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Lafratta A, Serrano O, Masqué P, Fernandes M, Gaylard S, Lavery PS. Seagrass soils sequester up to half the metal emissions of one of the world's largest smelters. Mar Pollut Bull 2023; 197:115684. [PMID: 37925990 DOI: 10.1016/j.marpolbul.2023.115684] [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] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 10/10/2023] [Accepted: 10/16/2023] [Indexed: 11/07/2023]
Abstract
One of the world's largest smelters has been operating in South Australia since 1889, affecting environment and human health. Here we quantified the magnitude of Pb, Zn and Cd emissions from the smelter sequestered in the soil of an adjacent 110 km2Posidonia australis seagrass meadows. Seagrass core records show that the smelter contaminated the entire area with decreasing sequestration with increasing distance from contamination points. The soil accumulated ~1300 t of Pb, ~3450 t of Zn, and ~ 90 t of Cd since 1889, and sequestered the equivalent of ~20 % of Pb, and ~50 % of Zn and Cd cumulative smelter emissions since 1999, showing that seagrass can be significant, long-term sinks of metal pollution in highly contaminated environments. Conservation efforts should prioritize these seagrass meadows to avoid the potential release of pollutants from their soils following habitat loss, which could turn seagrasses from a sink to a source of pollution.
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Affiliation(s)
- A Lafratta
- School of Sciences & Centre for Marine Ecosystems Research, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA 6027, Australia.
| | - O Serrano
- School of Sciences & Centre for Marine Ecosystems Research, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA 6027, Australia; Centro de Estudios Avanzados de Blanes, Consejo Superior de Investigaciones Científicas, Blanes 17300, Spain
| | - P Masqué
- School of Sciences & Centre for Marine Ecosystems Research, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA 6027, Australia; International Atomic Energy Agency, 4a Quai Antoine 1er, 98000, Monaco; Departament de Física & Institut de Ciència i Tecnologia Ambientals, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
| | - M Fernandes
- South Australian Water Corporation (SA Water), GPO Box 1751, Adelaide, SA 5001, Australia; College of Science and Engineering, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia
| | - S Gaylard
- South Australian Environment Protection Authority, GPO Box 2607, Adelaide, SA 5001, Australia
| | - P S Lavery
- School of Sciences & Centre for Marine Ecosystems Research, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA 6027, Australia; Centro de Estudios Avanzados de Blanes, Consejo Superior de Investigaciones Científicas, Blanes 17300, Spain
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Guadagna P, Fernandes M, Chen F, Santamaria A, Teng T, Frioni T, Caldwell DG, Poni S, Semini C, Gatti M. Using deep learning for pruning region detection and plant organ segmentation in dormant spur-pruned grapevines. Precis Agric 2023; 24:1-23. [PMID: 37363791 PMCID: PMC10032262 DOI: 10.1007/s11119-023-10006-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/27/2023] [Indexed: 06/28/2023]
Abstract
Even though mechanization has dramatically decreased labor requirements, vineyard management costs are still affected by selective operations such as winter pruning. Robotic solutions are becoming more common in agriculture, however, few studies have focused on grapevines. This work aims at fine-tuning and testing two different deep neural networks for: (i) detecting pruning regions (PRs), and (ii) performing organ segmentation of spur-pruned dormant grapevines. The Faster R-CNN network was fine-tuned using 1215 RGB images collected in different vineyards and annotated through bounding boxes. The network was tested on 232 RGB images, PRs were categorized by wood type (W), orientation (Or) and visibility (V), and performance metrics were calculated. PR detection was dramatically affected by visibility. Highest detection was associated with visible intermediate complex spurs in Merlot (0.97), while most represented coplanar simple spurs allowed a 74% detection rate. The Mask R-CNN network was trained for grapevine organs (GOs) segmentation by using 119 RGB images annotated by distinguishing 5 classes (cordon, arm, spur, cane and node). The network was tested on 60 RGB images of light pruned (LP), shoot-thinned (ST) and unthinned control (C) grapevines. Nodes were the best segmented GOs (0.88) and general recall was higher for ST (0.85) compared to C (0.80) confirming the role of canopy management in improving performances of hi-tech solutions based on artificial intelligence. The two fine-tuned and tested networks are part of a larger control framework that is under development for autonomous winter pruning of grapevines. Supplementary Information The online version contains supplementary material available at 10.1007/s11119-023-10006-y.
