1
|
Salgado-Borges J, Borges A, Ferreira I, González-Méijome JM, Faria-Ribeiro M. Optical characterization and through-focus performance of two advanced monofocal intraocular lenses. Graefes Arch Clin Exp Ophthalmol 2024; 262:1539-1544. [PMID: 38038729 PMCID: PMC11031439 DOI: 10.1007/s00417-023-06322-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 11/08/2023] [Accepted: 11/23/2023] [Indexed: 12/02/2023] Open
Abstract
PURPOSE To compare the refractive power profile, subjective depth-of-field and objective optical quality of two advanced monofocal intraocular lenses (IOLs) designed to improve intermediate vision. METHODS This prospective study evaluated forty-six eyes of twenty-three patients, aged 54-68 years, binocularly implanted with two monofocal enhanced intraocular lenses (IOLs), the Tecnis Eyhance and the Physiol Isopure. Subjective through-focus visual acuity curves were obtained by placing trial lenses in front of the eye while wearing its best spherical-cylindrical correction for distance. Objective optical quality was defined as the area under the modulation transfer function, calculated from the wavefront maps measured with a high-resolution aberrometer. The optical design of both lenses was compared based on their refractive power profiles measured with the lenses immersed in saline solution. RESULTS Both lenses have progressive aspherical geometries, in which the sagittal power decreases rapidly from the center to the edge of the optical zone. Mean monocular through-focus curves show a best corrected distance visual acuity of - 0.02 logMAR with both lenses. Through-focus visual acuity was marginally higher for the Eyhance, with a difference of 1 letter at the defocus position of - 0.5D and 3 letters between - 1.0D and - 2.0D. Objective assessment of optical quality revealed only a difference of about 2 points in MTF area at distance. CONCLUSION Both IOLs use a similar approach to improve intermediate vision. The Eyhance showed marginally better subjective performance than the Isopure at the target vergences between - 1.00D and - 2.00D, although these results did not reach statistical significance and were not replicated by the objective findings.
Collapse
Affiliation(s)
| | | | | | | | - Miguel Faria-Ribeiro
- Physics Center of Minho and Porto Universities, University of Minho, Campus de Gualtar, Ed. 6, Braga, Portugal.
| |
Collapse
|
2
|
Kreve S, Ferreira I, Dos Reis AC. Zirconia Implants Produced by Additive Manufacturing - A Scoping Review. Eur J Prosthodont Restor Dent 2024; 32:9-19. [PMID: 37721549 DOI: 10.1922/ejprd_2513kreve11] [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] [Received: 01/19/2023] [Accepted: 06/18/2023] [Indexed: 09/19/2023]
Abstract
INTRODUCTION Additive manufacturing is a tool with potential use in medicine and dentistry. The manufacture of metals and composites is already advanced, however, concerns about titanium hypersensitivity, tissue staining, and corrosion caused by gradual material degradation encourage research into more biocompatible alternatives. OBJECTIVE This systematic scoping review aimed to gather studies that evaluated zirconia implants produced by additive manufacturing to describe the current stage of the printing technique and the final product. METHODS Searches in Embase, PubMed, SCOPUS, Web of Science, and Google Scholar databases were enriched with manual searches between February and March 2021 and updated in June 2022 using keywords: zirconium implants, zirconium oxide, additive manufacturing, rapid prototyping, 3D printing, selective laser melting, and electron beam melting. The criteria included studies that evaluated or described zirconia implants obtained by 3D printing, with a direct relationship to dentistry or orthopedics. RESULTS The database search resulted in 671 articles. Eight articles were selected for full reading and remained in this systematic review. CONCLUSION The printing technique for zirconia implants is promising. However, further studies are required before implants produced by the printing technique can be tested clinically. The literature with results regarding the impression product is still limited.
Collapse
Affiliation(s)
- S Kreve
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - I Ferreira
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - A C Dos Reis
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo (USP), Ribeirão Preto, Brazil
| |
Collapse
|
3
|
de Castro DT, Ferreira I, Oliveira VC, Schiavon MA, Dos Reis AC. Denture Adhesives Associated with Silver Vanadate: Antimicrobial Approach Against Multi- Species Biofilms on Acrylic Resin Surfaces. Eur J Prosthodont Restor Dent 2024. [PMID: 38373220 DOI: 10.1922/ejprd_2640decastro09] [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] [Received: 10/11/2023] [Accepted: 01/17/2024] [Indexed: 02/21/2024]
Abstract
Alternatives have been sought to add an antimicrobial property to denture adhesives. This study evaluated the antimicrobial potential of adhesives associated with nanostructured silver vanadate decorated with silver nanoparticles (β-AgVO3). Specimens in acrylic resin were treated with the adhesives associated with β-AgVO3 (1%, 2.5%, 5% and 10%). As control, specimens treated only with Ultra Corega Cream (UCC) or Ultra Corega Powder (UCP) adhesive were used. Multispecies biofilm of Candida albicans, Candida glabrata, Streptococcus mutans and Staphylococcus aureus was evaluated by counting colony forming units per milliliter (CFU/mL), colorimetric assay and fluorescence microscopy. The data were analyzed using the two-way analysis of variance (ANOVA) and Bonferroni multiple comparisons test (α=0.05). For both adhesives, a small amount of β-AgVO3 (1%) completely inhibited S. mutans (P⟨0.05). For the other microorganisms, there was a reduction in metabolic activity and complete inhibition in the groups with intermediate or greater amounts of nanomaterial (P⟨0.05), except for C. albicans, which was reduced (P⟨0.05) but not completely inhibited in UCP. Microscopy that showed less biofilm in the groups with β-AgVO3 and in the UCC than UCP. Denture adhesives in powder and cream form with β-AgVO3 showed potential antimicrobial activity against multispecies biofilm. Powder adhesive showed higher biofilm formation.
Collapse
Affiliation(s)
- D T de Castro
- Postdoctorate, Department of Dental Materials and Prosthodontics, Ribeirao Preto School of Dentistry, University of Sao Paulo, Ribeirao Preto- SP, Brazil
| | - I Ferreira
- Graduate Student, Department of Dental Materials and Prosthodontics, Ribeirao Preto School of Dentistry, University of Sao Paulo, Ribeirao Preto-SP, Brazil
| | - V C Oliveira
- Specialized Laboratory Technician, Department of Dental Materials and Prosthodontics, Ribeirao Preto School of Dentistry, University of Sao Paulo, Ribeirao Preto-SP, Brazil
| | - M A Schiavon
- Titular Professor, Department of Natural Sciences, Federal University of São Joao Del-Rei (UFSJ), São Joao Del-Rei (MG), Brazil
| | - A C Dos Reis
- Associated Professor, Department of Dental Materials and Prosthodontics, Ribeirao Preto School of Dentistry, University of Sao Paulo, Ribeirao Preto-SP, Brazil
| |
Collapse
|
4
|
Antony JS, Birrer P, Bohnert C, Zimmerli S, Hillmann P, Schaffhauser H, Hoeflich C, Hoeflich A, Khairallah R, Satoh AT, Kappeler I, Ferreira I, Zuideveld KP, Metzger F. Local application of engineered insulin-like growth factor I mRNA demonstrates regenerative therapeutic potential in vivo. Mol Ther Nucleic Acids 2023; 34:102055. [PMID: 37928443 PMCID: PMC10622308 DOI: 10.1016/j.omtn.2023.102055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 10/11/2023] [Indexed: 11/07/2023]
Abstract
Insulin-like growth factor I (IGF-I) is a growth-promoting anabolic hormone that fosters cell growth and tissue homeostasis. IGF-I deficiency is associated with several diseases, including growth disorders and neurological and musculoskeletal diseases due to impaired regeneration. Despite the vast regenerative potential of IGF-I, its unfavorable pharmacokinetic profile has prevented it from being used therapeutically. In this study, we resolved these challenges by the local administration of IGF-I mRNA, which ensures desirable homeostatic kinetics and non-systemic, local dose-dependent expression of IGF-I protein. Furthermore, IGF-I mRNA constructs were sequence engineered with heterologous signal peptides, which improved in vitro protein secretion (2- to 6-fold) and accelerated in vivo functional regeneration (16-fold) over endogenous IGF-I mRNA. The regenerative potential of engineered IGF-I mRNA was validated in a mouse myotoxic muscle injury and rabbit spinal disc herniation models. Engineered IGF-I mRNA had a half-life of 17-25 h in muscle tissue and showed dose-dependent expression of IGF-I over 2-3 days. Animal models confirm that locally administered IGF-I mRNA remained at the site of injection, contributing to the safety profile of mRNA-based treatment in regenerative medicine. In summary, we demonstrate that engineered IGF-I mRNA holds therapeutic potential with high clinical translatability in different diseases.
Collapse
Affiliation(s)
| | | | | | - Sina Zimmerli
- Versameb AG, Technology Park, 4057 Basel, Switzerland
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
5
|
Ferreira I, Tardelli JDC, Dos Reis AC. Factors that Affect the Shear Bond Strength of Pit and Fissure Sealants to Tooth Structure: A Systematic Review. Eur J Prosthodont Restor Dent 2023; 31:332-345. [PMID: 37721539 DOI: 10.1922/ejprd_2503ferreira14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 05/15/2023] [Indexed: 09/19/2023]
Abstract
INTRODUCTION Pit and fissure sealants are effective in preventing caries disease, however, they may present flaws that damage the physical barrier leading to treatment failure. OBJECTIVE To answer the question ''Do pit and fissure sealants present good adhering to the dental structure when analyzed by their resistance to shear/microshear?". METHODS This systematic review followed the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) and was recorded in Open Science Framework. Embase, PubMed, SCOPUS, and Web of Science databases were used for the search strategy. The articles were selected according to the eligibility criteria. The risk of bias was performed with the adaptation of the quasi-experimental studies tool by Joanna Briggs Institute (JBI). RESULTS 1245 studies were found in the databases when applying the search strategy, after removal of duplicates 881 were evaluated and 44 were selected. After applying the JBI tool, 30 studies presented low risk and 15 moderate risk of bias. Meta-analysis was not possible to performed due to the heterogeneity of the studies. CONCLUSION The adhesion is dependent on the application protocol, and among the protocols evaluated, conditioning with 37% phosphoric acid for 60 seconds and contamination of the substrate, as these can affect sealant adhesion.
Collapse
Affiliation(s)
- I Ferreira
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - J D C Tardelli
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - A C Dos Reis
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo (USP), Ribeirão Preto, Brazil
| |
Collapse
|
6
|
Ferreira I, Brites G, Silva A, Caramelo F, Oliveiros B, Neves BM, Cruz MT. Development of an in chemico high-throughput screening method for the identification of skin sensitization potential. Arch Toxicol 2023; 97:2441-2451. [PMID: 37466788 PMCID: PMC10404171 DOI: 10.1007/s00204-023-03550-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 06/20/2023] [Indexed: 07/20/2023]
Abstract
It is well established that chemical-peptide conjugation represents the molecular initiating event (MIE) in skin sensitization. This MIE has been successfully exploited in the development of in chemico peptide reactivity assays, with the Direct Peptide Reactivity Assay (DPRA) being validated as a screening tool for skin sensitization hazard as well as an OECD test guideline. This test relies on the use of a high-performance liquid chromatography/ultraviolet detection method to quantify chemical-peptide conjugation through measurement of the depletion of two synthetic peptides containing lysine or cysteine residues, which is labor-intensive and time-consuming. To improve assay throughput, sensitivity, and accuracy, we have developed a spectrophotometric assay for skin sensitization potential based on MIE measurement-the ProtReact assay. ProtReact is also a cheaper, faster, simpler, and more accessible alternative for the DPRA, giving comparable results. A set of 106 chemicals was tested with ProtReact and the peptide depletion values compared with those reported for the DPRA. The predictive capacity of both assays was evaluated with human reference data. ProtReact and DPRA assays show similar predictive capacities for hazard identification (75% and 74%, respectively), although ProtReact showed a higher specificity (86% versus 74%, respectively) and lower sensitivity (69% versus 73%). Overall, the results show that ProtReact assay described here represents an efficient, economic, and accurate assay for the prediction of skin sensitization potential of chemical haptens.
Collapse
Affiliation(s)
- Isabel Ferreira
- Center for Neuroscience and Cell Biology (CNC), University of Coimbra, Coimbra, Portugal.
- Faculty of Pharmacy, University of Coimbra, Coimbra, Portugal.
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal.
| | - Gonçalo Brites
- Center for Neuroscience and Cell Biology (CNC), University of Coimbra, Coimbra, Portugal
- Faculty of Pharmacy, University of Coimbra, Coimbra, Portugal
- Toxfinder LDA, IPN - Instituto Pedro Nunes, Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal
| | - Ana Silva
- Center for Neuroscience and Cell Biology (CNC), University of Coimbra, Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal
| | - Francisco Caramelo
- Laboratory of Biostatistics and Medical Informatics, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal
| | - Bárbara Oliveiros
- Laboratory of Biostatistics and Medical Informatics, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal
| | - Bruno Miguel Neves
- Toxfinder LDA, IPN - Instituto Pedro Nunes, Coimbra, Portugal
- Department of Medical Sciences and Institute of Biomedicine - iBiMED, University of Aveiro, Aveiro, Portugal
| | - Maria Teresa Cruz
- Center for Neuroscience and Cell Biology (CNC), University of Coimbra, Coimbra, Portugal.
- Faculty of Pharmacy, University of Coimbra, Coimbra, Portugal.
- Toxfinder LDA, IPN - Instituto Pedro Nunes, Coimbra, Portugal.
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal.
| |
Collapse
|
7
|
Gomes S, Ramalhete C, Ferreira I, Bicho M, Valente A. Sleep Patterns, Eating Behavior and the Risk of Noncommunicable Diseases. Nutrients 2023; 15:nu15112462. [PMID: 37299426 DOI: 10.3390/nu15112462] [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: 04/30/2023] [Revised: 05/22/2023] [Accepted: 05/22/2023] [Indexed: 06/12/2023] Open
Abstract
Sleep is extremely important for the homeostasis of the organism. In recent years, various studies have been carried out to address factors related to sleep patterns and their influence on food choices, as well as on the onset of chronic noncommunicable diseases. The aim of this article is to provide a scientific literature review on the possible role of sleep patterns on eating behavior and the risk of noncommunicable diseases. A search was performed on Medline (PubMed interface) using several keywords (e.g., "Factors Influencing Sleep" OR "Sleep and Chronic Diseases"). Articles published between 2000 and the present date that relate sleep to cyclic metabolic processes and changes in eating behavior were selected. Changes in sleep patterns are increasingly detected today, and these modifications are mainly caused by work and lifestyle conditions as well as a growing dependence on electronic devices. Sleep deprivation and the resultant short sleep duration lead to an increased appetite via an increase in the hunger hormone (ghrelin) and a decrease in the satiety hormone (leptin). Nowadays, sleep is undervalued, and thus often impaired, with consequences for the performance of various body systems. Sleep deprivation alters physiological homeostasis and influences eating behavior as well as the onset of chronic diseases.
Collapse
Affiliation(s)
- Sofia Gomes
- ATLÂNTICA-University Institute, 2730-036 Barcarena, Portugal
| | - Cátia Ramalhete
- ATLÂNTICA-University Institute, 2730-036 Barcarena, Portugal
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Av. Prof. Gama Pinto, 1649-003 Lisbon, Portugal
| | - Isabel Ferreira
- ATLÂNTICA-University Institute, 2730-036 Barcarena, Portugal
- Ecogenetics and Human Health Research Group, Environmental Health Institute (ISAMB), Associate Laboratory TERRA, Faculty of Medicine (FMUL), University of Lisbon, 1649-028 Lisbon, Portugal
| | - Manuel Bicho
- Ecogenetics and Human Health Research Group, Environmental Health Institute (ISAMB), Associate Laboratory TERRA, Faculty of Medicine (FMUL), University of Lisbon, 1649-028 Lisbon, Portugal
- Instituto de Investigação Científica Bento da Rocha Cabral, Calçada Bento da Rocha Cabral 14, 1250-012 Lisbon, Portugal
| | - Ana Valente
- ATLÂNTICA-University Institute, 2730-036 Barcarena, Portugal
- Ecogenetics and Human Health Research Group, Environmental Health Institute (ISAMB), Associate Laboratory TERRA, Faculty of Medicine (FMUL), University of Lisbon, 1649-028 Lisbon, Portugal
| |
Collapse
|
8
|
Lago B, Brito M, Almeida CMM, Ferreira I, Baptista AC. Functionalisation of Electrospun Cellulose Acetate Membranes with PEDOT and PPy for Electronic Controlled Drug Release. Nanomaterials (Basel) 2023; 13:nano13091493. [PMID: 37177038 PMCID: PMC10180495 DOI: 10.3390/nano13091493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 04/22/2023] [Accepted: 04/24/2023] [Indexed: 05/15/2023]
Abstract
Controlled drug release via electrical stimulation from drug-impregnated fibres was studied using electrospun cellulose acetate (CA) membranes and encapsulated ibuprofen (IBU). This research outlines the influence of polypyrrole (PPy) and poly(3,4-ethylenedioxythiophene) (PEDOT)-functionalised CA membranes and their suitability for dermal electronic-controlled drug release. Micro Raman analysis confirmed polymer functionalisation of CA membranes and drug incorporation. Scanning electron microscopy (SEM) images evidenced the presence of PPy and PEDOT coatings. The kinetic of drug release was analysed, and the passive and active release was compared. In the proposed systems, the drug release is controlled by very low electrical potentials. A potential of -0.3 V applied to membranes showed the ibuprofen retention, and a positive potential of +0.3 V, +0.5 V, or +0.8 V, depending on the conductive polymer and membrane configuration, enhanced the drug release. A small adhesive patch was constructed to validate this system for cutaneous application and verified an "ON/OFF" ibuprofen release pattern from membranes.
