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Kim D, Natu R, Malinauskas R, Baek JH, Buehler PW, Feng X, Qu H, Pinto J, Xu X, Herbertson L. In vitro test methods for evaluating high molecular weight polyethylene oxide polymer induced hemolytic and thrombotic potential. Toxicol In Vitro 2024; 97:105793. [PMID: 38401745 DOI: 10.1016/j.tiv.2024.105793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 02/20/2024] [Indexed: 02/26/2024]
Abstract
To combat opioid abuse, the U.S. Food and Drug Administration (FDA) released a comprehensive action plan to address opioid addiction, abuse, and overdose that included increasing the prevalence of abuse-deterrent formulations (ADFs) in opioid tablets. Polyethylene oxide (PEO) has been widely used as an excipient to deter abuse via nasal insufflation. However, changes in abuse patterns have led to unexpected shifts in abuse from the nasal route to intravenous injection. Case reports identify adverse effects similar to thrombotic thrombocytopenic purpura (TTP) syndrome following the intravenous (IV) abuse of opioids containing PEO excipient. Increased risk of IV opioid ADF abuse compared to clinical benefit of the drug led to the removal of one opioid product from the market in 2017. Because many generic drugs containing PEO are still in development, there is interest in assessing safety consistent with generic drug regulation and unintended uses. Currently, there are no guidelines or in vitro assessment tools to characterize the safety of PEO excipients taken via intravenous injection. To create a more robust excipient safety evaluation tool and to study the mechanistic basis of HMW PEO-induced TMA, a dynamic in vitro test system involving blood flow through a needle model has been developed.
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Affiliation(s)
- Dongjune Kim
- US FDA, Center for Devices and Radiological Health, Office of Science and Engineering Laboratories, Silver Spring, MD, United States of America; US FDA, Center for Drug Evaluation and Research, Office of Pharmaceutical Quality, Office of Testing and Research, Silver Spring, MD, United States of America
| | - Rucha Natu
- US FDA, Center for Devices and Radiological Health, Office of Science and Engineering Laboratories, Silver Spring, MD, United States of America
| | - Richard Malinauskas
- US FDA, Center for Devices and Radiological Health, Office of Science and Engineering Laboratories, Silver Spring, MD, United States of America
| | - Jin Hyen Baek
- US FDA, Center for Biologics Evaluation and Research, Division of Blood Components and Devices, Laboratory of Biochemistry and Vascular Biology, Silver Spring, MD, United States of America
| | - Paul W Buehler
- University of Maryland School of Medicine, Center for Blood Oxygen Transport and Hemostasis and the Department of Pathology, Baltimore, MD, United States of America
| | - Xin Feng
- US FDA, Center for Drug Evaluation and Research, Office of Pharmaceutical Quality, Office of Testing and Research, Silver Spring, MD, United States of America
| | - Haiou Qu
- US FDA, Center for Drug Evaluation and Research, Office of Pharmaceutical Quality, Office of Testing and Research, Silver Spring, MD, United States of America
| | - Julia Pinto
- US FDA, Center for Drug Evaluation and Research, Office of Pharmaceutical Quality, Office of New Drug Products, Silver Spring, MD, United States of America
| | - Xiaoming Xu
- US FDA, Center for Drug Evaluation and Research, Office of Pharmaceutical Quality, Office of Testing and Research, Silver Spring, MD, United States of America
| | - Luke Herbertson
- US FDA, Center for Devices and Radiological Health, Office of Science and Engineering Laboratories, Silver Spring, MD, United States of America.
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Qu H, Smith WC, Feng X, Wang J, Pinto J, Xu X, Faustino PJ. Asymmetrical Flow Field Flow Fractionation for Molar Mass Characterization of Polyethylene Oxide in Abuse-Deterrent Formulations. J Chromatogr A 2023; 1705:464186. [PMID: 37453175 DOI: 10.1016/j.chroma.2023.464186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 06/16/2023] [Accepted: 06/28/2023] [Indexed: 07/18/2023]
Abstract
High molar mass polyethylene oxide (HM-PEO) is commonly used to enhance the mechanical strength of solid oral opioid drug products to deter abuse. Because the properties of PEO depend on molar mass distribution, accurately determining the molar mass distribution is a necessary part of understanding PEO's role in abuse-deterrent formulations (ADF). In this study, an asymmetrical flow field-flow fractionation (AF4) analytical procedure was developed to characterize PEO polymers with nominal molar masses of 1, 4 or 7 MDa as well as those from in-house prepared placebo ADF. The placebo ADF were manufactured using direct compress or hot-melt-extrusion methods, and subjected to physical manipulation, such as heating and grinding before measurement by AF4 were performed. The molar mass distribution characterized by AF4 revealed that PEO was sensitive to thermal stress, exhibiting decreased molar mass with increased heat exposure. The optimized AF4 method was deemed suitable for characterizing HM-PEO, offering adequate dynamic separation range for PEO with molar mass from 100 kDa to approximately 10 MDa.
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Affiliation(s)
- Haiou Qu
- Division of Product Quality Research, Office of Testing and Research, Office of Pharmaceutical Quality, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland 20993.
| | - William C Smith
- Division of Product Quality Research, Office of Testing and Research, Office of Pharmaceutical Quality, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland 20993
| | - Xin Feng
- Division of Product Quality Research, Office of Testing and Research, Office of Pharmaceutical Quality, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland 20993
| | - Jiang Wang
- Division of Product Quality Research, Office of Testing and Research, Office of Pharmaceutical Quality, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland 20993
| | - Julia Pinto
- Division of New Drug Product II, Office of New Drug Products, Office of Pharmaceutical Quality, Center for Drug Evaluation and Research U.S. Food and Drug Administration, Silver Spring, Maryland 20993
| | - Xiaoming Xu
- Division of Product Quality Research, Office of Testing and Research, Office of Pharmaceutical Quality, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland 20993
| | - Patrick J Faustino
- Division of Product Quality Research, Office of Testing and Research, Office of Pharmaceutical Quality, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland 20993.
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Mendes R, da Silva JCB, Magalhaes JM, St-Denis B, Bourgault D, Pinto J, Dias JM. Author Correction: On the generation of internal waves by river plumes in subcritical initial conditions. Sci Rep 2023; 13:11330. [PMID: 37443266 DOI: 10.1038/s41598-023-38503-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/15/2023] Open
Affiliation(s)
- R Mendes
- CIIMAR - Interdisciplinary Centre of Marine and Environmental Research, University of Porto, Matosinhos, Portugal.
- CESAM - Centre for Environmental and Marine Studies, Physics Department, University of Aveiro, Campus de Santiago, 3810-193, Aveiro, Portugal.
| | - J C B da Silva
- Department of Geoscience, Environment and Spatial Planning (DGAOT), Faculty of Sciences, University of Porto, Rua Do Campo Alegre, 687, 4169-007, Porto, Portugal
- Instituto de Ciências da Terra, Polo Porto, Universidade do Porto, Rua do Campo Alegre 687, 4169-007, Porto, Portugal
| | - J M Magalhaes
- CIIMAR - Interdisciplinary Centre of Marine and Environmental Research, University of Porto, Matosinhos, Portugal
- Department of Geoscience, Environment and Spatial Planning (DGAOT), Faculty of Sciences, University of Porto, Rua Do Campo Alegre, 687, 4169-007, Porto, Portugal
| | - B St-Denis
- Institut de Sciences de La Mer de Rimouski, Université du Québec À Rimouski, 310 allée des Ursulines, Rimouski, QC, G5L 3A1, Canada
| | - D Bourgault
- Institut de Sciences de La Mer de Rimouski, Université du Québec À Rimouski, 310 allée des Ursulines, Rimouski, QC, G5L 3A1, Canada
| | - J Pinto
- LSTS - Underwater Systems and Technology Laboratory, Department of Electrical and Computer Engineering, School of Engineering University of Porto, University of Porto, 4200-465, Porto, Portugal
| | - J M Dias
- CESAM - Centre for Environmental and Marine Studies, Physics Department, University of Aveiro, Campus de Santiago, 3810-193, Aveiro, Portugal
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Philpott C, Kumaresan K, Fjaeldstad AW, Macchi A, Monti G, Frasnelli J, Konstantinidis I, Pinto J, Mullol J, Boardman J, Vodička J, Holbrook E, Ramakrishnan VR, Lechner M, Hummel T. Developing a core outcome set for clinical trials in olfactory disorders: a COMET initiative. Rhinology 2023; 0:3082. [PMID: 37243690 DOI: 10.4193/rhin22.116] [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: 05/29/2023]
Abstract
STATEMENT OF PROBLEM Evaluating the effectiveness of the management of Olfactory Dysfunction (OD) has been limited by a paucity of high-quality randomised and/or controlled trials. A major barrier is heterogeneity of outcomes in such studies. Core outcome sets (COS) -standardized sets of outcomes that should be measured/reported as determined by consensus-would help overcome this problem and facilitate future meta-analyses and/or systematic reviews (SRs). We set out to develop a COS for interventions for patients with OD. METHODS A long-list of potential outcomes was identified by a steering group utilising a literature review, thematic analysis of a wide range of stakeholders' views and systematic analysis of currently available Patient Reported Outcome Measures (PROMs). A subsequent e-Delphi process allowed patients and healthcare practitioners to individually rate the outcomes in terms of importance on a 9-point Likert scale. RESULTS After 2 rounds of the iterative eDelphi process, the initial outcomes were distilled down to a final COS including subjective questions (visual analogue scores, quantitative and qualitative), quality of life measures, psychophysical testing of smell, baseline psychophysical testing of taste, and presence of side effects along with the investigational medicine/device and patient's symptom log. CONCLUSIONS Inclusion of these core outcomes in future trials will increase the value of research on clinical interventions for OD. We include recommendations regarding the outcomes that should be measured, although future work will be required to further develop and revalidate existing outcome measures.