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Affiliation(s)
- P. Guadagna
- Department of Sustainable Crop Production (DI.PRO.VE.S.), Università Cattolica del Sacro Cuore, Via Emilia Parmense 84, 29122 Piacenza, Italy
| | - M. Fernandes
- Istituto Italiano di Tecnologia, Via S. Quirico 19D, 16163 Genoa, Italy
| | - F. Chen
- Istituto Italiano di Tecnologia, Via S. Quirico 19D, 16163 Genoa, Italy
| | - A. Santamaria
- Department of Sustainable Crop Production (DI.PRO.VE.S.), Università Cattolica del Sacro Cuore, Via Emilia Parmense 84, 29122 Piacenza, Italy
| | - T. Teng
- Department of Sustainable Crop Production (DI.PRO.VE.S.), Università Cattolica del Sacro Cuore, Via Emilia Parmense 84, 29122 Piacenza, Italy
- Istituto Italiano di Tecnologia, Via S. Quirico 19D, 16163 Genoa, Italy
| | - T. Frioni
- Department of Sustainable Crop Production (DI.PRO.VE.S.), Università Cattolica del Sacro Cuore, Via Emilia Parmense 84, 29122 Piacenza, Italy
| | - D. G. Caldwell
- Istituto Italiano di Tecnologia, Via S. Quirico 19D, 16163 Genoa, Italy
| | - S. Poni
- Department of Sustainable Crop Production (DI.PRO.VE.S.), Università Cattolica del Sacro Cuore, Via Emilia Parmense 84, 29122 Piacenza, Italy
| | - C. Semini
- Istituto Italiano di Tecnologia, Via S. Quirico 19D, 16163 Genoa, Italy
| | - M. Gatti
- Department of Sustainable Crop Production (DI.PRO.VE.S.), Università Cattolica del Sacro Cuore, Via Emilia Parmense 84, 29122 Piacenza, Italy
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Neves Atti V, Fernandes M, Santiago de Lima Figueiredo G, Roth F, Gomes Valente S, Nakachima LR, Fernandes CH, Gomes Dos Santos JB. Peripheral nerve regeneration in rats using nerve graft in a vein conduit pre-filled with platelet-rich fibrin (PRF). Hand Surg Rehabil 2023; 42:61-68. [PMID: 36496199 DOI: 10.1016/j.hansur.2022.12.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/30/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022]
Abstract
Treatment of peripheral nerve injury is not always satisfactory. To improve results, specific adjuvant methods have been used, such as platelet-rich fibrin (PRF) and vein conduits. The goal of this study was to assess whether use of PRF and vein conduits after nerve suture improves nerve regeneration as measured by a functional score and histomorphometry analysis. Ten isogenic spontaneously hypertensive rats were randomly assigned to 4 experimental procedures: 1) Sham group (n = 10); 2) Nerve graft (NG) group (n = 10); 3) Nerve graft covered with a vein conduit (NGVC) (n = 10); and 4) Nerve graft covered with a vein conduit pre-filled with PRF (NGVCP) (n = 10). Nerve repair results were evaluated on: sciatic functional index (SFI) at 0, 30, 60 and 90 days; morphometric and morphologic analysis of the distal nerve; and histological analysis of Fluoro-Gold® stained motor neurons in the anterior horn of the spinal cord. Compared to the Sham control group, the NGVC and NGVCP groups exhibited lower SFI on all measures. The NGVC group showed improvement in SFI at day 90, which was significant compared to the NG group. Fiber and axon diameters were comparable in the NGVC and NGVCP groups, which were both significantly lower than in the Sham and NG groups. Significant improvement was expected with PRF, but in fact the release of factors from this substance was not as effective as hoped.
