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Campos L, Chimeno-Viñas MM, Carretero-Gómez J, Santos L, Cabrera-Rayo A, Valdez PR, Gómez-Huelgas R. Recommendations of the Spanish-Portuguese Internal Medicine services in the fight against climate change and environmental degradation. Rev Clin Esp 2024; 224:S2254-8874(24)00023-7. [PMID: 38458942 DOI: 10.1016/j.rceng.2024.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 01/10/2024] [Indexed: 03/10/2024]
Abstract
Facing the severity of the impact of climate change and environmental degradation on human health, 32 Internal Medicine societies, colleges, and associations of 29 Spanish and Portuguese-speaking countries issue a consensus document in which they call for the implication of doctors and all health professionals in the global fight against the causes of these changes. This commitment requires the cooperation of health-related organizations, elaboration and implementation of good environmental sustainability practices, greater awareness of professionals and population, promotion of education and research in this area, increasing climate resilience and environmental sustainability of health systems, combating inequalities and protecting the most vulnerable populations, adopting behaviors that protect the environment, and claiming Internal Medicine as a core specialty for empowerment of the health system to respond to these challenges.
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Affiliation(s)
- L Campos
- Portuguese Council for Health and Environment, Hospital CUF Tejo, Lisbon, Portugal.
| | - M M Chimeno-Viñas
- Spanish Society of Internal Medicine, Complejo Asistencial de Zamora, Zamora, Spain
| | - J Carretero-Gómez
- Spanish Society of Internal Medicine, Hospital Universitario de Badajoz, Universidad de Extremadura, Badajoz, Spain
| | - L Santos
- Portuguese Society of Internal Medicine, Centro Hospitalar Universitário de Coimbra, Faculdade de Medicina da Universidade de Coimbra, Coimbra, Portugal
| | - A Cabrera-Rayo
- Global Summit of Internal Medicine, Instituto Mexicano del Seguro Social, México, Ciudad de México, México
| | - P R Valdez
- International Forum of Internal Medicine, Hospital Vélez Sarsfield, Univesidad de Buenos Aires, Buenos Aires, Argentina
| | - R Gómez-Huelgas
- European Federation of Internal Medicine, Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga, Spain
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Caldeira D, Dores H, Franco F, Bravo Baptista S, Cabral S, Cachulo MDC, Peixeiro A, Rodrigues R, Santos M, Timóteo AT, Campos L, Vasconcelos J, Nogueira PJ, Gonçalves L. Global warming and heat wave risks for cardiovascular diseases: A position paper from the Portuguese Society of Cardiology. Rev Port Cardiol 2023; 42:1017-1024. [PMID: 36758747 DOI: 10.1016/j.repc.2023.02.002] [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: 01/21/2023] [Accepted: 02/03/2023] [Indexed: 02/11/2023] Open
Abstract
Global warming is a result of the increased emission of greenhouse gases. The consequences of this climate change threaten society, biodiversity, food and resource availability. The consequences include an increased risk of cardiovascular (CV) disease and cardiovascular mortality. In this position paper, we summarize the data from the main studies that assess the risks of a temperature increase or heat waves in CV events (CV mortality, myocardial infarction, heart failure, stroke, and CV hospitalizations), as well as the data concerning air pollution as an enhancer of temperature-related CV risks. The data currently support global warming/heat waves (extreme temperatures) as cardiovascular threats. Achieving neutrality in emissions to prevent global warming is essential and it is likely to have an effect in the global health, including the cardiovascular health. Simultaneously, urgent steps are required to adapt the society and individuals to this new climatic context that is potentially harmful for cardiovascular health. Multidisciplinary teams should plan and intervene healthcare related to temperature changes and heat waves and advocate for a change in environmental health policy.
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Affiliation(s)
- Daniel Caldeira
- Sociedade Portuguesa de Cardiologia, Lisboa, Portugal; Serviço de Cardiologia, Hospital Universitário de Santa Maria - CHULN, Portugal; Cardiovascular Pharmacology and Therapeutics Unit, Centro Cardiovascular da Universidade de Lisboa (CCUL@RISE), CEMBE, CAML, Faculdade de Medicina, Universidade de Lisboa, Portugal; Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina da Universidade de Lisboa, Portugal.
| | - Hélder Dores
- Sociedade Portuguesa de Cardiologia, Lisboa, Portugal; Hospital da Luz, Lisbon, Portugal; NOVA Medical School, Lisbon, Portugal
| | - Fátima Franco
- Sociedade Portuguesa de Cardiologia, Lisboa, Portugal; Unidade Tratamento IC Avançada (UTICA), Serviço de Cardiologia, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal
| | - Sérgio Bravo Baptista
- Sociedade Portuguesa de Cardiologia, Lisboa, Portugal; Hospital Prof. Doutor Fernando da Fonseca, EPE, Cardiology Department, Amadora, Portugal; Centro Cardiovascular da Universidade de Lisboa (CCUL@RISE), CAML, Faculdade de Medicina, Universidade de Lisboa, Portugal
| | - Sofia Cabral
- Sociedade Portuguesa de Cardiologia, Lisboa, Portugal; Department of Cardiology, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Maria do Carmo Cachulo
- Sociedade Portuguesa de Cardiologia, Lisboa, Portugal; Centro Hospitalar e Universitário de Coimbra, ICBR - Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - António Peixeiro
- Sociedade Portuguesa de Cardiologia, Lisboa, Portugal; Serviço de Cardiologia, Centro Hospitalar e Universitário da Cova da Beira (CHUCB), Covilhã, Portugal
| | - Rui Rodrigues
- Sociedade Portuguesa de Cardiologia, Lisboa, Portugal; Department of Cardiology, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Mário Santos
- Sociedade Portuguesa de Cardiologia, Lisboa, Portugal; Department of Cardiology, Centro Hospitalar Universitário do Porto, Porto, Portugal; UMIB - Unidade Multidisciplinar de Investigação Biomédica, ICBAS - Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal; ITR - Laboratory for Integrative and Translational Research in Population Health, Porto, Portugal
| | - Ana Teresa Timóteo
- Sociedade Portuguesa de Cardiologia, Lisboa, Portugal; NOVA Medical School, Lisbon, Portugal; Serviço de Cardiologia, Hospital Santa Marta, Centro Hospitalar Universitário Lisboa Central, Lisboa, Portugal
| | - Luís Campos
- Department of Internal Medicine, Hospital CUF Tejo, Portuguese Council for Health and Environment, Lisbon, Portugal
| | - João Vasconcelos
- Universidade de Lisboa, Instituto de Geografia e Ordenamento do Território (Centro de Estudos Geográficos), Portugal; Instituto Politécnico de Leiria, Portugal
| | - Paulo Jorge Nogueira
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Comprehensive Health Research Center (CHRC), Lisbon, Portugal; Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal; Laboratório Associado TERRA, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal; CIDNUR - Centro de Investigação, Inovação e Desenvolvimento em Enfermagem de Lisboa, Escola Superior de Enfermagem de Lisboa, Lisboa, Portugal
| | - Lino Gonçalves
- Sociedade Portuguesa de Cardiologia, Lisboa, Portugal; Centro Hospitalar e Universitário de Coimbra, ICBR - Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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Yamada K, Takata T, Anoushiravani A, Campos L, Graham T, Kotoku J, Farsad K. Abstract No. 53 Image Quality Improvement for Digital Subtraction Angiography (DSA) around High-Density Obstacles Using Deep Learning: A Bench-Top Study. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.096] [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: 02/27/2023] Open
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Li N, Al-Hakim R, Lewis S, Ferracane J, Campos L, Rugonyi S, Kaufman J. Abstract No. 96 Impact of Co-Axial Placement of Balloon-Expandable and Self-Expanding Stent on Crush Resistance in Vitro. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.144] [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: 02/26/2023] Open
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Sousa CN, Teles P, Ribeiro OMPL, Sousa R, Lira MN, Delgado E, Oliveira D, Campos L, Fernandes F, Moura SCM, Delgado MF, Sá TG, Teixeira SMP, Souza LH, Ribeiro RCHM, Oliveira GFN, Mendonça AEO, Ozen N. How to choose the appropriate cannulation technique for vascular access in hemodialysis patients. Ther Apher Dial 2023; 27:394-401. [PMID: 36717974 DOI: 10.1111/1744-9987.13973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 01/20/2023] [Accepted: 01/23/2023] [Indexed: 02/01/2023]
Abstract
The cannulation technique is important for the survival of the arteriovenous access. Choosing the appropriate technique is a complex decision. Such choice must be customized to patients, considering their characteristics, the type of arteriovenous access and the experience of the hemodialysis team. We describe seven items that can help nurses to identify the appropriate cannulation technique: type of arteriovenous access; drainage vein; hygienic self-care profile; experience of the nursing staff in the cannulation technique and nurse-to-patient ratio; hemodialysis treatment method; patient's condition; and patient's decision. Such items can help nurses in decision-making on the "ideal" cannulation technique for each patient.
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Affiliation(s)
- Clemente Neves Sousa
- S Francisco Dialysis Unit, Porto, Portugal.,CINTESIS-Center for Health Technology and Services Research Faculty of Medicine, Porto University, Porto, Portugal.,Nursing School of Porto, Porto, Portugal
| | - Paulo Teles
- School of Economics and LIAAD-INESC Porto LA, Porto University, Porto, Portugal
| | - Olga Maria Pimenta Lopes Ribeiro
- CINTESIS-Center for Health Technology and Services Research Faculty of Medicine, Porto University, Porto, Portugal.,Nursing School of Porto, Porto, Portugal
| | - Rui Sousa
- CINTESIS-Center for Health Technology and Services Research Faculty of Medicine, Porto University, Porto, Portugal
| | | | | | | | | | | | - Sandra Cristina Mendo Moura
- CINTESIS-Center for Health Technology and Services Research Faculty of Medicine, Porto University, Porto, Portugal.,Mogadouro Dialysis Unit-TECSAM; Unidade de Local Saúde Nordeste, Bragança, Portugal
| | - Millena Freire Delgado
- CINTESIS-Center for Health Technology and Services Research Faculty of Medicine, Porto University, Porto, Portugal
| | | | | | - Lara Helk Souza
- Medical School of São José do Rio Preto (FAMERP), São Paulo, Brazil
| | | | | | | | - Nurten Ozen
- Florence Nightingale Hospital School of Nursing, Demiroglu Bilim University, Istanbul, Turkey
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Llanos D, de la Pedraja I, Campos L, Armijo J, Ávila LF. Imaging palpable tumors in pediatrics: Part 2. Radiologia (Engl Ed) 2023; 65:43-54. [PMID: 36842785 DOI: 10.1016/j.rxeng.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 09/03/2022] [Indexed: 02/28/2023]
Abstract
Palpable tumors in children are a common reason for consulting a radiologist. The origin of these lesions varies widely, and although they are common, classic radiology books do not cover some of them. This series of two articles aims to review the clinical and radiological characteristics of a selection of palpable tumors in children that radiologists need to be familiar with.
