.
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Affiliation(s)
| | | | - Francesco Toti
- Department of Surgery, ASST Santi Paolo e Carlo, 20100 Milan, Italy
| | - Davide Schilirò
- Department of Surgery, Duke University, Durham, NC 27708, USA (D.S.)
| | - Federico Pinto
- Department of Surgery, University of Illinois at Chicago, Chicago, IL 60607, USA
| | - Francesco Giovinazzo
- Department of Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00131 Rome, Italy
- Department of Health Sciences, UniCamillus-Saint Camillus International University, 00131 Rome, Italy
- Department of Surgery, Saint Camillus Hospital, 31100 Treviso, Italy
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Anchuelo J, Rivero A, Galdós P, Alonso L, Astudillo R, Navarrete P, Arrojo E, Jimeno J, Albendea J, Pinto F, Fabregat R, De Juan A, Hinojo C, Hernanz F, Merino P, Díaz de Tuesta M, Borniquel F, Mazaira J, Muñoz P, Prada P. Accelerated partial breast irradiation (APBI) in a single 18 Gy fraction with high-dose-rate brachytherapy (HDR). Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01483-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Ferreira R, Velho T, Sena A, Goncalves J, Junqueira N, Pereira R, Almeida A, Pinto F, Nobre A. Rapid deployment bioprostesis for aortic valve stenosis: single center short and long-term outcomes. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Despite recent advances, surgical aortic valve replacement (SAVR) remains the gold standard for most of the patients with aortic valve stenosis. The ageing population, with increased comorbidities and the rising of minimally invasive techniques, led to the development of new prosthetic devices of easier and faster implantation.
Purpose
This study aimed to analyse short and long-term outcomes of SAVR with rapid-deployment (RD) aortic bioprosthesis for isolated aortic valve stenosis
Method
Singe center, retrospective longitudinal cohort study of patients with isolated aortic valve stenosis who underwent elective aortic valve replacement using RD devices between 2014 and December 2021.
Continuous variables are presented with median (IQR) and were analyzed using Mann-Whitney test. Categorical variables are presented in percentage or frequency and were analyzed using chi-square test. Kaplan-Meyer survival curve was constructed base on collected data from national registry.
Results
A RD device was implanted in 358 patients with a median age of 75,8 years and Euroscore II of 2,3. Median cross clamp and extracorporeal circulation time were 27,4 and 36,7 min, respectively. No significant paravalvular leaks.
Intensive care unit (ICU) length of stay was 3 days with acute renal lesion (any stage-53,2%; Dialysis-2,5%), need for hemodynamic support (63,1%) and new onset atrial fibrillation (33,6%) being the most frequent post-operative complications. Stroke occurred in 0,6% of cases and mortality was 1,1%. Pacemaker implementation rate of 11%.
The mean follow-up time was 6,7 years with 90% 5-years survival rate. Mean gradients of 11,2±4,8 mmHg at 6 months
Conclusion
Surgical treatment of aortic valve stenosis using RD devices is safe, with a low mortality rate. ICU length of stay and hospital length of stay are reduced. Follow-up shows an excellent long-term survival and hemodynamic performance.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- R Ferreira
- CHULN and Faculty of medicine of the University of Lisbon , Lisbon , Portugal
| | - T Velho
- CHULN and Faculty of medicine of the University of Lisbon , Lisbon , Portugal
| | - A Sena
- CHULN and Faculty of medicine of the University of Lisbon , Lisbon , Portugal
| | - J Goncalves
- CHULN and Faculty of medicine of the University of Lisbon , Lisbon , Portugal
| | - N Junqueira
- CHULN and Faculty of medicine of the University of Lisbon , Lisbon , Portugal
| | - R Pereira
- CHULN and Faculty of medicine of the University of Lisbon , Lisbon , Portugal
| | - A Almeida
- CHULN and Faculty of medicine of the University of Lisbon , Lisbon , Portugal
| | - F Pinto
- CHULN and Faculty of medicine of the University of Lisbon , Lisbon , Portugal
| | - A Nobre
- CHULN and Faculty of medicine of the University of Lisbon , Lisbon , Portugal
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Lopes J, Pinto R, Borges M, Pires M, Nunes A, Brito J, Silva P, Ricardo I, Pinto F, Abreu A. Cardiorespiratory fitness assessment on active patients who kept attending their phase III exercise-based cardiac rehabilitation during the COVID-19 era. Eur J Prev Cardiol 2022. [PMCID: PMC9383978 DOI: 10.1093/eurjpc/zwac056.249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Funding Acknowledgements Type of funding sources: None. Background Cardiorespiratory fitness (CRF) is a powerful predictor of all-cause mortality among individuals with coronary artery disease (CAD). A structured community-based phase III cardiac rehabilitation (CR) is very important in lifelong maintenance of phase II CRF and health gains. During the COVID-19 pandemic, CR programs had to adapt, mainly using new technologies and remote follow-up. The CRF impact in patients (Ps) who kept going their phase III program, during this troubled era is still unknown. Purpose Assess the variation in CRF and prognostic parameters in Ps with CAD who maintain high adherence levels in their phase III CR before and during the COVID-19 pandemic. Methods A cohort of Ps enrolled in a community-based phase 3 CR program, with active participation at the end of 2019, was included in this retrospective study. The inclusion criteria for this study were high levels of attendance (>80%) to the CR program before and during COVID-19 and high levels of physical activity with more than 150 mins of moderate to vigorous physical activity (MVPA). All Ps were evaluated with transthoracic echocardiography (TTE) and a cardiorespiratory exercise test (CPET) in a cycloergometer in 2019 and between october and november of 2021. All Ps had used accelerometers to measure their physical activity levels and dual-energy absorptiometry (DEXA) scan to evaluate their body composition. Between 2020 and 2021, Ps had online (in lockdown periods) and face to face exercise training sessions, 3xtimes per week, 60 mins each exercise session. A t-test paired two sample for means was used to compare CPET variables before the beginning of the first COVID lockdown (end of 2019) and after the removal of the majority of restrictions (end of 2021). Results A total of 30 Ps with high levels of adherence were included (99.6% male, 65 ± 9 years old). In this cohort, the majority had history of an ACS before the referral to the CR program (73.3%) and 55.6 ± 10.4% of left ventricular ejection fraction. There was no significant difference in body mass index (27.9 ± 3.2 kg/m2 vs 28.1 ± 3.6 kg/m2, p=0.493 but there was a significant increase in the percentage of body fat mass (30.1 ± 5.7% vs 31.0 ± 6.6%, p= 0.042). There was a maintenance on MVPA levels (352 ± 137 minutes/week vs 313 ± 194 minutes/week, p = 0.106) during this period. When comparing the 2 CPET results, Ps achieved higher exercise loads in the 2021 test (175 ± 51W vs 185 ± 52W, p=0.005), higher VO2 peak (25.3 ± 6.9 ml/kg/min vs 21.5 ± 6.3 ml/kg/min, p =0.001) and higher percentage of predicted VO2max (78.8 ± 16.8% vs 95.27 ± 20.8%, p = 0.001). Conclusion In spite of all the difficulties in maintaining a phase III CR program during the COVID-19 pandemic, we observed that in physically active CAD Ps, with the aid of new technologies and remote follow-up (during the lockdown periods) and face to face exercise sessions, it is still possible to have functional gains and improvements in CRF.
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Affiliation(s)
- J Lopes
- University Hospitals of Coimbra, Cardiology, Coimbra, Portugal
| | - R Pinto
- Faculty of Medicine of the University of Lisbon, Serviço de Cardiologia, Departamento Coração e Vasos, CHULN, CAML, CCUL, Lisbon, Portugal
| | - M Borges
- Faculty of Medicine of the University of Lisbon, Serviço de Cardiologia, Departamento Coração e Vasos, CHULN, CAML, CCUL, Lisbon, Portugal
| | - M Pires
- Faculty of Medicine of the University of Lisbon, Serviço de Cardiologia, Departamento Coração e Vasos, CHULN, CAML, CCUL, Lisbon, Portugal
| | - A Nunes
- Faculty of Medicine of the University of Lisbon, Serviço de Cardiologia, Departamento Coração e Vasos, CHULN, CAML, CCUL, Lisbon, Portugal
| | - J Brito
- Faculty of Medicine of the University of Lisbon, Serviço de Cardiologia, Departamento Coração e Vasos, CHULN, CAML, CCUL, Lisbon, Portugal
| | - P Silva
- Faculty of Medicine of the University of Lisbon, Serviço de Cardiologia, Departamento Coração e Vasos, CHULN, CAML, CCUL, Lisbon, Portugal
| | - I Ricardo
- Faculty of Medicine of the University of Lisbon, Serviço de Cardiologia, Departamento Coração e Vasos, CHULN, CAML, CCUL, Lisbon, Portugal
| | - F Pinto
- Faculty of Medicine of the University of Lisbon, Serviço de Cardiologia, Departamento Coração e Vasos, CHULN, CAML, CCUL, Lisbon, Portugal
| | - A Abreu
- Faculty of Medicine of the University of Lisbon, Serviço de Cardiologia, Departamento Coração e Vasos, CHULN, CAML, CCUL, Lisbon, Portugal
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Ragonese M, Pinto F, Foschi N, Dibitetto F, Akhundov A, Distante F, Bassi P. Endoneedle laser lithotripsy during percutaneous nephrolitotomy: The advantage of ecirs in the management of intra-operative complications. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)00099-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Mauricio AR, Goncalves S, Santiago H, Santos L, Prata S, Vaz R, Ribeiro F, Almeida AG, Pinto F. Transcatheter aortic valve implantation (balloon-expandable versus self-expandable valves) - what echocardiographic parameters should we evaluted? Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.307] [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.
Introduction
Transcatheter aortic valve implantation (TAVI) is currently the recommended treatment for aortic stenosis (AS) in high or intermediate-risk or inoperable patients. Balloon-expandable valve (BEV) and self-expanding valve (SEV) are the two major types of transcatheter heart valves (TTHV). Despite major diferences, both designs are recomended, however, there are only limited data available for the comparison of newer generation BEV and SEV.
Purpose
Compare echocardiographic and clinical parameters, during 1 year of follow-up of a balloon-expandable (BS) versus self-expanding (SE) transcatheter aortic valve implantantation, with emphasis on the composite endpoits proposed by uptade Valve Academic Researc Consortium (VARC-2).
Methods
Retrospective, comparative study in patients with symptomatic severe AS with a high operative risk, who implanted BEV or SEV between January 2016 and December 2019. All patients underwent echocardiographic study before an after the procedure (on the day , 6 months and 1 year of follow up), clinical data were collected. The following ecocardiographic parameters were evaluated: transvalvular and prosthetic aortic gradientes and paravalvular leak (PVL).
Results
We studied 106 patients (81 ± 8 years, 60% female) with severe AS (mean gradient of 49 ± 12 mmHg), who were threated with BE or SE transcatheter aortic valve. Comparative analysis between BEV vs SEV, showed: there were no statistically significant in mean transprosthetic gradients (9.5 ± 4.8 vs 10 ±6.2; p = 0.49). There were no statistically significant differences between BE and SE valves in the cumulative incidence of death from any cause (21% vs. 28%; p = 0.49), death from cardiovascular causes (3.3% vs. 0%; p= 0.26), all strokes (1.6% vs. 1.6%; p = 0.85), pacemaker implatation (18% vs. 15% p = 0.79); major bleeding (3.3% vs 6.5%; p = 0.18) and renal injury (1.6% vs. 2.1%: p = 0.67). There were statistically significant differences between BE and SE valves in the cumulative incidence of moderate or severe PVL (5% vs. 23.9%; p = 0.009) and repeat hospitalization (11.6% vs. 28%;p = 0.04). Device sucess was achieved in 97 % for BEV vs 91% for SEV (p = 0,39). The early safety at 30 days was observed in 5% for BVE vs. 4.3% for SVE (p = 0.87). The clinical efficacy after 30 days was achieved in 1,6% for BVE vs. 4.3% for SVE (p = 0.03), with higher incidence of moderate or severe PVL. The composite endpoint valve safety occured in 3,3 % for BVE vs 26% for SVE (p < 0,001), with moderate or severe PVL in 23%.