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Affiliation(s)
- C Philpott
- James Paget University Hospital, Great Yarmouth, United Kingdom
| | - K Kumaresan
- James Paget University Hospital, Great Yarmouth, United Kingdom
| | - A W Fjaeldstad
- Flavour Clinic, University Clinic for Flavour, Balance and Sleep, Department of Otorhinolaryngology, Regional Hospital Gødstrup, Denmark
| | - A Macchi
- ENT University of Insubria, Italian Academy of Rhinology, Varese, Italy
| | - G Monti
- Department of Biomedicine, Aarhus University, Denmark
| | - J Frasnelli
- Department of Anatomy, Université du Québec à Trois-Rivières, Canada
| | | | - J Pinto
- Section of Otolaryngology-Head and Neck Surgery, The University of Chicago, Chicago, IL, USA
| | | | - J Boardman
- Fifth Sense UK Charity, Bicester, United Kingdom
| | - J Vodička
- Department of Otorhinolaryngology and Head and Neck Surgery, Regional Hospital and University of Pardubice, Czech Republic
- Department of Otorhinolaryngology and Head and Neck Surgery, Regional Hospital and Faculty of Heath Studies, University of Pardubice, Czech Republic
| | - E Holbrook
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - V R Ramakrishnan
- Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indiana
| | - M Lechner
- Division of Surgery and Interventional Science and UCL Cancer Institute, University College London and Barts Health NHS Trust, United Kingdom
| | - T Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technische Universität Dresden, Dresden Germany
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Fernandes AL, Pinto J, Figueiredo C, Santos N, Campos V, Nascimento AC, Bento C, Costa L, Werneck F, Moura P. ANEMIA APLÁSTICA EM PEDIATRIA: DIAGNÓSTICO E TRATAMENTO. Hematol Transfus Cell Ther 2022. [DOI: 10.1016/j.htct.2022.09.601] [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: 11/06/2022] Open
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Pinto J, Bradbury K, Newell D, Bishop FL. Lifestyle and health behaviour change support in traditional acupuncture: a mixed method survey study of reported practice (UK). BMC Complement Med Ther 2022; 22:248. [PMID: 36131271 PMCID: PMC9490899 DOI: 10.1186/s12906-022-03719-6] [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] [Received: 04/05/2022] [Accepted: 08/31/2022] [Indexed: 11/26/2022] Open
Abstract
Aims Complementary medicine therapists such as traditional acupuncturists are a large resource for supporting public health targets to improve health behaviours. Our objectives were to determine the prevalence and patterns of UK acupuncturists’ provision of lifestyle change support, test theory-based hypotheses about facilitators and barriers to supporting lifestyle changes and to explore associated characteristics and attitudes. Methods A mixed methods design in which British Acupuncture Council members (Sept 2019-April 2020) completed an online questionnaire assessing prevalence of lifestyle change support, typical patterns across patients and behaviours, Theory of Planned Behaviour constructs, practitioner characteristics and open-text responses regarding additional behaviours and clinical decisions to introduce lifestyle change. Results Three hundred fifty-two traditional acupuncturists participated (Mean age = 51.5 years, SD 9.9; 81.8% (n = 288) female). 57.7% (n = 203) reported offering support for lifestyle change during their most recent consultation. 91.7% (n = 323) reported supporting lifestyle change ‘always or most of the time’ for patients with chronic conditions and 67.9% (n = 239) reported this for patients with acute conditions. The pattern of typical support for different health behaviours ranged from 44.6% (n = 157) for smoking reduction (acute conditions) to 95.2% (n = 335) for diet support (chronic conditions). A linear regression model found that frequency of support for lifestyle change in acute patients was predicted by acupuncturists’ attitudes to both clinical role and importance of health behaviours, confidence in their ability to provide lifestyle change support and use of fewer behaviour change techniques. The decision to first offer lifestyle change support was guided by perceived patient receptiveness, whether presenting condition/diagnosis were likely to improve with lifestyle change and whether a strong therapeutic relationship was established. Conclusions Traditional acupuncturists’ reports suggest their work supports key public health targets for promoting healthy behaviours. Less frequent support for alcohol/smoking may reflect user characteristics but may suggest training needs for acupuncturists. Increase could be made for support in acute presentations, however the importance of patient receptiveness, linking advice to condition, and therapeutic alliance should be explored further. There may be important differences between acupuncture practice and mainstream healthcare (e.g. high level of contact, longer visits, holistic approach) which impact mechanisms of action of behaviour change. Supplementary Information The online version contains supplementary material available at 10.1186/s12906-022-03719-6.
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Amaro F, Pisoeiro C, Valente M, Bastos M, de Pinho PG, Carvalho M, Pinto J. LP-40 Metabolome analysis reveals a distinct response of renal cell carcinoma and non-tumoral renal cells to sunitinib and pazopanib. Toxicol Lett 2022. [DOI: 10.1016/j.toxlet.2022.07.779] [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: 11/15/2022]
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C Romão V, Sousa Bandeira MJ, Silvério-António M, Simão R, Pinto J, Gonçalves AI, Gonçalves MJ, Martins AL, José P, Coutinho G, Morena Bueno Silva L, Brito Lança M, Esteves Marques R, Macieira C, Khmelinskii N, Rodrigues W, Salvado F, Fonseca JE. AB0501 COMPREHENSIVE ASSESSMENT OF PATIENTS WITH SUSPECTED SJÖGREN’S SYNDROME: 5-YEAR RESULTS OF A MULTIDISCIPLINARY SJÖGREN’S SYNDROME CLINIC. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundPrimary Sjögren’s syndrome (pSS) is a systemic rheumatic disease that affects several organ systems, most frequently the ocular, oral and musculoskeletal domains. Multidisciplinary care is thus crucial in the optimal management of SS patients.ObjectivesTo report the clinical impact of a Multidisciplinary SS Clinic (MSSC) over a 5-year period.MethodsWe prospectively included patients assessed in the MSSC from September 2015 to October 2020. All patients had a full clinical evaluation, including disease-related questionnaires, specialized oral/ocular assessment, salivary gland biopsy (SGB) and ultrasound (SGUS), tear and salivary flow and ocular staining scores. We compared the results of patient-reported outcomes, comprehensive clinical assessments and specialized complementary exams in patients with pSS and other diagnoses.Results445 patients (96% women, mean age 57±14 years) with sicca symptoms underwent complete multidisciplinary evaluation. Patients were most frequently referred from Rheumatology (91%), but also from Stomatology (5%), Ophthalmology (2%), Internal Medicine (1%) and other medical specialties (1%). Most patients were diagnosed with pSS (n=221; 50%), followed by non-Sjögren sicca syndrome (nSSS, n=134; 30%), secondary SS (sSS, n=60; 13%) and undifferentiated connective tissue disease (n=30; 7%). Positive sicca tests were present in 217/385 patients (56%): unstimulated whole salivary flow (UWSF) ≤0.1ml/min in 84/317 (27%); Schirmer’s test ≤5mm/5min in 163/354 (46%); van Bijsterveld score ≥4 in 42/349 (12%); Ocular Staining Score (OSS) ≥5 in 36/343 (11%). Subjective complaints assessed by the EULAR Sjögren’s Syndrome Patient Reported Index (ESSPRI), the EULAR Sicca Score (ESS), the Profile of Fatigue and Discomfort - Sicca Symptoms Inventory (PROFAD-SSI), the Xerostomia Inventory (XI), and the Ocular Surface Disease Index (OSDI) did not differ between patients with pSS and other diagnoses. However, objective dryness measures such as UWSF (31vs20%, p=0.028), Schirmer’s test (51vs40%, p=0.040) and OSS (14vs7%, p=0.048) were significantly associated with pSS. A positive SGB (focus score≥1) was seen in 48% of patients with a clinical diagnosis of pSS (p<0.001 vs. other diagnoses), with a mean focus score of 1.1±1.6. Instead, 94% of patients with nSSS had grade 0-1 biopsies. Mean SGUS scores (p=0.006) and the frequency of moderate/severe changes (p<0.001) were higher in pSS patients.ConclusionMultidisciplinary evaluation was crucial in the assessment of patients with similar sicca complaints and in the management of ocular/oral/systemic involvement. Objective measurements and specialized complementary exams greatly contribute to establishing or confirming the diagnosis of pSS.Disclosure of InterestsNone declared
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Rocha R, Matos M, Pinto J, Sarmento A. Zoonotic foodborne diseases in a tertiary healthcare setting: diagnostics, resistance and underreporting of campylobacteriosis in Northern Portugal. Int J Infect Dis 2022. [DOI: 10.1016/j.ijid.2021.12.192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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10
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Ruiz R, Galvez-Nino M, Roque K, Montes J, Nuñez M, Raez L, Sánchez-Gambetta S, Jauregui S, Viale S, Smith E, Mas L, Pinto J. P59.30 Genomic Landscape of Lung Cancer in the Young. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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El Idrissi AH, Larfaoui F, Dhingra M, Johnson A, Pinto J, Sumption K. Digital technologies and implications for Veterinary Services. REV SCI TECH OIE 2021; 40:455-468. [PMID: 34542102 DOI: 10.20506/rst.40.2.3237] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The pace of digital disruption over the past few years has been spectacular, transforming every sector of the economy, including animal production, health and welfare. This paper reviews some advanced digital technologies that may shape the future of Veterinary Services. These technologies are all data driven and are illustrated by three examples that fall under the following categories: a) wireless and mobile technologies for animal health monitoring, disease surveillance, reporting and information sharing; b) advanced data-processing technologies, such as big data and data analytics used to detect patterns, make predictions, find correlations and other information; and c) promising technologies such as blockchain applications, used for effective and efficient management of various input supply chains. The authors briefly discuss current challenges to increasing the use of these technologies in the animal health sector, along with some implications for Veterinary Services. Digital technologies will have a profound effect on how animal health services are delivered and how animal health systems are managed. It is therefore crucial for Veterinary Services to be proactive and adapt to the ongoing digital transformation. Investment in new technologies and preparing the current and future veterinary workforce with the necessary digital skills and knowledge to stay up to date and at the centre of digital innovation in animal health should be a priority for the years to come.
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Amaro F, Pinto J, Rocha S, Araújo A, Gonçalves V, Jerónimo C, Henrique R, Bastos M, Carvalho M, Pinho P. In vitro volatile exometabolome signature of clear cell renal cell carcinoma. Toxicol Lett 2021. [DOI: 10.1016/s0378-4274(21)00497-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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13
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Rodrigues HR, Ferreira V, Alves L, Sousa D, Pinto J, Pinto A, Rio P, Ferreira R. The impact of the cardiac rehabilitation program in patients with mid-range heart failure (40-50%) in improving cardio respiratory predictors. Eur J Cardiovasc Nurs 2021. [DOI: 10.1093/eurjcn/zvab060.074] [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]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public hospital(s). Main funding source(s): Centro Hospitalar Universitário Lisboa Central
Methods
We studied 30 patients (P) with ejection fraction (EF) 40-50%, in a number of 198 P that participated in cardiac rehabilitation program (CRP). Of these P, 24 (80%) male and 6 (20%) female, 20 P were diagnosed myocardial infarction with ST-segment elevation, 2 P myocardial infarction non ST and 8 P with myocardial hypertrophy non ischemic. Of these P 30% were diabetics, 56% hypertension, 70% dyslipidemia, 36% smokers previous to CRP and body mass index 26,3 medium.