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Affiliation(s)
- D Llanos
- Servicio de Radiodiagnóstico, Hospital Universitario Clínico San Carlos, Madrid, Spain.
| | - I de la Pedraja
- Servicio de Radiodiagnóstico, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - L Campos
- Servicio de Dermatología, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - J Armijo
- Servicio de Radiodiagnóstico, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - L F Ávila
- Servicio de Cirugía Pediátrica, Hospital Universitario Clínico San Carlos, Madrid, Spain
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Llanos D, de la Pedraja I, Campos L, Armijo J, Ávila L. Radiología de las tumoraciones palpables en el paciente pediátrico. Parte 2. Radiología 2023. [DOI: 10.1016/j.rx.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Payá C, Minguillón S, Hernández M, Miguel SM, Campos L, Rodrigo I, Bellés JM, López-Gresa MP, Lisón P. SlS5H silencing reveals specific pathogen-triggered salicylic acid metabolism in tomato. BMC Plant Biol 2022; 22:549. [PMID: 36443652 PMCID: PMC9706870 DOI: 10.1186/s12870-022-03939-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 11/11/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Salicylic acid (SA) is a major plant hormone that mediates the defence pathway against pathogens. SA accumulates in highly variable amounts depending on the plant-pathogen system, and several enzyme activities participate in the restoration of its levels. Gentisic acid (GA) is the product of the 5-hydroxylation of SA, which is catalysed by S5H, an enzyme activity regarded as a major player in SA homeostasis. GA accumulates at high levels in tomato plants infected by Citrus Exocortis Viroid (CEVd), and to a lesser extend upon Pseudomonas syringae DC3000 pv. tomato (Pst) infection. RESULTS We have studied the induction of tomato SlS5H gene by different pathogens, and its expression correlates with the accumulation of GA. Transient over-expression of SlS5H in Nicotiana benthamiana confirmed that SA is processed by SlS5H in vivo. SlS5H-silenced tomato plants were generated, displaying a smaller size and early senescence, together with hypersusceptibility to the necrotrophic fungus Botrytis cinerea. In contrast, these transgenic lines exhibited an increased defence response and resistance to both CEVd and Pst infections. Alternative SA processing appears to occur for each specific pathogenic interaction to cope with SA levels. In SlS5H-silenced plants infected with CEVd, glycosylated SA was the most discriminant metabolite found. Instead, in Pst-infected transgenic plants, SA appeared to be rerouted to other phenolics such as feruloyldopamine, feruloylquinic acid, feruloylgalactarate and 2-hydroxyglutarate. CONCLUSION Using SlS5H-silenced plants as a tool to unbalance SA levels, we have studied the re-routing of SA upon CEVd and Pst infections and found that, despite the common origin and role for SA in plant pathogenesis, there appear to be different pathogen-specific, alternate homeostasis pathways.
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Affiliation(s)
- C. Payá
- Instituto de Biología Molecular y Celular de Plantas (IBMCP), Consejo Superior de Investigaciones Científicas (CSIC), Universitat Politècnica de València (UPV), Ciudad Politécnica de la Innovación (CPI) 8 E, Ingeniero Fausto Elio s/n, 46011 Valencia, Spain
| | - S. Minguillón
- Instituto de Biología Molecular y Celular de Plantas (IBMCP), Consejo Superior de Investigaciones Científicas (CSIC), Universitat Politècnica de València (UPV), Ciudad Politécnica de la Innovación (CPI) 8 E, Ingeniero Fausto Elio s/n, 46011 Valencia, Spain
| | - M. Hernández
- Instituto de Biología Molecular y Celular de Plantas (IBMCP), Consejo Superior de Investigaciones Científicas (CSIC), Universitat Politècnica de València (UPV), Ciudad Politécnica de la Innovación (CPI) 8 E, Ingeniero Fausto Elio s/n, 46011 Valencia, Spain
| | - S. M. Miguel
- Instituto de Biología Molecular y Celular de Plantas (IBMCP), Consejo Superior de Investigaciones Científicas (CSIC), Universitat Politècnica de València (UPV), Ciudad Politécnica de la Innovación (CPI) 8 E, Ingeniero Fausto Elio s/n, 46011 Valencia, Spain
| | - L. Campos
- Instituto de Biología Molecular y Celular de Plantas (IBMCP), Consejo Superior de Investigaciones Científicas (CSIC), Universitat Politècnica de València (UPV), Ciudad Politécnica de la Innovación (CPI) 8 E, Ingeniero Fausto Elio s/n, 46011 Valencia, Spain
| | - I. Rodrigo
- Instituto de Biología Molecular y Celular de Plantas (IBMCP), Consejo Superior de Investigaciones Científicas (CSIC), Universitat Politècnica de València (UPV), Ciudad Politécnica de la Innovación (CPI) 8 E, Ingeniero Fausto Elio s/n, 46011 Valencia, Spain
| | - J. M. Bellés
- Instituto de Biología Molecular y Celular de Plantas (IBMCP), Consejo Superior de Investigaciones Científicas (CSIC), Universitat Politècnica de València (UPV), Ciudad Politécnica de la Innovación (CPI) 8 E, Ingeniero Fausto Elio s/n, 46011 Valencia, Spain
| | - M. P. López-Gresa
- Instituto de Biología Molecular y Celular de Plantas (IBMCP), Consejo Superior de Investigaciones Científicas (CSIC), Universitat Politècnica de València (UPV), Ciudad Politécnica de la Innovación (CPI) 8 E, Ingeniero Fausto Elio s/n, 46011 Valencia, Spain
| | - P. Lisón
- Instituto de Biología Molecular y Celular de Plantas (IBMCP), Consejo Superior de Investigaciones Científicas (CSIC), Universitat Politècnica de València (UPV), Ciudad Politécnica de la Innovación (CPI) 8 E, Ingeniero Fausto Elio s/n, 46011 Valencia, Spain
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Campos L, Barreto JV, Bassetti S, Bivol M, Burbridge A, Castellino P, Correia JA, Durusu-Tanriöver M, Fierbinteanu-Braticevici C, Hanslik T, Heleniak Z, Hojs R, Lazebnic L, Mylona M, Raspe M, Melo JQE, Pietrantonio F, Gans R, Pálsson R, Montano N, Gómez-Huelgas R, Dicker D. Physicians' responsibility toward environmental degradation and climate change: A position paper of the European Federation of Internal Medicine. Eur J Intern Med 2022; 104:55-58. [PMID: 36055953 DOI: 10.1016/j.ejim.2022.08.001] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/31/2022] [Accepted: 08/02/2022] [Indexed: 11/16/2022]
Abstract
The current data on climate change and environmental degradation are dramatic. The consequences of these changes are already having a significant impact on people's health. Physicians - as advocates of the patients, but also as citizens - have an ethical obligation to be involved in efforts to stop these changes. The European Federation of Internal Medicine (EFIM) strongly encourages the Internal Medicine societies and internists across Europe to play an active role in matters related to climate change and environmental degradation. At a national level, this includes advocating the adoption of measures that reduce greenhouse gas (GHG) emissions and environmental degradation and contributing to policy decisions related to these issues. At a hospital level and in clinical practice, supporting actions by the health sector to reduce its ecological footprint is vital. At the level of EFIM and its associated internal societies, promoting educational activities and developing a toolkit to prepare internists to better care for citizens who suffer from the consequences of climate change. In addition to advocating and implementing effective actions to reduce the ecological footprint of the health industry, recommending the introduction of these themes in scientific programs of Internal Medicine meetings and congresses and the pre- and postgraduate medical training. At a personal level, internists must be active agents in advocating sustainable practices for the environment, increasing the awareness of the community about the health risks of climate change and environmental degradation, and being role models in the adoption of environmentally friendly behaviour.
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Affiliation(s)
- Luís Campos
- Department of Internal Medicine, Hospital CUF Tejo, Lisbon, Portugal.
| | - J Vasco Barreto
- Internal Medicine Service, Medicine Department, Hospital Pedro Hispano, School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal
| | - Stefano Bassetti
- Division of Internal Medicine, University Hospital Basel, Basel, Switzerland
| | - Monica Bivol
- Medical Division, Akershus University Hospital, Lorenskog, Norway
| | - Amie Burbridge
- Acute Medicine Department, University Hospitals Coventry and Warwickshire, Coventry, United Kingdom
| | - Pietro Castellino
- Department of Internal Medicine, University of Catania, Catania, Italy
| | - João Araújo Correia
- Serviço de Medicina Interna, Centro Hospitalar e Universitário do Porto, Porto, Portugal
| | - Mine Durusu-Tanriöver
- Department of General Internal Medicine, Hacettepe University Hospital, Ankara, Turkey
| | - Carmen Fierbinteanu-Braticevici
- "Carol Davila" University of Medicine and Pharmacy Bucharest, Medical Clinic II and Gastroenterology, Department of Gastroenterology, University Hospital Bucharest, Bucharest, Romania
| | - Thomas Hanslik
- Service de Médecine Interne, Hôpital Ambroise Paré, Boulogne Billancourt, France
| | - Zbigniew Heleniak
- Department of Nephrology, Transplantology and Internal Medicine, Medical, University of Gdansk, Gdansk, Poland
| | - Radovan Hojs
- Clinic for Internal Medicine, University Clinical Centre Maribor, Faculty of Medicine, University of Maribor, Maribor, Slovenia
| | - Leonid Lazebnic
- The Moscow State University of Medicine and Dentistry, Moscow, Russian Federation
| | - Maria Mylona
- 1st Department of Propaedeutic & Internal Medicine, Laiko General Hospital, Athens University Medical School, Athens, Greece
| | - Matthias Raspe
- Department of Internal Medicine, Infectious Diseases and Respiratory Medicine, Charité - Universitaetsmedizin Berlin, Berlin, Germany
| | | | | | - Reinold Gans
- Internal Medicine Department, University Medical Center, Groningen, The Netherlands
| | - Runólfur Pálsson
- Landspitali-The National University Hospital of Iceland and University of Iceland, Reykjavik, Iceland
| | - Nicola Montano
- University of Milan, UNIMI - Department of Clinical Sciences and Community Health, Milan, Italy
| | - Ricardo Gómez-Huelgas
- Department of Internal Medicine, Regional University Hospital of Málaga, Biomedical Research Institute of Málaga, University of Málaga, Málaga, Spain
| | - Dror Dicker
- Internal Medicine D and Obesity Clinic, Hasharon Hospital, Rabin Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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Campos L, Jahangiri Y, Farsad K. Abstract No. 189 Muscle and fat composition changes in cirrhotic patients after portosystemic shunt creation as predictors of survival. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Costa LL, de Matos AN, Almeida P, Teles P, Loureiro L, Campos L, Delgado E, Oliveira D, Campos T, Inácio M, Fernandes F, Coutinho S, Ventura A, Pereira S, Castro A, Xavier E, Sousa CN. Radio-cephalic fistula recovered with drainage to median basilic vein by straightening of the forearm cephalic vein: A case report. Semin Dial 2022; 35:544-547. [PMID: 35608251 DOI: 10.1111/sdi.13096] [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] [Received: 01/23/2022] [Accepted: 05/05/2022] [Indexed: 11/30/2022]
Abstract
The distal arteriovenous fistula (AVF) has less complications and better patency than the proximal fistula, when it works properly. The complications of outflow of the fistula are complex, and it is necessary to analyze all solutions to solve the problem. We introduce a novel approach to solve outflow problems of a radio-cephalic AVF by straightening of the forearm cephalic vein with drainage into the median basilic vein.
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Affiliation(s)
- Luísa Lemos Costa
- Nephrology Department, Centro Hospitalar Viseu e Tondela, Viseu, Portugal.,Vascular Access Center (Grupo Estudos Vasculares-GEV), Porto, Portugal
| | | | - Paulo Almeida
- Vascular Access Center (Grupo Estudos Vasculares-GEV), Porto, Portugal.,Angiology and Vascular Surgery Departament, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Paulo Teles
- School of Economics and LIAAD-INESC Porto LA, Porto University, Porto, Portugal
| | - Luís Loureiro
- Vascular Access Center (Grupo Estudos Vasculares-GEV), Porto, Portugal.,Angiology and Vascular Surgery Departament, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | | | | | | | | | | | | | | | | | | | - Ana Castro
- S Francisco Dialysis Unit, Porto, Portugal
| | - Eva Xavier
- S Francisco Dialysis Unit, Porto, Portugal
| | - Clemente Neves Sousa
- Vascular Access Center (Grupo Estudos Vasculares-GEV), Porto, Portugal.,S Francisco Dialysis Unit, Porto, Portugal.,Nursing School of Porto, Porto, Portugal.,Faculty of Medicine, CINTESIS-Center for Health Technology and Services Research, University of Porto, Porto, Portugal
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Domínguez Conde C, Xu C, Jarvis LB, Rainbow DB, Wells SB, Gomes T, Howlett SK, Suchanek O, Polanski K, King HW, Mamanova L, Huang N, Szabo PA, Richardson L, Bolt L, Fasouli ES, Mahbubani KT, Prete M, Tuck L, Richoz N, Tuong ZK, Campos L, Mousa HS, Needham EJ, Pritchard S, Li T, Elmentaite R, Park J, Rahmani E, Chen D, Menon DK, Bayraktar OA, James LK, Meyer KB, Yosef N, Clatworthy MR, Sims PA, Farber DL, Saeb-Parsy K, Jones JL, Teichmann SA. Cross-tissue immune cell analysis reveals tissue-specific features in humans. Science 2022; 376:eabl5197. [PMID: 35549406 PMCID: PMC7612735 DOI: 10.1126/science.abl5197] [Citation(s) in RCA: 191] [Impact Index Per Article: 95.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Despite their crucial role in health and disease, our knowledge of immune cells within human tissues remains limited. We surveyed the immune compartment of 16 tissues from 12 adult donors by single-cell RNA sequencing and VDJ sequencing generating a dataset of ~360,000 cells. To systematically resolve immune cell heterogeneity across tissues, we developed CellTypist, a machine learning tool for rapid and precise cell type annotation. Using this approach, combined with detailed curation, we determined the tissue distribution of finely phenotyped immune cell types, revealing hitherto unappreciated tissue-specific features and clonal architecture of T and B cells. Our multitissue approach lays the foundation for identifying highly resolved immune cell types by leveraging a common reference dataset, tissue-integrated expression analysis, and antigen receptor sequencing.