Conclusion(s): In patients with symptomatic severe aortic stenosis who implanted BEV or SEV transcatheter aortic valve there was a significant improvement in the hemodynamic status. The present study suggests that use of SEV was associated with a higher risk of PVL and repeat hospitalization, with a endpoint clinical efficacy after 30 days (4,3%) and time-related valve safety (26%).
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Affiliation(s)
- AR Mauricio
- Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - S Goncalves
- Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - H Santiago
- Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - L Santos
- Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - S Prata
- Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - R Vaz
- Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - F Ribeiro
- Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - AG Almeida
- Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - F Pinto
- Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
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Costa Mauricio AR, Goncalves S, Santiago H, Prata S, Santos L, Vaz R, Ribeiro F, Almeida A, Pinto F. Regression of left ventricular mass after transcatheter aortic valve implantation. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.331] [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: 11/15/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
Regression of left ventricular mass (LVM) after transcatheter aortic valve implantation (TAVI) is an important parameter of left ventricular reverse remodeling and is associated with less hospitalizations 1year after TAVI. The association between LVM índex (LVMi) at 6 months and outcome 1 year after TAVI is unclear.
Purpose
Evaluate and compare LVMi, before TAVI and 6 months after, and determine the association between LVMi regression and clinical outcomes at 1-year follow-up.
Methods
Retrospective, comparative study in patients with symptomatic severe aortic stenosis with a high operative risk, after TAVI. All patients underwent echocardiographic study before TAVI and 6 months of follow-up, the LVMi (by the Devereux formula) was evaluated. Associations between LVMi regression (percent change between baseline and 6 months after TAVI), rehospitalization rate and death at 1 year of follow-up were examined.
Results
We studied 50 patients, 82% with moderade or severe LVMi before TAVI. Comparative analysis between ecocardiography study before and 6 months after TAVI, showed there was statistically significant decrease in LVMi (150,7 ± 38 g/m2 vs 132 ± 36 g/m2; p = 0.03). LVMi moderate or severe (between 130 and 154 g/m2) at 6 months was associated with biggest hospitalization rate (p = 0,03).Comparative analysis between regression of LVMi (before and 6 months after TAVI) and death, showed: decrease of 5% and 10% in LVMi was independently associated with death at 1 year (p = 0,77 vs p = 0,4).
Conclusions
Patients with severe symptomatic aortic stenosis treated with TAVI who had a significant decrease of LVMi after 6 months of follow-up had lower hospitalization rates, but decrease of LVMi is independently associated with death at 1 year of follow-up.
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Affiliation(s)
| | - S Goncalves
- Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - H Santiago
- Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - S Prata
- Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - L Santos
- Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - R Vaz
- Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - F Ribeiro
- Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - A Almeida
- Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - F Pinto
- Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
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Mano T, Viegas J, Bras P, Rito T, Agapito A, Pinto F, Cruz Ferreira R, De Sousa L. Trends in mortality of adult congenital heart disease patients in the last 4 decades. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1844] [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
Introduction
Medical, surgical, and technological advances over the past decades increased the life expectancy of congenital heart disease (CHD) patients (pts), with >90% reaching adulthood. Nonetheless, mortality for adults with CHD (ACHD) is still higher than for the general population.
Purpose
To analyse trends in mortality and causes of death of ACHD.
Methods
Retrospective analysis of pts followed in an ACHD outpatient clinic, in one tertiary center, who died between 1980 and December 2020. Data relating to the cardiac diagnosis, symptoms, interventions, comorbidities, and causes of death were analysed.
Results
During a median follow-up of 8.9 years (IQR 2.2–17), 251 pts of 3725 (6.7%) died during the study period: 127 males (51%), mean age at death 44.9±18.1 years, 54% with severe CHD. The majority of these death was CHD-related (171 pts – 68.1%) with no statistically significant differences over the years vs non-cardiovascular death (Table 1). However, a paradigm shift was noticed: in the first years the main cardiac cause was sudden-death that was replaced by heart failure in the last decade. Also, the mean age at death increased over the years (33±14.9 years until 2000 vs 52.3±17 years after the year 2010, p<0.001) as the number of implantable devices (4 vs 20, p=0.05).
Conclusion
Causes of death of ACHD patients are in the majority still CHD-related. However, in the last decade, according to the increase in life expectancy, heart failure became the leading cause of death.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- T Mano
- Hospital de Santa Marta, Lisbon, Portugal
| | - J Viegas
- Hospital de Santa Marta, Lisbon, Portugal
| | - P Bras
- Hospital de Santa Marta, Lisbon, Portugal
| | - T Rito
- Hospital de Santa Marta, Lisbon, Portugal
| | - A Agapito
- Hospital de Santa Marta, Lisbon, Portugal
| | - F Pinto
- Hospital de Santa Marta, Lisbon, Portugal
| | | | - L De Sousa
- Hospital de Santa Marta, Lisbon, Portugal
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Mano T, Ferreira V, Moreira RI, Teixeira B, Agapito A, Rito T, Pinto F, Cruz Ferreira R, De Sousa L. Fetal and maternal outcomes in patients with tetralogy of Fallot. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2899] [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
Introduction
Women with tetralogy of Fallot (TOF) have an increased risk of adverse cardiac and neonatal events during pregnancy. The aim was to assess fetal and maternal outcomes in patients (pts) with uncorrected and corrected TOF.
Methods
Retrospective analysis of cardiological and obstetric data in women with TOF followed at our institution. Pregnancy and neonatal outcomes were compared in patients (pts) submitted to corrective surgery vs pts with no previous intervention and in pts with or without cyanosis.
Results
51 women (median age 27 years; median number of previous interventions of 2), 22% with cyanosis, who experienced 126 pregnancies resulting in 73 live births A previous corrective surgery was found in 78% (40 pts), while 4% (2 pts) had previous palliative surgery and 18% (9 pts) no previous procedure. We found that women that were not submitted to previous intervention had a significant higher incidence of preterm birth (56% vs 17.5%, p=0.029), spontaneous abortion (56% vs 10%, p=0.006) and stillbirth (22% vs 0%). No difference was found for obstetric complications between groups. Cyanotic pts also demonstrated higher incidence of low birth weight (LBW) (36% vs 7.5%, p=0.031), preterm birth (54% vs 17.5%, p=0.021), spontaneous abortion (55% vs 10%, p=0.004) and stillbirth (18% vs 0%). There were no cardiac complications during pregnancy nor evident deterioration on cardiac status. Congenital heart disease was reported in 2 infants (3% of live births).
Conclusions
Pregnancy is well tolerated in pts with TOF. In our population, even in uncorrected TOF and in pts with cyanosis, there were no cardiac complications during pregnancy, although those pts had worse fetal outcomes. An explanation for the low incidence of cardiac events may be less severe forms of the disease, allowing survival into adulthood without intervention.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- T Mano
- Hospital de Santa Marta, Lisbon, Portugal
| | - V Ferreira
- Hospital de Santa Marta, Lisbon, Portugal
| | | | - B Teixeira
- Hospital de Santa Marta, Lisbon, Portugal
| | - A Agapito
- Hospital de Santa Marta, Lisbon, Portugal
| | - T Rito
- Hospital de Santa Marta, Lisbon, Portugal
| | - F Pinto
- Hospital de Santa Marta, Lisbon, Portugal
| | | | - L De Sousa
- Hospital de Santa Marta, Lisbon, Portugal
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Azevedo Coutinho MDC, Cortez-Dias N, Cantinho G, Goncalves S, Cunha N, Rodrigues T, Santos L, Conceicao I, Pinto F. Diagnostic and prognostic contribution of 99mTc-DPD scintigraphy in transthyretin V30M cardiac amyloidosis. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Early diagnosis and prognostic stratification of hereditary transthyretin amyloidosis (ATTR) are crucial. Previous findings suggested that 99mTc-3,3-diphosphono-1,2-propanodicarboxylic acid (DPD) scintigraphy presents suboptimal accuracy to detect ATTR cardiomyopathy caused by V30M mutation, particularly in patients with onset of symptoms under 50 years of age. Furthermore, its prognostic value has never been evaluated in ATTR caused by this mutation.
Purpose
To assess the diagnostic value of DPD scintigraphy to detect cardiomyopathy in a large cohort of patients with ATTR-V30M mutation and to explore its prognostic value regarding mortality.
Methods
Of the 305 ATTR-V30M mutation carriers followed prospectively and who underwent DPD scintigraphy, 288 individuals [median age 46 (39–56); 49% male] without myocardial thickening attributable to other causes were enrolled in the study. Amyloid cardiomyopathy was defined by septal thickness ≥13mm not attributable to other causes plus at least one of the following criteria: (1) late heart-to-mediastinum (H/M) 123I-metaiodobenzylguanidine (MIBG) ratio <1.60; (2) electrical heart disease (arrhythmia or cardiac conduction defect); or (3) amyloid infiltration documented in biopsy.
Results
Amyloid cardiomyopathy was identified in 41 (14.2%) patients and 44 (15.3%) individuals presented abnormal cardiac DPD uptake. Individuals with cardiac DPD retention had 27-fold higher likelihood of having amyloid cardiomyopathy (OR: 27.4; 95% CI 11.6–65.0; P<0.001). However, DPD scintigraphy presented suboptimal accuracy to detect ATTR cardiomyopathy (89.9%) with limitations in sensitivity (56.1%), specificity (95.6%), positive predictive value (67.7%) and negative predictive value (92.9%).
During a mean follow-up 33.6±1.2 months, 16 patients died (5.6%). Mortality was 14 times higher in patients with amyloid cardiomyopathy (HR: 14.1; 95% CI 4.9–40.7; P<0.001), 13 times higher in those with abnormal cardiac DPD uptake (HR: 12.59; 95% CI % 4.56–34.72; P<0.001) and 10 times higher in those with H/M MIBG ratio <1.60 (HR: 10.40; 95% CI 2.95–36.69; P<0.001). The prognostic value of ventricular thickness and cardiac DPD uptake was additive: patients without septal thickening and no cardiac DPD retention had excellent prognosis (5-year mortality of 0.75%), while those with septal thickening and/or abnormal DPD retention presented 5-year mortality rates ranging from 39.9 to 53.3%.
Conclusions
DPD scintigraphy is valuable in the evaluation of ATTR-V30M mutation carriers, particularly for prognostic stratification purposes, identifying patients at higher risk of death.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
| | - N Cortez-Dias
- Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - G Cantinho
- Faculty of Medicine of the University of Lisbon, Lisbon, Portugal
| | - S Goncalves
- Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - N Cunha
- Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - T Rodrigues
- Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - L Santos
- Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - I Conceicao
- Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - F Pinto
- Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
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Ferreira V, Branco Mano T, Rito T, Ilhao Moreira R, Agapito A, Pinto F, Sousa L. Pregnancy outcomes in women with severe congenital heart disease – a specialized centre experience. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2898] [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
Progress in pediatric cardiology and cardiac surgery has dramatically raised the number of women with severe complex congenital heart disease (SC-CHD) that reach reproductive age. Pregnancy (P) in this group of women has an increased risk of adverse cardiac and neonatal events and its predictive factors are not fully defined. Our purpose was to assess the experience of our center regarding P and neonatal outcomes in women with SC-CHD.