Collapse
Affiliation(s)
- Beatriz Lago
- CENIMAT|I3N, Materials Science Department, School of Science and Technology, NOVA University of Lisbon, 2829-516 Caparica, Portugal
| | - Miguel Brito
- CENIMAT|I3N, Materials Science Department, School of Science and Technology, NOVA University of Lisbon, 2829-516 Caparica, Portugal
| | - Cristina M M Almeida
- Laboratory of Bromatology and Water Quality, Faculty of Pharmacy, University of Lisbon, 1649-003 Lisbon, Portugal
- iMed.UL (Institute for Medicines and Pharmaceutical Sciences, Portugal), Faculty of Pharmacy, University of Lisbon, 1649-003 Lisbon, Portugal
| | - Isabel Ferreira
- CENIMAT|I3N, Materials Science Department, School of Science and Technology, NOVA University of Lisbon, 2829-516 Caparica, Portugal
| | - Ana Catarina Baptista
- CENIMAT|I3N, Materials Science Department, School of Science and Technology, NOVA University of Lisbon, 2829-516 Caparica, Portugal
| |
Collapse
|
9
|
Valente SA, Lopes GR, Ferreira I, Galrinho MF, Almeida M, Ferreira P, Cruz MT, Coimbra MA, Passos CP. Polysaccharide-Based Carriers for Pulmonary Insulin Delivery: The Potential of Coffee as an Unconventional Source. Pharmaceutics 2023; 15:pharmaceutics15041213. [PMID: 37111698 PMCID: PMC10144660 DOI: 10.3390/pharmaceutics15041213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/24/2023] [Accepted: 04/05/2023] [Indexed: 04/29/2023] Open
Abstract
Non-invasive routes for insulin delivery are emerging as alternatives to currently painful subcutaneous injections. For pulmonary delivery, formulations may be in powdered particle form, using carriers such as polysaccharides to stabilise the active principle. Roasted coffee beans and spent coffee grounds (SCG) are rich in polysaccharides, namely galactomannans and arabinogalactans. In this work, the polysaccharides were obtained from roasted coffee and SCG for the preparation of insulin-loaded microparticles. The galactomannan and arabinogalactan-rich fractions of coffee beverages were purified by ultrafiltration and separated by graded ethanol precipitations at 50% and 75%, respectively. For SCG, galactomannan-rich and arabinogalactan-rich fractions were recovered by microwave-assisted extraction at 150 °C and at 180 °C, followed by ultrafiltration. Each extract was spray-dried with insulin 10% (w/w). All microparticles had a raisin-like morphology and average diameters of 1-5 µm, which are appropriate for pulmonary delivery. Galactomannan-based microparticles, independently of their source, released insulin in a gradual manner, while arabinogalactan-based ones presented a burst release. The microparticles were seen to be non-cytotoxic for cells representative of the lung, specifically lung epithelial cells (A549) and macrophages (Raw 264.7) up to 1 mg/mL. This work shows how coffee can be a sustainable source of polysaccharide carriers for insulin delivery via the pulmonary route.
Collapse
Affiliation(s)
- Sara A Valente
- LAQV-REQUIMTE, Department of Chemistry, University of Aveiro, 3810-193 Aveiro, Portugal
| | - Guido R Lopes
- LAQV-REQUIMTE, Department of Chemistry, University of Aveiro, 3810-193 Aveiro, Portugal
| | - Isabel Ferreira
- Center for Neuroscience and Cell Biology, University of Coimbra, 3004-517 Coimbra, Portugal
- Faculty of Pharmacy, University of Coimbra, 3000-548 Coimbra, Portugal
| | - Miguel F Galrinho
- LAQV-REQUIMTE, Department of Chemistry, University of Aveiro, 3810-193 Aveiro, Portugal
| | - Margarida Almeida
- CICECO, Department of Materials and Ceramic Engineering, University of Aveiro, 3810-193 Aveiro, Portugal
| | - Paula Ferreira
- CICECO, Department of Materials and Ceramic Engineering, University of Aveiro, 3810-193 Aveiro, Portugal
| | - Maria T Cruz
- Center for Neuroscience and Cell Biology, University of Coimbra, 3004-517 Coimbra, Portugal
- Faculty of Pharmacy, University of Coimbra, 3000-548 Coimbra, Portugal
| | - Manuel A Coimbra
- LAQV-REQUIMTE, Department of Chemistry, University of Aveiro, 3810-193 Aveiro, Portugal
| | - Cláudia P Passos
- LAQV-REQUIMTE, Department of Chemistry, University of Aveiro, 3810-193 Aveiro, Portugal
| |
Collapse
|
10
|
Rafique A, Ferreira I, Abbas G, Baptista AC. Recent Advances and Challenges Toward Application of Fibers and Textiles in Integrated Photovoltaic Energy Storage Devices. Nanomicro Lett 2023; 15:40. [PMID: 36662335 PMCID: PMC9860006 DOI: 10.1007/s40820-022-01008-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 12/16/2022] [Indexed: 05/09/2023]
Abstract
Flexible microelectronic devices have seen an increasing trend toward development of miniaturized, portable, and integrated devices as wearable electronics which have the requirement for being light weight, small in dimension, and suppleness. Traditional three-dimensional (3D) and two-dimensional (2D) electronics gadgets fail to effectively comply with these necessities owing to their stiffness and large weights. Investigations have come up with a new family of one-dimensional (1D) flexible and fiber-based electronic devices (FBEDs) comprising power storage, energy-scavenging, implantable sensing, and flexible displays gadgets. However, development and manufacturing are still a challenge owing to their small radius, flexibility, low weight, weave ability and integration in textile electronics. This paper will provide a detailed review on the importance of substrates in electronic devices, intrinsic property requirements, fabrication classification and applications in energy harvesting, energy storage and other flexible electronic devices. Fiber- and textile-based electronic devices for bulk/scalable fabrications, encapsulation, and testing are reviewed and presented future research ideas to enhance the commercialization of these fiber-based electronics devices.
Collapse
Affiliation(s)
- Amjid Rafique
- CENIMAT|I3N, Department of Materials Science, School of Science and Technology, NOVA University Lisbon, Campus de Caparica, 2829-516, Caparica, Portugal.
| | - Isabel Ferreira
- CENIMAT|I3N, Department of Materials Science, School of Science and Technology, NOVA University Lisbon, Campus de Caparica, 2829-516, Caparica, Portugal
| | - Ghulam Abbas
- CENIMAT|I3N, Department of Materials Science, School of Science and Technology, NOVA University Lisbon, Campus de Caparica, 2829-516, Caparica, Portugal
| | - Ana Catarina Baptista
- CENIMAT|I3N, Department of Materials Science, School of Science and Technology, NOVA University Lisbon, Campus de Caparica, 2829-516, Caparica, Portugal
| |
Collapse
|
11
|
Dias AMGC, Cena C, Lutz-Bueno V, Mezzenga R, Marques A, Ferreira I, Roque ACA. Solvent modulation in peptide sub-microfibers obtained by solution blow spinning. Front Chem 2022; 10:1054347. [PMID: 36561144 PMCID: PMC9763608 DOI: 10.3389/fchem.2022.1054347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 11/21/2022] [Indexed: 12/12/2022] Open
Abstract
Peptides possess high chemical diversity at the amino acid sequence level, which further translates into versatile functions. Peptides with self-assembling properties can be processed into diverse formats giving rise to bio-based materials. Peptide-based spun fibers are an interesting format due to high surface-area and versatility, though the field is still in its infancy due to the challenges in applying the synthetic polymer spinning processes to protein fibers to peptides. In this work we show the use of solution blow-spinning to produce peptide fibers. Peptide fiber formation was assisted by the polymer poly (vinyl pyrrolidone) (PVP) in two solvent conditions. Peptide miscibility and further self-assembling propensity in the solvents played a major role in fiber formation. When employing acetic acid as solvent, peptide fibers (0.5 μm) are formed around PVP fibers (0.75 μm), whereas in isopropanol only one type of fibers are formed, consisting of mixed peptide and PVP (1 μm). This report highlights solvent modulation as a mean to obtain different peptide sub-microfibers via a single injection nozzle in solution blow spinning. We anticipate this strategy to be applied to other small peptides with self-assembly propensity to obtain multi-functional proteinaceous fibers.
Collapse
Affiliation(s)
- Ana Margarida Gonçalves Carvalho Dias
- Associate Laboratory i4HB, Chemistry Department, NOVA School of Science and Technology, Institute for Health and Bioeconomy, Caparica, Portugal,UCIBIO—Applied Molecular Biosciences Unit, Department of Chemistry, NOVA School of Science and Technology, NOVA University Lisbon, Caparica, Portugal,*Correspondence: Ana Margarida Gonçalves Carvalho Dias, ; Ana Cecília Afonso Roque,
| | - Cícero Cena
- UFMS—Federal University of Mato Grosso do Sul, Campo Grande, Brazil
| | - Viviane Lutz-Bueno
- Department of Health Sciences and Technology, ETH Zürich, Zürich, Switzerland,Paul Scherrer Institute, Villigen PSI, Switzerland
| | - Raffaele Mezzenga
- Department of Health Sciences and Technology, ETH Zürich, Zürich, Switzerland
| | - Ana Marques
- i3N, Materials Department, School of Science and Technology, NOVA University Lisbon, Caparica, Portugal,Physics Department, Faculty of Sciences, University of Lisbon, Lisbon, Portugal
| | - Isabel Ferreira
- i3N, Materials Department, School of Science and Technology, NOVA University Lisbon, Caparica, Portugal
| | - Ana Cecília Afonso Roque
- Associate Laboratory i4HB, Chemistry Department, NOVA School of Science and Technology, Institute for Health and Bioeconomy, Caparica, Portugal,UCIBIO—Applied Molecular Biosciences Unit, Department of Chemistry, NOVA School of Science and Technology, NOVA University Lisbon, Caparica, Portugal,*Correspondence: Ana Margarida Gonçalves Carvalho Dias, ; Ana Cecília Afonso Roque,
| |
Collapse
|
12
|
Pascoal C, Ferreira I, Teixeira C, Almeida E, Slade A, Brasil S, Francisco R, Ligezka AN, Morava E, Plotkin H, Jaeken J, Videira PA, Barros L, dos Reis Ferreira V. Patient reported outcomes for phosphomannomutase 2 congenital disorder of glycosylation (PMM2-CDG): listening to what matters for the patients and health professionals. Orphanet J Rare Dis 2022; 17:398. [PMID: 36309700 PMCID: PMC9618201 DOI: 10.1186/s13023-022-02551-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 10/11/2022] [Indexed: 11/15/2022] Open
Abstract
Background Congenital disorders of glycosylation (CDG) are a growing group of rare genetic disorders. The most common CDG is phosphomannomutase 2 (PMM2)-CDG which often has a severe clinical presentation and life-limiting consequences. There are no approved therapies for this condition. Also, there are no validated disease-specific quality of life (QoL) scales to assess the heterogeneous clinical burden of PMM2-CDG which presents a challenge for the assessment of the disease severity and the impact of a certain treatment on the course of the disease. Aim and methods This study aimed to identify the most impactful clinical signs and symptoms of PMM2-CDG, and specific patient and observer reported outcome measures (PROMs and ObsROMs, respectively) that can adequately measure such impact on patients’ QoL. The most burdensome signs and symptoms were identified through input from the CDG community using a survey targeting PMM2-CDG families and experts, followed by family interviews to understand the real burden of these symptoms in daily life. The list of signs and symptoms was then verified and refined by patient representatives and medical experts in the field. Finally, a literature search for PROMs and ObsROMs used in other rare or common diseases with similar signs and symptoms to those of PMM2-CDG was performed. Results Twenty-four signs/symptoms were identified as the most impactful throughout PMM2-CDG patients’ lifetime. We found 239 articles that included tools to measure those community-selected PMM2-CDG symptoms. Among them, we identified 80 QoL scales that address those signs and symptoms and, subsequently, their psychometric quality was analysed. These scales could be applied directly to the PMM2-CDG population or adapted to create the first PMM2-CDG-specific QoL questionnaire. Conclusion Identifying the impactful clinical manifestations of PMM2-CDG, along with the collection of PROMs/ObsROMs assessing QoL using a creative and community-centric methodology are the first step towards the development of a new, tailored, and specific PMM2-CDG QoL questionnaire. These findings can be used to fill a gap in PMM2-CDG clinical development. Importantly, this methodology is transferable to other CDG and rare diseases with multiple signs and symptoms. Supplementary Information The online version contains supplementary material available at 10.1186/s13023-022-02551-y.
Collapse
|
13
|
Delgado S, Aluja D, Llenas J, Vazquez E, Barrabes JA, Ferreira I, Inserte J. Comparative effectiveness of the new calpain inhibitor NPO-2270 versus enalapril in pressure overload-induced heart failure. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2950] [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
Studies performed in multiple preclinical models support the contribution of the Ca2+-dependent cysteine proteases calpains to ventricular remodelling and heart failure (HF). However, pharmacological calpain inhibition has not yet been tested in patients with HF mainly due to the limitations of available inhibitors.
Purpose
To determine the effect of NPO-2270 (NPO), a new ketoamide derivative calpain inhibitor, in a mouse model of pressure-overload and compare its effectiveness with that of enalapril.
Methods
C57BL6 mice were subjected to transverse aortic constriction (TAC) for 4 weeks. Mice were randomised to receive orally administered NPO or enalapril at the dose of 10 mg/kg/day once a day, or vehicle, starting at day 7 after TAC surgery. The combination of both drugs and the effect of NPO starting 1 day after surgery were tested in additional TAC mice. Echocardiographic data, markers of hypertrophy, fibrosis, calpain activity and cleavage of calpain substrates were measured at different time points.
Results
TAC increased calpain-1 and -2 expression and activity. Administration of NPO and enalapril prevented the progression of hypertrophy and interstitial fibrosis induced by TAC with no statistically significant differences between the two treatments. However, ongoing ventricular dysfunction was less severe in the NPO group than in the enalapril group (27% of LVEF reduction in control group, 6% in NPO group and 16% in the enalapril group after TAC, P=0.024 between NPO and enalapril groups). The combined treatment or the administration of NPO from the first day after TAC surgery was not superior to NPO alone starting 7 days after TAC. These differences in LVEF correlated with better preservation of cadherin-based cell adhesion complex in mice treated with NPO-2270. No adverse effects associated with long-term NPO administration were observed in a sham group.
Conclusions
The new calpain inhibitor NPO-2270 prevents the development of hypertrophy and fibrosis with similar efficacy than enalapril but prevents cardiac dysfunction more effectively in a preclinical model of pressure overload when given orally at equivalent doses.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Instituto de Salud Carlos III of the Spanish Ministry of Health
Collapse
Affiliation(s)
- S Delgado
- Vall d'Hebron Institut de Recerca (VHIR) Vall d'Hebron Hospital (HVH) , Barcelona , Spain
| | - D Aluja
- Vall d'Hebron Institut de Recerca (VHIR) Vall d'Hebron Hospital (HVH) , Barcelona , Spain
| | - J Llenas
- Landsteiner Genmed , Sevilla , Spain
| | - E Vazquez
- Landsteiner Genmed , Sevilla , Spain
| | - J A Barrabes
- Vall d'Hebron Institut de Recerca (VHIR) Vall d'Hebron Hospital (HVH) , Barcelona , Spain
| | - I Ferreira
- Vall d'Hebron Institut de Recerca (VHIR) Vall d'Hebron Hospital (HVH) , Barcelona , Spain
| | - J Inserte
- Vall d'Hebron Institut de Recerca (VHIR) Vall d'Hebron Hospital (HVH) , Barcelona , Spain
| |
Collapse
|
14
|
Beijnink C, Raessens S, Ortiz-Perez JT, Bodi V, Rodwell L, Valente F, Alamar M, Marcos-Garces V, Lorenzatti D, Rios-Navarro C, Gavara J, Ferreira I, Barrabes JA, Rodriguez Palomares J, Nijveldt R. Infarction of the papillary muscle is an independent predictor of heart failure, ventricular tachycardia, and consequent mortality. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1177] [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
Previous studies have assessed the effect of papillary muscle infarction (papMI) as seen with Late Gadolinium Enhancement (LGE) Cardiac Magnetic Resonance imaging (CMR) after ST-segment elevation myocardial infarction (STEMI) on patient prognosis. As these studies delivered inconclusive results due to limited sample size and follow-up, we set out to assess whether STEMI patients with papMI are at an increased risk of cardiovascular mortality, heart failure, and arrhythmic events.
Methods
This is a 3-center observational study in n=1,055 consecutive STEMI patients who underwent CMR at a median of 6 (4–9) days, with a mean follow-up of 6.0 years (IQR 3.1–9.1 years). Any presence of papMI, be it supero-lateral, infero-medial, or double, was evaluated visually on the LGE images and checked on the matched cine images. The primary outcomes are time to cardiovascular mortality, heart-failure events defined as heart failure death and hospital admission for heart failure, and arrhythmic events, defined as arrhythmic death and ventricular tachycardia (VT).
Results
PapMI was diagnosed in 351 patients (33%). PapMI is an independent predictor of cardiovascular mortality after correction for clinically relevant parameters such as infarct size and left ventricular ejection fraction (Multivariate Cox Regression Hazard Ratio (HR)=2.46, 95% confidence interval (CI) 1.23–4.92). Secondly, papMI independently predicts the combined endpoints of heart failure death/heart failure (HR=1.72, 95% CI 1.12–2.63) and arrhythmic death/ VT (HR=4.52, 95% CI 2.18–9.36).