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Affiliation(s)
- C Domínguez Conde
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge CB10 1SA, UK
| | - C Xu
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge CB10 1SA, UK
| | - LB Jarvis
- Department of Clinical Neurosciences, University of Cambridge
| | - DB Rainbow
- Department of Clinical Neurosciences, University of Cambridge
| | - SB Wells
- Department of Systems Biology, Columbia University Irving Medical Center
| | - T Gomes
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge CB10 1SA, UK
| | - SK Howlett
- Department of Clinical Neurosciences, University of Cambridge
| | - O Suchanek
- Molecular Immunity Unit, Department of Medicine, University of Cambridge, Cambridge, UK
| | - K Polanski
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge CB10 1SA, UK
| | - HW King
- Centre for Immunobiology, Blizard Institute, Queen Mary University of London, London, UK
| | - L Mamanova
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge CB10 1SA, UK
| | - N Huang
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge CB10 1SA, UK
| | - PA Szabo
- Department of Microbiology and Immunology, Columbia University Irving Medical Center
| | - L Richardson
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge CB10 1SA, UK
| | - L Bolt
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge CB10 1SA, UK
| | - ES Fasouli
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge CB10 1SA, UK
| | - KT Mahbubani
- Department of Surgery, University of Cambridge and NIHR Cambridge Biomedical Research Centre, Cambridge, UK
| | - M Prete
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge CB10 1SA, UK
| | - L Tuck
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge CB10 1SA, UK
| | - N Richoz
- Molecular Immunity Unit, Department of Medicine, University of Cambridge, Cambridge, UK
| | - ZK Tuong
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge CB10 1SA, UK
- Molecular Immunity Unit, Department of Medicine, University of Cambridge, Cambridge, UK
| | - L Campos
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge CB10 1SA, UK
- West Suffolk Hospital NHS Trust, Bury Saint Edmunds, UK
| | - HS Mousa
- Department of Clinical Neurosciences, University of Cambridge
| | - EJ Needham
- Department of Clinical Neurosciences, University of Cambridge
| | - S Pritchard
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge CB10 1SA, UK
| | - T Li
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge CB10 1SA, UK
| | - R Elmentaite
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge CB10 1SA, UK
| | - J Park
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge CB10 1SA, UK
| | - E Rahmani
- Center for Computational Biology, University of California, Berkeley, Berkeley, CA, USA
- Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, Berkeley, CA, USA
| | - D Chen
- Department of Systems Biology, Columbia University Irving Medical Center
| | - DK Menon
- Department of Anaesthesia, University of Cambridge, Cambridge, UK
| | - OA Bayraktar
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge CB10 1SA, UK
| | - LK James
- Centre for Immunobiology, Blizard Institute, Queen Mary University of London, London, UK
| | - KB Meyer
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge CB10 1SA, UK
| | - N Yosef
- Center for Computational Biology, University of California, Berkeley, Berkeley, CA, USA
- Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, Berkeley, CA, USA
- Chan Zuckerberg Biohub, San Francisco, CA, USA
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA, USA
| | - MR Clatworthy
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge CB10 1SA, UK
- Molecular Immunity Unit, Department of Medicine, University of Cambridge, Cambridge, UK
| | - PA Sims
- Department of Systems Biology, Columbia University Irving Medical Center
| | - DL Farber
- Department of Microbiology and Immunology, Columbia University Irving Medical Center
| | - K Saeb-Parsy
- Department of Surgery, University of Cambridge and NIHR Cambridge Biomedical Research Centre, Cambridge, UK
| | - JL Jones
- Department of Clinical Neurosciences, University of Cambridge
| | - SA Teichmann
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge CB10 1SA, UK
- Theory of Condensed Matter, Cavendish Laboratory, Department of Physics, University of Cambridge, JJ Thomson Ave, Cambridge CB3 0HE, UK
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Maltês S, Chambino B, Campos L. A Curious Case of Dysphagia Due to Osteophytes. ACTA MEDICA PORT 2022; 35:222-223. [PMID: 34100355 DOI: 10.20344/amp.14786] [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: 08/25/2020] [Revised: 03/10/2021] [Accepted: 02/26/2021] [Indexed: 11/20/2022]
Affiliation(s)
- Sérgio Maltês
- Cardiology Department. Hospital de Santa Cruz. Centro Hospitalar Lisboa Ocidental. Lisbon. Portugal
| | - Beatriz Chambino
- Departamento de Medicina Interna. Hospital de São Francisco Xavier. Centro Hospitalar Lisboa Ocidental. Lisboa. Portugal
| | - Luís Campos
- Departamento de Medicina Interna. Hospital de São Francisco Xavier. Centro Hospitalar Lisboa Ocidental. Lisboa. NOVA Medical School, Faculdade de Ciências Médicas. Universidade Nova de Lisboa. Lisbon. Portugal
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Sousa CN, Teles P, Paquete ARC, Dias VFF, Manzini CSS, Nicole AG, Sousa RASS, de Souza LH, Ribeiro OMPL, Lira MN, de Queiroz Frazão CMF, Ramos VP, Leal L, Ribeiro RCHM, Magalhães ALP, de Sá Basílio Lins SM, Mendonça AEO, Delgado MF, Pressi MMT, Pressi NT, Campos L, Ozen N. Effects of Demographic and Clinical Character on Differences in Self-care Behaviour Levels with Arteriovenous Fistula by Haemodialysis Patients: An Ordinal Logistic Regression Approach. Ther Apher Dial 2022; 26:992-998. [PMID: 34981641 DOI: 10.1111/1744-9987.13788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 12/07/2021] [Accepted: 12/29/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Haemodialysis (HD) patients should be trained to develop self-care behaviors in order to prevent and preserve their arteriovenous fistula (AVF). The aim of this study was identifying the factors that affect the levels of self-care behavior with AVF by HD patients. METHODS A cross-sectional study was conducted involving 89 patients. RESULTS Self-care levels were negatively affected by patients' location (Azores) and positively affected by marital status, education, employment, AVF duration and absence of complications with the AVF. Concerning the management of signs and symptoms, self-care levels were negatively affected by patients' location. Regarding prevention of complications, self-care levels were negatively affected by age and marital status and positively affected by marital status, employment, CKD etiology, AVF duration and previous AVF. CONCLUSION Further studies are required in order to confirm whether the considered factors affect levels of self-care behaviors with AVF, or whether other factors are needed as well.
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Affiliation(s)
- Clemente Neves Sousa
- CINTESIS - Center for Health Technology and Services Research Faculty of Medicine, Porto University.,Nursing School of Porto, Porto, Portugal
| | - Paulo Teles
- School of Economics and LIAAD-INESC Porto LA, Porto University, Porto, Portugal
| | | | | | | | | | | | | | - Olga Maria Pimenta Lopes Ribeiro
- CINTESIS - Center for Health Technology and Services Research Faculty of Medicine, Porto University.,Nursing School of Porto, Porto, Portugal
| | | | | | | | - Luciana Leal
- Federal University of Pernambuco, Recife, Brazil
| | | | | | | | | | | | | | | | | | - Nurten Ozen
- Florence Nightingale Hospital School of Nursing, Demiroglu Bilim University, Istanbul, Turkey
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Antunes A, Gomes B, Campos L, Coelho M, Lopes S. Emergency department and hospital utilisation and expenditures in the last year of life: retrospective chronic diseases cohort study. BMJ Support Palliat Care 2021:bmjspcare-2021-003103. [PMID: 34819328 DOI: 10.1136/bmjspcare-2021-003103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 11/04/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We aimed to examine the influence of chronic diseases in emergency department (ED) and inpatient utilisation and expenditures in the 12 months before death. METHODS Retrospective cohort study of ED and inpatient database. Adults deceased at a hospital in Portugal in 2013 were included. We tested the influence of chronic diseases on the number of ED visits, hospital admissions and expenditures using generalised linear models. RESULTS The study included 484 patients (81.8% ≥65 years, median two chronic diseases). Nearly all (91.3%) attended the ED in the 12 months before death. The median number of admissions was 1, median expenditure was €6159. Adjusting for confounders, chronic pulmonary disease increased ED and inpatient utilisation (1.49; 95% CI: 1.22 to 1.83; 95% CI 1.29, 1.09 to 1.51). Increased ED utilisation was observed for patients with renal disease, dementia and metastatic solid tumour (1.40, 95% CI 1.15 to 1.71; 1.39, 95% CI 1.11 to 1.75; 1.31, 95% CI 1.07 to 1.60). Other malignancies showed increased inpatient utilisation (1.24, 95% CI 1.09 to 1.42). The number of chronic conditions had a considerable effect on expenditures (3: 2.08, 95% CI 1.44 to 2.99; ≥4: 4.02, 95% CI 2.51 to 6.45). CONCLUSION We found a high use of hospitals at the end of life, particularly EDs. Our findings suggest that people with cancer, renal disease, chronic pulmonary disease and dementia are relevant when developing cost-effective alternatives to hospital care.
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Affiliation(s)
- Ana Antunes
- NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Barbara Gomes
- Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal
- Department of Palliative Care, Policy and Rehabilitation, Cicely Saunders Institute of Palliative Care and Rehabilitation, London, UK
| | - Luís Campos
- Serviço de Medicina do Hospital São Francisco Xavier, Centro Hospitalar de Lisboa Ocidental EPE, Lisboa, Portugal
- NOVA Medical School, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Miguel Coelho
- NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Sílvia Lopes
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal
- Comprehensive Health Research Centre, Universidade NOVA de Lisboa, Lisboa, Portugal
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16
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Conde-Taboada A, Iglesias-Puzas Á, Sirgado A, Campos L, Serrano I, López-Bran E. Influence of COVID-19 confinement on the size of malignant skin tumours surgically removed at a Spanish hospital. Clin Exp Dermatol 2021; 47:578-580. [PMID: 34610172 PMCID: PMC8653350 DOI: 10.1111/ced.14957] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 10/04/2021] [Accepted: 10/04/2021] [Indexed: 11/26/2022]
Abstract
The COVID‐19 pandemic required people to confine themselves to their homes where possible, and disrupted normal hospital activities. We examine whether this lockdown generated changes in the size of the tumours. We compared the dimensions of the surgically removed malignant skin tumours from the first 150 patients treated after the confinement ended in Spain (22 May 2020) with those of the last 150 patients to receive such treatment before the confinement began (13 March 2020). Data on tumour surface area were collected from pathology reports. Overall, no significant difference was seen in the tumour sizes. However, among men, the tumours removed after confinement were significantly larger (P < 0.05). Controversy exists over how the reduction in the number of tumours diagnosed during lockdowns might have influenced the characteristics of tumours. In this study, no overall difference was seen in the size of the tumours removed, although those removed from men after confinement were larger.