Methods
Retrospective analysis of obstetric data in women with CHD followed at our institution. P and neonatal outcomes were evaluated regarding patients presenting SC-CHD and mild and moderate complexity CHD (MMC-CHD), according to ESC guidelines CHD complexity classification.
Results
The study enrolled 680 women with CHD (median age, 27.2 years) who experienced 1262 pregnancies, resulting in 998 live births. A previous corrective procedure was found in 334 women (49.1%). CHD complexity was considered mild, moderate and severe in 263 (38.7%), 359 (52.8%) and 58 (8.5%), respectively. SC-CHD included 38 women with cyanotic CHD and 18 with pulmonary vascular disease. The most common heart defect in SC-CHD pts was cyanotic tetralogy of Fallot (19.0%), followed by dextro-transposition of the great arteries with atrial switch /palliative procedure (13.8%) – Figure 1.
Pts with SC-CHD had successful deliveries in 56.1% comparing with 82.1% in MMC-CHD. Women with SC-CHD had significantly higher incidence of preterm birth (24.6% vs 7.4%, p<0.001), spontaneous abortion (26.3% vs 12.3%, p=0.004) and neonatal mortality (10.3% vs 2.3%) comparing with MMC-CHD. Low birth weight was also extremely more frequent in the SC-CHD group (44.7% vs 8.5%, p<0.001). No difference was found relating to the presence of CHD in infants from SC-CHD mothers compared to off-spring from MMC-CHD (8.4 vs 5.3%, p=0.407). Cesarian deliveries had similar rates independently of increased CHD complexity (34.2% vs 32.1%). Overall, pregnancy was quite well tolerated, although cardiac complications were more common in SC-CHD P (0.4% vs 4.3%, p 0.013). Only one maternal death was registered, during 1st trimester, in a woman with a large unrepaired ventricular septal defect and cyanosis.
Conclusion
Severe complex CHD remains a challenging condition for pregnancy with increased maternal and neonatal morbimortality. This emphasizes the importance of extensive prepregnancy counselling and centralization of care to address specific risks and requirements of the condition.
Funding Acknowledgement
Type of funding sources: None. Figure 1. Severe CHD
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Affiliation(s)
- V Ferreira
- Hospital de Santa Marta, Lisbon, Portugal
| | | | - T Rito
- Hospital de Santa Marta, Lisbon, Portugal
| | | | - A Agapito
- Hospital de Santa Marta, Lisbon, Portugal
| | - F Pinto
- Hospital de Santa Marta, Lisbon, Portugal
| | - L Sousa
- Hospital de Santa Marta, Lisbon, Portugal
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Di Gianfrancesco L, Foti M, Ragonese M, Palermo G, Sacco E, Pinto F, Totaro A, Marino F, Akhundov A, Bassi P, Racioppi M. A large pilot study on the diagnostic performance of electronic nose in detecting Bladder Cancer. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)01227-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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13
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Pinto F, Simonetti CS, Paz SM, Orlandi F. 1183P Survival impact of concurrent chemoradiotherapy (CRT) with weekly cisplatin doses in patients with unresectable stage III non-small cell lung cancer (NSCLC) in a clinical referral center in Chile. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1787] [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] Open
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14
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Antonucci M, Recupero S, Marzio V, De Dominicis M, Pinto F, Foschi N, Di Gianfrancesco L, Bassi P, Ragonese M. The impact of COVID-19 outbreak on urolithiasis emergency department admissions, hospitalizations and clinical management in central Italy: a multicentric analysis. Actas Urol Esp 2020; 44:611-616. [PMID: 32713658 PMCID: PMC7332912 DOI: 10.1016/j.acuro.2020.06.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 06/07/2020] [Indexed: 11/17/2022]
Abstract
Introducción y objetivos Nuestro objetivo fue evaluar el impacto de la enfermedad del coronavirus de 2019 (COVID-19) en los ingresos en los servicios de urgencias (SU), las hospitalizaciones y el manejo clínico de los pacientes con urolitiasis. Pacientes y métodos Realizamos un análisis retrospectivo multicéntrico de las admisiones en los servicios de urgencias de tres departamentos de urología de gran volumen (uno directamente implicado en el tratamiento de los pacientes de COVID-19 y dos no implicados) en Roma (Italia) entre marzo y abril de 2020 y en el mismo período de 2019. Se realizó un análisis estadístico del número de admisiones por urolitiasis, la tasa de complicaciones, hospitalización y el tipo de tratamiento recibido. Resultados Fueron incluidos 304 pacientes en el análisis. Se observó una reducción significativa en el número global de pacientes ingresados en urgencias por urolitiasis entre 2019 y 2020 (48,8%). Además, con respecto a la elección del tratamiento de los pacientes hospitalizados, se informó un aumento estadísticamente significativo de los procedimientos de extracción de cálculos en comparación con el drenaje urinario en 2020 (p = 0,015). Conclusiones Durante la pandemia de la COVID-19 en Roma ha habido una reducción significativa de los ingresos en urgencias por urolitiasis. Los pacientes ingresados en el SU tuvieron más complicaciones, necesitaron hospitalización con más frecuencia y en cuanto al manejo clínico, se prefirió la extracción temprana de los cálculos, en vez del drenaje urinario. Todos los urólogos deben ser conscientes de que en los próximos meses podrían enfrentar un mayor número de admisiones por urolitiasis y un manejo de casos más complicados.
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Ferreira V, Almeida Morais L, Sousa L, Fiarresga A, Martins J, Timoteo A, Viveiros Monteiro A, Loureiro P, Soares C, Castelo A, Garcia Bras P, Reis J, Pinto F, Agapito A, Cruz Ferreira R. New onset atrial fibrillation after percutaneous Patent Foramen Ovale closure: how serious is this problem? Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2195] [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
Percutaneous Patent Foramen Ovale (pPFO) closure benefits for secondary prevention after cardio-embolic stroke have recently been proved. With the increasing number of cases and procedures, a concern with new onset atrial fibrillation (NOAF) has been raised.
Purpose
To evaluate long-term outcome regarding NOAF rate and to identify its predictors and clinical impact, in a real population submitted to pPFO closure.
Methods
From 2000 to 2017, consecutive patients (P) submitted to pPFO closure in a tertiary centre were prospectively enrolled. The primary endpoint was NOAF rate and secondary endpoints were all-cause, neurologic and cardiac mortality rates and recurrent ischemic events. Previous and follow-up electrocardiographic, echocardiographic and 24-hour heart rhythm monitoring data were analysed. Follow-up was performed through medical visits, medical charts consultation and a phone call based system, in order to assess clinical status, on-going treatment and events.
Results
496 patients were submitted to pPFO. Immediate success was achieved in 98.8% and 9.1% presented a residual shunt on the 1st year TEE. Mean age was 45.0±11.2 years-old with 50.2% of males. The prevalence of hypertension, hypercholesterolemia and atrial septum aneurysm (ASA) was 25.7%, 45.0% and 46.3%, respectively. Pre-procedural mean left atrial (LA) diameter was 36.0±5.3 mm. FU data was available for 490 (98.6%), for a mean FU time of 7.41±3.51 years. 34 P (6.9%) presented ischemic events recurrence (26 strokes and 8 TIA). The primary endpoint was observed in 21 P (4.3%) during the FU period.
Median time to 1st AF episode since PFO closure was 5.90±5.53 years. 11 P (52.3%) initiated oral anticoagulation. In univariate analysis, age (44.6±11.3 vs 51.8±6.0 years, p=0.005) and hypertension (24.7% vs 47.6%, p=0.019) were predictors of NOAF in this population. In multivariated analysis, only age remained a predictor of NOAF (OR 1.05 (1.007–1.101), p=0.025). LA pre pPFO closure dimensions, ASA, device type or size and the presence of residual shunt in TEE were not determinants of AF occurrence. The incidence of NOAF was associated with the need for hospitalization due to cardiac causes (19% vs 3.2%, p=0.001) and a trend towards higher rate of recurrent stroke (4.9% vs 14.3%, p=0.06).
Conclusion
Despite being a highly successful and safe procedure in most patients, pPFO closure was associated with a non-negligenciable rate of NOAF during long-term follow-up. NOAF predictors were related with classical cardiovascular risk factors, such as age and hypertension. None of the procedure or device features were associated with NOAF. Yet, a clinical impact was attributed to NOAF, with more hospitalizations and a trend towards ischemic events recurrence.
As young patients submitted to pPFO closure grow older, prevention strategies to diagnose and treat NOAF should be endeavoured.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- V Ferreira
- Hospital de Santa Marta, Lisbon, Portugal
| | | | - L Sousa
- Hospital de Santa Marta, Lisbon, Portugal
| | | | | | | | | | - P Loureiro
- Hospital de Santa Marta, Lisbon, Portugal
| | - C Soares
- Hospital de Santa Marta, Lisbon, Portugal
| | - A Castelo
- Hospital de Santa Marta, Lisbon, Portugal
| | | | - J Reis
- Hospital de Santa Marta, Lisbon, Portugal
| | - F Pinto
- Hospital de Santa Marta, Lisbon, Portugal
| | - A Agapito
- Hospital de Santa Marta, Lisbon, Portugal
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Bargagli M, De Leonardis R, Ragonese M, Totaro A, Pinto F, Recupero S, Bassi P, Ferraro P. Determinants of renal papillary appearance in renal stone formers: An in-depth examination. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33383-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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17
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Oliveira S, Abreu A, Cunha P, Carmo MM, Valente B, Ricardo I, Delgado AS, Oliveira L, Pinto F, Oliveira MM. P542Cardiac autonomic dysfunction and inflammatory response in heart failure - markers for cardiac resynchronization therapy response? Europace 2020. [DOI: 10.1093/europace/euaa162.215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
FCP
Introduction
Cardiac sympathetic activation and inflammatory response are involved in chronic heart failure (HF) pathophysiology. The severity of autonomic dysfunction and inflammation might be responsible for different responses to HF treatment.
Aim
To evaluate the impact of cardiac autonomic dysfunction, and it´s association with systemic inflammation, on cardiac resynchronization therapy (CRT) response in severe HF patients.
Methods
Single centre, prospective, longitudinal study, including consecutive patients, referred to CRT. Demographic data, HF aetiology and NYHA class were evaluated. Left ventricular (LV) function data (LV ejection fraction - LVEF) by echocardiography, heart to mediastinum early ratio (HMRe) by 123I-MIBG cardiac scintigraphy, and plasmatic TNF-α levels (pg/mL) were determined, at baseline and 4 months after CRT implantation. CRT response was defined by an absolute increase of at least 5% in LVEF at 4 months evaluation after CRT. Patients were divided in 4 groups according to HMRe and TNF-α cut-points: Group I (TNF-α > 2.0 pg/ml + HMRe ≥ 1.6), Group II (TNF-α > 2.0 pg/ml + HMRe < 1.6), Group III (TNF-α ≤ 2.0 pg/ml + HMRe ≥ 1.6) and Group IV (TNF-α ≤ 2.0 pg/ml + HMRe < 1.6). Data was analyzed using descriptive statistics and groups were compared by Fisher"s exact test.