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Affiliation(s)
- V Neves Atti
- Division of Hand Surgery, Department of Orthopedics and Traumatology, Escola Paulista de Medicina, Federal University of São Paulo, Borges Lagoa Street 786, 04038-001 São Paulo, Brazil
| | - M Fernandes
- Division of Hand Surgery, Department of Orthopedics and Traumatology, Escola Paulista de Medicina, Federal University of São Paulo, Borges Lagoa Street 786, 04038-001 São Paulo, Brazil
| | - G Santiago de Lima Figueiredo
- Division of Hand Surgery, Department of Orthopedics and Traumatology, Escola Paulista de Medicina, Federal University of São Paulo, Borges Lagoa Street 786, 04038-001 São Paulo, Brazil.
| | - F Roth
- Division of Hand Surgery, Department of Orthopedics and Traumatology, Escola Paulista de Medicina, Federal University of São Paulo, Borges Lagoa Street 786, 04038-001 São Paulo, Brazil
| | - S Gomes Valente
- Division of Hand Surgery, Department of Orthopedics and Traumatology, Escola Paulista de Medicina, Federal University of São Paulo, Borges Lagoa Street 786, 04038-001 São Paulo, Brazil
| | - L R Nakachima
- Division of Hand Surgery, Department of Orthopedics and Traumatology, Escola Paulista de Medicina, Federal University of São Paulo, Borges Lagoa Street 786, 04038-001 São Paulo, Brazil
| | - C H Fernandes
- Division of Hand Surgery, Department of Orthopedics and Traumatology, Escola Paulista de Medicina, Federal University of São Paulo, Borges Lagoa Street 786, 04038-001 São Paulo, Brazil
| | - J B Gomes Dos Santos
- Division of Hand Surgery, Department of Orthopedics and Traumatology, Escola Paulista de Medicina, Federal University of São Paulo, Borges Lagoa Street 786, 04038-001 São Paulo, Brazil
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Fernandes M, Lourenço T, Spínola Santos A, Pereira Barbosa M. Analysis of adrenaline autoinjectors acquisition in Portugal over 15 years. Eur Ann Allergy Clin Immunol 2023; 55:29-34. [PMID: 33949175 DOI: 10.23822/eurannaci.1764-1489.213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Summary Background. The adrenaline autoinjector (AAi) is universally recommended as the first-line treatment for anaphylactic reactions occurring outside the medical setting. The quantification of its acquisition may help estimate the prevalence of patients at risk of anaphylaxis with an indication for AAi. Objective. Evaluation of the global and regional frequency of AAi purchases in Mainland Portugal between 2003-2017 and calculate the inherent costs in 2017. Methods. AAi acquisition distribution analysis along this period. The population was divided in two age groups according to the adrenaline dosage. Results. A total of 10,993 AAi units of 0.15mg/0.3mL and 28,619 of 0.3mg/0.3mL were acquired in these 15 years, with an annual average of 733 and 1908 units, respectively. In cumulative values terms, Lisbon showed the highest number of AAI acquired and higher prevalence per region/100,000 inhabitants in both groups. In 2017, the annual cost for each age group was 64,202.71 € 187,447.70 € for patients and € 37,706.35 / 110,113.30 € for the National Health System. Conclusions. In the last 15 years, there was a progressive increase in AAi acquisition. We estimate a rate of anaphylaxis occurrence in Portugal according to AAi aquisition of 0.165%.