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Affiliation(s)
- A Conde-Taboada
- Department of Dermatology, Hospital Clínico San Carlos, Madrid, Spain
| | - Á Iglesias-Puzas
- Department of Dermatology, Hospital Clínico San Carlos, Madrid, Spain
| | - A Sirgado
- Department of Dermatology, Hospital Clínico San Carlos, Madrid, Spain
| | - L Campos
- Department of Dermatology, Hospital Clínico San Carlos, Madrid, Spain
| | - I Serrano
- Methodological Support Unit for Research, Hospital Clínico San Carlos, Madrid, Spain
| | - E López-Bran
- Department of Dermatology, Hospital Clínico San Carlos, Madrid, Spain
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17
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Camolesi GC, Ortega KL, Medina JB, Campos L, Lorenzo Pouso AI, Gándara Vila P, Pérez Sayáns M. Therapeutic alternatives in the management of osteoradionecrosis of the jaws. Systematic review. Med Oral Patol Oral Cir Bucal 2021; 26:e195-e207. [PMID: 33037800 PMCID: PMC7980297 DOI: 10.4317/medoral.24132] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 07/03/2020] [Accepted: 09/28/2020] [Indexed: 01/11/2023] Open
Abstract
Background to systematically review the literature, comparing the healing of osteoradionecrosis (ORN) among the therapeutic alternatives: surgical, pharmacological and combined.
Material and Methods The review was organized according to the PRISMA protocol with regards to the following PICO question: patients with ORN of the jaws (P=Patient); all interventions reported (I = intervention); between all therapies (C=Comparison); healing of lesions (O=outcome).
Results Surgical treatment was the most common choice (46.3%) followed by pharmacological treatment, exclusively (25.9%) or combined (26.9%). Treatment exclusively by surgical intervention seems to be most effective option, with 51.2% of the lesions healed, OR for healing of 5.7 (CI95% 1.9-16.9, p=0.002). Only 1 case (0.9%) corresponded to low level laser therapy.
Conclusions It seems clear that early intervention with conservative surgical combined with pharmacological methods improves the prognosis of ORN. Key words:Osteoradionecrosis, radiotherapy bone necrosis, hyperbaric oxygen, pentoxifylline, teriparatide, low level laser therapy.
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Affiliation(s)
- G-C Camolesi
- Entrerríos s/n, Santiago de Compostela C.P. 15782, Spain +
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18
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Costa-Martins I, Carreteiro J, Santos A, Costa-Martins M, Artilheiro V, Duque S, Campos L, Chedas M. Post-operative delirium in older hip fracture patients: a new onset or was it already there? Eur Geriatr Med 2021; 12:777-785. [PMID: 33569717 DOI: 10.1007/s41999-021-00456-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 01/20/2021] [Indexed: 12/16/2022]
Abstract
PURPOSE Hip fractures are a worldwide health issue primarily for older patients, conditioning major morbidity and mortality. An experienced multidisciplinary team is essential to manage surgery and peri-operative implications, to enable rapid functional and cognitive recovery. Delirium is a recognizable problem associated with negative outcomes. Our study aims to determine the influence of pre-operative delirium in the incidence of post-operative delirium, and to evaluate the association between other known peri-operative risk factors with both conditions. METHODS A single-center, retrospective cohort study, conducted at a Level II trauma center over a 14-month period, included 241 patients with 65 years of age or older submitted to hip fracture surgery. Peri-operative data were gathered regarding baseline characteristics (sociodemographic, functional and cognitive status), intra-operative events (anesthesia technique, surgery duration, blood loss) and post-operative outcomes (delirium occurrence). RESULTS Statistical analysis evidenced a female (75.5%) and elderly population (83.9 ± 7.8 years old) with significant comorbidities (cognitive impairment in 51.9%, ASA ≥ III in 79.7%, mean CIRS-G 8.83 ± 4.69) that underwent surgical fracture repair, mostly under 4 h (96.3%) and under regional anesthesia (63.1%). Pre- and post-operative delirium incidence was 18.3% and 12.9%, respectively, displaying increased presence according to cognitive impairment severity. CONCLUSION Post-operative delirium was almost inexistent when it was absent pre-operatively. Moreover, pre-operative cognitive status was associated with the development of pre- and post-operative delirium. Careful cognitive assessment, implementation of preventive strategies and avoidance of peri-operative pro-delirium factors are crucial for comprehensive geriatric care.
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Affiliation(s)
- Isabel Costa-Martins
- Anaesthesiology Department, Centro Hospitalar de Lisboa Ocidental, Estrada do Forte do Alto do Duque, 1449-005, Lisbon, Portugal.
| | - Joana Carreteiro
- Anaesthesiology Department, Centro Hospitalar de Lisboa Ocidental, Estrada do Forte do Alto do Duque, 1449-005, Lisbon, Portugal
| | - Ana Santos
- Internal Medicine Department, Centro Hospitalar de Lisboa Ocidental, Estrada do Forte do Alto do Duque, 1449-005, Lisbon, Portugal
| | - Mariana Costa-Martins
- Clinical Psychologist, Rua Major Neutel de Abreu, nr 13, 10° A, 1500-409, Lisbon, Portugal
| | - Vanessa Artilheiro
- Anaesthesiology Department, Centro Hospitalar de Lisboa Ocidental, Estrada do Forte do Alto do Duque, 1449-005, Lisbon, Portugal
| | - Sofia Duque
- Orthogeriatric Unit, Internal Medicine Department, Centro Hospitalar de Lisboa Ocidental, Estrada do Forte do Alto do Duque, 1449-005, Lisbon, Portugal
| | - Luís Campos
- Internal Medicine Department, Centro Hospitalar de Lisboa Ocidental, Estrada do Forte do Alto do Duque, 1449-005, Lisbon, Portugal
| | - Manuel Chedas
- Anaesthesiology Department, Centro Hospitalar de Lisboa Ocidental, Estrada do Forte do Alto do Duque, 1449-005, Lisbon, Portugal
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Huang X, Yoder PS, Campos L, Huang E, Hanigan MD. A method of assessing essential amino acid availability from microbial and ruminally undegraded protein in lactating dairy cows. J Dairy Sci 2020; 104:1777-1793. [PMID: 33309365 DOI: 10.3168/jds.2020-18248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 09/10/2020] [Indexed: 11/19/2022]
Abstract
The objective of this study was to extend a stable isotope-based assessment of AA absorption from rumen-degradable protein (RDP) sources to include determination of essential AA (EAA) availability from microbial protein (MCP). To demonstrate the technique, a study using a 2 × 2 factorial arrangement of treatments applied in a repeated 4 × 4 Latin square design was undertaken. Factors were high and low rumen-degradable protein and high and low starch. Twelve lactating cows were blocked into 3 groups according to days in milk and randomly assigned to the 4 treatment sequences. Each period was 14 d in length with 10 d of adaption followed by 4 d of ruminal infusions of 15N-labeled ammonium sulfate. On the last day of each period, a 13C-labeled AA mixture was infused into the jugular vein over a 6-h period to assess total AA entry. Rumen, blood, urine, and milk samples were collected during the infusions. Ruminal bacteria and blood samples were assessed for AA enrichment. Total plasma AA absorption rates were derived for 6 EAA from plasma 13C AA enrichment. Absorption of 6 EAA from MCP was calculated from total AA absorption based on 15N enrichment in blood and rumen bacteria. Essential AA absorption rates from total protein, MCP, and rumen-undegradable protein were derived with standard errors of the mean of 6, 14, and 14%, respectively. An average of 45% of absorbed EAA were from MCP, which varied among 6 EAA and was interactively affected by starch and RDP in diets. Microbial AA availability measured by isotope dilution method increased with the high RDP diets and was unaffected by starch level, except for Met, which decreased with high starch. Microbial protein outflow, estimated from urinary purine derivatives, increased with RDP and was not significantly affected by starch. This was consistent with measurements from the isotope dilution method. Total AA absorption rates measured from isotope dilution were similar to estimates from CNCPS (v. 6.55), but a lower proportion of absorbed AA was derived from MCP for the former method. Compared with the isotope and CNCPS estimates, the Fleming model underestimated microbial EAA and total EAA availability. An average of 58% of the absorbed EAA was converted into milk, which varied among individual AA and was interactively affected by starch and RDP in diets. The isotope dilution approach is advantageous because it provides estimates of EAA availability for individual EAA from rumen-undegradable protein and MCP directly with fewer errors of measurement than can be achieved with intestinal disappearance methods.
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Affiliation(s)
- X Huang
- Department of Dairy Science, Virginia Tech, Blacksburg 24061
| | - P S Yoder
- Department of Dairy Science, Virginia Tech, Blacksburg 24061; Perdue AgriBusiness LLC, Salisbury, MD 21804
| | - L Campos
- Department of Dairy Science, Virginia Tech, Blacksburg 24061
| | - E Huang
- Department of Dairy Science, Virginia Tech, Blacksburg 24061
| | - M D Hanigan
- Department of Dairy Science, Virginia Tech, Blacksburg 24061.
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Campos L, Mansinho K, Telles de Freitas P, Ramos V, Sakellarides C. [COVID-19 and Seasonal Flu During the Autumn-Winter of 2020/2021 and the Challenges Lying Ahead for Hospitals]. ACTA MEDICA PORT 2020; 33:716-719. [PMID: 33026314 DOI: 10.20344/amp.14818] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 09/26/2020] [Accepted: 09/28/2020] [Indexed: 11/20/2022]
Abstract
The possibility of a second wave of the COVID-19 pandemic coexisting with a simultaneous epidemic of influenza and the co-circulation of other seasonal respiratory viruses sets the stage for a perfect storm. Preparing for the Autumn-Winter of 2020/2021 is complex, requiring centralized guidance but local and regional solutions, with strong leadership and a high level of coordination. It is essential to act upstream of hospitals in order to reduce demand on emergency departments, minimizing the risk of transmission that occurs there and the team overload, as well as downstream to ensure capacity for hospitalization and in the hospital itself to optimize resources and organization. The failure of this plan will create unbearable pressure on hospital care. The authors describe the challenges lying ahead for hospitals and the most important measures that should be included in this plan to prepare the Autumn-Winter of 2020/2021 in Portugal.
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Affiliation(s)
- Luís Campos
- Hospital São Francisco Xavier. Centro Hospitalar Lisboa Ocidental. Lisboa. NOVA Medical School/Faculdade de Ciências Médicas. Lisboa. Portugal
| | - Kamal Mansinho
- Hospital São Francisco Xavier. Centro Hospitalar Lisboa Ocidental. Lisboa. NOVA Medical School/Faculdade de Ciências Médicas. Lisboa. Portugal
| | | | - Victor Ramos
- Escola Nacional de Saúde Pública. Lisboa. Portugal
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21
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Maltes S, Rocha B, Cunha G, Duarte J, Gomes R, Silverio R, Maravilha C, Presume J, Campos L, Henriques C, Rodrigues C, Araujo I, Fonseca M. Sleep apnea in heart failure: in search of a better prognosis predictor. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Sleep apnea (SA) is a burdensome and often underdiagnosed condition in heart failure (HF). Portable devices, such as ApneaLinkTM, are currently validated as a screening tool for SA. The apnea-hypopnea index (AHI) as been long considered the gold-standard measurement for the diagnosis of SA, also having a prognosis impact. Recently, however, other respiratory variables have been proposed as better prognosis predictors in patients with HF. The main goal of this study was to assess the prognostic value of other respiratory measurements evaluated by ApneaLinkTM at discharge in a population admitted for HF.
Methods
This was a single-center retrospective study enrolling consecutive patients admitted in a HF Clinic for acute HF from 2013 and 2018. All stable patients without previously known sleep-disordered breathing underwent ApneaLinkTM screening the night before discharge in the euvolemic state. Those with a total respiratory evaluation time <180 minutes or in need of supplemental oxygen were excluded. A primary endpoint of long-term HF hospitalizations was evaluated.
Results
Overall, 231 patients (mean age 74.5±10.6 years; 47% male; 83% hypertension; 41% chronic kidney disease; 44% anemia; 18% with a NYHA>2 at discharge; 43% ischaemic HF; 41% with a left ventricle ejection fraction lower than 50%) were assessed. One-hundred and sixty-nine patients (59.1%) had an AIH >15, with a median of 19 (IQR 7–42); the median number of obstructive apneas and central apneas was 13 (IQR 2–68), and 2 (IQR 0–10), respectively. Two-hundred patients (69.9%) had nocturnal periods of an oxygen saturation below 85% (T85), with a median time under that value of 8 (IQR 0–47) minutes. Over a median follow-up of 34.1 (IQR 18.40–54.37) months, 105 (45.7%) patients died and 128 (55.7%) were readmitted for AHF. After adjustment for cofounders (namely, the presence of anemia) a T85 above the 75th percentile was significantly correlated with a higher risk of HF readmission in a multivariate analysis (adjusted HR: 1.58, 95% CI: 1.08–2.30, p=0.017) (figure 1). These results were independent of the apnea-hypopnea index.