Results
A total of 95 patients were included (age 68.6 ± 10.2 years), 67.4% male and 32.6% female, 40% with diabetes mellitus, 30.5% with ischemic cardiomyopathy, 23.2% in NYHA III/IV, baseline LVEF - 26 ± 7%. At 4 months, LVEF was 40 ± 11%. In total, 73.7% were responders and 26.3% were non-responders to CRT. There were 28 patients (29.5%) with HMRe ≥ 1.6, with 25 responders (89.3%) and 48 patients (50.5%) with TNF-α ≤ 2.0 pg/ml, with 38 responders (79.2%). Group I had 16 patients (16.8%), with 81.2% responders; Group II had 31 patients (32.7%), with 61.3% responders; Group III had 12 patients (12.6%), with 100% responders, and Group IV had 36 patients (37.9%), with 72.2% responders. Conclusion: In patients with severe HF submitted to CRT, combining cardiac autonomic dysfunction and inflammation, associated to high rate of CRT non response. Contrarily, those with preserved cardiac autonomic function and no increased levels of inflammation identified most significantly CRT responders.
CRT response according to HMRe and TNFα HMRe ≥ 1.6 (n = 28) HMRe < 1.6 (n = 67) Responders NO Respondersn (%) Responders NO Respondersn (%) TNF α > 2 pg/mL (n = 47) G I: 13 (81.2%) 3 (18.8%) GII: 19 (61.3%) 12 (38.7%) * TNF α ≤ 2 pg/mL (n = 48) G III: 12 (100%) 0 (0%)* G IV: 26 (72.2%) 10 (27.8%)
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Affiliation(s)
- S Oliveira
- Faculty of Medicine of the University of Lisbon, Cardiovascular Exercise & Rehabilitation Laboratory, Cardiovascular Centre of the University of Lisb, Lisbon, Portugal
| | - A Abreu
- Faculty of Medicine of the University of Lisbon, Cardiovascular Exercise & Rehabilitation Laboratory, Cardiovascular Centre of the University of Lisb, Lisbon, Portugal
| | - P Cunha
- Hospital de Santa Marta, Arrhythmology, Pacing and Electrophysiology Unit, Cardiology Service, Santa Marta Hospital, Central , Lisbon, Portugal
| | - M M Carmo
- University of Lisbon, Nova Medical School, CEDOC Chronic Diseases, Lisbon, Portugal, Lisbon, Portugal
| | - B Valente
- Hospital de Santa Marta, Arrhythmology, Pacing and Electrophysiology Unit, Cardiology Service, Santa Marta Hospital, Central , Lisbon, Portugal
| | - I Ricardo
- Faculty of Medicine of the University of Lisbon, Cardiovascular Exercise & Rehabilitation Laboratory, Cardiovascular Centre of the University of Lisb, Lisbon, Portugal
| | - A S Delgado
- Hospital de Santa Marta, Arrhythmology, Pacing and Electrophysiology Unit, Cardiology Service, Santa Marta Hospital, Central , Lisbon, Portugal
| | - L Oliveira
- Quadrantes Clinic, Nuclear Medicine Department, Clinic Quadrantes, Lisbon, Portugal, Lisbon, Portugal
| | - F Pinto
- Faculty of Medicine of the University of Lisbon, Cardiovascular Exercise & Rehabilitation Laboratory, Cardiovascular Centre of the University of Lisb, Lisbon, Portugal
| | - M M Oliveira
- Hospital de Santa Marta, Arrhythmology, Pacing and Electrophysiology Unit, Cardiology Service, Santa Marta Hospital, Central , Lisbon, Portugal
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De Sousa J, Cortez-Dias N, Carpinteiro L, Silva G, Nunes Ferreira A, Silverio Antonio P, Bernardes A, Barreiros C, Ribeiro J, Sobral S, Pinto F. P1402Isolation of pulmonary veins with duty-cycled circular multi-polar catheter: randomized controlled clinical trial. Europace 2020. [DOI: 10.1093/europace/euaa162.088] [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
Introduction
Pulmonary vein isolation (PVI) is the central element in the ablation of atrial fibrillation (AF), and can be obtained with different ablation modalities. The duty-cycled circular multi-pole catheter PVAC® (Medtronic) allows linear application of radiofrequency energy, with the production of circumferential lesions. Conceptually, it can make ablation simpler and faster in patients with favorable anatomy.
Objectives
To evaluate the safety and efficacy of ablation with a PVAC® catheter and to compare it with the conventional technique point-by-point (PbP) with irrigated catheter.
Methods
Clinical trial with single-blinded patients with AF refractory to antiarrhythmic therapy, randomized (1: 1) for ablation with PVAC® or PbP. The ablation strategy consisted of PVI, complemented with ablation of the cavo-tricuspid isthmus in patients with history of concomitant flutter. Monitoring was performed with a 7-day event loop recorder at 3, 6 and 12 months and annually from the 2nd year. Success was defined by AF-free survival or any maintained supraventricular tachycardia (duration > 30seconds).
Results
354 patients (67.5% males, 58 ± 12 years, PbP: 175, PVAC: 179) were included, of which 59.1% had paroxysmal, 26.2% short-standing persistent and 14.7% had long-standing persistent AF. Baseline characteristics were similar between groups. Among patients treated with PVAC, 93.1% of the pulmonary veins were isolated (620/666), similar to the 98.3% immediate success of the PbP group (697/709). Although the complication rate was similar in both groups (PVAC: 4.9% vs. PbP: 7.8%; P = NS), the risk of hemopericardium was lower with PVAC (0% vs. 4.6%; P = 0.013). Two patients treated with PVAC developed stroke (1.13% vs. 0%; P = NS). The duration of the procedure was lower among the patients treated with PVAC [136 (100-180) vs. 230 (188-270) min; P <0.001], with no difference in fluoroscopy time [24.4 (14.5-36.8) vs. 27.1 (17.0-45.0) min]. The success rate after 1st ablation at 36 months was 68%, with no differences between groups. The success rate after multiple ablations increased to 85.8%, with no differences between groups.
Conclusion
The multipolar PVAC catheter can represent an added value in AF ablation, making the procedure simpler and faster, ensuring similar efficacy to the conventional technique and with a lower risk of cardiac tamponade. The present trial suggests the need for clinically manifested stroke risk surveillance, which may be increased with this technique.
Abstract Figure.
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Affiliation(s)
- J De Sousa
- Cardiology Department, Santa Maria University Hospital (CHULN), CAML, CCUL, Lisbon School of Medicine, Universidade de Lisboa, Portugal, Lisboa, Portugal
| | - N Cortez-Dias
- Cardiology Department, Santa Maria University Hospital (CHULN), CAML, CCUL, Lisbon School of Medicine, Universidade de Lisboa, Portugal, Lisboa, Portugal
| | - L Carpinteiro
- Cardiology Department, Santa Maria University Hospital (CHULN), CAML, CCUL, Lisbon School of Medicine, Universidade de Lisboa, Portugal, Lisboa, Portugal
| | - G Silva
- Cardiology Department, Santa Maria University Hospital (CHULN), CAML, CCUL, Lisbon School of Medicine, Universidade de Lisboa, Portugal, Lisboa, Portugal
| | - A Nunes Ferreira
- Cardiology Department, Santa Maria University Hospital (CHULN), CAML, CCUL, Lisbon School of Medicine, Universidade de Lisboa, Portugal, Lisboa, Portugal
| | - P Silverio Antonio
- Cardiology Department, Santa Maria University Hospital (CHULN), CAML, CCUL, Lisbon School of Medicine, Universidade de Lisboa, Portugal, Lisboa, Portugal
| | - A Bernardes
- Cardiology Department, Santa Maria University Hospital (CHULN), CAML, CCUL, Lisbon School of Medicine, Universidade de Lisboa, Portugal, Lisboa, Portugal
| | - C Barreiros
- Cardiology Department, Santa Maria University Hospital (CHULN), CAML, CCUL, Lisbon School of Medicine, Universidade de Lisboa, Portugal, Lisboa, Portugal
| | - J Ribeiro
- Cardiology Department, Santa Maria University Hospital (CHULN), CAML, CCUL, Lisbon School of Medicine, Universidade de Lisboa, Portugal, Lisboa, Portugal
| | - S Sobral
- Cardiology Department, Santa Maria University Hospital (CHULN), CAML, CCUL, Lisbon School of Medicine, Universidade de Lisboa, Portugal, Lisboa, Portugal
| | - F Pinto
- Cardiology Department, Santa Maria University Hospital (CHULN), CAML, CCUL, Lisbon School of Medicine, Universidade de Lisboa, Portugal, Lisboa, Portugal
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Almendra A, Pinto F, Carvalho J, Pinto P, Bárbara C. Sleeping habits in students from a medical school in Portugal. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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20
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Dias D, Lapa N, Bernardo M, Ribeiro W, Matos I, Fonseca I, Pinto F. Cr(III) removal from synthetic and industrial wastewaters by using co-gasification chars of rice waste streams. Bioresour Technol 2018; 266:139-150. [PMID: 29960244 DOI: 10.1016/j.biortech.2018.06.054] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 06/15/2018] [Accepted: 06/16/2018] [Indexed: 06/08/2023]
Abstract
Blends of rice waste streams were submitted to co-gasification assays. The resulting chars (G1C and G2C) were characterized and used in Cr(III) removal assays from a synthetic solution. A Commercial Activated Carbon (CAC) was used for comparison purposes. The chars were non-porous materials mainly composed by ashes (68.3-92.6% w/w). The influences of adsorbent loading (solid/liquid ratio - S/L) and initial pH in Cr(III) removal were tested. G2C at a S/L of 5 mg L-1 and an initial pH of 4.50 presented an uptake capacity significantly higher than CAC (7.29 and 2.59 mg g-1, respectively). G2C was used in Cr(III) removal assays from an industrial wastewater with Cr(III) concentrations of 50, 100 and 200 mg L-1. Cr(III) removal by precipitation (uptake capacity ranging from 11.1 to 14.9 mg g-1) was more effective in G2C, while adsorption (uptake capacity of 16.1 mg g-1) was the main removal mechanism in CAC.
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Affiliation(s)
- D Dias
- LAQV/REQUIMTE, Departamento de Ciências e Tecnologia da Biomassa (DCTB), Faculdade de Ciências e Tecnologia (FCT), Universidade Nova de Lisboa (UNL), 2829-516 Caparica, Portugal.
| | - N Lapa
- LAQV/REQUIMTE, Departamento de Ciências e Tecnologia da Biomassa (DCTB), Faculdade de Ciências e Tecnologia (FCT), Universidade Nova de Lisboa (UNL), 2829-516 Caparica, Portugal
| | - M Bernardo
- LAQV/REQUIMTE, Departamento de Química (DQ), Faculdade de Ciências e Tecnologia (FCT), Universidade Nova de Lisboa (UNL), 2829-516 Caparica, Portugal
| | - W Ribeiro
- LAQV/REQUIMTE, Departamento de Ciências e Tecnologia da Biomassa (DCTB), Faculdade de Ciências e Tecnologia (FCT), Universidade Nova de Lisboa (UNL), 2829-516 Caparica, Portugal
| | - I Matos
- LAQV/REQUIMTE, Departamento de Química (DQ), Faculdade de Ciências e Tecnologia (FCT), Universidade Nova de Lisboa (UNL), 2829-516 Caparica, Portugal
| | - I Fonseca
- LAQV/REQUIMTE, Departamento de Química (DQ), Faculdade de Ciências e Tecnologia (FCT), Universidade Nova de Lisboa (UNL), 2829-516 Caparica, Portugal
| | - F Pinto
- Unidade de Bioenergia (UB), Laboratório Nacional de Energia e Geologia (LNEG), Estrada do Paço do Lumiar, Ed. J, 1649-038 Lisboa, Portugal
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Grattagliano I, Craig F, Lisi A, Pierri G, Stallone V, Margari L, Lecce P, Lafortezza E, Pinto F, Pisani R, Zagaria G, Tangari D, Margari F. Awareness of the offense and perception of the victim among juvenile sex offenders. Clin Ter 2018; 169:e155-e164. [PMID: 30151548 DOI: 10.7417/t.2018.2072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION The present work presents data on research into adolescents who committed sex offenses, carried out in the Apulia Region of southern Italy and focused in particular on the perpetrators' perception of the peculiar profile of the criminal act committed. MATERIALS AND METHODS Three University sections of the School of Medicine, Bari University, took part in this research: Criminology and Forensic Psychopathology, Psychiatry and Juvenile Neuropsichiatry, working in collaboration with the Department for Juvenile Justice and the Community, and the Center for Juvenile Justice in Apulia. In total, 31 subjects were included in the study, all Juvenile Sex Offenders. A detailed questionnaire was employed to obtain all the relevant information of criminological concern. DISCUSSION Among most of the minors considered, a very poor awareness emerged of the peculiar type of offense committed, and of its consequences on the victims and the social context. RESULTS This finding highlights an evident contradiction and confusion between legislative provisions in the area of sex offenses and rape, and the perspectives of juveniles and adolescents. CONSLUSIONS There is an evident need for legislative norms to adopt registers that are more accessible to the complex juvenile world, that cannot be assimilated to the adult world.