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Affiliation(s)
- M Fernandes
- Immunoallergology Service, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), EPE, Lisbon, Portugal.,Immunoallergology Unit, Hospital Dr. Nélio Mendonça, SESARAM, EPE, Funchal, Portugal
| | - T Lourenço
- Immunoallergology Service, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), EPE, Lisbon, Portugal
| | - A Spínola Santos
- Immunoallergology Service, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), EPE, Lisbon, Portugal
| | - M Pereira Barbosa
- Immunoallergology Service, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), EPE, Lisbon, Portugal.,University Clinic of Immunoallergology, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
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Camarinha C, Fernandes M, Alarc Úo V, Franco J, Mana ºas ME, B Írbara C, Nicola PJ. Determinants associated with uncontrolled asthma in Portugal: A national population-based study. Pulmonology 2023; 29:29-41. [PMID: 33023866 DOI: 10.1016/j.pulmoe.2020.02.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 02/20/2020] [Accepted: 02/28/2020] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION AND OBJECTIVES Asthma is a chronic and heterogeneous disease that affects people of all ages and has a high estimated increase in prevalence worldwide. Asthma control represents a main goal in the disease management. International studies revealed low levels of disease control resulting in a significant burden for healthcare systems, not only in terms of quality of life, but also in terms of health costs. Modifiable and non-modifiable factors have been identified as relating to poor asthma control level. In this study we evaluated the distribution of asthma control levels in Portuguese adult population and examine the determinants associated with uncontrolled asthma. MATERIALS AND METHODS Using a similar methodology to the one employed in the Asthma Insights and Reality in Europe (AIRE) survey, 327 active asthmatic patients were identified by random phone number and completed a questionnaire during 2011 to 2012. Asthma control was assessed by the evaluation of GINA based symptom control, by Asthma Control Test.äó (ACT) and by self-perception of control. To examine the relationship between uncontrolled asthma and its determinants, univariate logistic regression analysis, sequential multivariable regression and population attributable risk percentage were determinate. RESULTS 35.2% active asthmatic patients had uncontrolled asthma, 64.8% partially controlled and none of the individuals had total control of asthma assessed by ACT test. Factors significantly associated with poor asthma control scores were: age (OR 1.02 per year of age; 95% CI: 1.01.Çô1.03), female sex (OR 1.87; 95% CI: 1.15.Çô3.04), educational level (OR 0.5; 95% CI: 0.28.Çô0.89 at high school level or over), occupation (OR 4.92; 95% CI: 2.12.Çô11.42 if looking for a first job or unemployed) (OR 2.51; 95% CI: 1.35.Çô4.65 if being retired), income (OR 0.23; 95% CI: 0.07.Çô0.72 if >619 euros), BMI (OR 1.09 per BMI unit; 95% CI: 1.03.Çô1.14), having rhinitis symptoms (OR 4.40; 95% CI: 2.56.Çô7.58) and using inhaled corticosteroids (OR 0.44; 95%CI: 0.24.Çô0.82 if used in the past or never used). Looking for a first job or being unemployed, BMI and having rhinitis symptoms remained significant after multivariate adjustments. CONCLUSIONS Uncontrolled asthma was associated with several determinants. Their identification can contribute to improve asthma care both from clinical and from public health perspectives.
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Affiliation(s)
- C Camarinha
- Epidemiology Unit, Institute of Preventive Medicine and Public Health, Faculty of Medicine, University of Lisbon, Hospital de Santa Maria Avenida Professor Egas Moniz, 1649-035 Lisboa, Portugal; Allergy Center, CUF Descobertas Hospital, Rua M.írio Botas, 1998-018 Lisboa, Portugal
| | - M Fernandes
- CTI Clinical Trial and Consulting Services, Rua Tierno Galvan, Torre 3, Piso 16, 1070-274 Lisboa, Portugal
| | - V Alarc Úo
- Institute of Preventive Medicine and Public Health, Faculty of Medicine, University of Lisbon, Hospital de Santa Maria Avenida Professor Egas Moniz, 1649-035 Lisboa, Portugal; Environmental Health Institute (ISAMB), Faculty of Medicine, University of Lisbon, Hospital de Santa Maria Avenida Professor Egas Moniz, 1649-035 Lisboa, Portugal; Centro de Investiga.º.úo e Estudos de Sociologia (CIES-IUL) do Instituto Superior de Ci.¬ncias do Trabalho e da Empresa - Instituto Universit.írio de Lisboa (ISCTE-IUL), Av..¬ das For.ºas Armadas, 1649-026 Lisboa, Portugal
| | - J Franco
- Pediatrics Department, Hospital Garcia da Orta, Av. Torrado da Silva, 2805-267 Almada, Portugal
| | - M E Mana ºas
- Institute of Preventive Medicine and Public Health, Faculty of Medicine, University of Lisbon, Hospital de Santa Maria Avenida Professor Egas Moniz, 1649-035 Lisboa, Portugal
| | - C B Írbara
- Thorax Department, Faculty of Medicine, University of Lisbon, Hospital de Santa Maria Avenida Professor Egas Moniz, 1649-035 Lisboa, Portugal; Environmental Health Institute (ISAMB), Faculty of Medicine, University of Lisbon, Hospital de Santa Maria Avenida Professor Egas Moniz, 1649-035 Lisboa, Portugal
| | - P J Nicola
- Epidemiology Unit, Institute of Preventive Medicine and Public Health, Faculty of Medicine, University of Lisbon, Hospital de Santa Maria Avenida Professor Egas Moniz, 1649-035 Lisboa, Portugal; Environmental Health Institute (ISAMB), Faculty of Medicine, University of Lisbon, Hospital de Santa Maria Avenida Professor Egas Moniz, 1649-035 Lisboa, Portugal.