Conclusion
Nocturnal hypoxemia (T85) was an independent predictor of rehospitalization in patients with HF. These results further validate the utility and prognosis impact of other respiratory measurements (other than AHI) evaluated by ApneaLinkTM screening at discharge in a population of patients admitted for HF.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- S.F.C Maltes
- Hospital de Sao Francisco Xavier, Lisbon, Portugal
| | - B.L Rocha
- Hospital de Sao Francisco Xavier, Lisbon, Portugal
| | - G.L Cunha
- Hospital de Sao Francisco Xavier, Lisbon, Portugal
| | - J Duarte
- Hospital de Sao Francisco Xavier, Lisbon, Portugal
| | - R.V Gomes
- Hospital de Sao Francisco Xavier, Lisbon, Portugal
| | - R Silverio
- Hospital de Sao Francisco Xavier, Lisbon, Portugal
| | - C Maravilha
- Hospital de Sao Francisco Xavier, Lisbon, Portugal
| | - J.P Presume
- Hospital de Sao Francisco Xavier, Lisbon, Portugal
| | - L Campos
- Hospital de Sao Francisco Xavier, Lisbon, Portugal
| | - C Henriques
- Hospital de Sao Francisco Xavier, Lisbon, Portugal
| | | | - I Araujo
- Hospital de Sao Francisco Xavier, Lisbon, Portugal
| | - M.C Fonseca
- Hospital de Sao Francisco Xavier, Lisbon, Portugal
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Maltes S, Rocha B, Cunha G, Presume J, Campos L, Henriques C, Rodrigues C, Araujo I, Fonseca M. Dapagliflozin in a real-world population with chronic heart failure: how many would be eligible? Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
In patients with heart failure (HF) and reduced left ventricle ejection fraction (LVEF), the sodium-glucose cotransporter inhibitor (iSGLT2) dapagliflozin has recently been shown to reduce the risk of worsening heart failure or death from cardiovascular causes in the DAPA-HF trial. Results of iSGLT2 in HF with preserved LVEF are awaited. Our goal was to investigate how many patients in a real-world setting would be eligible for dapagliflozin according to the DAPA-HF criteria.
Methods
This is a single-center retrospective study enrolling consecutive patients followed in an HF Clinic from 2013 to 2019. The key DAPA-HF inclusion criteria [i.e., Left Ventricular Ejection Fraction (LVEF) <40% and NT-proBNP >600pg/mL (or >900pg/ml if AF)] and exclusion criteria [estimated glomerular filtration rate (eGFR) <30ml/kg/1.73m2, systolic blood pressure (SBP) <95mmHg] were considered.
Results
Overall, 479 patients (mean age 75.7±12.8 years; 50.4% male; 78.8% with hypertension; 45.0% with an eGFR <60ml/min/1.73m2; 36.5% with type 2 diabetes mellitus; 33.5% ischaemic HF) were assessed. Of these, 155 (33.2%) patients had LVEF <40%. Patients had a mean SBP of 131±28 mmHg, a median eGFR of 48 (IQR 33–65) ml/min/m2 and a NT-proBNP of 2183 (IQR 1010–5310) pg/mL Overall, according to the DAPA-HF trial key criteria, 88 patients (18.3%) would be eligible for dapagliflozin. The remainder would be excluded due to a LVEF>40% (67.5%), eGFR <30 ml/min/1.73m2 (19.4%), NT-proBNP <600 pg/mL (or <900 pg/mL if AF) (16.7%) and/or SBP <90mmHg (2.1%) (figure 1). If we limit the analysis to those with a LVEF <40%, 56.7% would be eligible for dapagliflozin. The remainder would be excluded due to a eGFR <30ml/kg/1.73m2 (20%), NT-proBNP <600 pg/mL (or <900 pg/mL if AF) (16.1%) and/or SBP <90mmHg (8.4%) (figure 1).
Conclusion
Roughly one in every five patients in our real-world HF cohort would be eligible to start dapagliflozin according to the key criteria of the DAPA-HF trial. The main reason for non-eligibility was a LVEF >40%. These findings highlight the urgent need for disease-modifying drugs in mid-range and preserved LVEF. The results of ongoing iSGLT2 trials in these LVEF subgroups are eagerly awaited.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- S.F.C Maltes
- Hospital de Sao Francisco Xavier, Lisbon, Portugal
| | - B.L Rocha
- Hospital de Sao Francisco Xavier, Lisbon, Portugal
| | - G.L Cunha
- Hospital de Sao Francisco Xavier, Lisbon, Portugal
| | - J.P Presume
- Hospital de Sao Francisco Xavier, Lisbon, Portugal
| | - L Campos
- Hospital de Sao Francisco Xavier, Lisbon, Portugal
| | - C Henriques
- Hospital de Sao Francisco Xavier, Lisbon, Portugal
| | | | - I Araujo
- Hospital de Sao Francisco Xavier, Lisbon, Portugal
| | - M.C Fonseca
- Hospital de Sao Francisco Xavier, Lisbon, Portugal
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Abstract
INTRODUCTION In December 2019, an outbreak of pneumonia caused by a novel coronavirus occurred in Wuhan, the capital of Central China's Hubei Province and has been declared a public health emergency of international concern by the World Health Organization since January 2020. MATERIAL AND METHODS A comprehensive search using the PubMed database was carried out to summarize the latest published information about the epidemiology, definition, pathogenesis, clinical characteristics, treatment options, prognosis and prevention of coronavirus disease 2019. DISCUSSION This new strain of coronavirus, named severe acute respiratory syndrome coronavirus 2, enters human cells that express angiotensin-converting enzyme II receptors, which exist in the respiratory, gastrointestinal and genitourinary tracts and heart, causing coronavirus disease. Transmission occurs essentially through the respiratory tract and the main symptoms are fever, cough and dyspnea. Diagnosis is based on epidemiological, clinical and imaging features and confirmed by nucleic acid testing. CONCLUSION Despite intensive research, the exact origin of the virus and pathophysiology of coronavirus disease is not yet completely known, and clinically approved vaccines and drugs that target severe acute respiratory syndrome coronavirus 2 are lacking.
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Affiliation(s)
| | - Luís Campos
- Departamento de Medicina Interna. Hospital de São Francisco Xavier. Lisboa. Portugal
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Cunha GJL, Rocha BML, Gomes RV, Ferraz M, Fernandes L, Morais R, Campos L, Araújo I, Fonseca C. Levosimendan with other inotropes or vasopressors: Should you combine them? Am J Emerg Med 2020; 38:2723-2726. [PMID: 32278570 DOI: 10.1016/j.ajem.2020.03.059] [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] [Received: 02/02/2020] [Revised: 03/25/2020] [Accepted: 03/30/2020] [Indexed: 10/24/2022] Open
Affiliation(s)
- Gonçalo J L Cunha
- Serviço de Cardiologia, Hospital de Santa Cruz, Centro Hospitalar Lisboa Ocidental, Lisboa, Portugal.
| | - Bruno M L Rocha
- Serviço de Cardiologia, Hospital de Santa Cruz, Centro Hospitalar Lisboa Ocidental, Lisboa, Portugal
| | - Rita V Gomes
- Serviço de Cardiologia, Hospital Vila Franca de Xira, Lisbon, Portugal
| | - Mário Ferraz
- Serviço de Medicina, Centro Hospitalar Universitário Lisboa Central, Lisboa, Portugal
| | - Lúcia Fernandes
- Clínica de Insuficiência Cardíaca, Hospital de São Francisco Xavier, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal
| | - Rui Morais
- Clínica de Insuficiência Cardíaca, Hospital de São Francisco Xavier, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal
| | - Luís Campos
- Clínica de Insuficiência Cardíaca, Hospital de São Francisco Xavier, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal; NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Portugal
| | - Inês Araújo
- Clínica de Insuficiência Cardíaca, Hospital de São Francisco Xavier, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal
| | - Cândida Fonseca
- Clínica de Insuficiência Cardíaca, Hospital de São Francisco Xavier, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal; NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Portugal
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Rocha ML, Cunha GC, Gomes RM, Morais R, Campos L, Araujo I, Fonseca MC. P5008Empagliflozin in a real-world chronic heart failure population. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Heart Failure (HF) is a burdensome syndrome with significant mortality, morbidity and costs. Its prognosis is further aggravated by diabetes mellitus (DM). The EMPA-REG OUTCOME trial suggested that empagliflozin significantly reduced HF hospitalizations compared to placebo in patients with DM.
Purpose
We aimed to investigate which patients with chronic HF and DM in the outpatient setting could have been enrolled in the main empagliflozin trial.
Methods
This analysis is based on a retrospective cohort enrolling chronic HF patients who consecutively attended the HF appointment between January and July 2018. Of these, those with concomitant DM were selected and further analysed. The key EMPA-REG OUTCOME trial inclusion criteria [(i.e., hemoglobin A1c 7–10%, high cardiovascular (CV) risk and glomerular filtration rate [GFR] ≥30mL/min/1,73m2) were considered. Further, the European Medicine Agency (EMA) restriction (GFR>60mL/min/1,73m2) was also considered in an additional analysis.
Results
Of 316 patients with HF, 114 (36%) concomitantly had DM. Mean age was 74±10 years, 63% were male and most (54%) had preserved left ventricular ejection fraction. Ischemic (51%) and hypertensive (27%) HF were the most often observed etiologies. According to the inclusion criteria, 21 (18.4%) (or 5.3% when further considering the EMA restriction) HF patients could have been potentially enrolled in the main trial and derive a HF hospitalization reduction benefit from starting empagliflozin. The remainder would be excluded due to GFR<30mL/min/1.73m2 (2.6%), absence of “high CV risk” as per trial's definition (7%), HbA1c off target (18,4%) or a combination of the above criteria (53.6%). In light of the new Standards of Medical Care in Diabetes 2019, controlled patients with HbA1c off target (i.e., <7% or >10%) could be switched to a SGLT2 inhibitors, hence possibly expanding the indication to start empagliflozin to 36.8% of our HF cohort.
Figure 1
Conclusions
Roughly 1 in every 5 patients with HF and DM could have been enrolled in the main empagliflozin trial, as per key inclusion criteria, and potentially derive CV benefit from it. Thus, only a minority of our cohort shared the features for EMPA-REG OUTCOME trial inclusion, limiting the extrapolation of the trial's observed CV benefits to our HF cohort. Indeed, whether these benefits also expand to overall HF cohort is eagerly awaited by ongoing trials.