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Affiliation(s)
- I Grattagliano
- Department of Educational Sciences, Psychology, Communication University of Bari Aldo Moro
| | - F Craig
- Scientific Institute I.R.C.C.S. "Eugenio Medea"- "La Nostra Famiglia", Unit for Severe disabilities in developmental age and young adults, Developmental Neurology and Neurorehabilitation, Brindisi Research Centre, Brindisi, Italy
| | - A Lisi
- Department of Educational Sciences, Psychology, Communication University of Bari Aldo Moro
| | - G Pierri
- Department of Educational Sciences, Psychology, Communication University of Bari Aldo Moro
| | - V Stallone
- Department of Educational Sciences, Psychology, Communication University of Bari Aldo Moro
| | - L Margari
- Department of neuroscience and sense organs, University of Bari Aldo Moro
| | - P Lecce
- Department of neuroscience and sense organs, University of Bari Aldo Moro
| | - E Lafortezza
- Department of neuroscience and sense organs, University of Bari Aldo Moro
| | - F Pinto
- Department of neuroscience and sense organs, University of Bari Aldo Moro
| | - R Pisani
- Department of neuroscience and sense organs, University of Bari Aldo Moro
| | - G Zagaria
- Department of neuroscience and sense organs, University of Bari Aldo Moro
| | - D Tangari
- Department of Educational Sciences, Psychology, Communication University of Bari Aldo Moro
| | - F Margari
- Department of neuroscience and sense organs, University of Bari Aldo Moro
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Dias Ferreira Reis JP, Branco Mano T, Viveiros Monteiros A, Sousa L, Oliveira JA, Branco L, Galrinho A, Fragata J, Pinto F, Cruz Ferreira R. P5484Marfan syndrome - clinical evaluation and long-term prognosis. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5484] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | | | | | - L Sousa
- Hospital de Santa Marta, Lisbon, Portugal
| | | | - L Branco
- Hospital de Santa Marta, Lisbon, Portugal
| | - A Galrinho
- Hospital de Santa Marta, Lisbon, Portugal
| | - J Fragata
- Hospital de Santa Marta, Lisbon, Portugal
| | - F Pinto
- Hospital de Santa Marta, Lisbon, Portugal
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23
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Gomes, Abreu S, Bourbon M, Pinto F. Familial Hypercholesterolemia study in dyslipidemic children and adolescents: “Like father, Like son”. Atherosclerosis 2018. [DOI: 10.1016/j.atherosclerosis.2018.06.550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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24
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Vered Z, Manouras A, Adirevitz L, Dragu R, Karev E, Malka Y, Jorde UP, Pinto F. P5110A novel method for accurate noninvasive assessment of LV filling pressures. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5110] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Z Vered
- Assaf Harofeh Medical Center, Zerifin, Israel
| | - A Manouras
- Karolinska University Hospital, Cardiology, Stockholm, Sweden
| | | | - R Dragu
- Rambam Medical Center, Department of Cardiology, Technion Institute of Science, Haifa, Israel
| | - E Karev
- CardiArt Technologies, Or Yehuda, Israel
| | - Y Malka
- CardiArt Technologies, Or Yehuda, Israel
| | - U P Jorde
- Albert Einstein College of Medicine, Cardiology, New York, United States of America
| | - F Pinto
- University Hospital De Santa Maria, Cardiology, Lisbon, Portugal
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25
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Pinto F, Cárcano FM, da Silva ECA, Vidal DO, Scapulatempo-Neto C, Lopes LF, Reis RM. Brachyury oncogene is a prognostic factor in high-risk testicular germ cell tumors. Andrology 2018; 6:597-604. [PMID: 29749711 DOI: 10.1111/andr.12495] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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: 01/11/2018] [Revised: 03/06/2018] [Accepted: 03/27/2018] [Indexed: 02/06/2023]
Abstract
The T-box transcription factor Brachyury has been considered a cancer-specific marker and a novel oncotarget in solid tumors. Brachyury overexpression has been described in various cancers, being associated with epithelial-mesenchymal transition, metastasis, and poor prognosis. However, its clinical association with testicular germ cell tumor is unknown. We analyzed the expression of Brachyury by immunohistochemistry in a series of well-characterized testicular germ cell tumor samples and at transcript level by in silico analysis. Additionally, we aimed to investigate the clinical significance of Brachyury in testicular germ cell tumor. Brachyury cytoplasm immunostaining was present in 89.6% (86/96) of cases with nuclear staining observed in 24% (23/96) of testicular germ cell tumor. Bioinformatics microarray expression analysis of two independent cohorts of testicular germ cell tumors showed similar results with increased levels of Brachyury in testicular germ cell tumors and metastasis compared with normal testis. Clinically, Brachyury nuclear staining was statistically associated with lower event-free survival (p = 0.04) and overall survival (p = 0.01) in intermediate/high-risk testicular germ cell tumors. Univariate analysis showed that Brachyury nuclear subcellular localization was a predictor of poor prognosis (p = 0.02), while a tendency was observed by multivariate analysis (HR: 3.56, p = 0.06). In conclusion, these results indicate that Brachyury plays an oncogenic role in testicular germ cell tumors and its subcellular localization in the nucleus may constitute a novel biomarker of poor prognosis and a putative oncotarget for intermediate/high-risk testicular germ cell tumor patients.
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Affiliation(s)
- F Pinto
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal.,I3S - Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal.,Institute of Molecular Pathology and Immunology of the University of Porto - IPATIMUP, Porto, Portugal
| | - F M Cárcano
- Department of Clinical Oncology, Barretos Cancer Hospital, Barretos, Sao Paulo, Brazil.,Barretos School of Health Sciences, Dr. Paulo Prata-FACISB, Barretos, Sao Paulo, Brazil.,Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Sao Paulo, Brazil
| | - E C A da Silva
- Department of Pathology, Barretos Cancer Hospital, Barretos, Sao Paulo, Brazil
| | - D O Vidal
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Sao Paulo, Brazil.,Children's Cancer Hospital, Barretos Cancer Hospital, Barretos, Sao Paulo, Brazil
| | - C Scapulatempo-Neto
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Sao Paulo, Brazil
| | - L F Lopes
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Sao Paulo, Brazil.,Children's Cancer Hospital, Barretos Cancer Hospital, Barretos, Sao Paulo, Brazil
| | - R M Reis
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal.,Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Sao Paulo, Brazil
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26
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Sacco E, Pinto F, Tienforti D, Marangi F, Destito A, Racioppi M, Gardi M, Volpe A, Bassi P. Investigational Drug Therapies for Overactive Bladder Syndrome: The Potential Alternatives to Anticolinergics. Urologia 2018. [DOI: 10.1177/039156030907600301] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Background Overactive bladder is a high prevalent and quality of life affecting disease. The mainstay of the medical therapy is represented by antimuscarinic drugs, but their side effects markedly affect patient compliance and prompt studies on novel investigational drugs. Methods A systematic literature search of peer-reviewed papers and meeting abstracts published by December 2008 was performed. PubMed databank was searched for original English articles, by using the following search terms: “overactive bladder” or “detrusor overactivity” or “urinary incontinence” and “treatment”, alone and linked to any potential molecular target or novel drug cited in the literature. Results Effective alternative pharmacological treatments are currently scarce, but many new promising compounds are emerging which target key molecular pathways involved in micturition control. The most promising potential therapeutic targets include central nervous system GABAergic inhibitory pathway, dopaminergic and serotoninergic systems, b-adrenoceptors and cAMP metabolism, nonadrenergic-noncholinergic mechanisms such as purinergic and neuropeptidergic systems, vanilloid receptor, bladder sensory nervous terminals, nonneuronal bladder signalling systems including urothelium and interstitial cells, prostanoids, Rho-kinase and different subtypes of potassium and calcium channels. Conclusions Despite the enormous amount of new biologic insight, very few novel pharmacological therapies seems to have passed the proof-of-concept clinical stage. The ultimate clinical utility of new drugs will depend on the ability to exploit tissue-specific differences and disease-related changes in molecular expression/function and to improve storage phase dysfunctions without interfering with the emptying phase. Further preclinical investigations and controlled clinical trials are urgently needed in this challenging field.
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Affiliation(s)
- E. Sacco
- Urologia, Policlinico Universitario “Agostino Gemelli”, Università’ Cattolica del Sacro Cuore, Roma
| | - F. Pinto
- Urologia, Policlinico Universitario “Agostino Gemelli”, Università’ Cattolica del Sacro Cuore, Roma
| | - D. Tienforti
- Urologia, Policlinico Universitario “Agostino Gemelli”, Università’ Cattolica del Sacro Cuore, Roma
| | - F. Marangi
- Urologia, Policlinico Universitario “Agostino Gemelli”, Università’ Cattolica del Sacro Cuore, Roma
| | - A. Destito
- Urologia, Policlinico Universitario “Agostino Gemelli”, Università’ Cattolica del Sacro Cuore, Roma
| | - M. Racioppi
- Urologia, Policlinico Universitario “Agostino Gemelli”, Università’ Cattolica del Sacro Cuore, Roma
| | - M. Gardi
- Urologia, Policlinico Universitario “Agostino Gemelli”, Università’ Cattolica del Sacro Cuore, Roma
| | - A. Volpe
- Urologia, Policlinico Universitario “Agostino Gemelli”, Università’ Cattolica del Sacro Cuore, Roma
| | - P.F. Bassi
- Urologia, Policlinico Universitario “Agostino Gemelli”, Università’ Cattolica del Sacro Cuore, Roma
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Abstract
In the last decades a growing interest has been dedicated to prevention, diagnosis and therapy of male genital pathologies, such as varicocele, infertility and erectile dysfunction in the population involved in sport activities. High incidence (up to 30%) of varicocele has been reported in a population of athletes and up to 60–80% in the subgroup of body-builders. The incidence of varicocele specifically increases with hours of training, in a linear model. Controversial data come from literature about the effects of physical activity on fertility, with prevalence of trials demonstrating worsening of seminal parameters. Furthermore, it has been demonstrated that physical stress in healthy male athletes can interfere with LH levels. Bicycling is one of the major risk factors for erectile dysfunction, with incidence of 13–24%. This is due to the prolonged compression of perineal arteries leading to reduced chronic penile perfusion. Bioengineering studies have been the basis for industry to produce specifically shaped saddles that significantly reduce and minimize compressive effects. Finally, high frequency of lower urinary tract symptoms (LUTS) in cyclists has been related to increased incidence of erectile dysfunction in comparison with normal population.