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Lamberti G, Sadeghi H, Fernandes M, Filho S, Marchizeli J, Knychala R, Lucy M, Moraes J. 14 Effect of breed on oocyte recovery and embryo production following ovum pickup and fertility outcomes after transferring fresh. Reprod Fertil Dev 2022. [DOI: 10.1071/rdv35n2ab14] [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: 12/09/2022] Open
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Lupo C, Fernandes M, Giambrone M, Spanetta M, Placidi F, Izzi F, Mercuri N, Liguori C. Studio elettrofisiologico del tronco-encefalico nella sindrome delle apnee ostruttive del sonno e valutazione dell’effetto della terapia con CPAP. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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De Masi C, Fernandes M, Mari L, Chiaravallotti A, Paoli B, Nuccetelli M, Izzi F, Giambrone M, Camedda R, Bernardini S, Schillaci O, Mercuri N, Placidi F, Liguori C. 18F-FDG PET, cognitive, and CSF biomarkers in patients with obstructive sleep apnoea before and after continuous positive airway pressure treatment. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Fernandes M, Chiaravalloti A, Manfredi N, Placidi F, Nuccetelli M, Izzi F, Camedda R, Bernardini S, Schillaci O, Mercuri N, Liguori C. Ipossia intermittente notturna e frammentazione del sonno: duplice meccanismo di neurodegenerazione? Sindrome delle apnee ostruttive del sonno e disturbo da movimenti periodici degli arti a confronto. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Spanetta M, Fernandes M, Izzi F, Placidi F, Mercuri N, Liguori C. More than sleep and wake disturbances: an actigraphic study showing the sleep-wake pattern dysregulation in epilepsy. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Lupo C, Sarbu O, Fernandes M, Spanetta M, Di Gioia B, Placidi F, Izzi F, Mercuri N, Liguori C. Assessing blink reflex circuits in patients with REM behaviour disorder and patients with Parkinson’s disease. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.602] [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: 10/17/2022]
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Miranda M, Leitão T, Ferreira C, Fernandes M, Castro A, Lopes F, Palma Dos Reis J. Hereditary renal cell carcinoma surveillance protocols - a review and new surveillance protocol proposal. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)02555-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Miranda M, Sandul A, Fernandes M, Lopes F, Castro A, Oliveira P, Leitão T, Martins F, Palma Reis J. McAninch penile circular skin flap urethroplasty: Do skin flaps still have a role in complex urethral strictures? EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)02079-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Mogodi W, Billing D, Fernandes M, Fitch A. Thermodiffractometry study of (NH 4) 0.5Co 1.25(H 2O) 2[BP 2O 8]·(H 2O) 0.5 with CZP framework topology. Acta Cryst Sect A 2022. [DOI: 10.1107/s2053273322092658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
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Silva Gaspar SR, Fernandes M, Castro A, Oliveira T, Santos Dias J, Palma Dos Reis J. Active surveillance protocol in prostate cancer in Portugal. Actas Urol Esp 2022; 46:329-339. [PMID: 35277378 DOI: 10.1016/j.acuroe.2022.01.002] [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: 09/27/2020] [Revised: 12/16/2020] [Accepted: 01/13/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To examine clinical practice patterns in locally managing patients under an active surveillance protocol among Portuguese urologists. INTRODUCTION Prostate cancer (PCa) is a heterogeneous disease with many prostate adenocarcinomas being indolent and a low probability of ever causing symptoms or death. Active surveillance (AS) is a form of conservative management aimed to reduce over-treatment for low-risk PCa patients. Over the years, experience with AS has grown considerably and is now standard in some countries, however a universal protocol still does not exist. METHODS Nationwide anonymous e-survey concerning habits and practices on AS among Portuguese urologists, that consisted of twelve questions and was sent electronically to all 368 current members of the Portuguese Urological Association. RESULTS 56 urologists were surveyed (15.21% answer rate), evenly distributed geographically and allocated according to years of experience as well as number of PCa patients managed monthly. The vast majority of respondents recommends AS to their patients, particularly ISUP grade 1 patients, whose PSA serum level is bellow 20 ng/mL. Observance of AS programs by patients was not in question but concerns exist over psychological morbidity while harboring disease. Majority believed that international guidelines surveillance protocols were adequate and sufficient, but there are some constraints concerning availability of periodic MRIs and re-biopsy needs. CONCLUSIONS AS seems to be sustained in urologist clinical practice, although patients still lag to adhere and choose for active treatment. AS may not be an easy choice for patients and clinicians due to uncertainty of disease progression, risk of loss to follow-up and repeated biopsies but is also a cause for anxiety, depression, uncertainty and a perception of danger.