Acknowledgement/Funding
None
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Affiliation(s)
- M L Rocha
- Hospital de Santa Cruz, Lisbon, Portugal
| | - G C Cunha
- Hospital de Santa Cruz, Lisbon, Portugal
| | - R M Gomes
- Hospital de Vila Franca de Xira, Cardiology, Vila Franca de Xira, Portugal
| | - R Morais
- Hospital de Sao Francisco Xavier, Internal Medicine, Lisbon, Portugal
| | - L Campos
- Hospital de Sao Francisco Xavier, Internal Medicine, Lisbon, Portugal
| | - I Araujo
- Hospital de Sao Francisco Xavier, Heart Failure Clinic, Lisbon, Portugal
| | - M C Fonseca
- Hospital de Sao Francisco Xavier, Heart Failure Clinic, Lisbon, Portugal
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Bravo C, Nuñez M, Pastor J, Moya S, Campos L, Valenzuela A, Moscoso C, Palma C, Barrientos G. Mandibular condylar hyperplasia: clinical, histopathologic and demographic consideration in a series of 13 cases, retrospective study. Int J Oral Maxillofac Surg 2019. [DOI: 10.1016/j.ijom.2019.03.851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Santos AR, Freitas P, Ferreira J, Oliveira A, Gonçalves M, Faria D, Bicho Augusto J, Simões J, Santos A, Gago M, Oliveira J, Antunes RM, Correia D, Lynce A, Brito J, Morais C, Campos L, Mendes M. Risk stratification in normotensive acute pulmonary embolism patients: focus on the intermediate-high risk subgroup. Eur Heart J Acute Cardiovasc Care 2019; 9:279-285. [PMID: 31017472 DOI: 10.1177/2048872619846506] [Citation(s) in RCA: 9] [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] [Indexed: 01/08/2023]
Abstract
BACKGROUND Patients with acute pulmonary embolism are at intermediate-high risk in the presence of imaging signs of right ventricular dysfunction plus one or more elevated cardiac biomarker. We hypothesised that intermediate-high risk patients with two elevated cardiac biomarkers and imaging signs of right ventricular dysfunction have a worse prognosis than those with one cardiac biomarker and imaging signs of right ventricular dysfunction. METHODS We analysed the cumulative presence of cardiac biomarkers and imaging signs of right ventricular dysfunction in 525 patients with intermediate risk pulmonary embolism (intermediate-high risk = 237) presenting at the emergency department in two centres. Studied endpoints were composites of all-cause mortality and/or rescue thrombolysis at 30 days (primary endpoint; n=58) and pulmonary embolism-related mortality and/or rescue thrombolysis at 30 days (secondary endpoint; n=40). RESULTS Patients who experienced the primary endpoint showed a higher proportion of elevated troponin (47% vs. 76%, P<0.001), elevated N-terminal pro-brain natriuretic peptide (67% vs. 93%, P<0.001) and imaging signs of right ventricular dysfunction (47% vs. 80%, P<0.001). Multivariate analysis revealed N-terminal pro-brain natriuretic peptide (hazard ratio (HR) 3.6, 95% confidence interval (CI) 1.3-10.3; P=0.015) and imaging signs of right ventricular dysfunction (HR 2.8, 95% CI 1.5-5.2; P=0.001) as independent predictors of events. In the intermediate-high risk group, patients with two cardiac biomarkers performed worse than those with one cardiac biomarker (HR 3.3, 95% CI 1.8-6.2; P=0.003). CONCLUSIONS Risk stratification in normotensive pulmonary embolism should consider the cumulative presence of cardiac biomarkers and imaging signs of right ventricular dysfunction, especially in the intermediate-high risk subgroup.
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Affiliation(s)
- Ana Rita Santos
- Internal Medicine Department, Hospital de São Francisco Xavier, Portugal
| | - Pedro Freitas
- Cardiology Department, Hospital de Santa Cruz, Portugal
| | | | | | | | - Daniel Faria
- Cardiology Department, Hospital Prof Doutor Fernando Fonseca, Portugal
| | | | - Joana Simões
- Cardiology Department, Hospital Prof Doutor Fernando Fonseca, Portugal
| | - Ana Santos
- Radiology Department, Centro Hospitalar Lisboa Ocidental, Portugal
| | - Miguel Gago
- Radiology Department, Centro Hospitalar Lisboa Ocidental, Portugal
| | - João Oliveira
- Radiology Department, Centro Hospitalar Lisboa Ocidental, Portugal
| | | | - David Correia
- Radiology Department, Centro Hospitalar Lisboa Ocidental, Portugal
| | - Ana Lynce
- Internal Medicine Department, Hospital de São Francisco Xavier, Portugal
| | - João Brito
- Cardiology Department, Hospital de Santa Cruz, Portugal
| | - Carlos Morais
- Cardiology Department, Hospital Prof Doutor Fernando Fonseca, Portugal
| | - Luís Campos
- Internal Medicine Department, Hospital de São Francisco Xavier, Portugal
| | - Miguel Mendes
- Cardiology Department, Hospital de Santa Cruz, Portugal
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Zapatero Gaviría A, Campos L, Gómez Huelgas R, Araújo Correia J, Díez-Manglano J, Barreto V. Internal Medicine and its future in health systems. Positioning Statement of the Spanish Society of Internal Medicine and the Portuguese Society of Internal Medicine. Rev Clin Esp 2019. [DOI: 10.1016/j.rceng.2018.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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29
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Rocha BML, Gomes RV, Cunha GJL, Mendes G, Morais R, Campos L, Araújo I, Fonseca C. Empagliflozin Targeting the Real-World Heart Failure Population. J Card Fail 2019; 25:218-219. [PMID: 30743044 DOI: 10.1016/j.cardfail.2019.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 12/28/2018] [Accepted: 02/03/2019] [Indexed: 11/18/2022]
Affiliation(s)
- Bruno M L Rocha
- Unidade de Insuficiência Cardíaca, Serviço de Medicina III, Hospital de São Francisco Xavier, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal.
| | - Rita V Gomes
- Unidade de Insuficiência Cardíaca, Serviço de Medicina III, Hospital de São Francisco Xavier, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal; Serviço de Cardiologia, Hospital Vila Franca de Xira, Lisbon, Portugal
| | - Gonçalo J L Cunha
- Unidade de Insuficiência Cardíaca, Serviço de Medicina III, Hospital de São Francisco Xavier, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal
| | - Gonçalo Mendes
- Unidade de Insuficiência Cardíaca, Serviço de Medicina III, Hospital de São Francisco Xavier, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal; Serviço de Medicina, Hospital de São Bernando, Centro Hospitalar de Setúbal, Setúbal
| | - Rui Morais
- Unidade de Insuficiência Cardíaca, Serviço de Medicina III, Hospital de São Francisco Xavier, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal
| | - L Campos
- Unidade de Insuficiência Cardíaca, Serviço de Medicina III, Hospital de São Francisco Xavier, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal; NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Inês Araújo
- Unidade de Insuficiência Cardíaca, Serviço de Medicina III, Hospital de São Francisco Xavier, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal
| | - Cândida Fonseca
- Unidade de Insuficiência Cardíaca, Serviço de Medicina III, Hospital de São Francisco Xavier, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal; NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
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30
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Gomes R, Rocha B, Cunha G, Silva B, Morais R, Araujo I, Fonseca C, Campos L. P4736Empagliflozin targeting the real-world heart failure population. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4736] [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)
- R Gomes
- Hospital São Francisco Xavier, Heart Failure Unit, Internal Medicine Department, Lisboa, Portugal
| | - B Rocha
- Hospital São Francisco Xavier, Heart Failure Unit, Internal Medicine Department, Lisboa, Portugal
| | - G Cunha
- Hospital São Francisco Xavier, Heart Failure Unit, Internal Medicine Department, Lisboa, Portugal
| | - B Silva
- Hospital São Francisco Xavier, Heart Failure Unit, Internal Medicine Department, Lisboa, Portugal
| | - R Morais
- Hospital São Francisco Xavier, Heart Failure Unit, Internal Medicine Department, Lisboa, Portugal
| | - I Araujo
- Hospital São Francisco Xavier, Heart Failure Unit, Internal Medicine Department, Lisboa, Portugal
| | - C Fonseca
- Hospital São Francisco Xavier, Heart Failure Unit, Internal Medicine Department, Lisboa, Portugal
| | - L Campos
- Hospital São Francisco Xavier, Heart Failure Unit, Internal Medicine Department, Lisboa, Portugal
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31
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Freitas P, Santos AR, Ferreira A, Oliveira A, Goncalves M, Corte-Real A, Lameiras AC, Mauricio J, Matos C, Faria D, Ferreira I, Pedroso A, Morais C, Campos L, Mendes M. 2161Derivation and external validation of a new score to predict pulmonary embolism related mortality and/or thrombolysis at 30-days. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.2161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- P Freitas
- Hospital de Santa Cruz, Cardiology, Lisbon, Portugal
| | - A R Santos
- Hospital de Sao Francisco Xavier, Internal Medicine, Lisbon, Portugal
| | - A Ferreira
- Hospital de Santa Cruz, Cardiology, Lisbon, Portugal
| | - A Oliveira
- Hospital de Santa Cruz, Cardiology, Lisbon, Portugal
| | - M Goncalves
- Hospital de Santa Cruz, Cardiology, Lisbon, Portugal
| | - A Corte-Real
- Hospital Prof Fernando da Fonseca EPE, Internal Medicine III, Amadora, Portugal
| | - A C Lameiras
- Hospital Prof Fernando da Fonseca EPE, Internal Medicine III, Amadora, Portugal
| | - J Mauricio
- Hospital Prof Fernando da Fonseca EPE, Internal Medicine III, Amadora, Portugal
| | - C Matos
- Hospital Prof Fernando da Fonseca EPE, Internal Medicine III, Amadora, Portugal
| | - D Faria
- Hospital Prof Fernando da Fonseca EPE, Cardiology, Amadora, Portugal
| | - I Ferreira
- Hospital de Sao Francisco Xavier, Internal Medicine, Lisbon, Portugal
| | - A Pedroso
- Hospital de Sao Francisco Xavier, Internal Medicine, Lisbon, Portugal
| | - C Morais
- Hospital Prof Fernando da Fonseca EPE, Cardiology, Amadora, Portugal
| | - L Campos
- Hospital de Sao Francisco Xavier, Internal Medicine, Lisbon, Portugal
| | - M Mendes
- Hospital de Santa Cruz, Cardiology, Lisbon, Portugal
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Vilela EM, Ladeiras-Lopes R, Passos Silva M, Ruivo C, Miranda F, Campos L, Joao A, Torres S, Fonseca M, Ribeiro J, Braga P, Fontes-Carvalho R, Primo J, Teixeira M, Gama V. 57Impact of cardiac rehabilitation programs among myocardial infarction survivors not undergoing revascularization. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- E M Vilela
- Hospital Center of Vila Nova de Gaia/Espinho, Cardiology, Vila Nova de Gaia, Portugal
| | - R Ladeiras-Lopes
- Hospital Center of Vila Nova de Gaia/Espinho, Cardiology, Vila Nova de Gaia, Portugal
| | - M Passos Silva
- Hospital Center of Vila Nova de Gaia/Espinho, Cardiology, Vila Nova de Gaia, Portugal
| | - C Ruivo
- Hospital Santo Andre, Cardiology, Leiria, Portugal
| | - F Miranda
- Hospital Center of Vila Nova de Gaia/Espinho, Department of Physical and Rehabilitation Medicine, Vila Nova de Gaia, Portugal
| | - L Campos
- Hospital Center of Vila Nova de Gaia/Espinho, Department of Physical and Rehabilitation Medicine, Vila Nova de Gaia, Portugal
| | - A Joao
- Hospital Center of Vila Nova de Gaia/Espinho, Cardiology, Vila Nova de Gaia, Portugal
| | - S Torres
- Hospital Center of Vila Nova de Gaia/Espinho, Cardiology, Vila Nova de Gaia, Portugal
| | - M Fonseca
- Hospital Center of Vila Nova de Gaia/Espinho, Cardiology, Vila Nova de Gaia, Portugal
| | - J Ribeiro
- Hospital Center of Vila Nova de Gaia/Espinho, Cardiology, Vila Nova de Gaia, Portugal
| | - P Braga
- Hospital Center of Vila Nova de Gaia/Espinho, Cardiology, Vila Nova de Gaia, Portugal
| | - R Fontes-Carvalho
- Hospital Center of Vila Nova de Gaia/Espinho, Cardiology, Vila Nova de Gaia, Portugal
| | - J Primo
- Hospital Center of Vila Nova de Gaia/Espinho, Cardiology, Vila Nova de Gaia, Portugal
| | - M Teixeira
- Hospital Center of Vila Nova de Gaia/Espinho, Cardiology, Vila Nova de Gaia, Portugal
| | - V Gama
- Hospital Center of Vila Nova de Gaia/Espinho, Cardiology, Vila Nova de Gaia, Portugal
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Campos L, Pedro V, Couto F. Impact of translation on named-entity recognition in radiology texts. Database (Oxford) 2018; 2017:4097790. [PMID: 29220455 PMCID: PMC5737072 DOI: 10.1093/database/bax064] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 08/03/2017] [Indexed: 11/17/2022]
Abstract