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Affiliation(s)
- G. Gulino
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - F. Sasso
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - A. D'Onofrio
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - G. Palermo
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - Di Luigi
- Servizio di Endocrinologia, Facoltà Scienze Motorie, ISUM, Roma
| | - E. Sacco
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - F. Pinto
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - P.F. Bassi
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
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Abstract
Introduction Statistical data referring to sports-related traumas of the urinary tract are quite scarce; nevertheless, it is possible to draw general data on the relationship between sports and urological traumas. Methods Literature review of peer-reviewed articles published by May 2009. Results Urological traumas account for about 10% of all traumas, and about 13% of them is sports-related. Genitourinary traumas are among the most common cause of abdominal injuries in sports. Blunt injuries are more common than penetrating ones and renal injuries are by far the most common, followed by testicular injuries; ureters, bladder and penis injuries are much more infrequent. Considering chronic microtraumas, injuries of bulbar urethra are also common in sports that involve riding. Overall, the incidence of genitourinary trauma due to sports is low. Renal traumas in sports injuries usually consist of grade 1–11 lesions and usually do not require surgical treatment. Cycling is the sporting activity most commonly associated with genitourinary injuries, followed by winter sports, horse riding and contact/collision sports. Literature data suggest that significant injuries are rare also in athletes with only one testicle or kidney. General preventive measures against sport-related injuries, along with the use of protective cups for male external genitalia, are generally sufficient to reduce the incidence of urogenital trauma. Conclusions Overall, studies show that urogenital injuries are uncommon in team and individual sports, and that most of them are low-grade injuries. Participation in sports that involve the potential for contact or collision needs to be carefully assessed in the athletes with only one testicle or kidney, even though urogenital injuries should not preclude sports participation to an appropriately informed and counseled patient. Further research is needed to acquire more knowledge on genitourinary injuries according to age, sports type and technical skill.
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Affiliation(s)
- E. Sacco
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - F. Marangi
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - F. Pinto
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - A. D'Addessi
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - M. Racioppi
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - G. Gulino
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - A. Volpe
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - M. Gardi
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - P.F. Bassi
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
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Abstract
Clinical effectiveness of botulinum toxin (BTX) in the treatment of both neurogenic and idiopathic detrusor overactivity has been demonstrated in several studies. However, different protocols and techniques have been used by authors. Methods. Literature review on intradetrusor injection of BTX for detrusor overactivity. Results. The greatest clinical experience reports the use of 200 and 300 U Botox®. Available data suggest that clinical efficacy, duration, and the side effect profile is similar at these doses. Very few data, on the other hand, are available regarding the clinical outcomes using the Dysport® preparation; isolated reports support that efficacy is similar when using a dosing range of 500 to 1000 SU with increased risk of systemic side effects using 1000 SU. A variety of injection volumes was used, demonstrating similar efficacy and tolerability profile. Clinical effect duration extends six to ten months in the majority of studies. Data suggest that a repeated injection scheme proves successful in the vast majority of initial responders. Conclusions. Safety, effectiveness, specificity and reversibility make BTX a new attractive treatment modality for overactive bladder syndrome. However, more experience is needed to standardize the injection protocol with respect to therapeutic outcomes and adverse effects.
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Affiliation(s)
- E. Sacco
- Urologia, Policlinico Universitario “Agostino Gemelli”, Università Cattolica del Sacro Cuore, Roma
| | - M. Paolillo
- Urologia, Policlinico Universitario “Agostino Gemelli”, Università Cattolica del Sacro Cuore, Roma
| | - A. Totaro
- Urologia, Policlinico Universitario “Agostino Gemelli”, Università Cattolica del Sacro Cuore, Roma
| | - F. Pinto
- Urologia, Policlinico Universitario “Agostino Gemelli”, Università Cattolica del Sacro Cuore, Roma
| | - A. Volpe
- Urologia, Policlinico Universitario “Agostino Gemelli”, Università Cattolica del Sacro Cuore, Roma
| | - M. Gardi
- Urologia, Policlinico Universitario “Agostino Gemelli”, Università Cattolica del Sacro Cuore, Roma
| | - P.F. Bassi
- Urologia, Policlinico Universitario “Agostino Gemelli”, Università Cattolica del Sacro Cuore, Roma
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Abstract
Introduction Prostatitis-like syndromes are high prevalent health problems and frequently considered by patients and physicians as strictly correlated to sports causing perineal compression. These syndromes and their relationships with sporting activities have been discussed in this report. Methods We reviewed peer-reviewed scientific articles published by May 2009 and searched according to the following term selection: prostatitis, pudendal nerve, sport, cycling. Results Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a major healthcare burden heavily affecting patients’ Quality of Life. No clear evidence of any direct etiologic relationship has been found in literature between prostatitis, either bacterial or non-bacterial, and sports activities. On the other hand, some types of sport causing perineal compression, such as cycling, can exacerbate symptoms of acute and chronic prostatitis; a temporary sport discontinuation is justified in these patients. CP/CPPS may be often caused by pudendal nerve entrapment (PNE). Prostatitis-like urogenital neuropathic pain together with voiding and sexual dysfunctions are the hallmark of PNE. A common feature is that flexion activities of the hip, such as climbing, squatting, cycling provoke or worsen urogenital pain or pelvic pain. Many of the patients with PNE are cyclists, played American football, lifted weights, or wrestled as teenagers and young adults. PNE represents the most common bicycling associated urogenital problems. Conclusions Overall, studies show that no causal relationship has been demonstrated between prostatitis and sporting activities. Conversely, urologists should be aware that sports involving vigorous hip flexion activities or prolonged perineal compression are a potential and not an infrequent cause of uroand rological symptoms caused by pudendal nerve entrapment.
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Affiliation(s)
- E. Sacco
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - A. Totaro
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - F. Marangi
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - F. Pinto
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - M. Racioppi
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - G. Gulino
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - A. Volpe
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - M. Gardi
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
| | - P.F. Bassi
- Clinica Urologica, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma
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31
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Volpe A, Racioppi M, D'Agostino D, Cappa E, Gardi M, Totaro A, Pinto F, Sacco E, Marangi F, Palermo G, Bassi P. Bladder Tumor Markers: A Review of the Literature. Int J Biol Markers 2018; 23:249-61. [DOI: 10.1177/172460080802300409] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Bladder cancer is among the top eight most frequent cancers. Its natural history is related to a combination of factors that impact on its aggressiveness. Cystoscopy and urine cytology are the currently used techniques for the diagnosis and surveillance of non-invasive bladder tumors. The sensitivity of urine cytology for diagnosis is not high, particularly in low-grade tumors. The combination of voided urine cytology and new diagnostic urine tests would be ideal for the diagnosis and follow-up of bladder cancer. However, in order to have some clinical utility, new diagnostic and/or prognostic markers should achieve better predictive capacity that the currently used diagnostic tools. None of the markers evaluated over the last years showed remarkable sensitivity or specificity for the identification of any of the diverse types of bladder cancer in clinical practice. The limitations of the known prognostic markers have led to the research of new molecular markers for early detection of bladder cancer. This research focused in particular on the discovery of biomarkers capable of reducing the need for periodic cystoscopies or, ideally, offering a non-invasive examination instead. In this review, we will examine various new markers of bladder cancer and their value in the diagnosis and follow-up of non-muscle-invasive bladder cancer. When compared with urine cytology, which showed the highest specificity, most of these markers demonstrated an increased sensitivity.
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Affiliation(s)
- A. Volpe
- Department of Urology, The Catholic University School of Medicine, Rome - Italy
| | - M. Racioppi
- Department of Urology, The Catholic University School of Medicine, Rome - Italy
| | - D. D'Agostino
- Department of Urology, The Catholic University School of Medicine, Rome - Italy
| | - E. Cappa
- Department of Urology, The Catholic University School of Medicine, Rome - Italy
| | - M. Gardi
- Department of Urology, The Catholic University School of Medicine, Rome - Italy
| | - A. Totaro
- Department of Urology, The Catholic University School of Medicine, Rome - Italy
| | - F. Pinto
- Department of Urology, The Catholic University School of Medicine, Rome - Italy
| | - E. Sacco
- Department of Urology, The Catholic University School of Medicine, Rome - Italy
| | - F. Marangi
- Department of Urology, The Catholic University School of Medicine, Rome - Italy
| | - G. Palermo
- Department of Urology, The Catholic University School of Medicine, Rome - Italy
| | - P.F. Bassi
- Department of Urology, The Catholic University School of Medicine, Rome - Italy
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Marinho-Rito T, Freitas I, Diogo MJ, Rodrigues R, Fragata J, Pinto F. Aorto-left ventricular tunnel: a rare cause of heart failure in the newborn. Images Paediatr Cardiol 2018; 20:8-11. [PMID: 30792742 PMCID: PMC6360498] [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] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Aorto-left ventricular tunnel is a rare congenital cardiac anomaly, consisting of a short abnormal pathway, usually from a sinus of Valsalva into the left ventricular cavity. It is usually diagnosed with echocardiography. We report a case of a newborn presenting with heart murmur and rapid progression to heart failure and left ventricular enlargement due to an aorto-left ventricular tunnel. Despite successful closure of the tunnel, the patient required a Ross procedure due to progressive aortic disease.