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Affiliation(s)
- S R Silva Gaspar
- Department of Urology, Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal.
| | - M Fernandes
- Department of Urology, Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal
| | - A Castro
- Department of Urology, Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal
| | - T Oliveira
- Department of Urology, Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal
| | - J Santos Dias
- Department of Urology, Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal
| | - J Palma Dos Reis
- Department of Urology, Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal
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Cardoso A, Lourenco MR, Von Hafe P, Dias G, Pereira T, Tinoco M, Fernandes M, Azevedo O, Lourenco A. Prognostic value of exercise stress echocardiography in patients with known coronary artery disease. Eur J Prev Cardiol 2022. [DOI: 10.1093/eurjpc/zwac056.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Exercise stress echocardiography (EE) is useful for diagnosis and risk stratification in patients (pts) with suspected coronary artery disease (CAD). Pts with known CAD carry a high risk of events. Our aim was to assess the utility of EE in predicting outcomes in this population.
Methods
Single center retrospective study of consecutive pts with known CAD who performed an EE between 2018 and 2019. The primary endpoint was a composite of admission for acute coronary syndrome (ACS), coronary revascularization and cardiovascular death during the follow-up.
Results
A total of 76 pts were included (mean age 59±9 years; 87% male). Fifty-nine (78%) pts had history of ACS, 51 (67%) of percutaneous coronary intervention (PCI) and 14 (18%) of coronary artery bypass graft. The majority of pts had 2 or more vessel disease (42 pts; 55%).
The main reason for performing EE was new onset of chest pain (38 pts; 50%) followed by functional assessment of coronary stenoses after incomplete revascularization (29 pts; 38%). The majority of pts had a preserved left ventricular ejection fraction (67; 88%). The exam was performed under beta-blocker effect in 35 (46%) pts.
The results of EE were positive for myocardial ischemia in 7 (9%) pts, negative in 37 (49%) pts and inconclusive in 32 (42%) pts. Mean exercise time was 8±3 minutes and mean METs achieved was 9.4±2.6. ST-segment depression fulfilling electrocardiographic criteria for ischemia occurred in 17 (22%) pts. Eleven (14%) pts complained of chest pain during the exam.
During a median follow up of 22 months (IQR 15-26), the primary endpoint occurred in 9 pts (admission for ACS in 5 pts; revascularization for chronic coronary syndrome in 4 pts). No cardiovascular death occurred. The positive predictive value of EE for the primary endpoint was 57.1% and the negative predictive value (NPV) 97.3%.
In a survival analysis, the predictors of the primary endpoint were lower exercise time, lower METs achieved, untreated significant coronary lesions and a positive EE (figure).
After adjustment in a multivariate analysis, a positive EE was an independent predictor of the primary endpoint (HR 4.6, 95%CI: 1.1-16.7, p=.044).
Conclusion
In pts with known CAD, EE had a high NPV and a positive result was an independent predictor of future cardiovascular events.