Conclusions
PapMI predicts cardiovascular mortality, arrhythmic death and heart failure. PapMI should be taken into account, especially when conducting new prognosis studies after STEMI and as a stratification factor in studies for secondary prevention of VT and arrhythmic death.
Funding Acknowledgement
Type of funding sources: Other.
Collapse
Affiliation(s)
- C Beijnink
- University Medical Centre St Radboud (UMCN) , Nijmegen , The Netherlands
| | - S Raessens
- University Medical Centre St Radboud (UMCN) , Nijmegen , The Netherlands
| | | | - V Bodi
- Valencia University Clinical Hospital , Valencia , Spain
| | - L Rodwell
- University Medical Centre St Radboud (UMCN) , Nijmegen , The Netherlands
| | - F Valente
- University Hospital Vall d'Hebron , Barcelona , Spain
| | - M Alamar
- Barcelona Hospital Clinic, Cardiology , Barcelona , Spain
| | | | - D Lorenzatti
- Barcelona Hospital Clinic, Cardiology , Barcelona , Spain
| | - C Rios-Navarro
- Valencia University Clinical Hospital , Valencia , Spain
| | - J Gavara
- Polytechnic University of Valencia, Center for Biomaterials and Tissue Engineering , Valencia , Spain
| | - I Ferreira
- University Hospital Vall d'Hebron , Barcelona , Spain
| | - J A Barrabes
- University Hospital Vall d'Hebron , Barcelona , Spain
| | | | - R Nijveldt
- University Medical Centre St Radboud (UMCN) , Nijmegen , The Netherlands
| |
Collapse
|
15
|
Alonso Tello A, Sambola A, Valente F, Sao A, Rello P, Maymi M, Barrabes J, Otaegui I, Garcia Del Blanco B, Gavara J, Marcos-Garces V, Ferreira I, Ortiz JT, Bodi V, Rodriguez-Palomares JF. Sex-based differences on adverse left ventricular remodeling and clinical outcomes after an ST-segment elevation myocardial infarction in the PCI era. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.348] [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
There is conflicting evidence regarding sex-based differences in myocardial salvage and clinical outcome in patients after an ST-segment elevation myocardial infarction (STEMI) in the contemporary era of primary percutaneous coronary intervention (PCI) and optimal medical treatment.
Adverse left ventricular remodelling (LVR) after a STEMI worsens outcomes, however, the influence of sex is not yet clear.
Aim/Purpose
To analyze whether there are sex differences in clinical outcomes and adverse LVR in patients after a STEMI.
Methods
Patients with STEMI who underwent primary PCI were included and a cardiac magnetic resonance (CMR) was performed during hospitalization (6.2±2.6 days) and after 6 months (6.1±1.8 months). LVR, myocardial salvage (MS), infarct size (IS), microvascular obstruction (MVO), and area at risk (AAR) were quantified. Adverse LVR was defined as a 15% increase in LV end-diastolic volume and a relative fall in LV ejection fraction of 3% at 6 months. The primary outcome was a composite of cardiovascular death, admission for heart failure, or ventricular arrhythmia.
Results
A total of 1046 patients were included (mean age: 59.8±9 years; 16.6% women), and a second CMR was completed in 589 patients. Women were older (58.8±8 years vs 65.0±10 years, p<0.0001) and presented more cardiovascular risk factors (Table). The primary outcome occurred in 310 patients during follow-up of 75 months (range: 36–112 months) and was more frequent in women than in men (35.8% vs 22.3%, p<0.001). After adjusting for baseline differences (age, diabetes, hypertension, Killip class, and time to reperfusion), female sex was not an independent predictor of major adverse cardiac events (Fig. 1A & B).
Although adverse LVR was a strong independent predictor for the primary outcome, no interaction was present between sex and LVR (women 6.4% vs men 8%, p=0.46) (Fig 1B), nor did we find significant differences between sex and other CMR derived variables such as MS, IS, MVO and AAR.
Conclusions
After a STEMI, women present worse clinical outcomes than men. However, these differences are related to their clinical characteristics and higher incidence of cardiovascular risk factors, and not to a higher incidence of adverse left ventricular remodeling.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
| | - A Sambola
- University Hospital Vall d'Hebron , Barcelona , Spain
| | - F Valente
- University Hospital Vall d'Hebron , Barcelona , Spain
| | - A Sao
- University Hospital Vall d'Hebron , Barcelona , Spain
| | - P Rello
- University Hospital Vall d'Hebron , Barcelona , Spain
| | - M Maymi
- University Hospital Vall d'Hebron , Barcelona , Spain
| | - J Barrabes
- University Hospital Vall d'Hebron , Barcelona , Spain
| | - I Otaegui
- University Hospital Vall d'Hebron , Barcelona , Spain
| | | | - J Gavara
- Valencia University Clinical Hospital , Valencia , Spain
| | | | - I Ferreira
- Valencia University Clinical Hospital , Valencia , Spain
| | - J T Ortiz
- Barcelona Hospital Clinic, Cardiology , Barcelona , Spain
| | - V Bodi
- Valencia University Clinical Hospital , Valencia , Spain
| | | |
Collapse
|
16
|
Carbonell Prat B, Dos L, Gordon B, Ligero C, Gonzalez V, Vilte G, Pijuan A, Miranda B, Ferre M, Lorente M, Guedes P, Ferreira I, Castro MA. Predictors of long term tricuspid regurgitation after pulmonary valve replacement: a single center study on the cohort of significant preoperative tricuspid regurgitation. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1845] [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
Almost one-third of repaired tetralogy of Fallot (TOF) and pulmonary stenosis (PS) patients referred for pulmonary valve replacement (PVR) have at least moderate tricuspid regurgitation (TR). Predictors of long term TR in this population are not well defined and the role of Tricuspid Annuloplasty (TA) in addition to PVR in this setting is controversial.
Purpose
Patients with preoperative severe TR or moderate TR with dilated tricuspid annulus (>40mm) undergo TA at the time of PVR as per protocol in our instititution. The aim of this observational study was to evaluate the long term results of this approach and to identify predictors of significant TR at the end of follow-up.
Material and methods
We retrospectively reviewed 35 repaired TOF and PS patients who underwent surgical PVR with (n=17, group 1) or without (n=18, group 2) TA in a single tertiary hospital between June-2009 and June-2021. Pre- and postoperative echocardiographic and cardiac magnetic resonance data were assessed for TR severity and right ventricle size and systolic function. Baseline and clinical follow up data were collected. Uni- and multivariable tests were used to analyze predictors of at least moderate TR after PVR.
Results
Mean age at PVR and baseline image parameters were comparable between groups, except for TR grade (p 0.006), tricuspid annulus size (p 0.018) and right ventricle outflow tract diameter (p 0.04) which were greater in group 1. TA did not confer and increased risk of surgical and peroperative complications. Intensive care unit (p 0.94) and total hospital admission days (p 0.59) did not differ among groups. At one year, TR grade significantly improved regardless of TA. At the end of follow-up (5.29±2.9 years), the degree of TR increased in both groups with no differences between groups (p 0.38) (see table 1). In univariable analysis, two independent predictors of at least moderate TR at end of follow-up were identified; mixed TR mechanism (OR 12.5, p 0.006) and severe preoperative TR grade (OR 10.21, p 0.003). Mixed TR mechanism (OR 15.78, p 0.01) and a right ventricle ejection fraction below 45% (OR 1.47, p 0.01) were identified as risk factors of significant TR in multivariable analysis (see Table 2).
Conclusions
TA seems a reasonable approach at the time of PVR in patients with severe TR or moderate TR with dilated annulus. Mixed TR mechanism and a worse right ventricular function have been identified as independent predictors factors of long term significant postoperative TR in our study cohort.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
| | - L Dos
- University Hospital Vall d'Hebron , Barcelona , Spain
| | - B Gordon
- University Hospital Vall d'Hebron , Barcelona , Spain
| | - C Ligero
- University Hospital Sant Joan de Reus , Reus , Spain
| | - V Gonzalez
- University Hospital Vall d'Hebron , Barcelona , Spain
| | - G Vilte
- University Hospital Vall d'Hebron , Barcelona , Spain
| | - A Pijuan
- University Hospital Vall d'Hebron , Barcelona , Spain
| | - B Miranda
- University Hospital Vall d'Hebron , Barcelona , Spain
| | - M Ferre
- University Hospital Sant Joan de Reus , Reus , Spain
| | - M Lorente
- University Hospital Vall d'Hebron , Barcelona , Spain
| | - P Guedes
- University Hospital Vall d'Hebron , Barcelona , Spain
| | - I Ferreira
- University Hospital Vall d'Hebron , Barcelona , Spain
| | - M A Castro
- University Hospital Vall d'Hebron , Barcelona , Spain
| |
Collapse
|
17
|
Afonso C, Cardoso C, Gomes-Bispo A, Ferreira I, Rego A, Coelho I, Motta C, Prates J, Castanheira I, Bandarra N. Fatty Acids, Selenium, and Vitamin B12 in Chub Mackerel (Scomber colias) as Nourishment Considering Seasonality and Bioaccessibility as Factors. Food Chem 2022; 403:134455. [DOI: 10.1016/j.foodchem.2022.134455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/20/2022] [Accepted: 09/26/2022] [Indexed: 11/16/2022]
|
18
|
Dá Mesquita Faustino F, Costa AS, Ferreira I, Mendes JJ, Freitas P. An Unexpected Complication: Obstructive Shock Secondary to Venous Air Embolism. Cureus 2022; 14:e27922. [PMID: 36110467 PMCID: PMC9464420 DOI: 10.7759/cureus.27922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2022] [Indexed: 11/12/2022] Open
Abstract
Air embolism is a rare but possibly life-threatening situation. Gas embolism can be arterial, occurring as a complication of a lung biopsy, arterial catheterization, or extracorporeal circulation in the context of cardiopulmonary bypass, or venous, as in cases of venous catheter manipulation (especially with a central venous catheter in a spontaneously breathing patient), pressurized venous infusions, or in a neurosurgical context. Various clinical manifestations are described in the literature, ranging from asymptomatic cases to obstructive shock. Clinical manifestations may include chest pain, dyspnea, nausea and vomiting, altered consciousness, focal neurological deficits, seizures, vertigo, and amaurosis. Physical examination findings may include hypotension and “mill wheel murmur” on chest auscultation. Early diagnosis and treatment are essential to improve the outcome of these patients. Approach and management include placing the patient in the left lateral decubitus and/or Trendelenburg position and on high-flow oxygen. Hyperbaric oxygen therapy is the definitive treatment for arterial gas embolism, which may reduce air emboli size, improve tissue oxygenation, and reduce ischemic lesion. Here, we report the case of a 62-year-old female patient with obesity, hypertension, dyslipidemia, and recovering from coronavirus disease 2019 (COVID-19) with obstructive shock due to venous gas embolism.
Collapse
|
19
|
Pinto AM, Martins MB, Ferreira I, Moreira C. Fast-growing fibroepithelial stromal vaginal polyp. BMJ Case Rep 2022; 15:15/6/e250076. [DOI: 10.1136/bcr-2022-250076] [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: 11/04/2022] Open
|
20
|
Pereira AC, De Pascale J, Resende R, Cardoso S, Ferreira I, Neves BM, Carrascal MA, Zuzarte M, Madeira N, Morais S, Macedo A, do Carmo A, Moreira PI, Cruz MT, Pereira CF. ER-mitochondria communication is involved in NLRP3 inflammasome activation under stress conditions in the innate immune system. Cell Mol Life Sci 2022; 79:213. [PMID: 35344105 DOI: 10.1007/s00018-022-04211-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [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: 07/08/2021] [Revised: 02/14/2022] [Accepted: 02/16/2022] [Indexed: 12/11/2022]
Abstract
Endoplasmic reticulum (ER) stress and mitochondrial dysfunction, which are key events in the initiation and/or progression of several diseases, are correlated with alterations at ER-mitochondria contact sites, the so-called "Mitochondria-Associated Membranes" (MAMs). These intracellular structures are also implicated in NLRP3 inflammasome activation which is an important driver of sterile inflammation, however, the underlying molecular basis remains unclear. This work aimed to investigate the role of ER-mitochondria communication during ER stress-induced NLRP3 inflammasome activation in both peripheral and central innate immune systems, by using THP-1 human monocytes and BV2 microglia cells, respectively, as in vitro models. Markers of ER stress, mitochondrial dynamics and mass, as well as NLRP3 inflammasome activation were evaluated by Western Blot, IL-1β secretion was measured by ELISA, and ER-mitochondria contacts were quantified by transmission electron microscopy. Mitochondrial Ca2+ uptake and polarization were analyzed with fluorescent probes, and measurement of aconitase and SOD2 activities monitored mitochondrial ROS accumulation. ER stress was demonstrated to activate the NLRP3 inflammasome in both peripheral and central immune cells. Studies in monocytes indicate that ER stress-induced NLRP3 inflammasome activation occurs by a Ca2+-dependent and ROS-independent mechanism, which is coupled with upregulation of MAMs-resident chaperones, closer ER-mitochondria contacts, as well as mitochondrial depolarization and impaired dynamics. Moreover, enhanced ER stress-induced NLRP3 inflammasome activation in the immune system was found associated with pathological conditions since it was observed in monocytes derived from bipolar disorder (BD) patients, supporting a pro-inflammatory status in BD. In conclusion, by demonstrating that ER-mitochondria communication plays a key role in the response of the innate immune cells to ER stress, this work contributes to elucidate the molecular mechanisms underlying NLRP3 inflammasome activation under stress conditions, and to disclose novel potential therapeutic targets for diseases associated with sterile inflammation.
Collapse
Affiliation(s)
- Ana Catarina Pereira
- CNC-Center for Neuroscience and Cell Biology, CIBB-Center for Innovative Biomedicine and Biotechnology, University Coimbra, Coimbra, Portugal.,Faculty of Medicine, University Coimbra, Coimbra, Portugal.,CACC-Clinical Academic Center of Coimbra, Coimbra, Portugal
| | - Jessica De Pascale
- CNC-Center for Neuroscience and Cell Biology, CIBB-Center for Innovative Biomedicine and Biotechnology, University Coimbra, Coimbra, Portugal
| | - Rosa Resende
- CNC-Center for Neuroscience and Cell Biology, CIBB-Center for Innovative Biomedicine and Biotechnology, University Coimbra, Coimbra, Portugal.,CACC-Clinical Academic Center of Coimbra, Coimbra, Portugal
| | - Susana Cardoso
- CNC-Center for Neuroscience and Cell Biology, CIBB-Center for Innovative Biomedicine and Biotechnology, University Coimbra, Coimbra, Portugal.,CACC-Clinical Academic Center of Coimbra, Coimbra, Portugal
| | - Isabel Ferreira
- CNC-Center for Neuroscience and Cell Biology, CIBB-Center for Innovative Biomedicine and Biotechnology, University Coimbra, Coimbra, Portugal.,CACC-Clinical Academic Center of Coimbra, Coimbra, Portugal.,Faculty of Pharmacy, University Coimbra, Coimbra, Portugal
| | - Bruno Miguel Neves
- iBiMED-Department of Medical Sciences and Institute for Biomedicine, University Aveiro, Aveiro, Portugal
| | - Mylène A Carrascal
- CACC-Clinical Academic Center of Coimbra, Coimbra, Portugal.,Tecnimede Group, Sintra, Portugal
| | - Mónica Zuzarte
- Faculty of Medicine, University Coimbra, Coimbra, Portugal.,CACC-Clinical Academic Center of Coimbra, Coimbra, Portugal.,iCBR-Institute for Clinical and Biomedical Research, University Coimbra, Coimbra, Portugal
| | - Nuno Madeira
- Faculty of Medicine, University Coimbra, Coimbra, Portugal.,CACC-Clinical Academic Center of Coimbra, Coimbra, Portugal.,CIBIT-Coimbra Institute for Biomedical Imaging and Translational Research, University Coimbra, Coimbra, Portugal.,Department of Psychiatry, CHUC-UC-Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Sofia Morais
- Faculty of Medicine, University Coimbra, Coimbra, Portugal.,CACC-Clinical Academic Center of Coimbra, Coimbra, Portugal.,Department of Psychiatry, CHUC-UC-Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - António Macedo
- Faculty of Medicine, University Coimbra, Coimbra, Portugal.,CACC-Clinical Academic Center of Coimbra, Coimbra, Portugal.,Department of Psychiatry, CHUC-UC-Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Anália do Carmo
- CACC-Clinical Academic Center of Coimbra, Coimbra, Portugal.,Department of Clinical Pathology, CHUC-UC-Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Paula I Moreira
- CNC-Center for Neuroscience and Cell Biology, CIBB-Center for Innovative Biomedicine and Biotechnology, University Coimbra, Coimbra, Portugal.,Faculty of Medicine, University Coimbra, Coimbra, Portugal.,CACC-Clinical Academic Center of Coimbra, Coimbra, Portugal
| | - Maria Teresa Cruz
- CNC-Center for Neuroscience and Cell Biology, CIBB-Center for Innovative Biomedicine and Biotechnology, University Coimbra, Coimbra, Portugal.,CACC-Clinical Academic Center of Coimbra, Coimbra, Portugal.,Faculty of Pharmacy, University Coimbra, Coimbra, Portugal
| | - Cláudia F Pereira
- CNC-Center for Neuroscience and Cell Biology, CIBB-Center for Innovative Biomedicine and Biotechnology, University Coimbra, Coimbra, Portugal. .,Faculty of Medicine, University Coimbra, Coimbra, Portugal. .,CACC-Clinical Academic Center of Coimbra, Coimbra, Portugal. .,, Coimbra, Portugal.
| |
Collapse
|
21
|
Petrovic J, Fernandes Â, Stojković D, Soković M, Barros L, Ferreira I, Shekhar A, Glamočlija J. A Step Forward Towards Exploring Nutritional and Biological Potential of Mushrooms: A Case Study of Calocybe gambosa (Fr.) Donk Wild Growing in Serbia. POL J FOOD NUTR SCI 2022. [DOI: 10.31883/pjfns/144836] [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: 11/20/2022] Open
|
22
|
Faria J, Dionísio B, Soares Í, Baptista AC, Marques A, Gonçalves L, Bettencourt A, Baleizão C, Ferreira I. Cellulose acetate fibres loaded with daptomycin for metal implant coatings. Carbohydr Polym 2022; 276:118733. [PMID: 34823769 DOI: 10.1016/j.carbpol.2021.118733] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 09/24/2021] [Accepted: 10/02/2021] [Indexed: 12/11/2022]
Abstract
Multifunctional polymeric coatings containing drug delivery vehicles can play a key role in preventing/reducing biofilm formation on implant surfaces. Their requirements are biocompatibility, good adhesion, and controllable drug release. Although cellulose acetate (CA) films and membranes are widely studied for scaffolding, their applications as a protective coating and drug delivery vehicle for metal implants are scarce. The reason is that adhesion to stainless steel (SS) substrates is non-trivial. Grinding SS substrates enhances the adhesion of dip-coated CA films while the adhesion of electrospun CA membranes is improved by an electrosprayed chitosan intermediate layer. PMMA microcapsules containing daptomycin have been successfully incorporated into CA films and fibres. The released drug concentration of 3 × 10-3 mg/mL after 120 min was confirmed from the peak luminescence intensity under UV radiation of simulated body fluid (SBF) after immersion of the fibres.