All P were submitted to previous echocardiogram, cardiopulmonary exercise testing (CET) and a rehabilitation program minimum 4 sessions and maximum 52 sessions. At the end of the total sessions the echocardiogram and CET were repeated.
Results
Of the 30 P that participated in CRP only 20 completed the program, while the other 10 P dropped out because of social and economic problems. Of the P that completed the CRP, 70% got better on EF, 80% improved VE/VCO2 slope < 33 therefore are classified VC-II in ventilatory classification (VC), 5% VE/VCO2 slope > 40 VC-III classification, and 15% maintained the initial classification. 50% of the P increased at least one level metabolic equivalent of task (MET) from the first CET. Only 3 of the 20 patients came, once, to the hospital after the CRP with heart failure, and one died but did not fulfill the program.
Conclusion
Patients with mid-range heart failure submitted to a CRP can improve cardiorespiratory predictors, leading to a better quality of life. However, it is important to find solutions to minimize the causes that make patients to give up CRP.
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Affiliation(s)
| | - V Ferreira
- Hospital de Santa Marta, Lisbon, Portugal
| | - L Alves
- Hospital de Santa Marta, Lisbon, Portugal
| | - D Sousa
- Hospital de Santa Marta, Lisbon, Portugal
| | - J Pinto
- Hospital de Santa Marta, Lisbon, Portugal
| | - A Pinto
- Hospital de Santa Marta, Lisbon, Portugal
| | - P Rio
- Hospital de Santa Marta, Lisbon, Portugal
| | - R Ferreira
- Hospital de Santa Marta, Lisbon, Portugal
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Baek JH, Shin HKH, Koo SM, Gao Y, Qu H, Feng X, Xu X, Pinto J, Katneni U, Kimchi-Sarfaty C, Buehler PW. Polyethylene Oxide Molecular Size Determines the Severity of Atypical Thrombotic Microangiopathy in a Guinea Pig Model of Acute Intravenous Exposure. Toxicol Sci 2021; 177:235-247. [PMID: 32579216 DOI: 10.1093/toxsci/kfaa099] [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] [Indexed: 11/13/2022] Open
Abstract
In 2017, Opana ER was voluntarily removed from the U.S. market based on concerns that its risks outweighed its therapeutic benefits. The data that supported this conclusion were based on postmarketing evaluation that demonstrated increased intravenous abuse associated outbreaks of HIV, hepatitis C, and uniquely, a thrombotic thrombocytopenic purpura (TTP)-like syndrome. In 2017, the cause was mechanistically linked to intravenous exposure of the high-molecular weight polyethylene oxide (PEO), an excipient component of the drug product. However, it was unknown how differing PEO preparations might alter this response in vivo. Knowing the likelihood of a PEO driven atypical thrombotic microangiopathy with hemolytic uremic syndrome (TMA-HUS), this study was specifically designed with the primary objective focused on understanding the impact of PEO molecular weight on TMA-HUS in a guinea pig model of acute repeat PEO (1, 4, and 7 MDa) dosing. Results from this analysis suggest that repeated dosing with PEO 4 and 7 MDa, but not 1 MDa induced a marked intravascular hemolysis with schistocytes, mild anemia, thrombocytopenia, hemoglobinuria, and kidney injury, consistent with observations of a TMA-HUS-like syndrome. Nonetheless, observations of tissue microthrombi, complement or altered von Willebrand factor involvement were not observed, which would be consistent with a definitive TMA. Further, only 7 MDa PEO dosing was associated with marked renal hypoxia. Taken together, this study defines renal injury risk with PEO formulations >1 MDa that is driven by a robust intravascular hemolysis and potentially, tissue hypoxia.
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Affiliation(s)
- Jin Hyen Baek
- Laboratory of Biochemistry and Vascular Biology, Division of Blood Components and Devices, Office of Blood Research and Review; Center for Drug Evaluation and Review, FDA, Silver Spring, Maryland
| | - Hye Kyung H Shin
- Laboratory of Biochemistry and Vascular Biology, Division of Blood Components and Devices, Office of Blood Research and Review; Center for Drug Evaluation and Review, FDA, Silver Spring, Maryland
| | - Soo Min Koo
- Laboratory of Biochemistry and Vascular Biology, Division of Blood Components and Devices, Office of Blood Research and Review; Center for Drug Evaluation and Review, FDA, Silver Spring, Maryland
| | - Yamei Gao
- Division of Viral Products, Office of Vaccines, Center for Biologics Evaluation and Research (CBER), FDA, Silver Spring, Maryland
| | - Haiou Qu
- Division of Product Quality Research, Office of Testing and Research, Office of Pharmaceutical Quality; Center for Drug Evaluation and Review, FDA, Silver Spring, Maryland
| | - Xin Feng
- Division of Product Quality Research, Office of Testing and Research, Office of Pharmaceutical Quality; Center for Drug Evaluation and Review, FDA, Silver Spring, Maryland
| | - Xiaoming Xu
- Division of Product Quality Research, Office of Testing and Research, Office of Pharmaceutical Quality; Center for Drug Evaluation and Review, FDA, Silver Spring, Maryland
| | - Julia Pinto
- Division of New Drug Product II, Office of New Drug Products, Office of Pharmaceutical Quality, Center for Drug Evaluation and Research (CDER), FDA, Silver Spring Maryland
| | - Upendra Katneni
- Division of Plasma Protein Therapeutics, Office of Tissues and Advanced Therapies, Center for Biologics Evaluation and Research (CBER), FDA, Silver Spring Maryland
| | - Chava Kimchi-Sarfaty
- Division of Plasma Protein Therapeutics, Office of Tissues and Advanced Therapies, Center for Biologics Evaluation and Research (CBER), FDA, Silver Spring Maryland
| | - Paul W Buehler
- Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland.,The Center for Blood Oxygen Transport and Hemostasis, Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland
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15
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Serino M, Pinto J, van Zeller M, Drummond M. Phone medical appointments for sleep-disordered breathing in Covid-19 pandemic - were they useful? Sleep Med 2021; 86:123. [PMID: 34127389 PMCID: PMC8168330 DOI: 10.1016/j.sleep.2021.05.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 05/24/2021] [Indexed: 11/17/2022]
Affiliation(s)
- M Serino
- Pulmonology Department, Centro Hospitalar Universitário São João, Porto, Portugal.
| | - J Pinto
- Pulmonology Department, Centro Hospitalar Universitário São João, Porto, Portugal.
| | - M van Zeller
- Pulmonology Department, Centro Hospitalar Universitário São João, Porto, Portugal; Sleep and Non-Invasive Ventilation Unit, Centro Hospitalar Universitário São João, Porto, Portugal; Faculty of Medicine, University of Porto, Portugal.
| | - M Drummond
- Pulmonology Department, Centro Hospitalar Universitário São João, Porto, Portugal; Sleep and Non-Invasive Ventilation Unit, Centro Hospitalar Universitário São João, Porto, Portugal; Faculty of Medicine, University of Porto, Portugal.
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16
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Rodríguez DC, Carrascal D, Solórzano E, Pérez MR, Pinto J. Analysis of the retrograde behavior in PMMA-CO2 systems by measuring the (effective) glass transition temperature using refractive index variations. J Supercrit Fluids 2021. [DOI: 10.1016/j.supflu.2020.105159] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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17
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Stach J, Zhao I, Frolkis A, Haylock-Jacobs S, Israelson H, Pinto J, Williams S, Swain M, Stinton L, Aspinall A, Borman M, Sadler MD, Burak KW, Congly SE, Lee S, Coffin CS. A210 DECLINE IN HEPATITIS B QUANTITATIVE SURFACE ANTIGEN LEVELS IN CHRONIC HEPATITIS B PATIENTS ON TREATMENT WITH NUCLEOS(T)IDE ANALOGUES. J Can Assoc Gastroenterol 2021. [DOI: 10.1093/jcag/gwab002.208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The Hepatitis B virus (HBV) affects over 250 million people worldwide and can lead to cirrhosis and hepatocellular carcinoma. HBV surface antigen (HBsAg) quantification is increasingly used to predict disease activity and treatment response. As there is no virologic cure, clinicians are seeking a “functional cure”, or HBsAg loss, as a guide to safely stopping nucleos(t)ide analogue therapy. Tenofovir Disoproxil Fumarate (TDF) and Entecavir (ETV) are first line therapy but require prolonged treatment to achieve HBsAg clearance.
Aims
To assess the association between nucleos(t)ide therapy and decline in quantitative HBsAg (qHBsAg) in patients with HBV from Calgary, Alberta.
Methods
A retrospective review of adult patients with chronic HBV, followed at the University of Calgary Liver Clinic, was conducted between January 2012 and October 2020. Patients were excluded if treatment was discontinued or changed, only had a single qHBsAg measurement, or were co-infected with hepatitis C virus, hepatitis delta virus, or HIV. Patients were stratified according to therapy with TDF, ETV, or no treatment. To identify associations between mean changes in qHBsAg by medication exposure, one-way ANOVAs and t-tests were performed. Results were reported as means and 95% confidence intervals (CI). The median time from initial qHBsAg to most-recent was calculated.
Results
187 patients were included in the final analysis (Table 1). 77 were excluded for being on more than one medication over the study period, 10 were excluded due to discontinuation of treatment, and 195 were excluded for single qHBsAg measurements. The mean qHBsAg decline was -750.04 IU/mL (95% CI -1311.58, -188.50) in the TDF group (n=45) and -309.20 IU/mL (95% CI -600.90, -17.50) in the ETV group (n=35) (p=0.20). In the no treatment group (n=107), the mean qHBsAg increased by 711.29 IU/mL (95% CI -600.78, 2023.80)(Figure 1). The median time from initial qHBsAg to most-recent was 980 days.
Conclusions
Quantitative HBsAg levels declined in patients on TDF and ETV, but increased in untreated patients. Although HBsAg levels showed a trend for greater decline in TDF-treated patients, results failed to reach statistical significance, and may be affected by overall treatment duration. Future studies will explore medication use as a time-varying covariate to identify how change in treatment influences changes in HBsAg over time.