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Affiliation(s)
- A Cardoso
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - MR Lourenco
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - P Von Hafe
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - G Dias
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - T Pereira
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - M Tinoco
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - M Fernandes
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - O Azevedo
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - A Lourenco
- Hospital Senhora da Oliveira, Guimaraes, Portugal
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17
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Cordoeiro M, Fernandes M, Santos F, Torres I. 170 Rhombencephalosynapsis: a rare congenital defect. Eur J Obstet Gynecol Reprod Biol 2022. [DOI: 10.1016/j.ejogrb.2021.11.057] [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: 11/26/2022]
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18
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Cordoeiro M, Vieira-Coimbra M, Santos J, Fernandes M, Nogueira Martins N, Nogueira Martins F. 169 Obstetric admissions to intensive care unit in a central hospital. Eur J Obstet Gynecol Reprod Biol 2022. [DOI: 10.1016/j.ejogrb.2021.11.233] [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: 11/17/2022]
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19
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Cardoso A, Lourenco MR, Von Hafe P, Dias G, Pereira T, Tinoco M, Fernandes M, Azevedo O, Lourenco A. Impact of an inconclusive exercise stress echocardiogram on cardiovascular outcomes. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Exercise stress echocardiography (ESE) is used for the assessment of suspected or known coronary artery disease (CAD); however, a certain percentage of ESE studies are inconclusive. We aim to evaluate the prognostic impact of an inconclusive ESE on cardiovascular outcomes.
Methods
Single-center retrospective study of consecutive patients (pts) who performed an ESE between 2018 and 2019 for diagnosis or stratification of CAD. All pts performed a symptom-limited Bruce protocol. ESE was considered inconclusive when 85% of age-predicted maximum HR was not reached. Primary endpoint was a composite of admission for acute coronary syndrome (ACS), coronary revascularization and cardiovascular death during the follow-up.
Results
A total of 141 pts were included (76% male; mean age 60 ± 9 years). ESE was inconclusive in 51 (36%) pts, positive in 11 (8%) and negative in 79 (56%).
The mean exercise time of pts with inconclusive ESE was 7 ± 2 minutes and 76% had normal functional capacity. Fatigue (25 pts; 49%) and lower extremities pain (11 pts; 22%) were the main reasons for ESE stopping. Five pts (10%) complained of chest pain during exam.
Pts with an inconclusive ESE were more diabetic (inconclusive 43%, positive 9%, negative 13%; p=.001), had more chronic obstructive pulmonary disease (COPD) (14%, 0%, 2.5%; p=.026), performed more frequently the exam under beta blocker (BB) therapy (59%, 27%, 18%; p=.041) and had less ST-segment depression fulfilling electrocardiographic criteria for ischemia (10%, 64%, 27%, p<.001). Their functional capacity was worse than negative ESE pts (p<.001).
During a median follow up of 22 months (IQR 15-27), 13 (9.2%) pts had the primary endpoint, including 5 pts (3.5%) with ACS.
Pts with an inconclusive ESE had a lower incidence of the primary outcome than pts with a positive ESE and a higher incidence of events than pts with negative results (figure).
In multivariate analysis, after adjusting for functional capacity and electrocardiographic criteria for ischemia, an inconclusive ESE was an independent predictor of the primary endpoint (HR 9.7, IC95% 1.1-87,6 p= .042)
Conclusions
The frequency of inconclusive ESE is not negligible (36%). These pts had more diabetes and COPD and performed the exam under BB therapy more frequently, highlighting the importance of proper patient selection. An inconclusive ESE was associated to a higher risk of cardiovascular events compared to negative ESE. Abstract Figure.
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Affiliation(s)
- A Cardoso
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - MR Lourenco
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - P Von Hafe
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - G Dias
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - T Pereira
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - M Tinoco
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - M Fernandes
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - O Azevedo
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - A Lourenco
- Hospital Senhora da Oliveira, Guimaraes, Portugal
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20
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Cardoso A, Lourenco MR, Von Hafe P, Dias G, Pereira T, Tinoco M, Fernandes M, Azevedo O, Lourenco A. Prevalence and clinical impact of latent obstruction in hypertrophic cardiomyopathy. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
BACKGROUND
Hypertrophic cardiomyopathy (HCM) is characterized by varying degrees of left ventricular outflow tract obstruction (LVOTobs). We aim to define the prevalence, clinical profile and impact of LVOTobs under physiological exercise in HCM patients (pts).