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Affiliation(s)
- T Marinho-Rito
- aPediatric Cardiology Department, Hospital de Santa Marta - CHLC, EPE, Lisbon, Portugal.,Tiago Filipe Marinho-Rito: Serviço de Cardiologia Pediátrica - Hospital de Santa Marta. Rua de Santa Marta. 1169-024 Lisboa, PortugalTelephone: +351 213 594 332; Fax: +351 213 594 034
| | - I Freitas
- aPediatric Cardiology Department, Hospital de Santa Marta - CHLC, EPE, Lisbon, Portugal
| | - Martins J Diogo
- aPediatric Cardiology Department, Hospital de Santa Marta - CHLC, EPE, Lisbon, Portugal
| | - R Rodrigues
- bCardiothoracic Surgery Department, Hospital de Santa Marta - CHLC, EPE, Lisbon, Portugal
| | - J Fragata
- bCardiothoracic Surgery Department, Hospital de Santa Marta - CHLC, EPE, Lisbon, Portugal
| | - F Pinto
- aPediatric Cardiology Department, Hospital de Santa Marta - CHLC, EPE, Lisbon, Portugal
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33
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Abreu D, Sousa P, Matias-Dias C, Pinto F. Impact of public health initiatives in acute coronary syndrome and stroke. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx187.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Daisy Abreu
- Escola Nacional de Saúde Pública, Lisbon, Portugal
| | - P Sousa
- Escola Nacional de Saúde Pública, Lisbon, Portugal
| | - C Matias-Dias
- Department of Epidemiology of the Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal
| | - F Pinto
- Serviço de Cardiologia, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte - EPE, Lisbon, Portugal
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34
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Barata A, Leal I, Sousa F, Teixeira F, Henriques J, Pinto F. Macular thickness changes using spectral-domain optical coherence tomography automated layer segmentation in multiple sclerosis. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.0t025] [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. Barata
- Ophthalmology; Hospital de Santa Maria; Lisbon Portugal
| | - I. Leal
- Ophthalmology; Hospital de Santa Maria; Lisbon Portugal
| | - F. Sousa
- Ophthalmology; Hospital de Santa Maria; Lisbon Portugal
| | - F. Teixeira
- Ophthalmology; Hospital de Santa Maria; Lisbon Portugal
| | - J. Henriques
- Ophthalmology; Instituto de Retina de Lisboa; Lisbon Portugal
| | - F. Pinto
- Ophthalmology; Hospital de Santa Maria; Lisbon Portugal
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35
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Barata A, Teixeira F, Pinto F. ISNT rule applicability based on optical coherence tomography parameters in a normal Portuguese population. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.0s060] [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: 11/29/2022]
Affiliation(s)
- A. Barata
- Ophthalmology; Hospital de Santa Maria; Lisboa Portugal
| | - F. Teixeira
- Ophthalmology; Hospital de Santa Maria; Lisboa Portugal
| | - F. Pinto
- Ophthalmology; Hospital de Santa Maria; Lisboa Portugal
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36
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Teixeira F, Barata A, Pinto-Ferreira N, Mano S, Pinto F, Fonseca A. A review of orbital tumors in adult Portuguese population. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.04145] [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: 11/27/2022]
Affiliation(s)
- F. Teixeira
- Ophthalmology; Hospital Santa Maria; Lisboa Portugal
| | - A. Barata
- Ophthalmology; Hospital Santa Maria; Lisboa Portugal
| | | | - S. Mano
- Ophthalmology; Hospital Santa Maria; Lisboa Portugal
| | - F. Pinto
- Ophthalmology; Hospital Santa Maria; Lisboa Portugal
| | - A. Fonseca
- Ophthalmology; Hospital Santa Maria; Lisboa Portugal
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37
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Barata A, Leal I, Sousa F, Teixeira F, Pinto F. Inner retina changes in hydroxychloroquine patients. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.01517] [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: 11/30/2022]
Affiliation(s)
- A. Barata
- Ophthalmology; Hospital de Santa Maria; Lisboa Portugal
| | - I. Leal
- Ophthalmology; Hospital de Santa Maria; Lisboa Portugal
| | - F. Sousa
- Ophthalmology; Hospital de Santa Maria; Lisboa Portugal
| | - F. Teixeira
- Ophthalmology; Hospital de Santa Maria; Lisboa Portugal
| | - F. Pinto
- Ophthalmology; Hospital de Santa Maria; Lisboa Portugal
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38
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Lima Da Silva G, Cortez-Dias N, Guimaraes T, Nobre Menezes M, Santos L, Goncalves S, Conceicao I, Pinto F, Azevedo Coutinho M. P5847Long-term evolution of longitudinal myocardial deformation in the natural history of familial amyloid polyneuropathy. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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39
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Dias D, Lapa N, Bernardo M, Godinho D, Fonseca I, Miranda M, Pinto F, Lemos F. Properties of chars from the gasification and pyrolysis of rice waste streams towards their valorisation as adsorbent materials. Waste Manag 2017; 65:186-194. [PMID: 28400156 DOI: 10.1016/j.wasman.2017.04.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Revised: 03/21/2017] [Accepted: 04/03/2017] [Indexed: 06/07/2023]
Abstract
Rice straw (RS), rice husk (RH) and polyethylene (PE) were blended and submitted to gasification and pyrolysis processes. The chars obtained were submitted to textural, chemical, and ecotoxic characterisations, towards their possible valorisation. Gasification chars were mainly composed of ashes (73.4-89.8wt%), while pyrolysis chars were mainly composed of carbon (53.0-57.6wt%). Silicon (Si) was the major mineral element in all chars followed by alkaline and alkaline-earth metal species (AAEMs). In the pyrolysis chars, titanium (Ti) was also a major element, as the feedstock blends contained high fractions of PE which was the main source of Ti. Gasification chars showed higher surface areas (26.9-62.9m2g-1) and some microporosity, attributed to porous silica. On the contrary, pyrolysis chars did not present a porous matrix, mainly due to their high volatile matter content. The gasification bed char produced with 100% RH, at 850°C, with O2 as gasification agent, was selected for further characterization. This char presented the higher potential to be valorised as adsorbent material (higher surface area, higher content of metal cations with exchangeable capacity, and lowest concentrations of toxic heavy metals). The char was submitted to an aqueous leaching test to assess the mobility of chemical species and the ecotoxic level for V. fischeri. It was observed that metallic elements were significantly retained in the char, which was attributed mainly to its alkaline character. This alkaline condition promoted some ecotoxicity level on the char eluate that was eliminated after the pH correction.
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Affiliation(s)
- D Dias
- LAQV/REQUIMTE, Departamento de Ciências e Tecnologia da Biomassa (DCTB), Faculdade de Ciências e Tecnologia (FCT), Universidade Nova de Lisboa (UNL), 2829-516 Caparica, Portugal
| | - N Lapa
- LAQV/REQUIMTE, Departamento de Ciências e Tecnologia da Biomassa (DCTB), Faculdade de Ciências e Tecnologia (FCT), Universidade Nova de Lisboa (UNL), 2829-516 Caparica, Portugal
| | - M Bernardo
- LAQV/REQUIMTE, Departamento de Química (DQ), Faculdade de Ciências e Tecnologia (FCT), Universidade Nova de Lisboa (UNL), 2829-516 Caparica, Portugal.
| | - D Godinho
- LAQV/REQUIMTE, Departamento de Ciências e Tecnologia da Biomassa (DCTB), Faculdade de Ciências e Tecnologia (FCT), Universidade Nova de Lisboa (UNL), 2829-516 Caparica, Portugal
| | - I Fonseca
- LAQV/REQUIMTE, Departamento de Química (DQ), Faculdade de Ciências e Tecnologia (FCT), Universidade Nova de Lisboa (UNL), 2829-516 Caparica, Portugal
| | - M Miranda
- Unidade de Bioenergia (UB), Laboratório Nacional de Energia e Geologia (LNEG), Estrada do Paço do Lumiar, Ed. J, 1649-038 Lisboa, Portugal
| | - F Pinto
- Unidade de Bioenergia (UB), Laboratório Nacional de Energia e Geologia (LNEG), Estrada do Paço do Lumiar, Ed. J, 1649-038 Lisboa, Portugal
| | - F Lemos
- IBB - Instituto de Biotecnologia e Bioengenharia, Departamento de Engenharia Química (DEQ), Instituto Superior Técnico (IST), Universidade de Lisboa (UL), Av. Rovisco Pais, 1049-001 Lisboa, Portugal
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40
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Arantes C, Cortez-Dias N, Agostinho J, Goncalves IS, Lima Da Silva G, Francisco AR, Carneiro M, Neto S, Quaresma J, Carpinteiro L, Pinto F, Sousa J. P371Impact of contact force sensing ablation catheter on atrial fibrillation ablation procedure. Europace 2017. [DOI: 10.1093/ehjci/eux141.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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41
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Arantes C, Cortez-Dias N, Lima Da Silva G, Agostinho J, Goncalves IS, Guimaraes T, Cota S, Neto S, Barreiros C, Carpinteiro L, Pinto F, Sousa J. 1170Ablation of atrial fibrillation: does age matters? Europace 2017. [DOI: 10.1093/ehjci/eux153.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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42
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Cardoso B, Loureiro P, Gomes I, Gordo A, Banazol N, Fragata I, Trigo C, Pinto F, Fragata J. Mitral Valve Surgery for Rheumatic Lesions in Young Patients. World J Pediatr Congenit Heart Surg 2017; 7:321-8. [PMID: 27142399 DOI: 10.1177/2150135116637806] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [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: 10/04/2015] [Accepted: 02/12/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND The appropriateness of rheumatic mitral valve repair remains controversial due to the risks of recurrent mitral dysfunction and need for reoperation. The aims of this study were to determine the overall short- and long-term outcomes of pediatric rheumatic mitral valve surgery in our center. METHODS Single-center, observational, retrospective study that analyzed the results of rheumatic mitral valve surgery in young patients, consecutively operated by the same team, between 1999 and 2014. RESULTS We included 116 patients (mean age = 12.6 ± 3.5 years), of which 66 (57%) were females. A total of 116 primary surgical interventions and 22 reoperations were performed. Primary valve repair was possible in 86 (74%) patients and valve replacement occurred in 30 (26%). Sixty percent of the patients were followed up beyond three months after surgery (median follow-up time = 9.2 months [minimum = 10 days; maximum = 15 years]). Long-term clinical outcomes were favorable, with most patients in New York Heart Association functional class I (89.6%) and in sinus rhythm (85%). Freedom from reoperation for primary valve repair at six months, five years, and ten years was 96.4% ± 0.25%, 72% ± 0.72%, and 44.7% ± 1.34%, respectively. Freedom from reoperation for primary valve replacement at six months, five years, and ten years was 100%, 91.7% ± 0.86%, and 91.7% ± 0.86%, respectively. Mitral stenosis as the primary lesion dictated early reintervention. CONCLUSIONS Despite the greater rate of reoperation, especially when the primary lesion was mitral stenosis, rheumatic mitral valve repair provides similar clinical outcomes as compared with replacement, with the advantage of avoiding anticoagulation.
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Affiliation(s)
- B Cardoso
- Department of Pediatric Cardiology, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, EPE, Lisbon, Portugal
| | - P Loureiro
- Department of Pediatric Cardiology, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, EPE, Lisbon, Portugal
| | - I Gomes
- Department of Pediatric Cardiology, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, EPE, Lisbon, Portugal
| | - A Gordo
- Department of Cardiothoracic Surgery, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, EPE, Lisbon, Portugal
| | - N Banazol
- Department of Cardiothoracic Surgery, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, EPE, Lisbon, Portugal
| | - I Fragata
- Department of Anesthesiology, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, EPE, Lisbon, Portugal
| | - C Trigo
- Department of Pediatric Cardiology, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, EPE, Lisbon, Portugal
| | - F Pinto
- Department of Pediatric Cardiology, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, EPE, Lisbon, Portugal
| | - José Fragata
- Department of Cardiothoracic Surgery, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, EPE, Lisbon, Portugal
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43
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Pinto F, Große‐Büning S, Karsai S, Weiß C, Bäumler W, Hammes S, Felcht M, Raulin C. Neodymium‐doped yttrium aluminium garnet (Nd:
YAG
) 1064‐nm picosecond laser vs. Nd:
YAG
1064‐nm nanosecond laser in tattoo removal: a randomized controlled single‐blind clinical trial. Br J Dermatol 2017; 176:457-464. [DOI: 10.1111/bjd.14962] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2016] [Indexed: 12/23/2022]
Affiliation(s)
- F. Pinto
- Pinto Medical Spa Centro Laser Dermatologico Roma Rome Italy
| | - S. Große‐Büning
- Laserklinik Karlsruhe und Medizinisches Versorgungszentrum Karlsruhe Germany
| | - S. Karsai
- Department of Dermatology Klinikum Darmstadt Darmstadt Germany
- Department of Dermatology University Hospital Greifswald Ferdinand‐Sauerbruchstraße Greifswald Germany
| | - C. Weiß
- Department of Medical Statistics, Biomathematics and Information Processing Medical Faculty Mannheim Heidelberg University Mannheim Germany
| | - W. Bäumler
- Department of Dermatology Regensburg University Hospital Regensburg Germany
| | - S. Hammes
- Laserklinik Karlsruhe und Medizinisches Versorgungszentrum Karlsruhe Germany
| | - M. Felcht
- Department of Dermatology, Venereology and Allergy University Medical Centre Mannheim Centre of Excellence of Dermatology of Baden‐Wuerttemberg Ruprecht‐Karls‐University of Heidelberg Mannheim Germany
| | - C. Raulin
- Laserklinik Karlsruhe und Medizinisches Versorgungszentrum Karlsruhe Germany
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Godinho D, Dias D, Bernardo M, Lapa N, Fonseca I, Lopes H, Pinto F. Adding value to gasification and co-pyrolysis chars as removal agents of Cr 3. J Hazard Mater 2017; 321:173-182. [PMID: 27619963 DOI: 10.1016/j.jhazmat.2016.09.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 08/17/2016] [Accepted: 09/03/2016] [Indexed: 06/06/2023]
Abstract
The present work aims to assess the efficiency of chars, obtained from the gasification and co-pyrolysis of rice wastes, as adsorbents of Cr3+ from aqueous solution. GC and PC chars, produced in the gasification and co-pyrolysis, respectively, of rice husk and polyethylene were studied. Cr3+ removal assays were optimised for the initial pH value, adsorbent mass, contact time and Cr3+ initial concentration. GC showed a better performance than PC with about 100% Cr3+ removal, due to the pH increase that caused Cr precipitation. Under pH conditions in which the adsorption prevailed (pH<5.5), GC presented the highest uptake capacity (21.1mg Cr3+ g-1 char) for the following initial conditions: 50mg Cr3+ L-1; pH 5; contact time: 24h;L/S ratio: 1000mLg-1. The pseudo-second order kinetic model showed the best adjustment to GC experimental data. Both the first and second order kinetic models fitted well to PC experimental data. The ion exchange was the dominant phenomenon on the Cr3+ adsorption by GC sample. Also, this char significantly reduced the ecotoxicity of Cr3+ solutions for the bacterium Vibrio fischeri. GC char proved to be an efficient material to remove Cr3+ from aqueous solution, without the need for further activation.