Radiology reports describe the results of radiography procedures and have the potential of being a useful source of information which can bring benefits to health care systems around the world. One way to automatically extract information from the reports is by using Text Mining tools. The problem is that these tools are mostly developed for English and reports are usually written in the native language of the radiologist, which is not necessarily English. This creates an obstacle to the sharing of Radiology information between different communities. This work explores the solution of translating the reports to English before applying the Text Mining tools, probing the question of what translation approach should be used. We created MRRAD (Multilingual Radiology Research Articles Dataset), a parallel corpus of Portuguese research articles related to Radiology and a number of alternative translations (human, automatic and semi-automatic) to English. This is a novel corpus which can be used to move forward the research on this topic. Using MRRAD we studied which kind of automatic or semi-automatic translation approach is more effective on the Named-entity recognition task of finding RadLex terms in the English version of the articles. Considering the terms extracted from human translations as our gold standard, we calculated how similar to this standard were the terms extracted using other translations. We found that a completely automatic translation approach using Google leads to F-scores (between 0.861 and 0.868, depending on the extraction approach) similar to the ones obtained through a more expensive semi-automatic translation approach using Unbabel (between 0.862 and 0.870). To better understand the results we also performed a qualitative analysis of the type of errors found in the automatic and semi-automatic translations. Database URL:https://github.com/lasigeBioTM/MRRAD
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Affiliation(s)
- Luís Campos
- LASIGE, Departamento de Informática, Faculdade de Ciências, Universidade de Lisboa, 1749-016 Lisboa, Portugal
| | - Vasco Pedro
- Unbabel Lda, Rua Visconde de Santarém, 67-B, 1000-286 Lisboa, Portugal
| | - Francisco Couto
- LASIGE, Departamento de Informática, Faculdade de Ciências, Universidade de Lisboa, 1749-016 Lisboa, Portugal
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Campos L, Caldas J, De Nardi S, Hackner I, Dos Santos C, Barros N. 500 Sexual dysfunction in women with locally advanced or metastatic cancer – a cross sectional study. J Sex Med 2018. [DOI: 10.1016/j.jsxm.2018.04.406] [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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Talledo-Ulfe L, Buitrago O, Filorio Y, Casanova F, Campos L, Cortés F, Mejia C. Factors associated with uninvestigated dyspepsia in students at 4 Latin American schools of medicine: A multicenter study. Revista de Gastroenterología de México (English Edition) 2018. [DOI: 10.1016/j.rgmxen.2017.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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36
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Talledo-Ulfe L, Buitrago OD, Filorio Y, Casanova F, Campos L, Cortés F, Mejia CR. Factors associated with uninvestigated dyspepsia in students at 4 Latin American schools of medicine: A multicenter study. Rev Gastroenterol Mex (Engl Ed) 2018; 83:215-222. [PMID: 29706421 DOI: 10.1016/j.rgmx.2017.05.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 04/25/2017] [Accepted: 05/31/2017] [Indexed: 12/19/2022]
Abstract
INTRODUCTION AND AIMS Dyspepsia is a multifactorial disease that can involve alcohol, tobacco, or nonsteroidal anti-inflammatory drug use, as well as lifestyle, diet, socioeconomic elements, or psychologic factors. The aim of the present article was to establish the frequency of uninvestigated dyspepsia and determine its associated factors in students at 4 Latin American schools of medicine. MATERIALS AND METHODS A cross-sectional, analytic study was conducted, in which a survey made up of closed-ended questions was applied at just one point in time. The association between the variables was then analyzed. A new questionnaire for the diagnosis of dyspepsia was one of the tests utilized to diagnose uninvestigated dyspepsia. Generalized linear models were used for the bivariate and multivariate analyses, employing the Poisson model with the log link function, obtaining crude prevalence ratios, adjusted prevalence ratios, and their 95% confidence intervals. RESULTS Of the 1,241 individuals surveyed, 54% (841) were females and the median age was 21 years (range: 19-23 years). Prevalence of uninvestigated dyspepsia was 46%. The factors that had a direct association with dyspepsia were: depression, difficulty sleeping, and coffee consumption. On the contrary, eating regularly in a boarding house and the male sex had an inverse association. CONCLUSIONS Uninvestigated dyspepsia frequency was high in students at 4 Latin American schools. Depression, difficulty sleeping, and steady coffee drinking were factors directly associated with dyspepsia, whereas male sex and eating out at regular hours were factors with a reverse association. Therefore, we recommend that universities implement early detection programs for this highly preventable pathology.
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Affiliation(s)
- L Talledo-Ulfe
- Universidad César Vallejo, Piura, Perú; Consejo de Asesores, Federación Latinoamericana de Sociedades Científicas de Estudiantes de Medicina, Lima, Perú
| | - O D Buitrago
- Universidad Tecnológica de Pereira, Pereira, Colombia; Asociación Científica de Estudiantes de Medicina de Risaralda, Pereira, Colombia
| | - Y Filorio
- Universidad Autónoma del Estado de México, Toluca, México
| | - F Casanova
- Universidad Católica de Santa María, Arequipa, Perú
| | - L Campos
- Asociación de Estudiantes de Medicina de la Universidad Dr. José Matías Delgado, San Salvador, El Salvador
| | - F Cortés
- Asociación Científica de Estudiantes de Medicina de la Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras
| | - C R Mejia
- Coordinación de Investigación, Universidad Continental, Huancayo, Perú.
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Affiliation(s)
- Luís Campos
- Presidente. Sociedade Portuguesa de Medicina Interna. Lisboa. Portugal; Presidente. Comissão de Qualidade e Assuntos Profissionais. European Federation of Internal Medicine. Bruxelas. Bélgica; Diretor. Serviço de Medicina. Hospital São Francisco Xavier. Centro Hospitalar Lisboa Oriental. Lisboa. Portugal
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Fonseca C, Araújo M, Moniz P, Marques F, Araújo I, Costa L, Rodrigues J, Frade L, Botella A, Jesus S, Leitão A, Campos L. Prevalence and prognostic impact of anemia and iron deficiency in patients hospitalized in an internal medicine ward: The PRO-IRON study. Eur J Haematol 2017; 99:505-513. [DOI: 10.1111/ejh.12963] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2017] [Indexed: 12/30/2022]
Affiliation(s)
- Cândida Fonseca
- Internal Medicine III Ward; Hospital de São Francisco Xavier - Centro Hospitalar de Lisboa Ocidental (CHLO); Lisboa Portugal
- NOVA Medical School; Faculdade de Ciências Médicas; Universidade Nova de Lisboa; Lisboa Portugal
| | - Manuel Araújo
- Internal Medicine III Ward; Hospital de São Francisco Xavier - Centro Hospitalar de Lisboa Ocidental (CHLO); Lisboa Portugal
| | - Patrícia Moniz
- Internal Medicine III Ward; Hospital de São Francisco Xavier - Centro Hospitalar de Lisboa Ocidental (CHLO); Lisboa Portugal
| | - Filipa Marques
- Internal Medicine III Ward; Hospital de São Francisco Xavier - Centro Hospitalar de Lisboa Ocidental (CHLO); Lisboa Portugal
- NOVA Medical School; Faculdade de Ciências Médicas; Universidade Nova de Lisboa; Lisboa Portugal
| | - Inês Araújo
- Internal Medicine III Ward; Hospital de São Francisco Xavier - Centro Hospitalar de Lisboa Ocidental (CHLO); Lisboa Portugal
- NOVA Medical School; Faculdade de Ciências Médicas; Universidade Nova de Lisboa; Lisboa Portugal
| | - Luís Costa
- Internal Medicine III Ward; Hospital de São Francisco Xavier - Centro Hospitalar de Lisboa Ocidental (CHLO); Lisboa Portugal
| | - Joana Rodrigues
- Internal Medicine III Ward; Hospital de São Francisco Xavier - Centro Hospitalar de Lisboa Ocidental (CHLO); Lisboa Portugal
| | - Luciana Frade
- Internal Medicine III Ward; Hospital de São Francisco Xavier - Centro Hospitalar de Lisboa Ocidental (CHLO); Lisboa Portugal
| | - Arturo Botella
- Internal Medicine III Ward; Hospital de São Francisco Xavier - Centro Hospitalar de Lisboa Ocidental (CHLO); Lisboa Portugal
- NOVA Medical School; Faculdade de Ciências Médicas; Universidade Nova de Lisboa; Lisboa Portugal
| | - Susana Jesus
- Internal Medicine III Ward; Hospital de São Francisco Xavier - Centro Hospitalar de Lisboa Ocidental (CHLO); Lisboa Portugal
- NOVA Medical School; Faculdade de Ciências Médicas; Universidade Nova de Lisboa; Lisboa Portugal
| | - Ana Leitão
- Internal Medicine III Ward; Hospital de São Francisco Xavier - Centro Hospitalar de Lisboa Ocidental (CHLO); Lisboa Portugal
- NOVA Medical School; Faculdade de Ciências Médicas; Universidade Nova de Lisboa; Lisboa Portugal
| | - Luís Campos
- Internal Medicine III Ward; Hospital de São Francisco Xavier - Centro Hospitalar de Lisboa Ocidental (CHLO); Lisboa Portugal
- NOVA Medical School; Faculdade de Ciências Médicas; Universidade Nova de Lisboa; Lisboa Portugal
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Campos L. A Medicina Interna Perante os Desafios do Futuro dos Cuidados aos Doentes Crónicos. Gaz Med 2017. [DOI: 10.29315/gm.v4i1.30] [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: 11/14/2022] Open
Abstract
A Medicina Interna está numa fase de crescimento determinada essencialmente pela modificação da demografia hospitalar, pela hiperespecialização e pela ameaça à sustentabilidade do sistema induzida pelos custos da inovação. Em Portugal, temos uma situação privilegiada no contexto europeu, porque soubemos preservar o carácter generalista da Medicina Interna, ao contrário dos países da Europa Central e do Norte, que optaram pela dupla titulação e onde a maior parte dos internistas tem uma subespecialidade médica. No entanto, a forma como nos organizamos atualmente para cuidar dos nossos doentes não é a adequada: nos hospitais necessitamos grandes departamentos para doentes médicos agudos geridos pelos internistas, a cogestão dos doentes nos serviços cirúrgicos deve ser implementada assim como unidades de Medicina Ambulatória, que reúnam os hospitais de dia, unidades de diagnóstico rápido, programas de hospitalização domiciliária e unidades de cuidados integrados, de forma a diminuir as admissões urgentes e criar alternativas ao internamento. A necessidade de internistas tem crescido mais rapidamente do que a sua formação, pelo que necessitamos mais internistas e uma maior valorização do nosso trabalho porque os internistas portugueses têm qualidade, são flexíveis, eficientes e multipotenciais; estas são qualidades cada vez mais necessárias para o futuro dos cuidados aos doentes crónicos.
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Rodrigues M, Costa R, Brito S, Pissarra A, Lourenço A, Grenho F, Campos L. Ischemic stroke and cancer correlation: A stroke unit experience. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx363.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Cotomacio C, Campos L, Simões A, Jaguar G, Crosato EM, Abreu-Alves F. Influence of bethanechol on salivary parameters in irradiated patients. Med Oral Patol Oral Cir Bucal 2017; 22:e76-e83. [PMID: 27918737 PMCID: PMC5217501 DOI: 10.4317/medoral.21395] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Accepted: 11/25/2016] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Some studies have shown evidence that the prophylactic use of bethanechol chloride (BC) may be useful in preventing the incidence and/or severity of xerostomia (XT). However, the indication of BC in irradiated patients with XT needs to be better characterized. The study aimed to evaluate the influence of BC on XT, salivary flow rate, and salivary composition in patients previously submitted to head and neck radiotherapy. MATERIAL AND METHODS Forty five irradiated patients complaining of XT used 50 mg/day of BC for 3 months, and the salivary parameters were evaluated in 4 Phases (Before BC therapy, after one month of BC, 2 months of BC, and 3 months of BC). Biochemical analysis included buffering capacity; pH; total protein concentration (TP); amylase concentration (AM); catalase (CAT) and peroxidase (PX) activities. In addition, unstimulated and stimulated salivary flow rates were determined and XT was classified. RESULTS According to the XT grading system used, patients showed improvement in XT between Phase 1, and Phases 2, 3 and 4. In addition, some changes were observed in TP concentration (decreased); AM concentration (increased); and PX and CAT activities (decreased and increased, respectively) after Phase 2, for stimulated saliva collection (p<0.05). CONCLUSIONS Our results suggested that when BC was used to treat salivary gland dysfunction induced by head and neck radiotherapy, improvement in XT symptoms, and some changes in saliva composition were shown.