Collapse
Affiliation(s)
- Jaime Faria
- CENIMAT/I3N, Departamento de Ciência dos Materiais, Faculdade de Ciências e Tecnologia, FCT, Universidade Nova de Lisboa, 2829-516 Campus de Caparica, Portugal
| | - Bruno Dionísio
- CENIMAT/I3N, Departamento de Ciência dos Materiais, Faculdade de Ciências e Tecnologia, FCT, Universidade Nova de Lisboa, 2829-516 Campus de Caparica, Portugal
| | - Íris Soares
- CENIMAT/I3N, Departamento de Ciência dos Materiais, Faculdade de Ciências e Tecnologia, FCT, Universidade Nova de Lisboa, 2829-516 Campus de Caparica, Portugal
| | - Ana Catarina Baptista
- CENIMAT/I3N, Departamento de Ciência dos Materiais, Faculdade de Ciências e Tecnologia, FCT, Universidade Nova de Lisboa, 2829-516 Campus de Caparica, Portugal.
| | - Ana Marques
- CENIMAT/I3N, Departamento de Ciência dos Materiais, Faculdade de Ciências e Tecnologia, FCT, Universidade Nova de Lisboa, 2829-516 Campus de Caparica, Portugal
| | - Lídia Gonçalves
- Research Institute for Medicines (iMed.ULisboa), Faculdade de Farmácia, Universidade de Lisboa, Avenida Prof. Gama Pinto, 1649-003 Lisboa, Portugal
| | - Ana Bettencourt
- Research Institute for Medicines (iMed.ULisboa), Faculdade de Farmácia, Universidade de Lisboa, Avenida Prof. Gama Pinto, 1649-003 Lisboa, Portugal
| | - Carlos Baleizão
- Centro de Química Estrutural, Departamento de Engenharia Química, Instituto Superior Técnico, Universidade de Lisboa, 1049-001 Lisboa, Portugal
| | - Isabel Ferreira
- CENIMAT/I3N, Departamento de Ciência dos Materiais, Faculdade de Ciências e Tecnologia, FCT, Universidade Nova de Lisboa, 2829-516 Campus de Caparica, Portugal.
| |
Collapse
|
23
|
Pina AS, Morgado L, Duncan KL, Carvalho S, Carvalho HF, Barbosa AJM, de P. Mariz B, Moreira IP, Kalafatovic D, Morais Faustino BM, Narang V, Wang T, Pappas CG, Ferreira I, Roque ACA, Ulijn RV. Discovery of phosphotyrosine-binding oligopeptides with supramolecular target selectivity. Chem Sci 2022; 13:210-217. [PMID: 35059169 PMCID: PMC8694286 DOI: 10.1039/d1sc04420f] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 12/05/2021] [Indexed: 12/16/2022] Open
Abstract
Phage-display screening on self-assembled tyrosine-phosphate ligands enables the identification of oligopeptides selective to dynamic supramolecular targets, with the lead peptide showing a preferred hairpin-like conformation and catalytic activity.
Collapse
Affiliation(s)
- Ana S. Pina
- Advanced Science Research Center (ASRC) at the Graduate Center, City University of New York (CUNY), NY 10031, USA
- Associate Laboratory i4HB – Institute for Health and Bioeconomy, NOVA School of Science and Technology, NOVA University Lisbon, 2829-516 Caparica, Portugal
- UCIBIO – Applied Molecular Biosciences Unit, Department of Chemistry, School of Science and Technology, NOVA University of Lisbon, 2829-516 Caparica, Portugal
| | - Leonor Morgado
- Associate Laboratory i4HB – Institute for Health and Bioeconomy, NOVA School of Science and Technology, NOVA University Lisbon, 2829-516 Caparica, Portugal
- UCIBIO – Applied Molecular Biosciences Unit, Department of Chemistry, School of Science and Technology, NOVA University of Lisbon, 2829-516 Caparica, Portugal
| | - Krystyna L. Duncan
- Advanced Science Research Center (ASRC) at the Graduate Center, City University of New York (CUNY), NY 10031, USA
- Department of Pure & Applied Chemistry, University of Strathclyde, 295 Cathedral Street, Glasgow G1 1XL, UK
| | - Sara Carvalho
- Associate Laboratory i4HB – Institute for Health and Bioeconomy, NOVA School of Science and Technology, NOVA University Lisbon, 2829-516 Caparica, Portugal
- UCIBIO – Applied Molecular Biosciences Unit, Department of Chemistry, School of Science and Technology, NOVA University of Lisbon, 2829-516 Caparica, Portugal
| | - Henrique F. Carvalho
- Associate Laboratory i4HB – Institute for Health and Bioeconomy, NOVA School of Science and Technology, NOVA University Lisbon, 2829-516 Caparica, Portugal
- UCIBIO – Applied Molecular Biosciences Unit, Department of Chemistry, School of Science and Technology, NOVA University of Lisbon, 2829-516 Caparica, Portugal
| | - Arménio J. M. Barbosa
- Associate Laboratory i4HB – Institute for Health and Bioeconomy, NOVA School of Science and Technology, NOVA University Lisbon, 2829-516 Caparica, Portugal
- UCIBIO – Applied Molecular Biosciences Unit, Department of Chemistry, School of Science and Technology, NOVA University of Lisbon, 2829-516 Caparica, Portugal
| | - Beatriz de P. Mariz
- Associate Laboratory i4HB – Institute for Health and Bioeconomy, NOVA School of Science and Technology, NOVA University Lisbon, 2829-516 Caparica, Portugal
- UCIBIO – Applied Molecular Biosciences Unit, Department of Chemistry, School of Science and Technology, NOVA University of Lisbon, 2829-516 Caparica, Portugal
| | - Inês P. Moreira
- Associate Laboratory i4HB – Institute for Health and Bioeconomy, NOVA School of Science and Technology, NOVA University Lisbon, 2829-516 Caparica, Portugal
- UCIBIO – Applied Molecular Biosciences Unit, Department of Chemistry, School of Science and Technology, NOVA University of Lisbon, 2829-516 Caparica, Portugal
| | - Daniela Kalafatovic
- Advanced Science Research Center (ASRC) at the Graduate Center, City University of New York (CUNY), NY 10031, USA
| | - Bruno M. Morais Faustino
- CENIMAT/I3N, Department of Materials Science, School of Science and Technology, NOVA University of Lisbon, 2829-516 Caparica, Portugal
| | - Vishal Narang
- Advanced Science Research Center (ASRC) at the Graduate Center, City University of New York (CUNY), NY 10031, USA
| | - Tong Wang
- Advanced Science Research Center (ASRC) at the Graduate Center, City University of New York (CUNY), NY 10031, USA
- Imaging Facility of CUNY ASRC, 85 St Nicholas Terrace, New York 10031, USA
| | - Charalampos G. Pappas
- Advanced Science Research Center (ASRC) at the Graduate Center, City University of New York (CUNY), NY 10031, USA
- Department of Pure & Applied Chemistry, University of Strathclyde, 295 Cathedral Street, Glasgow G1 1XL, UK
| | - Isabel Ferreira
- CENIMAT/I3N, Department of Materials Science, School of Science and Technology, NOVA University of Lisbon, 2829-516 Caparica, Portugal
| | - A. Cecília A. Roque
- Associate Laboratory i4HB – Institute for Health and Bioeconomy, NOVA School of Science and Technology, NOVA University Lisbon, 2829-516 Caparica, Portugal
- UCIBIO – Applied Molecular Biosciences Unit, Department of Chemistry, School of Science and Technology, NOVA University of Lisbon, 2829-516 Caparica, Portugal
| | - Rein V. Ulijn
- Advanced Science Research Center (ASRC) at the Graduate Center, City University of New York (CUNY), NY 10031, USA
- Hunter College of CUNY, Department of Chemistry and Biochemistry, 695 Park Avenue, New York 10065, USA
- PhD Programs in Chemistry and Biochemistry, The Graduate Center of CUNY, New York 10016, USA
| |
Collapse
|
24
|
Cardoso T, Rodrigues PP, Nunes C, Almeida M, Cancela J, Rosa F, Rocha-Pereira N, Ferreira I, Seabra-Pereira F, Vaz P, Carneiro L, Andrade C, Davis J, Marçal A, Friedman ND. Prospective international validation of the predisposition, infection, response and organ dysfunction (PIRO) clinical staging system among intensive care and general ward patients. Ann Intensive Care 2021; 11:180. [PMID: 34950977 PMCID: PMC8702585 DOI: 10.1186/s13613-021-00966-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 12/04/2021] [Indexed: 11/17/2022] Open
Abstract
Background Stratifying patients with sepsis was the basis of the predisposition, infection, response and organ dysfunction (PIRO) concept, an attempt to resolve the heterogeneity in treatment response. The purpose of this study is to perform an independent validation of the PIRO staging system in an international cohort and explore its utility in the identification of patients in whom time to antibiotic treatment is particularly important. Methods Prospective international cohort study, conducted over a 6-month period in five Portuguese hospitals and one Australian institution. All consecutive adult patients admitted to selected wards or the intensive care, with infections that met the CDC criteria for lower respiratory tract, urinary, intra-abdominal and bloodstream infections were included. Results There were 1638 patients included in the study. Patients who died in hospital presented with a higher PIRO score (10 ± 3 vs 8 ± 4, p < 0.001). The observed mortality was 3%, 15%, 24% and 34% in stage I, II, III and IV, respectively, which was within the predicted intervals of the original model, except for stage IV patients that presented a lower mortality. The hospital survival rate was 84%. The application of the PIRO staging system to the validation cohort resulted in a positive predictive value of 97% for stage I, 91% for stage II, 85% for stage III and 66% for stage IV. The area under the receiver operating characteristics curve (AUROC) was 0.75 for the all cohort and 0.70 if only patients with bacteremia were considered. Patients in stage III and IV who did not have antibiotic therapy administered within the desired time frame had higher mortality rate than those who have timely administration of antibiotic. Conclusions To our knowledge, this is the first external validation of this PIRO staging system and it performed well on different patient wards within the hospital and in different types of hospitals. Future studies could apply the PIRO system to decision-making about specific therapeutic interventions and enrollment in clinical trials based on disease stage. Supplementary Information The online version contains supplementary material available at 10.1186/s13613-021-00966-7.
Collapse
Affiliation(s)
- T Cardoso
- Intensive Care Unit (UCIP) and Hospital Infection Control Committee, Hospital de Santo António, Oporto University Hospital Center, University of Porto, Largo Prof. Abel Salazar, 4099-001, Porto, Portugal.
| | - P P Rodrigues
- Department of Community Medicine, Information and Health Decision Sciences & CINTESIS, Faculty of Medicine, University of Porto, Rua Dr. Plácido Costa, s/n, 4200-450, Porto, Portugal
| | - C Nunes
- Intensive Care Unit and Hospital Infection Control Committee, Hospital de Bragança, Northeastern Local Health Unit, Av. Abade Baçal, 5301-852, Bragança, Portugal
| | - M Almeida
- Neurocritical Care Unit and Hospital Infection Control Committee, Hospital de São Marcos, Sete Fontes - São Vitor, 4710-243, Braga, Portugal.,Intensive Care Unit (UCIP), Hospital de Santo António, Oporto University Hospital Center, Largo Prof. Abel Salazar, 4099-001, Porto, Portugal
| | - J Cancela
- Internal Medicine Department, Hospital Pedro Hispano, Matosinhos Local Health Unit, R. Dr. Eduardo Torres, Sra. da Hora, Portugal
| | - F Rosa
- Internal Medicine Department, Hospital Pedro Hispano, Matosinhos Local Health Unit, R. Dr. Eduardo Torres, Sra. da Hora, Portugal
| | - N Rocha-Pereira
- Infectious Diseases Department, São João Hospital Center, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
| | - I Ferreira
- Internal Medicine Department, Hospital de Santo António, Oporto University Hospital Center, Largo Prof. Abel Salazar, 4099-001, Porto, Portugal
| | - F Seabra-Pereira
- Intensive Care Unit (UCIP), Hospital de Santo António, Oporto University Hospital Center, Largo Prof. Abel Salazar, 4099-001, Porto, Portugal.,Intensive Care Unit and Internal Medicine Department, Hospital da Prelada, Rua de Sarmento de Beires, 4250-449, Porto, Portugal
| | - P Vaz
- Internal Medicine Department and Hospital Infection Control Committee, Hospital de Bragança, Northeastern Local Health Unit, Av. Abade Baçal, 5301-852, Bragança, Portugal
| | - L Carneiro
- Internal Medicine Department, Hospital Pedro Hispano, Matosinhos Local Health Unit, R. Dr. Eduardo Torres, Sra. da Hora, Portugal
| | - C Andrade
- Internal Medicine Department, Hospital Pedro Hispano, Matosinhos Local Health Unit, R. Dr. Eduardo Torres, Sra. da Hora, Portugal.,Internal Medicine Department, Hospital de Santo António, Oporto University Hospital Center, Largo Prof. Abel Salazar, 4099-001, Porto, Portugal
| | - J Davis
- Department of Renal Medicine, Barwon Health, Geelong, VIC, 3220, Australia
| | - A Marçal
- Internal Medicine Department, Hospital Pedro Hispano, Matosinhos Local Health Unit, R. Dr. Eduardo Torres, Sra. da Hora, Portugal.,Internal Medicine Department, Hospital de Santo António, Oporto University Hospital Center, Largo Prof. Abel Salazar, 4099-001, Porto, Portugal
| | - N D Friedman
- Department of Infectious Diseases, Barwon Health, Geelong, VIC, 3220, Australia
| |
Collapse
|
25
|
Harris RG, Batterham M, Neale EP, Ferreira I. Impact of missing outcome data in meta-analyses of lifestyle interventions during pregnancy to reduce postpartum weight retention: An overview of systematic reviews with meta-analyses and additional sensitivity analyses. Obes Rev 2021; 22:e13318. [PMID: 34477276 DOI: 10.1111/obr.13318] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 06/20/2021] [Accepted: 06/22/2021] [Indexed: 12/01/2022]
Abstract
High risk of bias associated with missing outcome data (MOD) in meta-analyses (MAs) of the effects of lifestyle interventions during pregnancy on postpartum weight retention (PPWR) casts doubt on whether such interventions can be relied upon as truly effective. This systematic overview of three MAs (19 RCTs), each with high MOD rates in the subset of RCTs included, examined how MOD were addressed in the estimation of summary intervention effects. All MAs reported beneficial and statistically significant intervention effects estimated based on complete case analyses, deemed valid if MOD was missing at random (MAR). Therefore, we conducted sensitivity analyses using pattern mixture models and informative missingness parameters (describing how the outcome in the missing participants may be related to the outcome in the completers), to ascertain the robustness of the estimates to reasonable deviations from the MAR assumption. In plausible scenarios where the response in intervention group participants with versus without MOD was worse (by just 0.5 kg), effect estimates were attenuated in all MAs and no longer statistically significant in two MAs. Statistical significance was retained when all 19 RCTs identified across MAs were examined together in a broader meta-analysis: -0.63 kg (95%CI -0.17, -0.08), but the clinical relevancy of effects of this magnitude remains unclear.