Funding Agencies
None
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Affiliation(s)
- J Stach
- Gastroenterology, University of Calgary, Medicine Hat, AB, Canada
| | - I Zhao
- McMaster University, Hamilton, ON, Canada
| | - A Frolkis
- University of Calgary, Calgary, AB, Canada
| | - S Haylock-Jacobs
- Gastroenterology, University of Calgary, Medicine Hat, AB, Canada
| | - H Israelson
- Gastroenterology, University of Calgary, Medicine Hat, AB, Canada
| | - J Pinto
- Gastroenterology, University of Calgary, Medicine Hat, AB, Canada
| | - S Williams
- Gastroenterology, University of Calgary, Medicine Hat, AB, Canada
| | - M Swain
- University of Calgary, Calgary, AB, Canada
| | - L Stinton
- University of Calgary, Calgary, AB, Canada
| | - A Aspinall
- Gastroenterology, University of Calgary, Medicine Hat, AB, Canada
| | - M Borman
- Gastroenterology, University of Calgary, Medicine Hat, AB, Canada
| | - M D Sadler
- University of Calgary, Calgary, AB, Canada
| | - K W Burak
- Liver Unit, Univ Calgary, Calgary, AB, Canada
| | - S E Congly
- Liver Unit, Division of Gastroenterology, Department of Medicine, University of Calgary, Calgary, AB, Canada
| | - S Lee
- University of Calgary, Calgary, AB, Canada
| | - C S Coffin
- Medicine, University of Calgary, Calgary, AB, Canada
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18
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Gutierrez J, Araujo J, Ruiz R, Pinto J, Flores C, Morante Z, Amorin E, Mas L. P33.21 Epidemiological Characteristics and Survival in Patients With Lung Cancer in a Peruvian Private Institution Between 2011-2014. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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19
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Capron T, Cautela J, Scemama U, Miola C, Bartoli A, Theron A, Pinto J, Porto A, Collart F, Lepidi H, Bernard M, Guye M, Thuny F, Avierinos JF, Jacquier A. Cardiac magnetic resonance assessment of left ventricular dilatation in chronic severe left-sided regurgitations: comparison with standard echocardiography. Diagn Interv Imaging 2020; 101:657-665. [DOI: 10.1016/j.diii.2020.04.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 04/05/2020] [Accepted: 04/18/2020] [Indexed: 12/19/2022]
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20
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Monteiro S, Pinto J, Mira Coelho A, Leão M, Dória S. Identification of Copy Number Variation by Array-CGH in Portuguese Children and Adolescents Diagnosed with Autism Spectrum Disorders. Neuropediatrics 2019; 50:367-377. [PMID: 31398764 DOI: 10.1055/s-0039-1694797] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 10/26/2022]
Abstract
BACKGROUND Autism spectrum disorders (ASD) affect many children with an estimated prevalence of 1%. Array-comparative genomic hybridization (CGH) offers significant sensitivity for the identification of submicroscopic chromosomal abnormalities and it is one of the most used techniques in daily practice. The main objective of this study was to describe the usefulness of array-CGH in the etiologic diagnosis of ASD. METHODS Two-hundred fifty-three patients admitted to a neurogenetic outpatient clinic and diagnosed with ASD were selected for array-CGH (4 × 180K microarrays). Public databases were used for classification in accordance with the American College of Medical Genetics Standards and Guidelines. RESULTS About 3.56% (9/253) of copy number variations (CNVs) were classified as pathogenic. When likely pathogenic CNVs were considered, the rate increased to 11.46% (29/253). Some CNVs apparently not correlated to the ASD were also found. Considering a phenotype-genotype correlation, the patients were divided in two groups. One group according to previous literature includes all the CNVs related to ASDs (23 CNVs present in 22 children) and another with those apparently not related to ASD (10 CNVs present in 7 children). In 18 patients, a next-generation sequencing (NGS) panel were performed. From these, one pathogenic and 16 uncertain significance variants were identified. CONCLUSION The results of our study are in accordance with the literature, highlighting the relevance of array-CGH in the genetic of diagnosis of ASD population, namely when associated with other features. Our study also reinforces the need for complementarity between array-CGH and NGS panels or whole exome sequencing in the etiological diagnosis of ASD.
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Affiliation(s)
- S Monteiro
- Department of Genetics, Faculty of Medicine, University of Porto, Porto, Portugal.,MMED, Master's Degree in Medicine, University of Porto, Porto, Portugal
| | - J Pinto
- Department of Genetics, Faculty of Medicine, University of Porto, Porto, Portugal.,i3S - Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal
| | - A Mira Coelho
- Department of Child Psychiatry Consultation, Centro hospitalar de São João (CHSJ) Porto, Porto, Portugal
| | - M Leão
- Department of Genetics, Faculty of Medicine, University of Porto, Porto, Portugal.,Department of Neurogenetic Consultation, Centro hospitalar de São João (CHSJ) Porto, Porto, Portugal
| | - S Dória
- Department of Genetics, Faculty of Medicine, University of Porto, Porto, Portugal.,i3S - Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal
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21
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Lan J, Paterniti M, Bertha C, Pinto J, Randazzo G, Sood R, Seymour S. Evaluation of epinephrine's expiration date: A US Food and Drug Administration's perspective. J Allergy Clin Immunol Pract 2019; 7:2948. [PMID: 31706500 DOI: 10.1016/j.jaip.2019.08.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 08/08/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Jennifer Lan
- U.S. Food and Drug Administration, Silver Spring, Md.
| | | | - Craig Bertha
- U.S. Food and Drug Administration, Silver Spring, Md
| | - Julia Pinto
- U.S. Food and Drug Administration, Silver Spring, Md
| | | | - Ramesh Sood
- U.S. Food and Drug Administration, Silver Spring, Md
| | - Sally Seymour
- U.S. Food and Drug Administration, Silver Spring, Md
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22
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De La Rocque S, Caya F, El Idrissi AH, Mumford L, Belot G, Carron M, Sreedharan R, Suryantoro L, Stelter R, Copper F, Isla N, Mayigane LN, Bell A, Huda Q, Stratton J, Di Giacinto A, Corning S, Pinto J, Ormel HJ, Chungong S. One Health operations: a critical component in the International Health Regulations Monitoring and Evaluation Framework. REV SCI TECH OIE 2019; 38:303-314. [PMID: 31564720 DOI: 10.20506/rst.38.1.2962] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Under the International Health Regulations (IHR, 2005), a legally binding document adopted by 196 States Parties, countries are required to develop their capacity to rapidly detect, assess, notify and respond to unusual health events of potential international concern. To support countries in monitoring and enhancing their capacities and complying with the IHR (2005), the World Health Organization (WHO) developed the IHR Monitoring and Evaluation Framework (IHR MEF). This framework comprises four complementary components: the State Party Annual Report, the Joint External Evaluation, after-action reviews and simulation exercises. The first two are used to review capacities and the second two to help to explore their functionality. The contribution of different disciplines, sectors, and areas of work, joining forces through a One Health approach, is essential for the implementation of the IHR (2005). Therefore, WHO, in partnership with the Food and Agriculture Organization of the United Nations (FAO), the World Organisation for Animal Health (OIE), and other international and national partners, has actively worked on facilitating the inclusion of the relevant sectors, in particular the animal health sector, in each of the four components of the IHR MEF. Other tools complement the IHR MEF, such as the WHO/OIE IHR-PVS [Performance of Veterinary Services] National Bridging Workshops, which facilitate the optimal use of the results of the IHR MEF and the OIE Performance of Veterinary Services Pathway and create an opportunity for stakeholders from animal health and human health services to work on the coordination of their efforts. The results of these various tools are used in countries' planning processes and are incorporated in their National Action Plan for Health Security to accelerate the implementation of IHR core capacities. The present article describes how One Health is incorporated in all components of the IHR MEF.
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23
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Pinho T, Jácome C, Pinto J, Marques A. Reference equation for the incremental shuttle walk test in Portuguese children and adolescents. Pulmonology 2019; 25:208-214. [PMID: 31076288 DOI: 10.1016/j.pulmoe.2019.02.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 02/13/2019] [Accepted: 02/18/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The incremental shuttle walk test (ISWT) is one of the most widely used field tests to assess cardiorespiratory fitness in clinical and research settings. Reference equations to predict ISWT distance in different populations and age cohorts have been established. However, an equation for the Portuguese pediatric population is not available. This study aimed to develop a reference equation for predicting ISWT in Portuguese children and adolescents. METHOD Healthy children and adolescents aged between 5 and 17 years old were recruited. Sociodemographic (sex, age), anthropometric (height, weight) and physical activity (Physical Activity Index) data were collected. Lung function was assessed through spirometry and quadriceps muscular strength through hand-held dynamometry. The ISWT was performed twice. A reference equation was established with a multiple linear regression. RESULTS 130 (60 male; 13.66±2.61y) participants with normal lung function (forced expiratory volume in one second 102.73±15.09% predicted), body mass index (BMI) (20.27±3.59kg/m2) and quadriceps muscular strength (19.75±6.84kgf), completed the assessment. 50.8% (n=66) of the participants were moderately active. Participants walked on average 1165.08±327.19m in the ISWT. Sex, age and BMI were independent contributors to the ISWT, explaining 54% of its variability (p<0.001). The derived reference equation was: ISWT=342.06+(283.07×sex)+(83.61×age)-(22.22×BMI), with female=0 and male=1. CONCLUSION Sex, age and BMI were found to be contributors to the ISWT predictive equation for pediatric population, providing a simple reference to assess their cardiorespiratory fitness.
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Affiliation(s)
- T Pinho
- Lab 3R-Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), 3810-193 Aveiro, Portugal
| | - C Jácome
- Lab 3R-Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), 3810-193 Aveiro, Portugal; CINTESIS - Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal
| | - J Pinto
- Lab 3R-Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), 3810-193 Aveiro, Portugal; Santa Casa da Misericórdia de Águeda, 3750-130 Águeda, Portugal
| | - A Marques
- Lab 3R-Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), 3810-193 Aveiro, Portugal; Institute for Research in Biomedicine (iBiMED), University of Aveiro, 3810-193 Aveiro, Portugal.