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Affiliation(s)
- C Cotomacio
- Stomatology Department - AC Camargo Hospital, R. Prof. Antônio Prudente, 211, CEP: 01509-900 São Paulo, Brazil,
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Villodre C, Rebasa P, Estrada JL, Zaragoza C, Zapater P, Mena L, Lluís F, Alcázar C, Campos L, Franco M, Espinosa J, Bravo JA, Carbonell S, Apio AB, Lillo M, Saeta R, Rey M, Rojas N, Parra J, Doménech E, Gil MJ, Negre D, Caravaca I. aLicante sUrgical Community Emergencies New Tool for the enUmeration of Morbidities: a simplified auditing tool for community-acquired gastrointestinal surgical emergencies. Am J Surg 2016; 212:917-926. [DOI: 10.1016/j.amjsurg.2016.01.041] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 01/19/2016] [Accepted: 01/24/2016] [Indexed: 11/25/2022]
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Laranjinha I, Matias P, Mateus S, Aguiar F, Pereira P, Perneta Santos M, Costa R, Lourenço A, Guia J, Barata JD, Campos L. Diabetic kidney disease: Is there a non-albuminuric phenotype in type 2 diabetic patients? Nefrologia 2016; 36:503-509. [PMID: 27445098 DOI: 10.1016/j.nefro.2016.03.025] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 02/26/2016] [Accepted: 03/30/2016] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Albuminuria was widely considered as the first clinical sign of diabetic kidney disease (DKD), which is why it has traditionally been used as a screening test for DKD. However, increasing evidence has shown that a significant number of type 2 diabetes mellitus (DM) patients have a decreased glomerular filtration rate (GFR) without significant albuminuria, known as non-albuminuric DKD (NA-DKD). The aim of this study was to determine the prevalence and the demographic and clinical characteristics of patients with NA-DKD. METHODS This was a 1-year retrospective study that included 146 type 2 diabetic patients with GFR<75mL/min followed-up in a diabetes outpatient department. Patients were divided into two groups according to their ACR status - NA-DKD and albuminuric DKD (A-DKD). RESULTS Of the 146 patients included in the study, 53.4% had A-DKD and 46.6% had NA-DKD. According to the multivariable analysis performed, patients with NA-DKD tended to be older (p=0.021), female (p=0.045) and with a lower GFR (p=0.004) than A-DKD patients. There was no difference between the groups in terms of body mass index, metabolic control of DM, duration of DM diagnosis and prevalence of metabolic syndrome. CONCLUSIONS The majority of patients with DKD had albuminuria, but a significant proportion had a non-albuminuric phenotype (46.6% in this population). These patients exhibit distinct clinical features that could have screening, therapeutic and prognosis implications.
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Affiliation(s)
- Ivo Laranjinha
- Nephrology Department, Hospital de Santa Cruz, Lisbon, Portugal.
| | - Patrícia Matias
- Nephrology Department, Hospital de Santa Cruz, Lisbon, Portugal
| | - Sofia Mateus
- Internal Medicine Department, Hospital São Francisco Xavier, Lisbon, Portugal
| | - Filipa Aguiar
- Internal Medicine Department, Hospital São Francisco Xavier, Lisbon, Portugal
| | - Patrícia Pereira
- Internal Medicine Department, Hospital São Francisco Xavier, Lisbon, Portugal
| | | | - Rui Costa
- Internal Medicine Department, Hospital São Francisco Xavier, Lisbon, Portugal
| | - Ana Lourenço
- Internal Medicine Department, Hospital São Francisco Xavier, Lisbon, Portugal
| | - José Guia
- Internal Medicine Department, Hospital São Francisco Xavier, Lisbon, Portugal
| | | | - Luís Campos
- Internal Medicine Department, Hospital São Francisco Xavier, Lisbon, Portugal
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Rodríguez-Zaragoza F, Ortiz M, Berrios F, Campos L, de Jesús-Navarrete A, Castro-Pérez J, Hernández-Flores A, García-Rivas M, Fonseca-Peralta F, Gallegos-Aguilar E. Trophic models and short-term dynamic simulations for benthic-pelagic communities at Banco Chinchorro Biosphere Reserve (Mexican Caribbean): a conservation case. COMMUNITY ECOL 2016. [DOI: 10.1556/168.2016.17.1.7] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Ferreira NR, Vaz R, Carmona S, Mateus S, Pereira P, Fernandes L, Moreira H, Chorão M, Saldanha L, Carvalho A, Campos L. IgG4-related disease presenting with an epidural inflammatory pseudotumor: a case report. J Med Case Rep 2016; 10:61. [PMID: 26975393 PMCID: PMC4791931 DOI: 10.1186/s13256-016-0838-2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 02/14/2016] [Indexed: 12/24/2022] Open
Abstract
Background Inflammatory pseudotumor is a rare clinical condition that can be related to immunoglobulin G4 disease. Only a few cases of spinal inflammatory pseudotumors have been reported in the literature and an association with immunoglobulin G4 disease was not conclusive in any of them. We describe what we believe to be the first biopsy-proven case of an epidural inflammatory pseudotumor related to immunoglobulin G4 disease. Case presentation A 57-year-old Caucasian woman presented to our hospital with severe paraparesis, gait disturbance, and sensory loss secondary to a relapsing epidural mass. Examination of a biopsy specimen revealed a lymphoplasmacytic infiltration with fibrosis and an immunoglobulin G4-positive plasma cell ratio of over 50 %, which are compatible with a diagnosis of immunoglobulin G4-related inflammatory pseudotumor. Our patient was successfully treated with systemic and epidural administration of glucocorticoids. Conclusion Immunoglobulin G4-related disease is an emerging clinical condition in which central nervous system involvement is still uncommon. We describe the case of a patient with an epidural mass with medullar compression, which was proved to be an immunoglobulin G4-related epidural inflammatory pseudotumor. Our findings suggest a new manifestation of immunoglobulin G4-related disease. This disorder should be considered in the differential diagnosis of spinal tumors as a potentially treatable condition with glucocorticoids.
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Affiliation(s)
- Nuno Ribeiro Ferreira
- Department of Internal Medicine, Hospital São Francisco Xavier, Centro Hospitalar de Lisboa Ocidental, Estrada do Forte do Alto do Duque, 1495-005, Lisboa, Portugal.
| | - Rita Vaz
- Department of Internal Medicine, Hospital São Francisco Xavier, Centro Hospitalar de Lisboa Ocidental, Estrada do Forte do Alto do Duque, 1495-005, Lisboa, Portugal
| | - Sara Carmona
- Department of Internal Medicine, Hospital São Francisco Xavier, Centro Hospitalar de Lisboa Ocidental, Estrada do Forte do Alto do Duque, 1495-005, Lisboa, Portugal
| | - Sofia Mateus
- Department of Internal Medicine, Hospital São Francisco Xavier, Centro Hospitalar de Lisboa Ocidental, Estrada do Forte do Alto do Duque, 1495-005, Lisboa, Portugal
| | - Patrícia Pereira
- Department of Internal Medicine, Hospital São Francisco Xavier, Centro Hospitalar de Lisboa Ocidental, Estrada do Forte do Alto do Duque, 1495-005, Lisboa, Portugal
| | - Liliana Fernandes
- Department of Internal Medicine, Hospital São Francisco Xavier, Centro Hospitalar de Lisboa Ocidental, Estrada do Forte do Alto do Duque, 1495-005, Lisboa, Portugal
| | - Hugo Moreira
- Department of Internal Medicine, Hospital São Francisco Xavier, Centro Hospitalar de Lisboa Ocidental, Estrada do Forte do Alto do Duque, 1495-005, Lisboa, Portugal
| | - Martinha Chorão
- Department of Pathology, Hospital Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Rua da Junqueira, 126, 1349-019, Lisboa, Portugal
| | - Luís Saldanha
- Department of Anaesthesiology, Hospital São Francisco Xavier, Centro Hospitalar de Lisboa Ocidental, Estrada do Forte do Alto do Duque, 1495-005, Lisboa, Portugal
| | - António Carvalho
- Department of Internal Medicine, Hospital São Francisco Xavier, Centro Hospitalar de Lisboa Ocidental, Estrada do Forte do Alto do Duque, 1495-005, Lisboa, Portugal
| | - Luís Campos
- Department of Internal Medicine, Hospital São Francisco Xavier, Centro Hospitalar de Lisboa Ocidental, Estrada do Forte do Alto do Duque, 1495-005, Lisboa, Portugal
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Ribeiro F, Oliveira NL, Silva G, Campos L, Miranda F, Teixeira M, Alves AJ, Oliveira J. Exercise-based cardiac rehabilitation increases daily physical activity of patients following myocardial infarction: subanalysis of two randomised controlled trials. Physiotherapy 2015; 103:59-65. [PMID: 27012822 DOI: 10.1016/j.physio.2015.12.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [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: 02/09/2015] [Accepted: 12/12/2015] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To assess the effects of an exercise-based cardiac rehabilitation programme on daily physical activity levels of patients following myocardial infarction. DESIGN Subanalysis of two randomised, prospective controlled trials. SETTING Outpatient clinic of a secondary hospital. PARTICIPANTS Fifty consecutive patients randomised to the exercise group {n=25; 23 males; mean age 54 [standard deviation (SD) 9] years} or the control group [n=25; 20 males; mean age 58 (SD 9) years]. INTERVENTIONS The exercise group participated in an 8-week aerobic exercise programme plus usual medical care and follow-up. The control group received usual medical care and follow-up. MAIN OUTCOME MEASURES The primary outcome measure was change in time spent undertaking moderate-to-vigorous physical activity per day, assessed by accelerometer over 7 consecutive days. Secondary outcome measures were cardiorespiratory fitness, body mass, and resting blood pressure and heart rate. RESULTS Moderate-to-vigorous physical activity levels increased significantly in the exercise group [43.2 (SD 36.3) to 53.5 (SD 31.9) minutes/day, P=0.030], and remained unchanged in the control group [40.8 (SD 26.2) to 36.8 (SD 26.5) minutes/day, P=0.241] from baseline to the end of the programme. Cardiorespiratory fitness increased significantly in the exercise group (mean difference 2.8; 95% of the difference 1.3 to 4.4ml/kg/minute, P=0.001) after the 8-week programme. CONCLUSIONS In patients under optimal medication following myocardial infarction, participation in an 8-week exercise-based cardiac rehabilitation programme was found to improve physical activity levels consistent with health-related benefits. Future studies are needed to determine whether the increase in physical activity is maintained in the long term.
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Affiliation(s)
- F Ribeiro
- School of Health Sciences and Institute of Biomedicine - iBiMED, University of Aveiro, Aveiro, Portugal.
| | - N L Oliveira
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - G Silva
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal; Department of Sport, Higher Institute of Educational Sciences of Douro (ISCE Douro), Portugal
| | - L Campos
- Physical Medicine and Rehabilitation Department, Centro Hospitalar de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - F Miranda
- Physical Medicine and Rehabilitation Department, Centro Hospitalar de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - M Teixeira
- Cardiology Department, Centro Hospitalar de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - A J Alves
- ISMAI - University Institute of Maia, Castêlo da Maia, Portugal
| | - J Oliveira
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
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Guimarães R, Dagher A, Piovesana L, Larcher K, Campos L, Azevedo P, Zeighami Y, D'Abreu A, Cendes F. Cortical thinning pattern in Parkinson's disease stages. J Neurol Sci 2015. [DOI: 10.1016/j.jns.2015.08.221] [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: 10/22/2022]
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Fernandes GC, Koltermann T, Campos L, Vedolin L, Rieder CRM. Teaching NeuroImages: The lentiform fork sign: An MRI pattern of metformin-associated encephalopathy. Neurology 2015; 84:e15. [DOI: 10.1212/wnl.0000000000001154] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Fernandes L, Duque S, Silvestre J, Freitas P, Pinto M, Sousa A, Batalha V, Campos L. Prognostic factors of patients admitted in a medical intermediate care unit: a prospective observational study. Int Arch Med 2015. [DOI: 10.3823/1762] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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