Collapse
Affiliation(s)
- Rebecca G Harris
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Marijka Batterham
- School of Mathematics and Applied Statistics, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, New South Wales, Australia
| | - Elizabeth P Neale
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Isabel Ferreira
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia.,Public Health Department, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| |
Collapse
|
26
|
Gonzalez Del Hoyo M, Servato L, Fernandez-Galera R, Rodenas E, Garcia M, Casas G, Jordan P, Herrador L, Bach M, Valente F, Gutierrez L, Baneras J, Evangelista A, Ferreira I, Rodriguez-Palomares J. Clinical impact on treatment and prognosis of advanced cardiac imaging with echocardiography in the acute setting of a COVID-19 infection. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0136] [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 and objectives
Despite myocardial injury being related to excess mortality in acute COVID-19 infection, its impact on imaging findings remains unclear. This study aimed to characterize transthoracic echocardiographic (TTE) findings in patients admitted with COVID-19 infections and its impact on management and prognosis.
Methods
A prospective observational cohort study was performed among 66 COVID-19 patients who were admitted to a tertiary center between March 1 and May 25, 2020 and underwent TTE. High-sensitivity troponin I (hs-cTnI) data, echocardiographic assessment of right and left ventricular (LV) functional parameters, strain, and myocardial work analysis were obtained.
Results
2025 patients were admitted with COVID-19 and in 200 a complete TTE study was performed. Due to poor image quality, only 66 studies were included in the final analysis. The median age was 62 years (IQR, 55–70) and 59.1% of patients were males. The most common comorbidity was hypertension (47%), followed by smoking history (30.3%), atrial fibrillation (9.1%), and chronic obstructive pulmonary disease (7.9%). More than half of the patients (39, 59%) were admitted to the ICU, and half of them (33, 50%) required invasive mechanical ventilation. TTE was mainly indicated because of concerns for systemic conditions (50%) and evaluation of hemodynamic assessment (30%). Thirty-six patients (54.5%) had an abnormal TTE result and 57% had elevated hs-cTnI levels. The most common cardiac abnormality was LV diastolic dysfunction in 33% of the patients, followed by right ventricular dysfunction (12%) and LV dysfunction (6%) (Figure 1). LV GLS was reduced in 48.5% of the cases. Myocardial work performance indices were all reduced in patients with an abnormal TTE (GWI 30%, GCW 30%, GWW 40%, and GWE 40%), although differences were not significant (P>0.2 for all parameters). Patients with an abnormal TTE were older and presented a higher cardiovascular risk profile. There were no significant differences in the levels of D-dimer, NTproBNP, and hs-cTnI between patients with and without diastolic dysfunction, RV, or LV dysfunction (P>0.3 for all parameters). Using Spearman rank correlation, there was an inverse relationship between hs-cTnI and LV strain and myocardial work analysis. TTE results impacted clinical management in 60 patients, mainly de-escalation of medical treatment (Figure 2). Abnormal TTE results did not impact in-hospital outcomes.
Conclusions
Severe echocardiographic abnormalities are uncommon in hospitalized patients with COVID-19 infections, presenting mostly with subclinical myocardial changes, such as diastolic dysfunction, reduced LV GLS, and myocardial work indices, both associated with high-sensitivity troponin I elevation. An echocardiographic study should be limited to rule out long-term ICU complications or to evaluate hemodynamic instability. Although TTE was a valuable tool for guiding management, it had no significant impact on prognosis.
Funding Acknowledgement
Type of funding sources: None. Figure 1. Findings on TTE studies.Figure 2. Changes in management.
Collapse
Affiliation(s)
| | - L Servato
- Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | | | - E Rodenas
- Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - M Garcia
- Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - G Casas
- Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - P Jordan
- Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - L Herrador
- Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - M Bach
- Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - F Valente
- Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - L Gutierrez
- Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - J Baneras
- Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - A Evangelista
- Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - I Ferreira
- Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | | |
Collapse
|
27
|
Valente F, Gavara J, Calvo M, Rello P, Maymi M, Barrabes J, Sao-Aviles A, Burcet G, Cuellar H, Otaegui I, Garcia-Blanco B, Ferreira I, Ortiz J, Bodi V, Rodriguez-Palomares JF. Prognostic value of baseline versus 6-month follow infarct size in patients with reperfused STEMI. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0217] [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
Acute infarct size is a predictor of clinical outcomes in acute ST segment elevation myocardial infarction (STEMI) patients, although its prognostic value has differed between studies. In acute STEMI, infarct size is often overestimated due to the presence of extensive myocardial oedema, a confounder that is no longer present at a 6-month follow-up study. It was our purpose to assess whether infarct size in the acute phase or at 6-months follow-up provided superior prognostic information in STEMI patients.
Methods
STEMI patients who underwent successful primary percutaneous revascularization were included and a cardiac magnetic resonance (CMR) was performed between 5–7 days after STEMI and at 6 months to study infarct size (as a % of myocardial mass). The primary endpoint was a composite of cardiovascular mortality, hospitalization for heart failure and ventricular arrhythmia.
Results
A total of 796 patients were included (mean age 58.3±11.5 years, 82.4% male, 52.3% anterior infarction). During a mean follow-up of 59 months, 59 patients (7.4%) presented with the primary end-point (cardiovascular death n=7, hospitalization for heart failure n=52, ventricular arrhythmia n=1). ROC curve analysis (figure 1) showed a non-significant difference between baseline and 6-month infarct size for the prediction of the primary endpoint (baseline AUC 0.685 95% CI 0.610–0.760, 6-month AUC 0.713 95% CI 0.643–0.782, p=0.60). Optimal cut-off values for baseline and 6-months follow-up infarct size for prediction of outcomes, respectively 22% and 17.5%, were used for Kaplan-Meier curve analysis (figure 2).
Conclusion
Infarct size estimated during the first week after STEMI and at 6-months follow-up showed similar predictive value and with similar cut-off values. Therefore, the prognostic information provided by infarct size can be obtained during initial STEMI admission and does not require a waiting period for infarct size stabilization.
Funding Acknowledgement
Type of funding sources: None. ROC curve analysisKaplan-Meier analysis
Collapse
Affiliation(s)
- F Valente
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - J Gavara
- Research Foundation Hospital of Valencia (INCLIVA), Valencia, Spain
| | - M Calvo
- Barcelona Hospital Clinic, Cardiology, Barcelona, Spain
| | - P Rello
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - M Maymi
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - J Barrabes
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - A Sao-Aviles
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - G Burcet
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - H Cuellar
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - I Otaegui
- University Hospital Vall d'Hebron, Barcelona, Spain
| | | | - I Ferreira
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - J Ortiz
- Barcelona Hospital Clinic, Cardiology, Barcelona, Spain
| | - V Bodi
- Research Foundation Hospital of Valencia (INCLIVA), Valencia, Spain
| | | |
Collapse
|
28
|
Mendes DN, Gaspar A, Ferreira I, Mota JP, Ribeiro RP. 3D-printed hybrid zeolitic/carbonaceous electrically conductive adsorbent structures. Chem Eng Res Des 2021. [DOI: 10.1016/j.cherd.2021.08.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
29
|
Harris R, Batterham M, Neale E, Ferreira I. 1463Impact of missing outcome data in meta-analyses of lifestyle interventions during pregnancy to reduce postpartum-weight-retention. Int J Epidemiol 2021. [DOI: 10.1093/ije/dyab168.265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
High risk of bias associated with missing outcome data (MOD) in meta-analyses (MAs) of the effects of lifestyle interventions during pregnancy on postpartum weight retention (PPWR), casts doubt on whether such interventions can be relied upon as truly effective, since estimates are deemed valid only if MOD was missing at random (MAR).
Methods
We conducted a systematic overview of MAs to examine the impact of MOD on the estimation of meta-analytic summary intervention effects and conducted sensitivity analyses using pattern mixture models and informative missingness parameters (describing how the outcome in the missing participants may be related to the outcome in the completers), to ascertain the robustness of the estimates to reasonable deviations from the MAR assumption.
Results
Three relevant MAs were identified, all with high MOD rates in the RCTs included (median>30%), and all reporting beneficial intervention effects on PPWR (in kg) estimated based on complete case analyses: [-0.78 (95%CI: -1.39,-0.16), -0.81 (-1.57,-0.06), and -0.94 (-1.52,-0.37)] in MAs of any lifestyle, exercise, or diet + exercise interventions, respectively. In plausible scenarios where the outcome for the intervention group in participants with vs without MOD was worse (by 0.5kg), effect estimates were attenuated in all and no longer significant in 2 of the MAs [-0.58 (-1.29,0.13), -0.70 (-1.50,0.10) and -0.88 (-1.73,-0.02)].
Conclusions
Statistical significance was retained when all 19 RCTs identified across MAs were meta-analysed: -0.63 (-0.17,-0.08).
Key messages
The clinical relevancy of effects of this magnitude remains unclear.
Collapse
Affiliation(s)
- Rebecca Harris
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Marijka Batterham
- School of Mathematics and Applied Statistics, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, Australia
| | - Elizabeth Neale
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Isabel Ferreira
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| |
Collapse
|
30
|
Brites G, Ferreira I, Silva A, Carrascal M, Vitorino C, Neves B, Cruz M. Prevention of allergic contact dermatitis, myth or reality? Avoiding contact allergens: from basic research to development of a new medical device. Toxicol Lett 2021. [DOI: 10.1016/s0378-4274(21)00508-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
31
|
Daubé P, Cagnazzo F, Barreau X, Morganti R, Ferreira I, Gariel F, Dargazanli C, Gascou G, Riquelme C, Derraz I, Berge J, Lefevre PH, Costalat V, Marnat G. Influence of operator experience on the technical and clinical results of Woven EndoBridge endovascular treatment for intracranial aneurysms. Clin Neurol Neurosurg 2021; 208:106900. [PMID: 34454205 DOI: 10.1016/j.clineuro.2021.106900] [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: 06/30/2021] [Revised: 08/10/2021] [Accepted: 08/17/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND & PURPOSE The safety and efficacy of the Woven EndoBridge (WEB) device has been proven in recent multicenter trials. This study investigated whether operator experience influences WEB treatment-related outcomes. MATERIAL AND METHODS This was a retrospective analysis of a prospectively collected multicenter database. The data of all patients who underwent WEB treatment for an intracranial aneurysm from March 2014 to June 2020 in two high-volume centers were pooled. Operator experience was indexed by the number of WEB treatments performed previously. The primary endpoint was the overall complication rate. Secondary endpoints were long-term adequate (Raymond-Roy classification of 1-2.) angiographic occlusion, WEB-related complications, number of WEB not deployed, procedure duration, and radiation exposure (air kerma). RESULTS Among 237 patients (mean age 59.4 +/- 11.5 years) treated with WEB (median aneurysm diameter, 5.8 mm; interquartile range 4.5-7 mm), WEB-related complications occurred in 28 patients (11.8%) and adequate long-term occlusion was achieved for 154 aneurysms (86%). The median number of WEB treatment performed previously per operator was 20 (IQR, 9-41). The overall complication rate, WEB-related complication rate and aneurysm occlusion rate were not significantly correlated with WEB operator experience. There were also no significant correlations between the WEB operator experience and the number of WEB not deployed, procedure duration or radiation exposure. CONCLUSION There was no significant association between the number of WEB treatments previously performed per operator and any technical or clinical results after intracranial aneurysm treatment with WEB. These results imply a relatively short learning curve for this device in high-volume neurovascular centers.
Collapse
Affiliation(s)
- P Daubé
- Department of Neuroradiology, CHU Poitiers, Poitiers, France.
| | - F Cagnazzo
- Department of Neuroradiology, CHU Montpellier, Montpellier, France.
| | - X Barreau
- Department of Neuroradiology, CHU Bordeaux, Bordeaux, France.
| | - R Morganti
- Section of Statistics, University Hospital of Pisa, Pisa, Italy.
| | - I Ferreira
- Department of Neuroradiology, CHU Montpellier, Montpellier, France.
| | - F Gariel
- Department of Neuroradiology, CHU Bordeaux, Bordeaux, France.
| | - C Dargazanli
- Department of Neuroradiology, CHU Montpellier, Montpellier, France; Institut de Génomique Fonctionnelle, Université Montpellier, CNRS, INSERM, Montpellier, France.
| | - G Gascou
- Department of Neuroradiology, CHU Montpellier, Montpellier, France.
| | - C Riquelme
- Department of Neuroradiology, CHU Montpellier, Montpellier, France.
| | - I Derraz
- Department of Neuroradiology, CHU Montpellier, Montpellier, France.
| | - J Berge
- Department of Neuroradiology, CHU Bordeaux, Bordeaux, France.
| | - P H Lefevre
- Department of Neuroradiology, CHU Montpellier, Montpellier, France.
| | - V Costalat
- Department of Neuroradiology, CHU Montpellier, Montpellier, France; Institut de Génomique Fonctionnelle, Université Montpellier, CNRS, INSERM, Montpellier, France.
| | - G Marnat
- Department of Neuroradiology, CHU Bordeaux, Bordeaux, France.
| |
Collapse
|
32
|
Baptista AC, Brito M, Marques A, Ferreira I. Electronic control of drug release from gauze or cellulose acetate fibres for dermal applications. J Mater Chem B 2021; 9:3515-3522. [PMID: 33909745 DOI: 10.1039/d1tb00249j] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Electronic controlled drug release from fibres was studied using ibuprofen as a model drug, one of the most popular analgesics, to impregnate gauze and cellulose acetate (CA) membranes. Conductivity in the range of 1-10 mS cm-1 was obtained in polypyrrole (Ppy) functionalised gauze and CA fibres, providing voltage-controlled drug release in a system consisting of Ppy/Ibuprofen/Ppy membranes and an Ag electrode. SEM images evidenced the Ppy adhesion to fibres and Micro Raman spectra proved drug incorporation and release. A small wound adhesive built with these membranes retains ibuprofen at 1.5 V and quickly releases it when -0.5 V is applied.
Collapse
Affiliation(s)
- Ana Catarina Baptista
- CENIMAT/I3N, Departamento de Ciência dos Materiais, Faculdade de Ciências e Tecnologia, FCT, Universidade NOVA de Lisboa, 2829-516 Campus de Caparica, Portugal.
| | - Miguel Brito
- CENIMAT/I3N, Departamento de Ciência dos Materiais, Faculdade de Ciências e Tecnologia, FCT, Universidade NOVA de Lisboa, 2829-516 Campus de Caparica, Portugal.
| | - Ana Marques
- CENIMAT/I3N, Departamento de Ciência dos Materiais, Faculdade de Ciências e Tecnologia, FCT, Universidade NOVA de Lisboa, 2829-516 Campus de Caparica, Portugal.
| | - Isabel Ferreira
- CENIMAT/I3N, Departamento de Ciência dos Materiais, Faculdade de Ciências e Tecnologia, FCT, Universidade NOVA de Lisboa, 2829-516 Campus de Caparica, Portugal.
| |
Collapse
|
33
|
Ruiz Munoz A, Guala A, Rodriguez-Palomares JF, Dux-Santoy L, Servato L, Lopez-Sainz A, La Mura L, Gonzalez-Alujas T, Galian-Gay L, Gutierrez L, Johnson K, Wieben O, Ferreira I, Evangelista A, Teixido-Tura G. Aortic rotational flow patterns and stiffness by 4D flow CMR in patients with Loeys-Dietz syndrome compared to healthy volunteers and patients with Marfan syndrome. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeab090.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): La Marató de TV3, Instituto de Salud Carlos III through the project and Spanish Ministry of Science, Innovation and Universities.
BACKGROUND
Loeys-Dietz (LDS) and Marfan (MFS) syndromes are rare genetic connective tissue disorders associated with progressive aortic dilation, however, aortic dissections have been observed at lower aortic root diameters in LDS than in MFS. Recent CMR studies in MFS patients reported increased aortic stiffness (1–3) and altered rotational flow (4), but research on aortic flow dynamics and biomechanics in LDS is lacking.
PURPOSE
The aim of this study was to assess rotational aortic flow and aortic stiffness in LDS compared to healthy volunteers (HV) and MFS patients, using 4Dflow CMR.
METHODS
Twenty-one LDS and 44 MFS patients, without previous aortic dissection or surgery, and 43 HV underwent a non-contrast-enhanced 4D flow CMR. Aortic stiffness was quantified at the AAo and DAo using pulse wave velocity (PWV). In-plane rotational flow (IRF), systolic flow reversal ratio (SFRR) (5) and local aortic diameters were obtained at 20 equidistant planes from the ascending (AAo) to the proximal descending aorta (DAo).
RESULTS
LDS patients had lower IRF at the distal AAo and proximal DAo compared to HV (p = 0.053 and 0.004, respectively), once adjusted for age, stroke volume and local aortic diameter; but no differences were found with respect to MFS (Figure). Although SFRR at the proximal DAo was increased in LDS patients compared to both HV (p = 0.037) and MFS populations (p = 0.015), once adjusted for age and aortic diameter, the difference in magnitude was small (Figure). On the other hand, AAo and DAo PWV revealed stiffer aortas in LDS patients compared to HV but no differences versus MFS patients (Table).
CONCLUSIONS
Patients with Loeys-Dietz syndrome showed decreased in-plane rotational flow and abnormally-high regional aortic stiffness compared to healthy controls, and similar hemodynamics and aortic stiffness with respect to patients with Marfan syndrome.