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Affiliation(s)
- D Godinho
- LAQV-REQUIMTE, Departamento de Ciências e Tecnologia da Biomassa, Faculdade de Ciências e Tecnologia, Universidade Nova de Lisboa, 2829-516 Caparica, Portugal
| | - D Dias
- LAQV-REQUIMTE, Departamento de Ciências e Tecnologia da Biomassa, Faculdade de Ciências e Tecnologia, Universidade Nova de Lisboa, 2829-516 Caparica, Portugal
| | - M Bernardo
- LAQV-REQUIMTE, Departamento de Química, Faculdade de Ciências e Tecnologia, Universidade Nova de Lisboa, 2829-516 Caparica, Portugal
| | - N Lapa
- LAQV-REQUIMTE, Departamento de Ciências e Tecnologia da Biomassa, Faculdade de Ciências e Tecnologia, Universidade Nova de Lisboa, 2829-516 Caparica, Portugal.
| | - I Fonseca
- LAQV-REQUIMTE, Departamento de Química, Faculdade de Ciências e Tecnologia, Universidade Nova de Lisboa, 2829-516 Caparica, Portugal
| | - H Lopes
- Unidade de Bioenergia, Laboratório Nacional de Energia e Geologia, Estrada do Paço do Lumiar, Ed. J, 1649-038 Lisboa, Portugal
| | - F Pinto
- Unidade de Bioenergia, Laboratório Nacional de Energia e Geologia, Estrada do Paço do Lumiar, Ed. J, 1649-038 Lisboa, Portugal
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Tojino AL, Laymouna R, Monteiro A, Velcea A, Almeida Morais L, Enzan N, Wang TL, Kemaloglu Oz TUĞBA, Mursa A, Pfeiffer B, Tomaszewski M, Cuddy S, Giubertoni A, Rojo Prieto N, Ruivo C, Saito M, Dorobantu DM, Kemal HS, Sta Maria HF, Tiongco RP, Elsharkawy E, Morsy Y, Elshafei M, Elgowelly M, Almaghraby A, Branco L, Agapito A, Sousa L, Galrinho A, Pinto F, Rio P, Rosa S, Portugal G, Ferreira R, Mihaila S, Patrascu N, Adronic A, Cinteza M, Vinereanu D, Fiarresga A, Cacela D, Sousa L, Galrinho A, Branco L, Rodrigues R, Banazol N, Ferreira L, Ferreira R, Tsutsumi T, Matsumoto T, Uchida T, Yamada A, Hsiung MC, Eren MEHMET, Zarma L, Popescu BA, Ginghina C, Jurcut R, Neugebauer A, Rigopoulos A, Seggewiss H, Czekajska-Chehab E, Pietura R, Tomaszewski A, Sullivan V, Cosgrave J, Daly C, Murphy R, Zanaboni J, Gravellone M, Piccinino C, Marino PN, Lezcano Pertejo C, Hernandez Diez C, Alvarez Roy L, Martinez Paz E, Ascencio Lemus MG, Lopez Benito M, Fernandez-Vazquez F, Martin Gutierrez E, Castano Ruiz M, Guardado J, Santos L, Montenegro Sa F, Saraiva F, Correia J, Morais J, Mahara K, Ueda T, Ishii T, Hamamichi Y, Katsuragi S, Enache R, Platon P, Vladaia A, Popescu BA, Ginghina CD, Gunsel A, Cerit L, Duygu HS. Clinical Case Poster session 2P608Infective endocarditis in an adult female with bicuspid aortic valve, hypertrophic cardiomyopathy and amyopathic dermatomyositisP609Left ventricular massP610A rare case of mitral stenosis - Shones syndromeP611The added value of three-dimensional echocardiography in the late diagnosis of a pacemaker complication in a patient with severe congestive heart failureP612Percutaneous paravalvular leak closure - procedure pitfallsP613A case of late left ventricular pseudoaneurysm after aortic valve replacement for infective endocarditis.P614Pseudoaneurysm of right ventricle and acute heart failure caused by prosthetic aortic valve endocarditisP615A misclassification of pulmonary stenosis severity during pregnancyP616A problematic case of left ventricular hypertrophyP617High variability of dynamic obstruction in a patient with hypertrophic obstructive cardiomyopathy and tako-tsubo-cardiomyopathyP618Arterio-venous pulmonary fistula in patient after cerebral strokeP619Rapid myocardial calcification in acute sepsisP620Acute right heart failure after delivery in patient with new-diagnosed pulmonary arterial hypertensionP621When the right ventricle plays hide-and-seekP622Adult congenital heart disease: when what grows wrong goes wrongP623Prenatal diagnosis of mixed type total anomalous pulmonary venous connection in aspleniaP624Uncorrected single ventricle in an adult patient: do coexisting valvular abnormalities matter?P625Ventricular septal aneurysm associated with bicuspid aorta: a case report. Eur Heart J Cardiovasc Imaging 2016. [DOI: 10.1093/ehjci/jew249] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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46
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Cordeiro Sousa D, Leal I, Couceiro R, Bigotte Vieira M, Lopez N, Resina C, Neves F, Gomes da Costa A, Pinto F, Marques-Neves C, Proença H. Changes in choroidal thickness and mean ocular perfusion pressure with hemodialysis. Acta Ophthalmol 2016. [DOI: 10.1111/j.1755-3768.2016.0626] [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]
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47
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Leal I, Cordeiro Sousa D, Couceiro R, Bigotte Vieira M, Noélia L, Resina C, Neves F, Gomes da Costa A, Pinto F, Marques-Neves C, Proença H. Ultrafiltration rate in hemodialysis does not affect mean ocular perfusion pressure or intraocular pressure in end-stage renal disease. Acta Ophthalmol 2016. [DOI: 10.1111/j.1755-3768.2016.0495] [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]
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48
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Barberi S, D Auria E, Bernardo L, Pinto F, Pietra B, Ciprandi G. Isotonic saline in children with perennial allergic rhinitis. J BIOL REG HOMEOS AG 2016; 30:605-608. [PMID: 27358156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Children with HDM allergy suffer from perennial allergic rhinitis (PAR). The present pilot study evaluated nasal lavage with isotonic saline (0.9%) in 25 children (mean age 8.9 years; 13 males) with HDM-dependent PAR, assessing: nasal symptoms severity and parental perception of rhinitis control, sleep, and school performance. Nasal symptoms, rated by total symptom score, parental perception of PER control, sleep quality, and school performance, measured by visual analogue scale, were significantly improved by nasal lavage (p < 0.001) after treatment. The effects tended to persist also during the follow-up. In conclusion, the present pilot study provides the first evidence that nasal lavage with isotonic saline relieved the nasal symptoms of children with PAR and improved the parental perception of the disease.
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Affiliation(s)
- S Barberi
- Department of Pediatrics, A.O. Fatebenefratelli, Milan, Italy
| | - E D Auria
- Department of Pediatrics, San Paolo Hospital, University of Milan, Italy
| | - L Bernardo
- Department of Pediatrics, A.O. Fatebenefratelli, Milan, Italy
| | - F Pinto
- Department of Pediatrics, A.O. Fatebenefratelli, Milan, Italy
| | - B Pietra
- Department of Pediatrics, San Paolo Hospital, University of Milan, Italy
| | - G Ciprandi
- Department of Medicine, IRCCS-AOU San Martino, Genoa, Italy
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49
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Marsico G, Rasulo A, Dimatteo S, Tarricone S, Pinto F, Ragni M. Pig, F1 (wild boar x pig) and wild boar meat quality. Italian Journal of Animal Science 2016. [DOI: 10.4081/ijas.2007.1s.701] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- G. Marsico
- Dipartimento di Produzione Animale. Università di Bari, Italy
| | - A. Rasulo
- Dipartimento di Produzione Animale. Università di Bari, Italy
| | - S. Dimatteo
- Dipartimento di Produzione Animale. Università di Bari, Italy
| | - S. Tarricone
- Dipartimento di Produzione Animale. Università di Bari, Italy
| | - F. Pinto
- Dipartimento di Produzione Animale. Università di Bari, Italy
| | - M. Ragni
- Dipartimento di Produzione Animale. Università di Bari, Italy
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50
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Vieira H, Rodrigues C, Pereira L, Jesus J, Bento C, Seco C, Pinto F, Eufrásio A, Calretas S, Silva N, Ferrão J, Tomé L, Barros A, Diogo D, Furtado E. Liver retransplantation in patients with acquired familial amyloid polyneuropathy: a Portuguese center experience. Transplant Proc 2016; 47:1012-5. [PMID: 26036507 DOI: 10.1016/j.transproceed.2015.04.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
In 1995 Furtado et al performed the first domino transplantation using a donor liver with familial amyloid polyneuropathy (FAP), thereby increasing the pool of donors. Our experience showed that the onset of FAP symptoms occurs earlier in some patients. Patients with FAP acquired by transplantation are candidates for liver retransplantation to minimize the progression of symptoms. Liver retransplantation is considered to be a high-risk procedure and has lower survival compared with the first transplantation. We evaluated the risk of liver retransplantation in patients with acquired FAP. We did a retrospective analysis of these patients based on the records of perioperative data. From 1995 to 2004 we carried out 81 domino transplantations, of which 10 were submitted to liver retransplantation because of acquired FAP. The better outcomes in this group lead us to think that the liver retransplantation in patients with acquired FAP is not associated with the same risks of liver retransplantation in candidates with graft failure.
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Affiliation(s)
- H Vieira
- Serviço de Anestesiologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Unidade de Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
| | - C Rodrigues
- Serviço de Anestesiologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - L Pereira
- Serviço de Anestesiologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Unidade de Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - J Jesus
- Serviço de Anestesiologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - C Bento
- Serviço de Anestesiologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Unidade de Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - C Seco
- Serviço de Anestesiologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Unidade de Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - F Pinto
- Serviço de Anestesiologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Unidade de Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - A Eufrásio
- Serviço de Anestesiologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Unidade de Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - S Calretas
- Unidade de Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - N Silva
- Unidade de Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - J Ferrão
- Unidade de Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - L Tomé
- Unidade de Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - A Barros
- Unidade de Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - D Diogo
- Unidade de Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - E Furtado
- Unidade de Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
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