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24
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Petolat E, Laine M, Ammar C, Pinto J, Gaubert M, Resseguier N, Thuny F, Bonello L. Right ventricular systolic dysfunction in intermediate high-risk pulmonary embolism treated by ultrasound-assisted catheter-directed thrombolysis. Archives of Cardiovascular Diseases Supplements 2019. [DOI: 10.1016/j.acvdsp.2019.02.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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25
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Alarco R, Ponce J, Pinto J, Doimi F, Dyer R, Ledesma R, Vigil C. Experience and results in sentinel lymph node (SLN) biopsy in a peruvian clinic. Breast 2019. [DOI: 10.1016/s0960-9776(19)30403-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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26
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Araujo J, Flores C, Schwarz L, Doimi F, Dyer R, Gomez H, Pinto J. Prognostic capability of a TNBC 3-genes score among triplenegative breast cancer subtypes. Breast 2019. [DOI: 10.1016/s0960-9776(19)30141-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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27
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Xu L, Wroblewski K, McClintock M, Pinto J. OLDER US ADULTS WITH PERSISTENT OLFACTORY DYSFUNCTION FACE INCREASED MORTALITY. Innov Aging 2018. [DOI: 10.1093/geroni/igy031.3644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - K Wroblewski
- Department of Public Health Sciences, University of Chicago
| | - M McClintock
- Departments of Comparative Human Development and Psychology
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28
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Tekola B, Myers L, Lubroth J, Plee L, Calistri P, Pinto J. International health threats and global early warning and response mechanisms. REV SCI TECH OIE 2018; 36:657-670. [PMID: 30152454 DOI: 10.20506/rst.36.2.2683] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The global community continues to incur the high costs of crisis mitigation and emergency response to outbreaks of emerging infectious diseases, such as those caused by the H5N1 highly pathogenic avian influenza virus, Ebola virus, Nipah virus, Zika virus or the Middle East respiratory syndrome coronavirus. These viruses are particularly dangerous in regions associated with poor development indicators and high vulnerability. The drivers of these disease crises include failures in the way that animal diseases are detected and reported and failures in the way in which disease response is implemented by animal health and public health systems. In addition, the lack of a coordinated response hampers disease control efforts. A comprehensive approach for disease prevention, detection and response, however, requires a coordinated and joint effort among governments, communities, donors and international networks to invest effectively in prevention systems that can identify early signals of the emergence, spillover and spread of animal pathogens at the local level. These signals include trade bans, market closures, civil unrest, heavy rains and droughts associated with climate change, and livestock intensification or changes in consumer behaviour. The global community needs to increase its investment in early warning and detection systems that can provide information that enables action to be taken at the national, regional and global levels in the event of an outbreak of a transboundary animal disease (TAD). Like any preventive measure, an early warning system requires financial resources, but these are insignificant when compared to the losses that are avoided. Building a global early warning and effective response system for outbreaks is value for money, as the benefits far outweigh the costs. The goal of the Food and Agriculture Organization of the United Nations (FAO) is to end hunger and poverty, which is a challenging and complex task. Building global capacity to prepare for and respond to TADs is an important element of the FAO's strategic objective to increase the resilience of livelihoods to threats and crises. Each year, livestock, and the people who rely upon them for their livelihoods, are confronted with animal disease and crises. They can strike suddenly, causing obvious illness and death, or emerge insidiously and become well established before becoming apparent. Animal disease emergencies threaten the production of, and access to, food; consequently, one of the FAO's missions is to help countries to prepare for and respond to animal health disasters.
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29
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Galvez Nino M, Ruiz R, Pinto J, Raez L, Mas Lopez L. P2.15-07 Lung Cancer in the Young. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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30
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Lima A, Araújo A, Pinto J, Jerónimo C, Henrique R, Bastos M, Carvalho M, Guedes de Pinho P. Evaluation of prostate cancer volatilome: An in vitro approach. Toxicol Lett 2018. [DOI: 10.1016/j.toxlet.2018.07.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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31
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Pereira F, Azevedo R, Linhares M, Fernandes A, Dias I, Ribeiro H, Pinto J, Leitão C, Caldeira A, Tristan J, Pereira E, Sousa R, Banhudo A. (Mal)nutrition in liver cirrhotic patients. Clin Nutr 2018. [DOI: 10.1016/j.clnu.2018.06.1277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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32
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Calzetta M, Perugini E, Seixas G, Sousa CA, Guelbeogo WM, Sagnon N, Della Torre A, Pinto J, Pombi M, Mancini E. A novel nested polymerase chain reaction assay targeting Plasmodium mitochondrial DNA in field-collected Anopheles mosquitoes. Med Vet Entomol 2018; 32:372-377. [PMID: 29344968 DOI: 10.1111/mve.12293] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 11/01/2017] [Accepted: 11/25/2017] [Indexed: 06/07/2023]
Abstract
Sensitive techniques for the detection of Plasmodium (Aconoidasida: Plasmodiidae) sporozoites in field-collected malaria vectors are essential for the correct assessment of risk for malaria transmission. A real-time polymerase chain reaction (RT-PCR) protocol targeting Plasmodium mtDNA proved to be much more sensitive in detecting sporozoites in mosquitoes than the widely used enzyme-linked immunosorbent assay targeting Plasmodium circumsporozoite protein (CSP-ELISA). However, because of the relatively high costs associated with equipment and reagents, RT-PCRs are mostly used to assess the outcomes of experimental infections in the frame of research experiments, rather than in routine monitoring of mosquito infection in the field. The present authors developed a novel mtDNA-based nested PCR protocol, modified from a loop-mediated isothermal amplification (LAMP) assay for Plasmodium recognition in human blood samples, and compared its performance with that of routinely used CSP-ELISAs in field-collected Anopheles coluzzii (Diptera: Culicidae) samples. The nested PCR showed 1.4-fold higher sensitivity than the CSP-ELISA. However, nested PCR results obtained in two laboratories and in different replicates within the same laboratory were not 100% consistent, probably because the copy number of amplifiable Plasmodium mtDNA was close in some specimens to the threshold of nested PCR sensitivity. This implies that Plasmodium-positive specimens should be confirmed by a second nested PCR to avoid false positives. Overall, the results emphasize the need to use molecular approaches to obtain accurate estimates of the actual level of Plasmodium circulation within malaria vector populations.
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Affiliation(s)
- M Calzetta
- Dipartimento di Sanità Pubblica e Malattie Infettive, Istituto Pasteur Italia Fondazione Cenci Bolognetti, Sapienza University of Rome, Rome, Italy
| | - E Perugini
- Dipartimento di Sanità Pubblica e Malattie Infettive, Istituto Pasteur Italia Fondazione Cenci Bolognetti, Sapienza University of Rome, Rome, Italy
- Dipartimento di Scienze, Roma Tre University, Rome, Italy
| | - G Seixas
- Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa, Lisbon, Portugal
| | - C A Sousa
- Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa, Lisbon, Portugal
| | - W M Guelbeogo
- Centre National de Recherche et de Formation sur le Paludisme (CNRFP), Ouagadougou, Burkina Faso
| | - N Sagnon
- Centre National de Recherche et de Formation sur le Paludisme (CNRFP), Ouagadougou, Burkina Faso
| | - A Della Torre
- Dipartimento di Sanità Pubblica e Malattie Infettive, Istituto Pasteur Italia Fondazione Cenci Bolognetti, Sapienza University of Rome, Rome, Italy
| | - J Pinto
- Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa, Lisbon, Portugal
| | - M Pombi
- Dipartimento di Sanità Pubblica e Malattie Infettive, Istituto Pasteur Italia Fondazione Cenci Bolognetti, Sapienza University of Rome, Rome, Italy
| | - E Mancini
- Dipartimento di Scienze, Roma Tre University, Rome, Italy
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33
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Albuquerque N, Pinto J, Loureiro M, Félix T, Peixoto I. Ultrasound-guided genicular nerve block in chronic knee pain. Ann Phys Rehabil Med 2018. [DOI: 10.1016/j.rehab.2018.05.234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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34
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Syed A, Lee S, Israelson H, Pinto J, Coffin CS. A189 A RETROSPECTIVE ANALYSIS OF OUTCOMES ASSOCIATED WITH PEGYLATED-INTERFERON (PEG-IFN) TREATMENT IN CHRONIC HEPATITIS B (CHB). J Can Assoc Gastroenterol 2018. [DOI: 10.1093/jcag/gwy009.189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- A Syed
- Liver Unit, Division of Gastroenterology, Department of Medicine, University of Calgary, Calgary, AB, Canada
| | - S Lee
- Liver Unit, Division of Gastroenterology, Department of Medicine, University of Calgary, Calgary, AB, Canada
| | - H Israelson
- Liver Unit, Division of Gastroenterology, Department of Medicine, University of Calgary, Calgary, AB, Canada
| | - J Pinto
- Liver Unit, Division of Gastroenterology, Department of Medicine, University of Calgary, Calgary, AB, Canada
| | - C S Coffin
- Liver Unit, Division of Gastroenterology, Department of Medicine, University of Calgary, Calgary, AB, Canada
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De la Cruz-Ku G, Morante Z, Pinto J, Enriquez D, Eyzaguirre E, Saavedra A, Luján M, Luque R, Ramírez M, Araujo J, Fuentes H, Flores C, Moller M, Yakoub D, Neciosup S, Gomez H. Abstract P3-01-07: Comparison of the prognostic value of lymph node ratio versus residual lymph node status in triple negative breast cancer. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p3-01-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Triple negative breast cancer (TNBC) patients with residual disease are characterized for a bad outcome. In these patients nodal involvement after neoadjuvant chemotherapy (NAC) is one of the most important prognostic determinants. In this study we compare two prognostic variables based on nodal status, the lymph node ratio (LNR=#positive nodes/#resected nodes) and residual lymph node status (ypN) in TNBC who received NAC.
Methods: We evaluated a retrospective cohort of TNBC patients with residual disease in the lymph nodes (at least 4 resected nodes) and treated with NAC between 2000-2014 at the Instituto Nacional de Enfermedades Neoplasicas (Lima-Peru). Patients were grouped in three LNR groups (≤0.20, 0.20-0.69 and ≥0.70). Survival differences were calculated by the log rank test. Prognostic factors for progression free survival (PFS) and overall survival (OS) were assessed by the Cox regression analysis.
Results: Overall, 189 were evaluated. Mean age was 48y (range: 26-73) where 53.5% were premenopausal and 16.5% had breast/ovary cancer familial background. A total of 175 pts (92.6%) had clinical T3-T4 tumors and 85.2% had nodal involvement at diagnosis. Indeed, the majority of patients had III CS (94.2%). Regarding to the LNR, 48.2% (n=91), 29.6% (n=56) and 22.2% (n=42) (22.2) had LNR ≤0.20, 0.21-0.69 and ≥0.70, respectively. Distribution of clinical differences was similar between groups, except for the clinical N stage (N2-N3: 15.4%, 46.4%, 52,3%, respectively; p<0.001). The median follow-up was 7 years. Progression risk was higher in patients with LNR ≤0.20 than 0.20-0.69 and ≥0.70 (HR=1.77, 95%CI:1.21-2.59, p=0.003 and HR=2.22, 95%CI:1.47-3.35, respectively, p<0.001). It was similar for the risk of death (HR=1.78, 95%CI: 1.17-2.70, p=0.007 and HR=2.95, 95%CI:1.91-4.56, respectively, p<0.001). LNR groups were associated to progression events (P=0.02) in contrast to ypN groups (P=0.07). In the multivariate analysis, pre-menopausal status, a higher LNR and ypT with non-complete response were prognostic factors of worse DFS. Only a higher LNR has a negative impact on OS (table 1).