Collapse
Affiliation(s)
- A Ruiz Munoz
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - A Guala
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | | | - L Dux-Santoy
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - L Servato
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - A Lopez-Sainz
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - L La Mura
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | | | - L Galian-Gay
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - L Gutierrez
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - K Johnson
- University of Wisconsin, Wisconsin, United States of America
| | - O Wieben
- University of Wisconsin, Wisconsin, United States of America
| | - I Ferreira
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - A Evangelista
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - G Teixido-Tura
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| |
Collapse
|
34
|
Simões LA, Cristina de Souza A, Ferreira I, Melo DS, Lopes LAA, Magnani M, Schwan RF, Dias DR. Probiotic properties of yeasts isolated from Brazilian fermented table olives. J Appl Microbiol 2021; 131:1983-1997. [PMID: 33704882 DOI: 10.1111/jam.15065] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [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: 11/02/2020] [Revised: 02/23/2021] [Accepted: 03/05/2021] [Indexed: 12/15/2022]
Abstract
AIMS To investigate the probiotic potential of yeasts isolated from naturally fermented Brazilian table olives. METHODS AND RESULTS Eighteen yeast strains were tested in terms of: safety; survival of gastrointestinal and digestion conditions; antimicrobial activity; cellular hydrophobicity; autoaggregation ability and adhesion to epithelial cells; coaggregation and inhibition of pathogenic bacteria adhesion. Six yeasts showed favourable results for all probiotic attributes: Saccharomyces cerevisiae CCMA 1746, Pichia guilliermondii CCMA 1753, Candida orthopsilosis CCMA 1748, Candida tropicalis CCMA 1751, Meyerozyma caribbica CCMA 1758 and Debaryomyces hansenii CCMA 1761. These yeasts demonstrated resistance to 37°C, pH 2·0 and bile salts, and survived in vitro digestion (≥106 CFU per ml). Furthermore, the yeasts exhibited a hydrophobic cell surface (42·5-92·2%), autoaggregation capacity (41·0-91·0%) and adhesion to Caco-2 (62·0-82·8%) and HT-29 (57·6-87·3%) epithelial cell lines. Also, the strains showed antimicrobial activity against Salmonella Enteritidis as well as the ability to coaggregate and reduce the adhesion of this pathogen to intestinal cells. CONCLUSIONS Autochthonous yeasts from naturally fermented Brazilian table olives have probiotic properties, with potential for development of new probiotic food products. SIGNIFICANCE AND IMPACT OF STUDY These data are important and contribute to the knowledge of new potential probiotic yeasts capable of surviving gastrointestinal tract conditions and inhibiting pathogenic bacteria.
Collapse
Affiliation(s)
- L A Simões
- Biology Department, Federal University of Lavras, Lavras, Minas Gerais, Brazil
| | - A Cristina de Souza
- Biology Department, Federal University of Lavras, Lavras, Minas Gerais, Brazil
| | - I Ferreira
- Biology Department, Federal University of Lavras, Lavras, Minas Gerais, Brazil
| | - D S Melo
- Biology Department, Federal University of Lavras, Lavras, Minas Gerais, Brazil
| | - L A A Lopes
- Department of Food Engineering, Federal University of Paraíba, João Pessoa, Brazil
| | - M Magnani
- Department of Food Engineering, Federal University of Paraíba, João Pessoa, Brazil
| | - R F Schwan
- Biology Department, Federal University of Lavras, Lavras, Minas Gerais, Brazil
| | - D R Dias
- Department of Food Science, Federal University of Lavras, Lavras, Minas Gerais, Brazil
| |
Collapse
|
35
|
Casas G, Limeres J, Oristrell G, Gutierrez L, Barriales R, Garcia-Pavia P, Zorio E, Gimeno JR, Villacorta E, Jimenez-Jaimez J, Ripoll T, Bayes A, Ferreira I, Rodriguez-Palomares JF. Long term outcomes in left ventricular noncompaction. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Left ventricular noncompaction (LVNC) is a heterogeneous entity with a wide phenotypic expression. Risk factors have not been well established and prognostic stratification remains challenging.
Objectives
Describe long term outcomes of LVNC patients and determine predictors of cardiovascular events.
Methods
Prospective multicentric study of consecutive patients fulfilling imaging diangostic criteria for LVNC (Jenni echo criteria and Petersen CMR criteria). Demographic, ECG, imaging and genetic variables were collected. End points were heart failure (HF), ventricular arrhythmias (VA), systemic embolisms (SE) and all-cause death. Major adverse cardiovascular events (MACE) was the combination of the four previous end points.
Results
585 patients from 12 referral centres were included from 2000 to 2018. Age at diagnosis was 45 ± 20 years, 334 (57%) were male, baseline LVEF was 48 ± 17% and 18% presented late gadolinium enhancement (LGE). During a median follow-up of 5.1 years (IQR 2.3-8.1), 110 (19%) patients presented HF, 87 (15%) VA, 18 (3%) SE and 34 (6%) died. MACE occurred in 223 (38%) patients.
LVEF was independently associated with HF, VA, SE and MACE: HR were 1.08, 1.02, 1.04 and 1.02 respectively (all p < 0.05). LGE was more frequent in patients with reduced LVEF (39 Vs 53%, p < 0.001) and was associated with higher HF and VA risk in patients with LVEF > 35% (HR 2.69 and 2.48 respectively, p < 0.05) (Figure 1). Patients with a normal ECG, LVEF≥50%, no LGE and no family aggregation presented no MACE (0%) at long term follow-up.
Among patients who underwent genetic testing (354, 61%), TTN variants and complex genotype (more than one variant) presented lower LVEF and higher HF risk. ACTC1 variants were associated with VA.
Conclusions
LVNC carries a high long term risk of heart faliure and ventricular arrhythmias. LVEF is the most important predictor and myocardial fibrosis is associated with increased risk in patients without severe systolic dysfunction. Genotype is a modifier of outcomes. These factors might be used to risk stratify LVNC patients.
Abstract Figure. Kaplan Meier survival curves
Collapse
Affiliation(s)
- G Casas
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - J Limeres
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - G Oristrell
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - L Gutierrez
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - R Barriales
- University Hospital Complex A Coru??a, A Coruna, Spain
| | - P Garcia-Pavia
- University Hospital Puerta de Hierro Majadahonda, Madrid, Spain
| | - E Zorio
- Hospital Universitario y Politecnico La Fe, Valencia, Spain
| | - JR Gimeno
- Hospital Universitario Virgen Arrixaca, Murcia, Spain
| | - E Villacorta
- Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
| | | | - T Ripoll
- Hospital Son Llatzer, Palma de Mallorca, Spain
| | - A Bayes
- Germans Trias i Pujol Hospital, Badalona, Spain
| | - I Ferreira
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | | |
Collapse
|
36
|
Guala A, Pons MI, Ruiz-Munoz A, Dux-Santoy L, Madrenas L, Valente F, Lopez-Sainz A, Galian L, Gutierrez L, Sao-Aviles A, Gonzalez-Alujas T, Ferreira I, Evangelista A, Rodriguez-Palomares J, Teixido-Tura G. Aortic root longitudinal strain by speckle-tracking echocardiography predicts progressive aortic root dilation in Marfan syndrome patients. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Spanish Ministry of Science, Innovation and Universities; Instituto de Salud Carlos III
Introduction
In Marfan syndrome (MFS) patients reduced longitudinal strain of the ascending aorta (AAo) as measured by applying feature-tracking on cine cardiac magnetic resonance (CMR) images predicts aortic root dilation and aortic events during the follow-up. Speckle-tracking is well established for cardiac deformation assessment but proximal aorta applications are challenging due to limited wall thickness and substantial cardiac motion. Moreover, echocardiography is widely used in the clinical assessment aortic diseases.
Purpose
We aimed to test a speckle-tracking tool for root longitudinal strain analysis in terms of comparison with CMR-derived AAo longitudinal strain and reproducibility and as predictor of dilation in MFS patients.
Methods
Thirty-five MFS patients diagnosed by original GHENT criteria, with maximum aortic root diameter of 45 mm and free from previous aortic dissection or cardiac/aortic surgery and non-severe aortic regurgitation were consecutive enrolled and followed-up. CMR and echocardiography were performed less than 2 months apart. Baseline and final aortic root diameter were measured on CMR images. To quantify aortic root cyclic elongation by echocardiography, two regions of interests were manually created covering both walls in a parasternal long-axis view and tracked along the cardiac cycle (Figure 1). Longitudinal strain was computed as the average of maximum increase in relative distance of several sub-regions covering both walls. CMR-derived AAo longitudinal strain was available in 29 patients. Intra-observer reproducibility was tested in 15 patients via intraclass correlation coefficient (ICC) for single-rater absolute agreement.
Results
Aortic root longitudinal strain by echocardiography was mildly related to CMR-derived AAo longitudinal strain (R = 0.27) and was larger compared to CMR-derived values (16.2 ± 6.0 vs 11.3 ± 4.3). Reproducibility was high, with ICC of 0.811, R = 0.802, p < 0.001. After a mean follow up of 76 ± 13 months, aortic root diameter grew in 20 patients with a rate of 0.29± 0.24 mm/year. Overall mean growth-rate was 0.87 ± 0.33 mm/year. In multivariable analysis corrected for age and baseline aortic root diameter, baseline longitudinal strain by echocardiography was independently and inversely related to progressive dilation (p = 0.033).
Conclusions
The measurement of aortic root longitudinal strain by speckle-tracking echocardiography is feasible. Aortic root longitudinal strain is an independent predictor of progressive dilation in MFS patients. This may permit the improvement of risk-stratification in aortic diseases in large scale studies.
Abstract Figure 1
Collapse
Affiliation(s)
- A Guala
- University Hospital Vall d"Hebron, Barcelona, Spain
| | - MI Pons
- University Hospital Vall d"Hebron, Barcelona, Spain
| | - A Ruiz-Munoz
- University Hospital Vall d"Hebron, Barcelona, Spain
| | - L Dux-Santoy
- University Hospital Vall d"Hebron, Barcelona, Spain
| | - L Madrenas
- University Hospital Vall d"Hebron, Barcelona, Spain
| | - F Valente
- University Hospital Vall d"Hebron, Barcelona, Spain
| | | | - L Galian
- University Hospital Vall d"Hebron, Barcelona, Spain
| | - L Gutierrez
- University Hospital Vall d"Hebron, Barcelona, Spain
| | - A Sao-Aviles
- University Hospital Vall d"Hebron, Barcelona, Spain
| | | | - I Ferreira
- University Hospital Vall d"Hebron, Barcelona, Spain
| | | | | | | |
Collapse
|
37
|
Guala A, Evangelista A, La Mura L, Teixido-Tura G, Dux-Santoy L, Ruiz-Munoz A, Cinque A, Valente F, Lopez-Sainz A, Galian-Gay L, Gutierrez L, Gonzalez-Alujas T, Sao-Aviles A, Ferreira I, Rodriguez-Palomares JF. Leaflets fusion length in bicuspid aortic valve is related to ascending and aortic root dilation and ascending aorta wall shear stress. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): Spanish Ministry of Science, Innovation and Universities, Instituto de Salud Carlos III
Background
Bicuspid aortic valve (BAV) is the most common congenital heart defect, consisting in the fusion of two aortic valve leaflets. Altered flow patterns have been related to aortic wall degeneration in BAV patients and may be responsible for the high prevalence of aortic disease in these patients. A number of studies on excised BAV or using advanced imaging modalities reported a wide variability of fusion extent between leaflet, but no previous study assessed whether leaflet fusion length may be used to stratify BAV patients.
Purpose
We aimed to test whether leaflet fusion extent can be quantified by cardiac magnetic resonance imaging (CMR) and whether it is related to aortic dilation and flow abnormalities in non-dysfunctional BAV.
Methods
One hundred and twenty BAV adults with no previous aortic or aortic valve surgery or significant valvular disease were consecutively enrolled. Patients with two sinuses of Valsalva (true BAV) or fusion of the left and non-coronary cusps, both being rare forms of BAV, were excluded. Twenty-eight healthy volunteers were also included for comparison. A 4D flow CMR sequence was acquired and circumferential wall shear stress and pulse wave velocity were assessed in the ascending aorta. A stack of double-oblique cine images of the aortic valve were used to quantify the length of the fusion between leaflets.
Results
The length of the fusion between leaflets was effectively measured in 112/120 patients (93%). Reproducibility was good (ICC = 0.826). Fusion length varied greatly (range 2.3 – 15.4 mm, 7.8 ± 3.2 mm, tertiles cut-off points were 6 and 9.3 mm). After correction for age, BSA, stroke volume and BAV fusion morphotype, fusion length was independently associated with diameter at the sinus of Valsalva (p = 0.002). Moreover, once corrected for age, stroke volume and ascending aorta pulse wave velocity, fusion length was positively related to ascending aorta diameter (p = 0.028). The comparison of maps of circumferential peak-systolic WSS in healthy volunteers (left) and BAV patients pertaining to the three leaflet fusion length tertiles is shown in Figure 1. Circumferential WSS progressively increase with larger fusion length. This trend was statistically significant (p < 0.05) in the right and outer regions of the proximal and mid ascending aorta.
Conclusions
Bicuspid aortic leaflet fusion length varies considerably and it is independently associated with ascending aorta and aortic root dilation, possibly through flow alterations.
Abstract Figure 1
Collapse
Affiliation(s)
- A Guala
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - A Evangelista
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - L La Mura
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - G Teixido-Tura
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - L Dux-Santoy
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - A Ruiz-Munoz
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - A Cinque
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - F Valente
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - A Lopez-Sainz
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - L Galian-Gay
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - L Gutierrez
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | | | - A Sao-Aviles
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - I Ferreira
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | | |
Collapse
|
38
|
Guala A, Dux-Santoy L, Teixido-Tura G, Ruiz-Munoz A, Lopez-Sainz A, La Mora L, Galian L, Gutierrez L, Valente F, Gonzalez-Alujas T, Johnson K, Wieben O, Ferreira I, Evangelista A, Rodriguez-Palomares J. Regional curvature in thoracic aortic aneurysms of different aetiologies and its relationship with established risk factors. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.320] [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: Public grant(s) – National budget only. Main funding source(s): Spanish Ministry of Science, Innovation and Universities ; Instituto de Salud Carlos III
Introduction
The aorta is a 3D hollow, curvilinear elastic structure whose diseases have life-threatening consequences. Despite much effort has been paid to study aortic diameter, diameter is a poor predictor of events. Conversely, much less is known about aortic curvature, its distribution in the thoracic aorta and the potential impact of risk factors in aneurysms associated with different conditions. Currently, 4D flow magnetic resonance imaging (4D flow CMR) allows to obtain 3D geometry, 4D flow data and regional aortic stiffness.
Purpose
We aim to study regional aortic curvature in thoracic aorta aneurysms of different aetiologies and define its relationship with established risk factors.
Methods
One-hundred twenty patients (40 for each group, selected out of prospective cohorts of 156 bicuspid aortic valve – BAV-, 77 Marfan –MFS- and 67 patients with a degenerative aneurysm – TAVdeg-) were matched for age, sex and BSA via propensity score with 40 healthy volunteers (HV). The thoracic aorta was semi-automatically segmented from angiograms and the centreline was computed. Local curvature was assessed at 20 planes covering the thoracic aorta from the sinotubular junction to the proximal descending aorta (DAo) at the level of the pulmonary artery bifurcation. Local curvature was normalized by subject mean thoracic aorta curvature. Length was measured as centreline length. Aortic stiffness was measured in the DAo by pulse wave velocity (PWV). Aneurysm was defined by z-score ≥ 2 using diameters measured by double-oblique cine CMR.
Results
Matching was successful in all groups with the exception of a residual age difference between HV and TAVdeg. Curvature in HV showed a fairly smooth transition between the straighter ascending aorta (AAo) and DAo to a more curved aortic arch, with a peak in the mid aortic arch (Figure 1A). Conversely, all patients’ groups presented a peak in curvature in the proximal DAo and a decreased local curvature in the aortic arch and mid DAo close to the level of the pulmonary artery. BAV and TAVdeg patients showed also increased curvature in the mid AAo, were dilation is prevalent. Conversely, in the same area MFS showed a reduced curvature and limited prevalence of aneurysm. In the overall population, age, AAo and root diameters, mean blood pressure, DAo PWV and aortic length, all established risk factors for aortic events, were inversely related to curvature in the distal AAo and aortic arch (Figure 1B).
Conclusions
Aneurysms related to different aetiologies show similar abnormalities in aortic curvature, with limited curvature in the aortic arch and a peak soon after the third supra-aortic vessel. Age, aortic diameter, length, stiffness and blood pressure, all known risk factors, are all related to reduced curvature in the distal ascending aorta and aortic arch.
Abstract Figure.
Collapse
Affiliation(s)
- A Guala
- University Hospital Vall d"Hebron, Barcelona, Spain
| | - L Dux-Santoy
- University Hospital Vall d"Hebron, Barcelona, Spain
| | | | - A Ruiz-Munoz
- University Hospital Vall d"Hebron, Barcelona, Spain
| | | | - L La Mora
- University Hospital Vall d"Hebron, Barcelona, Spain
| | - L Galian
- University Hospital Vall d"Hebron, Barcelona, Spain
| | - L Gutierrez
- University Hospital Vall d"Hebron, Barcelona, Spain
| | - F Valente
- University Hospital Vall d"Hebron, Barcelona, Spain
| | | | - K Johnson
- University of Wisconsin-Madison, Departments of Medical Physics & Radiology, Madison, United States of America
| | - O Wieben
- University of Wisconsin-Madison, Departments of Medical Physics & Radiology, Madison, United States of America
| | - I Ferreira
- University Hospital Vall d"Hebron, Barcelona, Spain
| | | | | |
Collapse
|
39
|
Mejia Cordova M, Guala A, Morales X, Jimenez-Perez G, Dux-Santoy L, Ruiz-Munoz A, Teixido-Tura G, Ferreira I, Evangelista A, Rodriguez-Palomares J, Camara O. Reinforcement machine learning-based aortic anatomical landmarks detection from phase-contrast enhanced magnetic resonance angiography. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Spanish Ministry of Science, Innovation and Universities; La Marató de TV3
Introduction
Automatic analysis of medical imaging data may improve their clinical impact by reducing analysis time and improving reproducibility. Many medical imaging data, like 4D-flow magnetic resonance imaging (MRI), are often quantified regionally, implying the need for anatomical landmark identification to locate correspondences in the extracted data and compare among patients. Machine learning (ML) techniques hold potential for automatic analysis of medical imaging. Phase-contrast enhanced magnetic resonance angiography (PC-MRA) is a class of angiograms not requiring the administration of contrast agents.
Purpose
We aimed to test whether a machine learning algorithm can be trained to identify key anatomical cardiovascular landmarks on PC-MRA images and compare its performance with humans.
Methods
Three-hundred twenty-three aortic PC-MRA were manually annotated with the location of 4 landmarks: sinotubular junction, pulmonary artery bifurcation and first and third supra-aortic vessels (Figure 1), often used to separate the aorta in sub-regions. Patients included in the training dataset comprised healthy volunteers (40), bicuspid aortic valve patients (141), patients with degenerative aortic disease (60) and patients with genetically-triggered aortic disease (82), all without previous aortic surgery and with native aortic valve. PC-MRA images and manual annotations were used to train a DQN, a reinforcement learning algorithm that combines Q-learning with deep neural networks. The agents can navigate the images and optimally find the landmarks by following the policies learned during training. Data from thirty patients, distributed in terms of aortic condition as the training set, unseen by the algorithm in the training phase, were used to quantify intra-observer reproducibility and to assess ML algorithm performance. Distance between points was used as metric for comparisons, original human annotation was used as ground-truth and repeated-measures ANOVA was used for statistical testing.
Results
Human and machine learning performed similarly in the identification of the sinotubular junction (distance between points of 11.0 ± 8.1 vs. 11.1 ± 8.6 mm, respectively, p = 0.949) and first (6.6 ± 3.9 vs. 6.8 ± 5.6 mm, p = 0.886) and third (6.8 ± 4.0 vs. 8.4 ± 7.4 mm, p = 0.161) supra-aortic vessels branches but human annotation outperformed ML landmark detection in the identification of the pulmonary artery bifurcation (10.2 ± 7.0 vs. 15.2 ± 13.1 mm, p = 0.008). Computation time for landmark detection by ML was between 0.8 and 1.6 seconds on a standard computer while human annotation took approximatively two minutes.
Conclusions
ML-based aortic landmarks detection from phase-contrast enhanced magnetic resonance angiography is feasible and fast and performs similarly to human. Reinforced learning anatomical landmark identification unlock automatic extraction of a variety of regional aortic data, including complex 4D flow parameters.
Abstract Figure
Collapse
Affiliation(s)
- M Mejia Cordova
- University Pompeu Fabra, Physense, BCN Medtech, Department of Information and Communications Technologies, Barcelona, Spain
| | - A Guala
- University Hospital Vall d"Hebron, Barcelona, Spain
| | - X Morales
- University Pompeu Fabra, Physense, BCN Medtech, Department of Information and Communications Technologies, Barcelona, Spain
| | - G Jimenez-Perez
- University Pompeu Fabra, Physense, BCN Medtech, Department of Information and Communications Technologies, Barcelona, Spain
| | - L Dux-Santoy
- University Hospital Vall d"Hebron, Barcelona, Spain
| | - A Ruiz-Munoz
- University Hospital Vall d"Hebron, Barcelona, Spain
| | | | - I Ferreira
- University Hospital Vall d"Hebron, Barcelona, Spain
| | | | | | - O Camara
- University Pompeu Fabra, Physense, BCN Medtech, Department of Information and Communications Technologies, Barcelona, Spain
| |
Collapse
|
40
|
Massahi S, Christensen FE, Ferreira DDM, Svendsen S, Henriksen PL, Vu LM, Gellert NC, Jegers AS, Shortt B, Bavdaz M, Ferreira I, Collon M, Landgraf B, Girou D, Sokolov A, Schoenberger W. Investigation of boron carbide and iridium thin films, an enabling technology for future x-ray telescopes. Appl Opt 2020; 59:10902-10911. [PMID: 33361911 DOI: 10.1364/ao.409453] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 11/06/2020] [Indexed: 06/12/2023]
Abstract
We present an experimental examination of iridium and boron carbide thin-film coatings for the purpose of fabricating x-ray optics. We use a combination of x-ray reflectometry and x-ray photoelectron spectroscopy to model the structure, composition, density, thickness, and micro-roughness of the thin films. We demonstrate in our analyses how the two characterization techniques are complementary, and from this we derive that an overlayer originating from atmospheric contamination with a thickness between 1.0-1.6 nm is present on the surface. The magnetron sputtered iridium films are measured to have a density of 22.4g/cm3. The boron carbide film exhibits a change in chemical composition in the top ∼2nm of the film surface when exposed to the ambient atmosphere. The chemical reaction occurring on the surface is due to an incorporation of oxygen and hydrogen present in the ambient atmosphere. Lastly, we present a correlation between the absorption edges and the emission lines exhibited by the thin films in an energy range from 50-800 eV and the impact on the reflectivity performance due to contamination in thin films.
Collapse
|
41
|
Brites GS, Ferreira I, Sebastião AI, Silva A, Carrascal M, Neves BM, Cruz MT. Allergic contact dermatitis: From pathophysiology to development of new preventive strategies. Pharmacol Res 2020; 162:105282. [PMID: 33161140 DOI: 10.1016/j.phrs.2020.105282] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 10/29/2020] [Accepted: 10/30/2020] [Indexed: 11/25/2022]
Abstract
As the body's first line of defense, the skin is the organ most frequently exposed to chemicals present in personal hygiene products, household products, or materials used in the work environment. In this context, skin disorders account for more than 40 % of all occupational and work-related diseases, constituting a significant public health burden. Among skin disorders, allergic contact dermatitis (ACD) is the most prevalent occupational disease and the most common form of immunotoxicity in humans. ACD is a T-cell-mediated skin inflammation resulting from the priming and expansion of allergen-specific CD4+ and CD8+ T cells. The clinical condition is characterized by local skin rash, itchiness, redness, swelling, and lesions, being mainly diagnosed by the patch test. Upon ACD diagnosis, avoiding the exposure to the triggering allergen is the mainstay of treatment to prevent future flares. In cases where avoidance is not possible, the use of a standard of care interim treatments such as steroid creams or ointments, barrier creams, and moisturizers are strongly recommended to alleviate symptoms. In this review, we sought to provide the reader with an overview of the pathophysiology of ACD as well as the currently available pharmacological treatment options. Furthermore, a comprehensive outline of several preventive strategies is also provided.
Collapse
Affiliation(s)
- Gonçalo Sousa Brites
- Faculty of Pharmacy, University of Coimbra, Coimbra, 3000-548, Portugal; Center for Neuroscience and Cell Biology - CNC, University of Coimbra, Coimbra, 3004-504, Portugal
| | - Isabel Ferreira
- Faculty of Pharmacy, University of Coimbra, Coimbra, 3000-548, Portugal; Center for Neuroscience and Cell Biology - CNC, University of Coimbra, Coimbra, 3004-504, Portugal
| | | | - Ana Silva
- Center for Neuroscience and Cell Biology - CNC, University of Coimbra, Coimbra, 3004-504, Portugal
| | - Mylene Carrascal
- Center for Neuroscience and Cell Biology - CNC, University of Coimbra, Coimbra, 3004-504, Portugal; Tecnimede Group, Sintra, 2710-089, Portugal
| | - Bruno Miguel Neves
- Department of Medical Sciences and Institute of Biomedicine - iBiMED, University of Aveiro, Aveiro, 3810-193, Portugal
| | - Maria T Cruz
- Faculty of Pharmacy, University of Coimbra, Coimbra, 3000-548, Portugal; Center for Neuroscience and Cell Biology - CNC, University of Coimbra, Coimbra, 3004-504, Portugal.
| |
Collapse
|
42
|
Casas G, Oristrell G, Limeres J, Gutierrez Garcia-Moreno L, Barriales R, Garcia-Pavia P, Zorio E, Gimeno J, Villacorta E, Jimenez-Jaimez J, Ripoll T, Bayes A, Diez C, Ferreira I, Rodriguez-Palomares J. Long term outcomes in left ventricular non-compaction. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2070] [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
Left ventricular non-compaction (LVNC) is a highly heterogeneous entity with a wide phenotypic expression. Risk factors have not been well established and prognostic stratification remains challenging.
Objectives
Describe long term outcomes of LVNC patients and determine predictors of cardiovascular events.
Methods
Prospective multicentric study of consecutive patients fulfilling imaging criteria for LVNC. Demographic, ECG, imaging and genetic variables were collected. End points were heart failure (HF), ventricular arrhythmias (VA), systemic embolisms (SE) and all-cause death. Major adverse cardiovascular event (MACE) was described as the combination of the four previous end points.
Results
592 patients from 13 referral centres were included from 2000 to 2018. Mean age at diagnosis was 45 years, 252 (43%) were female and mean LVEF was 48% (Table 1). During a median follow-up of 55 months (IQR 24–90), 144 (25%) patients presented HF, 101 (18%) VA, 27 (5%) SE and 33 (6%) died. MACE occurred in 223 (39%) patients.
In multivariate analysis, independent predictors of HF were LVEF (OR 0.9), PSAP (OR 1.17) and late gadolinium enhancement (LGE) (OR 1.3). VA were independently associated with LVEF (OR 0.97) and LGE (OR 2.51). Independent predictors of SE were LVEF (OR 0.96) and LA diameter (OR 1.07). No independent predictors of all-cause death could be described. MACE were independently associated with LVEF (OR 1.04) and PSAP (OR 1.08) (Table 1).
Among patients who underwent genetic testing (340, 57%), genotype was associated with outcomes: MYH7 and ACTC1 variants were protective while multiple mutations, TTN and MYBPC3 variants exhibited worse prognosis.
Conclusions
In a large prospective multicentric cohort of LVNC patients, there was a moderate long term incidence of cardiovascular events. LVEF and fibrosis were the main predictors and genotype was a modifier of outcomes. These factors might be used to risk stratify LVNC patients.
Funding Acknowledgement
Type of funding source: None
Collapse
Affiliation(s)
- G Casas
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | - G Oristrell
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | - J Limeres
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | | | - R Barriales
- University Hospital Complex A Coruña, A Coruna, Spain
| | - P Garcia-Pavia
- University Hospital Puerta de Hierro Majadahonda, Madrid, Spain
| | - E Zorio
- University Hospital y Politecnico La Fe, Valencia, Spain
| | - J.R Gimeno
- Hospital Universitario Virgen Arrixaca, Murcia, Spain
| | - E Villacorta
- Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
| | | | - T Ripoll
- Hospital Son Llatzer, Palma de Mallorca, Spain
| | - A Bayes
- Germans Trias i Pujol Hospital, Badalona, Spain
| | - C Diez
- University Hospital of Bellvitge, Hospitalet De Llobregat, Spain
| | - I Ferreira
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | | |
Collapse
|
43
|
La Mura L, Teixido-Tura G, Guala A, Ruiz-Munoz A, Servato M, Fassano N, Valente F, Lopez-Sainz A, Galian-Gay L, Gonzalez-Alujas T, Cinque A, Ferreira I, Evangelista A, Galderisi M, Rodriguez-Palomares J. Relationship between aortic distensibility and aortic regurgitation depending on aortic valve anatomy. A CMR study. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2337] [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
Background
Aortic regurgitation (AR) can be evaluated by cardiac magnetic resonance (CMR).The most commonly used method to quantify AR is direct measurement using phase contrast (PC) imaging, at the aortic root (as close as possible to the aortic valve), for the calculation of regurgitant fraction (RF). Aortic distensibility (AD) may affect aortic valve dynamics and, as a result, aortic regurgitation grade. However, the impact of aortic distensibility in this evaluation remains unknown.
Purpose
The aim of the study was to evaluate the relationship between AD and AR in patients with different aortic valve anatomy.
Methods
213 patients with different AR severity grades and aortic valve anatomy (tricuspid (TAV) and bicuspid valve (BAV) patients) were enrolled (32.2% female, 74% BAV, 55.5±15.4 years), excluding connective tissue disease. All patients underwent a CMR study with PC sequences for the evaluation of regurgitant fraction at the aortic valve level. AR was considered as mild (<15%), moderate (15–30%) or severe (>30%) depending on RF value. Furthermore we used cine-sequences to estimate aortic diameters and distensibilities, using Art Fun software. Distensibility was calculated as (change in aortic area between systole and diastole/diastolic area)/brachial pulse pressure.
Results
159 (73.7%) AR were mild, 30 (14.1%) moderate and 24 (11.3%) severe. RF significantly correlated with aortic root diameter (r=0.337, p<0.001) and did not correlate with AD at the level of proximal descending aorta (r=0.121 and p=0.107). Furthermore descendig aorta distensibility correlated with age (r=−0.631, p<0.001) and aortic root diameter (r=−0.224, p=0.002). Dividing population in two different groups, depending on aortic valve anatomy, in TAV patients RF continued to not correlate with AD (r=0.159, p=0.369). In contrast, RF in BAV patients was positively correlated with AD (r=0.223, p=0.007) even after adjustment for aortic diameter and age in a multiple regression model (p<0.001, R2=0.478).
Conclusions
In our study, aortic regurgitation is positively related to descending aorta distensibility in BAV patients, regardless of age and aortic root diameter. Thus, AD may play a role in the evaluation of AR in case of bicuspid valves. In contrast, in TAV patients, distensibility does not seem to influence the assessment of AR severity.
Descending aorta distensibility
Funding Acknowledgement
Type of funding source: Other. Main funding source(s): Research grant provided by the Cardiopath PhD program
Collapse
Affiliation(s)
- L La Mura
- University of Naples Federico II, Napoli, Italy
| | | | - A Guala
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - A Ruiz-Munoz
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - M.L Servato
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - N Fassano
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - F Valente
- University Hospital Vall d'Hebron, Barcelona, Spain
| | | | - L Galian-Gay
- University Hospital Vall d'Hebron, Barcelona, Spain
| | | | - A Cinque
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - I Ferreira
- University Hospital Vall d'Hebron, Barcelona, Spain
| | | | - M Galderisi
- University of Naples Federico II, Napoli, Italy
| | | |
Collapse
|
44
|
Ruiz Munoz A, Guala A, Rodriguez-Palomares J, Dux-Santoy L, Servato L, Lopez-Sainz A, La Mura L, Gonzalez-Alujas T, Galian-Gay L, Gutierrez L, Johnson K, Wieben O, Ferreira I, Evangelista A, Teixido-Tura G. Aortic stiffness and hemodynamics in Loeys-Dietz syndrome by 4Dflow CMR: a comparison with healthy volunteers and patients with Marfan syndrome. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2336] [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
Connective tissue disorders, such as Loeys-Dietz (LDS) and Marfan (MFS) syndromes, are rare genetic diseases associated with progressive aortic dilation. Aortic dissections have been observed at lower aortic root diameters in LDS than in MFS, and research on aortic flow dynamics and biomechanics in LDS is lacking.
Purpose
To evaluate rotational aortic flow and aortic stiffness in LDS compared to healthy volunteers (HV) and MFS patients, using 4Dflow CMR.
Methods
Twenty-one LDS and 44 MFS patients, without previous aortic dissection or surgery, and 44 HV underwent a non-contrast-enhanced 4D flow CMR. In-plane rotational flow (IRF), systolic flow reversal ratio (SFRR) and local aortic diameters were obtained at 20 equidistant planes from the ascending (AAo) to the proximal descending aorta (DAo). Aortic stiffness was quantified at the AAo and DAo using pulse wave velocity (PWV).
Results
LDS patients had lower IRF at the distal AAo and proximal DAo compared to HV (p=0.053 and 0.004, respectively), once adjusted for age, stroke volume and local aortic diameter; but no differences were found with respect to MFS (Figure). Although SFRR at the proximal DAo was increased in LDS patients compared to both HV (p=0.037) and MFS populations (p=0.015), once adjusted for age and aortic diameter, the difference in magnitude was small (Figure). On the other hand, AAo and DAo PWV revealed stiffer aortas in LDS patients compared to HV but no differences versus MFS patients (Table).
Conclusions
LDS patients showed decreased in-plane rotational flow and abnormally-high regional aortic stiffness compared to healthy controls, and similar hemodynamics and aortic stiffness with respect to MFS patients
Funding Acknowledgement
Type of funding source: Public Institution(s). Main funding source(s): Instituto de Salud Carlos III, La Maratό TV3
Collapse
Affiliation(s)
- A Ruiz Munoz
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | - A Guala
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | | | - L Dux-Santoy
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | - L Servato
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | - A Lopez-Sainz
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | - L La Mura
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | | | - L Galian-Gay
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | - L Gutierrez
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | - K Johnson
- University of Wisconsin, Wisconsin, United States of America
| | - O Wieben
- University of Wisconsin, Wisconsin, United States of America
| | - I Ferreira
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | - A Evangelista
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | - G Teixido-Tura
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| |
Collapse
|
45
|
Guala A, Gil Sala D, Ruiz-Munoz A, Garcia Reyes M, Dux-Santoy L, Teixido-Tura G, Tello C, Cinque A, Valente F, Lopez Sainz A, Galian Gay L, Ferreira I, Evangelista A, Bellmunt Montoya S, Rodriguez Palomares J. Patients with blunt traumatic thoracic aortic injury treated with TEVAR present increased flow dynamics alterations and pulse wave velocity: a 4D flow CMR study. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2351] [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
Thoracic endovascular aortic repair (TEVAR) is widely used for the treatment of blunt traumatic thoracic aortic injuries. Aortic flow dynamics and mechanical implications of this intervention are poorly investigated and may be of particular interest in the long-term follow-up of these mostly young patients.