Conclusion: LNR was an independent prognostic factor for TNBC in patients with residual disease with better capability than ypN to predict progression events. LNR should be considered in the risk stratification after NAC among these patients.
Table 1. Multivariate Cox Regression AnalysisCharacteristicsDFS OS HR95%CIp valueHR95%CIp valuePremenopausal status1.931.37-2.73<0.001nsnsnsLNR 0.20 vs 0.21-0.692.011.36-2.970.0011.781.17-2.700.007LNR 0.20 vs 0.701.751.57-3.74<0.0012.921.88-4.55<0.001ypT complete vs partial1.751.13-2.710.012nsnsnsypT complete vs non-response2.041.20-3.480.009nsnsnsns=not significant
Citation Format: De la Cruz-Ku G, Morante Z, Pinto J, Enriquez D, Eyzaguirre E, Saavedra A, Luján M, Luque R, Ramírez M, Araujo J, Fuentes H, Flores C, Moller M, Yakoub D, Neciosup S, Gomez H. Comparison of the prognostic value of lymph node ratio versus residual lymph node status in triple negative breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P3-01-07.
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Affiliation(s)
- G De la Cruz-Ku
- Universidad Cientifica del Sur, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Oncosalud - AUNA, Lima, Peru; Jackson Memorial Hospital, Miami, FL
| | - Z Morante
- Universidad Cientifica del Sur, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Oncosalud - AUNA, Lima, Peru; Jackson Memorial Hospital, Miami, FL
| | - J Pinto
- Universidad Cientifica del Sur, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Oncosalud - AUNA, Lima, Peru; Jackson Memorial Hospital, Miami, FL
| | - D Enriquez
- Universidad Cientifica del Sur, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Oncosalud - AUNA, Lima, Peru; Jackson Memorial Hospital, Miami, FL
| | - E Eyzaguirre
- Universidad Cientifica del Sur, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Oncosalud - AUNA, Lima, Peru; Jackson Memorial Hospital, Miami, FL
| | - A Saavedra
- Universidad Cientifica del Sur, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Oncosalud - AUNA, Lima, Peru; Jackson Memorial Hospital, Miami, FL
| | - M Luján
- Universidad Cientifica del Sur, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Oncosalud - AUNA, Lima, Peru; Jackson Memorial Hospital, Miami, FL
| | - R Luque
- Universidad Cientifica del Sur, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Oncosalud - AUNA, Lima, Peru; Jackson Memorial Hospital, Miami, FL
| | - M Ramírez
- Universidad Cientifica del Sur, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Oncosalud - AUNA, Lima, Peru; Jackson Memorial Hospital, Miami, FL
| | - J Araujo
- Universidad Cientifica del Sur, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Oncosalud - AUNA, Lima, Peru; Jackson Memorial Hospital, Miami, FL
| | - H Fuentes
- Universidad Cientifica del Sur, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Oncosalud - AUNA, Lima, Peru; Jackson Memorial Hospital, Miami, FL
| | - C Flores
- Universidad Cientifica del Sur, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Oncosalud - AUNA, Lima, Peru; Jackson Memorial Hospital, Miami, FL
| | - M Moller
- Universidad Cientifica del Sur, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Oncosalud - AUNA, Lima, Peru; Jackson Memorial Hospital, Miami, FL
| | - D Yakoub
- Universidad Cientifica del Sur, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Oncosalud - AUNA, Lima, Peru; Jackson Memorial Hospital, Miami, FL
| | - S Neciosup
- Universidad Cientifica del Sur, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Oncosalud - AUNA, Lima, Peru; Jackson Memorial Hospital, Miami, FL
| | - H Gomez
- Universidad Cientifica del Sur, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Oncosalud - AUNA, Lima, Peru; Jackson Memorial Hospital, Miami, FL
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Morante Z, De la Cruz-Ku G, Pinto J, Araujo J, Eyzaguirre E, Saavedra A, Lujan M, Enriquez D, Ramirez M, Fuentes H, Neciosup S, Gomez H. Abstract P3-10-11: Triple negative breast cancer in young Peruvian patients: 15-years' experience in a public hospital. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p3-10-11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: The incidence of breast cancer (BC) is low in young women and is characterized by a high prevalence of triple-negative tumors, representing a group of high risk. In this work, we describe the clinicopathological and epidemiological features of triple-negative breast cancer (TNBC) in patients aged ≤35 years.
Methods: We reviewed information of TNBC patients diagnosed at ≤35 years old and treated at the Instituto Nacional de Enfermedades Neoplasicas (between 2000 and 2014). The Cox proportional hazard model was used to identify prognostics factors for DFS and OS.
Results: In total, of 243 out 2007 cases (12.11%) were very young TNBC patients. The median follow-up was 9 years. The median age was 32 years (range: 19-35); 14.8% had obesity. A total of 40 (16.5%) patients had a family history of breast-ovary cancer (FHBOC). Regarding to the clinical-pathological characteristics, 59.4% presented T-Stages 3/4; 65.2% had nodal involvement and 7 patients (2.9%) had bilateral BC. Most of patients were diagnosed at Clinical Stage (CS) III (50.8%). The most common histological subtype the was ductal invasive carcinoma (92.1%), followed by medullar (4.5%) and lobulillar (1.7%). A high histological grade was frequent (84.7%), while 71 cases (49%) were diagnosed with vascular permeation and 55 (48.2%) with macrometastasis in lymph nodes. The majority of patients underwent mastectomy (60.2%) compared to lumpectomy (39.8%). Locoregional relapse and distant metastasis were reported in 30.9% and 49.4% of cases, respectively. The most frequent sites of metastases were lung (14.8%) and brain (11.5%). In the multivariate analysis, only N3 stage was associated with a poor outcome in terms of (N0 vs N3, HR=7.89, 95%CI:2.76-22.56, p<0.001). Variables associated with the risk of death were N stage (P<0.001 for N0 vs N3), neoadjuvant chemotherapy (P<0.027), adjuvant chemotherapy (P<0.001), and radiotherapy (P=0.008).
Conclusions: TNBC in very young Peruvian women was characterized by advanced stage at diagnosis. In these patients, nodal involvement was the most important prognostic factor for DFS. It presents distinctive characteristics and poorer outcomes in terms of DFS and OS.
Table 1. Multivariate Cox Regression Analysis.CharacteristicsPFS OS HR95% CIp valueHR95% CIp valueN0 vs N11.820.74-4.480.191.510.88-2.590.14N0 vs N22.260.69-7.360.183.031.69-5.46<0.001N0 vs N37.892.76-22.56<0.0013.581.83-7.01<0.001Adjuvant chemotherapynsnsns0.340.20-0.55<0.001Neo-Adjuvant Chemotherapynsnsns0.590.37-0.940.027Radiotherapynsnsns0.560.37-0.860.008ns = not significant
Citation Format: Morante Z, De la Cruz-Ku G, Pinto J, Araujo J, Eyzaguirre E, Saavedra A, Lujan M, Enriquez D, Ramirez M, Fuentes H, Neciosup S, Gomez H. Triple negative breast cancer in young Peruvian patients: 15-years' experience in a public hospital [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P3-10-11.
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Affiliation(s)
- Z Morante
- Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Oncosalud, Lima, Peru; Universidad Cientifica del Sur, Lima, Peru
| | - G De la Cruz-Ku
- Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Oncosalud, Lima, Peru; Universidad Cientifica del Sur, Lima, Peru
| | - J Pinto
- Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Oncosalud, Lima, Peru; Universidad Cientifica del Sur, Lima, Peru
| | - J Araujo
- Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Oncosalud, Lima, Peru; Universidad Cientifica del Sur, Lima, Peru
| | - E Eyzaguirre
- Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Oncosalud, Lima, Peru; Universidad Cientifica del Sur, Lima, Peru
| | - A Saavedra
- Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Oncosalud, Lima, Peru; Universidad Cientifica del Sur, Lima, Peru
| | - M Lujan
- Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Oncosalud, Lima, Peru; Universidad Cientifica del Sur, Lima, Peru
| | - D Enriquez
- Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Oncosalud, Lima, Peru; Universidad Cientifica del Sur, Lima, Peru
| | - M Ramirez
- Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Oncosalud, Lima, Peru; Universidad Cientifica del Sur, Lima, Peru
| | - H Fuentes
- Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Oncosalud, Lima, Peru; Universidad Cientifica del Sur, Lima, Peru
| | - S Neciosup
- Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Oncosalud, Lima, Peru; Universidad Cientifica del Sur, Lima, Peru
| | - H Gomez
- Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Oncosalud, Lima, Peru; Universidad Cientifica del Sur, Lima, Peru
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Morante Z, De la Cruz-Ku G, Pinto J, Araujo J, Fuentes H, Enriquez D, Luque R, Eyzaguirre E, Saavedra A, Luján M, Neciosup S, Gomez H. Abstract P1-15-02: Benefit of adjuvant chemotherapy in disease-free survival for T1N0 triple negative breast cancer. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p1-15-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Although chemotherapy is not recommended in low-risk early breast cancer, triple-negative breast cancers (TNBC) have twice risk of recurrence despite an aggressive treatment. In this study we evaluated the role of chemotherapy in the outcome of T1N0 TNBC patients in terms of disease-free survival (DFS) and overall survival (OS).
Methods: We evaluated a retrospective cohort T1N0 TNBC patients diagnosed between 2000 to 2014 at the Instituto Nacional de Enfermedades Neoplasicas (Lima-Peru). Survival rates differences were assessed by Log-rank test and prognostic factors were identified using the Cox proportional hazards model.
Results: We identified 123 T1N0 TNBC patients. The median age was 51 years (range: 28-85), where 38.5% were premenopausal. Thirty-six (29.3%) were pT1a/b and 87 were pT1c (70.7%). ACT was administered more frequently in pT1c patients (74.7% vs 55.6%; P=0.036). Locoregional relapse and distant metastases rates were 8.3% vs 19.5% and 5.6% vs 16.1% for tumors pT1a/b and pT1c, respectively. The median of follow-up was 8.8 years. Independent prognostic factors were pT stage and treatment with ACT. In relation to pT stage, DFS rates were 97% vs 78% (at 5-years) and 97% vs 70% (at 8-years) for pT1a/b vs pT1c patients, respectively (HR=4.8; 95%CI:1.46-17.0; P=0.015). In the other hand, patients treated with ACT had a better outcome with DFS rates to 5-years of 86% vs 74% and 8-years of 81% vs 65% (HR: 0.41, 95%CI: 0.17-0.97, p=0.043). Our study had not statistical power to evaluate benefit of ACT in pT1a/b patients. In cases with pT1c tumors, treatment with ACT was the only factor associated with a better DFS (HR=0.29, 95%CI: 0.11-0.77, p=0.012). Because the low mortality in our cohort, OS was not evaluable.
Conclusions: Treatment with adjuvant chemotherapy reduces the recurrence risk in 71% among pT1cN0 TNBC.
Citation Format: Morante Z, De la Cruz-Ku G, Pinto J, Araujo J, Fuentes H, Enriquez D, Luque R, Eyzaguirre E, Saavedra A, Luján M, Neciosup S, Gomez H. Benefit of adjuvant chemotherapy in disease-free survival for T1N0 triple negative breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P1-15-02.
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Affiliation(s)
- Z Morante
- Universidad Cientifica del Sur, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Oncosalud - AUNA, Lima, Peru
| | - G De la Cruz-Ku
- Universidad Cientifica del Sur, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Oncosalud - AUNA, Lima, Peru
| | - J Pinto
- Universidad Cientifica del Sur, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Oncosalud - AUNA, Lima, Peru
| | - J Araujo
- Universidad Cientifica del Sur, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Oncosalud - AUNA, Lima, Peru
| | - H Fuentes
- Universidad Cientifica del Sur, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Oncosalud - AUNA, Lima, Peru
| | - D Enriquez
- Universidad Cientifica del Sur, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Oncosalud - AUNA, Lima, Peru
| | - R Luque
- Universidad Cientifica del Sur, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Oncosalud - AUNA, Lima, Peru
| | - E Eyzaguirre
- Universidad Cientifica del Sur, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Oncosalud - AUNA, Lima, Peru
| | - A Saavedra
- Universidad Cientifica del Sur, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Oncosalud - AUNA, Lima, Peru
| | - M Luján
- Universidad Cientifica del Sur, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Oncosalud - AUNA, Lima, Peru
| | - S Neciosup
- Universidad Cientifica del Sur, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Oncosalud - AUNA, Lima, Peru
| | - H Gomez
- Universidad Cientifica del Sur, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Oncosalud - AUNA, Lima, Peru
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Morante Z, Pinto J, Enriquez D, Araujos J, Luque R, Eyzaguirre E, Saavedra A, Fuentes H, Neciosup S, Gomez H. Abstract P6-08-26: Outcomes and prognostic factors in 2000 patients with TNBC: Long-term results covering 10 years. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p6-08-26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Triple-negative breast cancer (TNBC) is characterized by being a heterogeneous disease with different risk factors and poor survival rates. TNBC have a higher prevalence in the Peruvian population (21.3%) than in Caucasian groups. Our study aims to determine the outcome and identify prognostic factors in Peruvian women with TNBC.
Methods: We retrospectively analyzed TNBC patients treated at the “Instituto Nacional de Enfermedades Neoplasicas” between 2000 and 2014. Survival rates and differences were calculated by the Kaplan-Meier method and Log-rank test, respectively. With the Cox regression, in univariate and multivariate analysis, we identified prognostic factors in for our TNBC population.
Results: In total, 2007 patients were diagnosed.The mean age was 50 years (range: 19-95 years); 44.8% were premenopausal and 26.2% had obesity at diagnosis. A family history of breast and/or ovarian cancer was present in 266 (28.9%) patients. Regarding the clinical-pathological features, 1860 (93.5%) had ductal invasive carcinoma and 1024 (51.6%) patients were in Stage (S) III. Local relapse and distant metastasis affected to 34.5% and 51.4% of our patients, respectively. Lung (14.5%) and bone (9.7%) were the most frequent sites of metastasis. The median follow-up was 9 years. The 5 and 10 yrs DFS/OS rates are shown in table 1. In the multivariate analysis, adjuvant chemotherapy (ACT) (HR: 0.60, 95%CI: 0.44-0.82, p=0.001) and radiotherapy (RT) (HR:0.72, 95%CI:0.55-0.93, p=0.014) were associated with a reduced risk of recurrence, while nodal involvement were associated to a high recurrence risk. Factors associated to a reduction in the risk of death were ACT (HR:0.73, 95%CI:0.61-0.88, p=0.001), RT (HR: 0.70, 95%CI: 0.60-0.92, p<0.001), and Neoadjuvant CT (HR: 0.61, 95%CI: 0.51-0.73, p<0.001); in contrast, a NLR≥3 (HR:1.60,95%CI: 1.36-1.87, p<0.001), N stage were associated with a higher risk of death.
Conclusions: Sociodemographic features of Peruvian patients with TNBC resemble other populations; however, our population is diagnosed at more advanced clinical stages, hence DFS and OS were lower than international reports while prognostic factors were similar to previous studies.
Table 1. 5- and 10-years DFS/OS ratesClinical StageIIIIIIIVTotalp (value)DFS (%) <0.0015-years837540-63 10-years696429-52 OS (%) <0.0015-years938239655 10-years837532550
Citation Format: De la Cruz-Ku G, Morante Z, Pinto J, Enriquez D, Araujos J, Luque R, Eyzaguirre E, Saavedra A, Fuentes H, Neciosup S, Gomez H. Outcomes and prognostic factors in 2000 patients with TNBC: Long-term results covering 10 years [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P6-08-26.
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Affiliation(s)
- Z Morante
- Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Oncosalud, Lima, Peru; Universidad Cientifica del Sur, Lima, Peru
| | - J Pinto
- Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Oncosalud, Lima, Peru; Universidad Cientifica del Sur, Lima, Peru
| | - D Enriquez
- Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Oncosalud, Lima, Peru; Universidad Cientifica del Sur, Lima, Peru
| | - J Araujos
- Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Oncosalud, Lima, Peru; Universidad Cientifica del Sur, Lima, Peru
| | - R Luque
- Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Oncosalud, Lima, Peru; Universidad Cientifica del Sur, Lima, Peru
| | - E Eyzaguirre
- Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Oncosalud, Lima, Peru; Universidad Cientifica del Sur, Lima, Peru
| | - A Saavedra
- Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Oncosalud, Lima, Peru; Universidad Cientifica del Sur, Lima, Peru
| | - H Fuentes
- Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Oncosalud, Lima, Peru; Universidad Cientifica del Sur, Lima, Peru
| | - S Neciosup
- Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Oncosalud, Lima, Peru; Universidad Cientifica del Sur, Lima, Peru
| | - H Gomez
- Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Oncosalud, Lima, Peru; Universidad Cientifica del Sur, Lima, Peru
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Barroso-Solares S, Pinto J, Nanni G, Fragouli D, Athanassiou A. Enhanced oil removal from water in oil stable emulsions using electrospun nanocomposite fiber mats. RSC Adv 2018; 8:7641-7650. [PMID: 35539125 PMCID: PMC9078395 DOI: 10.1039/c7ra12646h] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [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: 11/21/2017] [Accepted: 02/12/2018] [Indexed: 11/21/2022] Open
Abstract
Fibrous mats with hydrophobic and oleophilic properties have been fabricated and used as absorbents of oil from stable water in oil emulsions.
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Affiliation(s)
- S. Barroso-Solares
- Smart Materials
- Nanophysics
- Istituto Italiano di Tecnologia
- 16163 Genova
- Italy
| | - J. Pinto
- Smart Materials
- Nanophysics
- Istituto Italiano di Tecnologia
- 16163 Genova
- Italy
| | - G. Nanni
- Smart Materials
- Nanophysics
- Istituto Italiano di Tecnologia
- 16163 Genova
- Italy
| | - D. Fragouli
- Smart Materials
- Nanophysics
- Istituto Italiano di Tecnologia
- 16163 Genova
- Italy
| | - A. Athanassiou
- Smart Materials
- Nanophysics
- Istituto Italiano di Tecnologia
- 16163 Genova
- Italy
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Aguilar A, Murillo A, Ponce J, Araujo J, Pinto J, Vigil C, Fujita R, Buleje J. Evaluation of cell free circulating DNA in plasma by digital PCR for early diagnosis in Peruvian breast cancer patients. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx361.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Silva V, Campos C, Sá A, Cavadas M, Pinto J, Simões P, Machado S, Murillo-Rodríguez E, Barbosa-Rocha N. Wii-based exercise program to improve physical fitness, motor proficiency and functional mobility in adults with Down syndrome. J Intellect Disabil Res 2017; 61:755-765. [PMID: 28585394 DOI: 10.1111/jir.12384] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 02/24/2017] [Accepted: 04/26/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND People with Down syndrome (DS) usually display reduced physical fitness (aerobic capacity, muscle strength and abnormal body composition), motor proficiency impairments (balance and postural control) and physical functional limitations. Exergames can be an appealing alternative to enhance exercise engagement and compliance, whilst improving physical fitness and motor function. This study aims to analyse the effects of a Wii-based exercise program on physical fitness, functional mobility and motor proficiency of adults with DS. METHODS Twenty-seven adults with DS were randomly allocated to an experimental group (Wii; n = 14) or control group (n = 13). Participants in the experimental group completed a 2-month Wii-based exercise program, with three 1-h sessions per week that included training games for aerobic endurance, balance and isometric strength. Participants completed assessments regarding anthropometric measures, physical fitness, functional mobility and motor proficiency. RESULTS Mixed ANOVA analysis showed a significant group by time interaction for aerobic endurance, explosive leg power and flexibility. Independent samples t-test for change scores indicated significant between-group differences favouring the experimental group regarding speed of limb movement, trunk strength and functional mobility, as well as a trend towards significance on body weight. Mann-Whitney's U test for change scores demonstrated between-group differences favouring the experimental group for visceral fat as well as running speed and agility. Large within-group effect sizes were observed for explosive leg power (d = 1.691), body weight (d = 1.281), functional mobility (d = 1.218), aerobic endurance (d = 1.020), speed of limb movement (d = 0.867) and flexibility (d = 0.818) in the experimental group. CONCLUSIONS Our findings suggest that Wii-based exercise can be an effective tool to improve physical fitness, functional mobility and motor proficiency of adults with DS, including crucial measures such as aerobic capacity and lower limb strength. Exergames using Wii Fit or other equipment can be appealing alternatives for adults with DS to engage in regular physical activity, preventing sedentary behaviour and decreasing the risk to develop cardiovascular diseases.