Purpose
To assess whether the presence of TEVAR in a cohort of otherwise healthy subjects was related to dilation of the proximal aorta or increase in aortic stiffness and flow alterations.
Methods
Nineteen patients who underwent TEVAR implantation after a traumatic injury of the thoracic descending aorta (DAo) (10.0±6.1 years from intervention) and 44 healthy volunteers (HV) underwent 4D flow CMR to compute ascending aorta (AAo) pulse wave velocity (PWV), a marker of aortic stiffness, systolic flow reversal ratio (SFRR), quantifying backward flow during systole and in-plane rotational flow (IRF), measuring in-plane strength of helical flow. IRF and SFRR were assessed at 20 planes between the sinotubular junction and the mid thoracic DAo. Aortic diameters were measured using double-oblique cine CMR.
Results
Patients with TEVAR and HV did not differ in age, sex, body surface area, blood pressure and DAo diameter distal to TEVAR (Table). However, TEVAR patients presented larger diameters at the sinus of Valsalva and AAo, increased AAo PWV and strong flow alterations: IRF was reduced from the distal AAo to the proximal DAo, while SFRR was increased in the whole thoracic aorta (Figure).
Conclusions
In patients with blunt traumatic thoracic aortic injury treated with TEVAR the aorta proximal to TEVAR is dilated, stiffer and present potentially pathogenic flow conditions. Longitudinal studies are needed to assess whether these alterations have prognostic value and may improve clinical prevention and management of these patients.
Figure 1. IRF and SFRR in healthy vs TEVAR
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): This study has been funded by Instituto de Salud Carlos III, Spanish Ministry of Science and Innovation (PI19/01480). Guala A. received funding from the Spanish Ministry of Science, Innovation and Universities (IJC2018-037349-I).
Collapse
Affiliation(s)
- A Guala
- University Hospital Vall d'Hebron, Department of Cardiology, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - D Gil Sala
- University Hospital Vall d'Hebron, Dept. Vascular and endovascular surgery, Vall d'Hebron Research Institute, U. Autònoma de Barcelona, Barcelona, Spain
| | - A Ruiz-Munoz
- University Hospital Vall d'Hebron, Department of Cardiology, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M.E Garcia Reyes
- University Hospital Vall d'Hebron, Dept. Vascular and endovascular surgery, Vall d'Hebron Research Institute, U. Autònoma de Barcelona, Barcelona, Spain
| | - L Dux-Santoy
- University Hospital Vall d'Hebron, Department of Cardiology, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - G Teixido-Tura
- University Hospital Vall d'Hebron, Department of Cardiology, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - C Tello
- University Hospital Vall d'Hebron, Dept. Vascular and endovascular surgery, Vall d'Hebron Research Institute, U. Autònoma de Barcelona, Barcelona, Spain
| | - A Cinque
- University Hospital Vall d'Hebron, Department of Cardiology, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - F Valente
- University Hospital Vall d'Hebron, Department of Cardiology, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A Lopez Sainz
- University Hospital Vall d'Hebron, Department of Cardiology, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - L Galian Gay
- University Hospital Vall d'Hebron, Department of Cardiology, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - I Ferreira
- University Hospital Vall d'Hebron, Department of Cardiology, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A Evangelista
- University Hospital Vall d'Hebron, Department of Cardiology, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - S Bellmunt Montoya
- University Hospital Vall d'Hebron, Dept. Vascular and endovascular surgery, Vall d'Hebron Research Institute, U. Autònoma de Barcelona, Barcelona, Spain
| | - J.F Rodriguez Palomares
- University Hospital Vall d'Hebron, Department of Cardiology, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| |
Collapse
|
46
|
Guala A, Evangelista A, La Mura L, Teixido-Tura G, Dux-Santoy L, Ruiz-Munoz A, Cinque A, Valente F, Lopez Sainz A, Galian Gay L, Gutierrez L, Gonzalez Alujas T, Sao-Aviles A, Ferreira I, Rodriguez Palomares J. The length of the fusion between leaflets in bicuspid aortic valve is independently related to ascending aorta dilation and flow dynamics alterations assessed by 4D-flow CMR. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2334] [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
Aortic dilation in bicuspid aortic valve (BAV) patients has been related to altered flow patterns, which contribute to aortic wall degeneration. However, preventive aortic replacement is currently based on a diameter threshold. Several studies on excised BAV reported wide variability of fusion extent.
Purpose
To unveil whether leaflet fusion extent can be quantified by CMR and is related to aortic dilation and flow abnormalities in non-dysfunctional BAV.
Methods
One hundred and twenty adults with non-dysfunctional BAV and no previous aortic or aortic valve surgery and 28 healthy volunteers underwent double-oblique cine and 4D flow CMR. BAV patients with two sinuses of Valsalva or left and non-coronary cusps fusion were excluded. Peak systolic circumferential wall shear stress (WSSc) and pulse wave velocity (PWV) in the ascending aorta (AAo) were assessed by 4D flow CMR. Fusion length between leaflets was measured using a stack of double-oblique cine CMR images of the aortic valve.
Results
The length of the fusion was effectively measured in 112/120 (93%) patients with good reproducibility (ICC = 0.826) and showed great variability (range 2.3–15.4 mm, 7.8±3.2 mm and tertiles cut-off points 6 and 9.3 mm). In multivariate analysis adjusted for clinical and demographic characteristics and PWV, fusion length was independently associated with the diameter at the sinus of Valsalva (p=0.002) and the AAo (p=0.02) (Table). WSSc progressively increased with larger fusion length (Figure), with statistical significance (p<0.05) in the right and outer regions of the proximal and mid AAo.
Conclusions
Bicuspid aortic leaflet fusion length varies considerably, and it is independently associated with AAo and aortic root dilation, possibly through flow alterations.
Figure 1. Maps of circumferential WSS
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): This study has been partially funded by Instituto Carlos III, Spanish Ministry of Science and Innovation (PI17/00381). Guala A. has received funding from the Spanish Ministry of Science, Innovation and Universities (IJC2018-037349-I).
Collapse
Affiliation(s)
- A Guala
- University Hospital Vall d'Hebron, Department of Cardiology, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A Evangelista
- University Hospital Vall d'Hebron, Department of Cardiology, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - L La Mura
- Federico II University, Department of Advanced Biomedical Sciences, Napoli, Italy
| | - G Teixido-Tura
- University Hospital Vall d'Hebron, Department of Cardiology, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - L Dux-Santoy
- University Hospital Vall d'Hebron, Department of Cardiology, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A Ruiz-Munoz
- University Hospital Vall d'Hebron, Department of Cardiology, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A Cinque
- University Hospital Vall d'Hebron, Department of Cardiology, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - F Valente
- University Hospital Vall d'Hebron, Department of Cardiology, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A Lopez Sainz
- University Hospital Vall d'Hebron, Department of Cardiology, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - L Galian Gay
- University Hospital Vall d'Hebron, Department of Cardiology, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - L Gutierrez
- University Hospital Vall d'Hebron, Department of Cardiology, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - T Gonzalez Alujas
- University Hospital Vall d'Hebron, Department of Cardiology, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A Sao-Aviles
- University Hospital Vall d'Hebron, Department of Cardiology, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - I Ferreira
- University Hospital Vall d'Hebron, Department of Cardiology, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - J.F Rodriguez Palomares
- University Hospital Vall d'Hebron, Department of Cardiology, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| |
Collapse
|
47
|
La Mura L, Teixido-Tura G, Guala A, Ruiz-Munoz A, Servato M, Fassano N, Valente F, Lopez-Sainz A, Galian-Gay L, Gonzalez-Alujas T, Cinque A, Ferreira I, Evangelista A, Galderisi M, Rodriguez-Palomares J. The role of descending aorta diastolic reverse flow in the quantification of aortic regurgitation by CMR. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0246] [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
EACVI recommends the use of an “integrative approach”, using several parameters, in aortic regurgitation (AR) quantification. This approach is easily achieved by echocardiography although cardiovascular magnetic resonance (CMR) remains the gold standard for the quantification of regurgitant fraction (RF).
Purpose
The aim of the study was to analyze the accuracy of descending aorta (DA) diastolic reverse flow in the assessment of chronic AR severity by CMR to identify an additional parameter.
Methods
188 patients (34% female, 54.6±15.6 years) with different severity grades of chronic AR were enrolled. All patients underwent a CMR study. Aortic regurgitation was considered as absent (≤1%), mild (≤15%), moderate (≤15%) or severe (≥30%) depending on RF value at valve level. Furthermore, cine-sequences were used to estimate aortic diameters and distensibilities using Art Fun software. Velocity-time integral (VTI) of reverse flow in DA was calculated from maximum velocity curves by an in-house MatLab code.
Results
AR was absent in 21 (12%) patients, mild in 114 (62.9%), moderate in 23 (12.7%) and severe in 21 (11.6%).DA VTI reverse flow was significantly higher as was the RF at valve level (r=0.805, p<0.001) (IMG, Table). It also positively correlated withaortic root diameter (r=0.347, p<0.001) and DA distensibility (r=0.279, p<0.001). It did not correlate with age (r=−0.91, p=0.22). In a statistically significant multiple regression model (p<0.001, R2 = 0.697), although VTI reverse flow in DA correlated strongly with RF at valve level (p<0.001; beta = 0.733), it was also influenced by DA distensibility (p<0.001; beta = 0.197) and aortic root diameter (p<0.001; beta= 0.140).
Conclusions
VTI reverse flow in DA correlates strongly with the degree of AR and may be useful in the assessment of its severity. Neverthless, owing to the influence of other factors (aortic distensibility and aortic root diameter), it cannot be used as a single parameter in the quantification of AR severity by CMR.
Scatter Plot graphs
Funding Acknowledgement
Type of funding source: Other. Main funding source(s): research grant provided by the Cardiopath PhD program
Collapse
Affiliation(s)
- L La Mura
- University of Naples Federico II, Napoli, Italy
| | | | - A Guala
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - A Ruiz-Munoz
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - M.L Servato
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - N Fassano
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - F Valente
- University Hospital Vall d'Hebron, Barcelona, Spain
| | | | - L Galian-Gay
- University Hospital Vall d'Hebron, Barcelona, Spain
| | | | - A Cinque
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - I Ferreira
- University Hospital Vall d'Hebron, Barcelona, Spain
| | | | - M Galderisi
- University of Naples Federico II, Napoli, Italy
| | | |
Collapse
|
48
|
da Silva AM, Torres C, Ferreira I, Moreira I, Samões R, Sousa AP, Santos E, Teixeira-Pinto A, Cavaco S. Prognostic value of odor identification impairment in multiple sclerosis: 10-Years follow-up. Mult Scler Relat Disord 2020; 46:102486. [PMID: 32916510 DOI: 10.1016/j.msard.2020.102486] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 08/23/2020] [Accepted: 09/02/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Olfactory dysfunction has been linked to clinical severity variables in multiple MS populations. Though, its prognostic value is still unknown. OBJECTIVE The aim of this study was to explore the long-term outcome associated with Brief-Smell Identification Test (B-SIT) performance in a cohort of MS patients. METHODS A retrospective review of the clinical records was conducted in 149 patients who participated in a previous study, with a median follow-up of 121 months. Demographic and clinical data regarding the last clinical appointment with EDSS measurement were collected. Multiple Sclerosis Severity Scale (MSSS) and Age-Related Multiple Sclerosis Severity (ARMSS) scores were calculated. Date of the last clinical contact or death was recorded. RESULTS Among MS patients with progressive clinical course (n = 33), those with impaired B-SIT at baseline had greater change per month during follow-up (as measured by increases in MSSS and ARMSS scores) and a higher hazard of death. No significant associations were found among patients with relapsing and remitting MS (n = 116). CONCLUSIONS The study results demonstrate that odor identification impairment has prognostic value in progressive MS, suggesting that a brief odor identification measure can be a marker of neurodegeneration in progressive MS.
Collapse
Affiliation(s)
- Ana Martins da Silva
- Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal; Neurology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal.
| | - C Torres
- Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - I Ferreira
- Neurology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal; Neuropsychology Unit, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - I Moreira
- Neurology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal; Neuropsychology Unit, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - R Samões
- Neurology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - A P Sousa
- Neurology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal; Neurophysiology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - E Santos
- Neurology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - A Teixeira-Pinto
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - S Cavaco
- Neurology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal; Neuropsychology Unit, Centro Hospitalar Universitário do Porto, Porto, Portugal
| |
Collapse
|
49
|
Chung HF, Ferreira I, Mishra GD. The association between menstrual symptoms and hypertension among young women: A prospective longitudinal study. Maturitas 2020; 143:17-24. [PMID: 33308624 DOI: 10.1016/j.maturitas.2020.08.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 08/03/2020] [Accepted: 08/12/2020] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To investigate whether menstrual symptoms are associated with increased risk of hypertension among young women, and whether the relationship is bi-directional. STUDY DESIGN We included 7729 women participating in the Australian Longitudinal Study on Women's Health, aged 22-27 years in 2000 and who were followed up every 3 years until 2015. Premenstrual syndrome, painful (dysmenorrhoea), heavy (menorrhagia), and irregular menstrual periods over the previous 12 months were self-reported and recorded as 'never', 'rarely', 'sometimes', or 'often'. Questions regarding physician-diagnosed hypertension were asked, specifically for other than during pregnancy (defined as chronic hypertension) and during pregnancy (hypertensive disorder in pregnancy, HDP). Longitudinal data were analysed with generalised estimating equation time-lagged models to estimate relative risks (RRs) and 95 % confidence intervals (CI), adjusted for time-varying covariates. MIAN OUTCOME MEASURES Chronic hypertension, HDP, and menstrual disorders. RESULTS Over 15 years of follow-up, 757 women (9.8 %) reported having been diagnosed with chronic hypertension. Among 4473 parous women, 483 (10.8 %) reported a diagnosis of HDP. Women who often experienced heavy periods had an increased risk of incident chronic hypertension (RR 1.53, 1.13-2.09), compared with those who had not experienced heavy periods. We also found that women with chronic hypertension had an increased risk of incident heavy (RR 1.23, 1.02-1.50) and irregular periods (RR 1.42, 1.17-1.72). However, there was no apparent association between any menstrual symptoms and subsequent risk of HDP. CONCLUSIONS The association between heavy periods (menorrhagia) and chronic hypertension may be bi-directional in young women. Chronic hypertension may also be associated with subsequent risk of irregular periods.
Collapse
Affiliation(s)
- Hsin-Fang Chung
- School of Public Health, The University of Queensland, Queensland, Australia.
| | - Isabel Ferreira
- Illawarra Health and Medical Research Institute & School of Medicine, University of Wollongong, New South Wales, Australia
| | - Gita D Mishra
- School of Public Health, The University of Queensland, Queensland, Australia
| |
Collapse
|
50
|
Silva FALS, Brites G, Ferreira I, Silva A, Miguel Neves B, Costa Pereira JLGFS, Cruz MT. Evaluating Skin Sensitization Via Soft and Hard Multivariate Modeling. Int J Toxicol 2020; 39:547-559. [PMID: 32757797 DOI: 10.1177/1091581820944395] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Allergic contact dermatitis is the most frequent manifestation of immunotoxicity in humans with a prevalence rate of 15% to 20% over general population. Skin sensitization is a complex end point that was for a long time being evaluated using animal testing. Great efforts have been made to completely substitute the use of animals and replace them by integrating data from in vitro and in chemico assays with in silico calculated parameters. However, it remains undefined how to make the best use of the cumulative data in such a way that information gain is maximized and accomplished with the fewest number of tests possible. In this work, 3 skin sensitization prediction models were considered: one to discriminate sensitizers from non-sensitizers, considering a 2-level scale; one according to the GHS, considering a 3-level scale; and the other to categorize potency in a 6-level scale, according to available human data. We used a data set of known human skin allergens for which in vitro, in chemico, and in silico descriptors where available to build classifiers based on soft and hard multivariate modeling. Model building, optimization, and refinement resulted in 100% accuracy in distinguishing between sensitizers and non-sensitizers. The same model was able to perform the characterization, in 3 and 6 levels, respectively, with 98.8 and 97.5% accuracy. Combining data from in vitro and in chemico tests with in silico descriptors is relatively simple to implement and some predictors are fitting the adverse outcome pathway for skin sensitization.
Collapse
Affiliation(s)
- Filipa A L S Silva
- Department of Chemistry, Faculty of Sciences and Technology, Coimbra Chemistry Centre, 56069University of Coimbra, Coimbra, Portugal
| | - Gonçalo Brites
- 530237Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal.,Faculty of Pharmacy, 530237University of Coimbra, Health Sciences Campus, Coimbra, Portugal
| | - Isabel Ferreira
- 530237Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal.,Faculty of Pharmacy, 530237University of Coimbra, Health Sciences Campus, Coimbra, Portugal
| | - Ana Silva
- 530237Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal
| | - Bruno Miguel Neves
- Department of Medical Sciences and Institute of Biomedicine - iBiMED, University of Aveiro, Aveiro, Portugal
| | - Jorge L G F S Costa Pereira
- Department of Chemistry, Faculty of Sciences and Technology, Coimbra Chemistry Centre, 56069University of Coimbra, Coimbra, Portugal
| | - Maria T Cruz
- 530237Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal.,Faculty of Pharmacy, 530237University of Coimbra, Health Sciences Campus, Coimbra, Portugal
| |
Collapse
|