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Affiliation(s)
- V Silva
- Polytechnic Institute of Porto, Health School, Porto, Portugal
| | - C Campos
- Panic and Respiration Laboratory, Institute of Psychiatry, Federal University of Rio de Janeiro, Brazil
| | - A Sá
- Polytechnic Institute of Porto, Health School, Porto, Portugal
| | - M Cavadas
- Polytechnic Institute of Porto, Health School, Porto, Portugal
| | - J Pinto
- Polytechnic Institute of Porto, Health School, Porto, Portugal
| | - P Simões
- Polytechnic Institute of Porto, Health School, Porto, Portugal
| | - S Machado
- Panic and Respiration Laboratory, Institute of Psychiatry, Federal University of Rio de Janeiro, Brazil
| | - E Murillo-Rodríguez
- División Ciencias de la Salud, Escuela de Medicina, Universidad Anahuac Mayab Laboratorio de Neurociencias Moleculares e Integrativas, Merida, Mexico
| | - N Barbosa-Rocha
- Polytechnic Institute of Porto, Health School, Porto, Portugal
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Fernandes P, Pinto J, Ustrell-Torrent J. Relationship between oro and nasopharynx permeability and the direction of facial growth. Eur J Paediatr Dent 2017; 18:37-40. [PMID: 28494601 DOI: 10.23804/ejpd.2017.18.01.08] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIM Most scientific literature relates vertical growth to individuals with decreased upper airway permeability. However, we often find subjects with a long face and a normal breathing pattern, most likely caused by other aetiological factors. And, frequently, we also find decreased upper airway permeability with horizontal growth. The aim of the study was to compare the cephalometric measurements of the oro and nasopharynx permeability with the facial growth direction and to identify the most common facial growth direction in individuals with decreased upper airway permeability. MATERIALS AND METHODS Cephalometric analysis was carried out in 158 pre-adolescent patients at the Orthodontic appointment, using facial profile teleradiographs. Parameters used were Jabarak's ratio and measurement of oro-nasopharynx space. Data collected were submitted to statistical treatment. RESULTS This study points to the presence of an intermediate growth in individuals with diminished oro and nasopharynx permeability, either simultaneous or separate. The number of individuals with diminished permeability and vertical growth is close to the number of individuals with horizontal growth. CONCLUSIONS The individuals with diminished permeability of the upper airway present an intermediate growth direction, representing the most frequent type. In the less common growth directions, there is a slight tendency to horizontal facial growth verified in individuals with diminished nasopharynx permeability. Also, a light tendency to vertical facial growth is present when oropharynx permeability is reduced.
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Affiliation(s)
- P Fernandes
- Oporto University Faculty of Medicine, (Portugal) - University of Barcelona
| | - J Pinto
- Oporto University Faculty of Medicine, (Portugal) - University of Barcelona
| | - J Ustrell-Torrent
- Oporto University Faculty of Medicine, (Portugal) - University of Barcelona
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Barreira D, Martins L, Valdemar P, Costa I, Brito J, Garganta J, Pinto J, Souza C. Annex II. Abstracts from the 3rd International Workshop of the International Society of Performance Analysis of Sport. INT J PERF ANAL SPOR 2017. [DOI: 10.1080/24748668.2009.11868494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- D. Barreira
- Faculdade de Desporto – Universidade do Porto, Portugal
| | - L. Martins
- Faculdade de Desporto – Universidade do Porto, Portugal
| | - P. Valdemar
- Faculdade de Desporto – Universidade do Porto, Portugal
| | - I. Costa
- Faculdade de Desporto – Universidade do Porto, Portugal
| | - J. Brito
- Faculdade de Desporto – Universidade do Porto, Portugal
| | - J. Garganta
- Faculdade de Desporto – Universidade do Porto, Portugal
| | - J. Pinto
- Faculdade de Desporto – Universidade do Porto, Portugal
| | - C. Souza
- Faculdade de Desporto – Universidade do Porto, Portugal
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45
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Pedraz JI, Jara DF, Araujo J, Pinto J, Li B, Comai L. A novel and unanticipated link between the Werner syndrome protein (WRN) and protein translation. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw362.42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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46
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Sousa F, Pinto J, Marques-Neves C. Retinal structural changes before and after idiopahic epiretinal membrane peeling - a study using OCT segmentation. Acta Ophthalmol 2016. [DOI: 10.1111/j.1755-3768.2016.0583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Pinto J, Velasco D, Sutil S, Boucher M, Rodriguez-Perez M. Enhancement of Carbon Nanofibers Dispersion on Epoxy Resin Foams Leading to Remarkable Electrical Conductivity Improvement. Cellular Polymers 2016. [DOI: 10.1177/026248931603500501] [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] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A simple procedure to evaluate and improve the dispersion of carbon nanofibers is presented and validated, relating the observed dispersion of the nanofibers in an intermediate stage of the production process to the final macroscopic properties of the foams. Epoxy/carbon nanofiber foams with optimal nanofiber dispersion are produced taking advantage of this procedure using inexpensive industrial vapor grown carbon nanofibers. Furthermore, the main characteristics and the electrical resistivity of the foams with improved nanofibers dispersion have been determined and related to the presence of the carbon nanofibers, greatly enhancing the electrical conductivity of the epoxy/carbon nanofiber foams.
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Affiliation(s)
- J. Pinto
- Cellular Materials Laboratory (CellMat), Condensed Matter Physics Department, University of Valladolid, 47011 Valladolid, Spain
- Smart Materials, Istituto Italiano di Tecnologia (IIT), Via Morego 30, 16163 Genova, Italy
| | - D. Velasco
- Cellular Materials Laboratory (CellMat), Condensed Matter Physics Department, University of Valladolid, 47011 Valladolid, Spain
| | - S.B. Sutil
- Cellular Materials Laboratory (CellMat), Condensed Matter Physics Department, University of Valladolid, 47011 Valladolid, Spain
| | - M. Boucher
- Cellular Materials Laboratory (CellMat), Condensed Matter Physics Department, University of Valladolid, 47011 Valladolid, Spain
| | - M.A. Rodriguez-Perez
- Cellular Materials Laboratory (CellMat), Condensed Matter Physics Department, University of Valladolid, 47011 Valladolid, Spain
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48
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Pinto J, Paladini D, Severino M, Morana G, Pais R, Martinetti C, Rossi A. Delayed rotation of the cerebellar vermis: a pitfall in early second-trimester fetal magnetic resonance imaging. Ultrasound Obstet Gynecol 2016; 48:121-124. [PMID: 26482947 DOI: 10.1002/uog.15782] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 09/29/2015] [Accepted: 10/02/2015] [Indexed: 06/05/2023]
Abstract
We describe two cases in which delayed rotation of the cerebellar vermis simulated a Dandy-Walker malformation (DWM) on early second-trimester magnetic resonance imaging (MRI). Two pregnant women with suspected fetal posterior fossa anomaly on ultrasound examination underwent fetal MRI at 21 (Case 1) and 19 (Case 2) weeks' gestation. In both cases, upward rotation of the cerebellar vermis was noted; on midsagittal imaging, the brainstem-vermis angle was 28° and 43°, respectively, while cerebellar morphometry showed a reduced vermian anteroposterior diameter compared to reference data. The posterior fossa appeared to be mildly enlarged, while all other findings were normal. Follow-up MRI at 28 + 3 weeks' gestation (Case 1) and at 1 postnatal year (Case 2) showed completely normal findings. Both children had normal psychomotor development and neurological examinations at 1 year of age. Incomplete rotation of the cerebellar vermis can be a physiological finding on early second-trimester fetal MRI examination and can simulate DWM or other forms of cerebellar hypoplasia. Embryologically, delayed permeabilization of Blake's pouch could account for the delayed vermian rotation. Follow-up imaging at a later gestational age is crucial to ensure that this condition is not over-reported and to avoid the potential risk of unnecessary pregnancy interruption. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- J Pinto
- Neuroradiology Unit, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal
| | - D Paladini
- Fetal Medicine Unit, Istituto Giannina Gaslini, Genoa, Italy
| | - M Severino
- Neuroradiology Unit, Istituto Giannina Gaslini, Genoa, Italy
| | - G Morana
- Neuroradiology Unit, Istituto Giannina Gaslini, Genoa, Italy
| | - R Pais
- Neuroradiology Unit, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal
| | - C Martinetti
- Neuroradiology Unit, Istituto Giannina Gaslini, Genoa, Italy
| | - A Rossi
- Neuroradiology Unit, Istituto Giannina Gaslini, Genoa, Italy
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Abstract
This study investigates risk communication within genetic counselling. Transcripts of 115 U.K. genetic consultations were reliably coded into form of risk expression used, whether the patient responded with understanding and agreement or showed signs of misunderstanding or disagreement, or did not respond at all, and whether clinicians assessed patient comprehension. Of the 492 risk expressions used, 53% were words and 47% were numbers (32% probabilities and 15% percentages). There was no association between form of risk expression and response. Clinicians assessed comprehension on only 25% of occasions, less often following the use of words than numbers, and on only 9% of occasions when there was no response to their risk communication. Because patients did not respond to 43% of risk communications, there is a concern that patients may make decisions without understanding the risks involved.
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Affiliation(s)
- Susan Michie
- Centre for Outcomes Research and Effectiveness, Department of Psychology, University College London, London.
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50
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Barroso-Solares S, Zahedi MG, Pinto J, Nanni G, Fragouli D, Athanassiou A. Oil removal from water–oil emulsions using magnetic nanocomposite fibrous mats. RSC Adv 2016. [DOI: 10.1039/c6ra12246a] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
PMMA-based magnetic nanocomposite fibrous mats reach oil absorption efficiencies up to 90% in water–oil stable emulsions.
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Affiliation(s)
- S. Barroso-Solares
- Smart Materials
- Nanophysics
- Istituto Italiano di Tecnologia
- 16163 Genova
- Italy
| | - M. G. Zahedi
- Smart Materials
- Nanophysics
- Istituto Italiano di Tecnologia
- 16163 Genova
- Italy
| | - J. Pinto
- Smart Materials
- Nanophysics
- Istituto Italiano di Tecnologia
- 16163 Genova
- Italy
| | - G. Nanni
- Smart Materials
- Nanophysics
- Istituto Italiano di Tecnologia
- 16163 Genova
- Italy
| | - D. Fragouli
- Smart Materials
- Nanophysics
- Istituto Italiano di Tecnologia
- 16163 Genova
- Italy
| | - A. Athanassiou
- Smart Materials
- Nanophysics
- Istituto Italiano di Tecnologia
- 16163 Genova
- Italy
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