METHODS
Single center retrospective study of consecutive HCM pts without LVOTobs at rest (resting gradient <30mmHg), referred for exercise stress echocardiogram (ESE) between 2015 and 2019. Significative latent obstruction was defined as a LVOT gradient ≥50 mmHg during exercise or at early recuperation.
RESULTS
A total of 56 pts were included (64% men, mean age 57 ± 11 years, 61% septal HCM). The majority of pts (47; 84%) were in NYHA I functional class, 20 (36%) had history of syncope or pre-syncope (S/pS) and 7 (13%) had an implantable cardioverter defibrillator (ICD). Twelve (21%) pts had systolic anterior motion (SAM) of the mitral valve at rest.
Thirty-five (63%) pts performed ESE under beta-blocker (BB) therapy. Mean exercise time was 8 ± 3 min. During ESE, 2 (4%) pts developed a LVOT gradient between 30 to 50 mmHg and 17 pts (30%) developed a significative LVOTobs gradient (mean 85 ± 18 mmHg).
Pts with significative latent LVOTobs had more previous complaints of S/pS (59% vs 26%, p=.017), a tendency for a higher NYHA functional class (p=.082) and were more frequently on BB therapy (82% vs 18%, p=.043). Mean septum thickness was similar between groups (17 ± 0.7 vs 16 ± 0.6 mm, p=.536). The presence of SAM at rest was more frequent in the significative latent LVOTobs pts (p<.001). No differences were noted in exercise tolerance (p=.526).
During a median follow-up of 43 (IQR 15-53) months, 7 (41%) pts with significative latent LVOTobs had a pre-syncope, 3 (18%) were diagnosed with atrial fibrillation and 2 (12%) had a cardiovascular admission . There was up-titration/initiation of BB therapy in 5 (29%) pts, referral for septal myectomy in 3 (18%) and ICD implantation for primary prevention in 3 (18%) pts. No proper ICD shocks, sustained ventricular arrythmias or deaths occurred.
Comparing significative latent to non LVOTobs pts, the first ones had more ICD implantation (log rank p =.04) and performed a surgical myectomy more frequently (log rank p= .018) during the follow-up.
CONCLUSION
In our study, significative latent LVOTobs was observed in 30% of pts. Its presence can have clinical implications in HCM pts approach and should be suspected in more symptomatic pts and when SAM is present at rest.
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Affiliation(s)
- A Cardoso
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - MR Lourenco
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - P Von Hafe
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - G Dias
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - T Pereira
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - M Tinoco
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - M Fernandes
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - O Azevedo
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - A Lourenco
- Hospital Senhora da Oliveira, Guimaraes, Portugal
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21
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Cardoso A, Tinoco M, Von Hafe P, Dias G, Pereira T, Oliveira L, Fernandes M, Azevedo O, Lourenco A. Characterization of temporal trends of systolic and diastolic indexes over time in breast cancer patients treated with trastuzumab. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Trastuzumab therapy increases survival in patients (pts) with HER2 positive breast cancer, however, it is associated with a risk of cardiotoxicity (CT). Our aim was to: 1) assess the temporal evolution of systolic and diastolic left and right ventricular indexes during and after T therapy and 2) study the incidence of CT in this group.
Methods
Retrospective study of breast cancer pts treated with T in a single center, during 2017 and 2018, who underwent a comprehensive echocardiographic examination before, quarterly, and after conclusion of T therapy. Pts with a baseline left ventricular ejection fraction (EF) <50% were excluded. CT was defined as a reduction of EF >10% to a value <50% or as a relative reduction of global longitudinal strain (GLS) of more than 15%.
Results
We included 50 women with mean age of 56 ± 10 years and mean body mass index (BMI) of 27 ± 5 kg/m2. Thirty-six (72%) patients underwent anthracycline chemotherapy prior to T and 44 (88%) had performed radiotherapy.
During treatment with T there was an increase of indexed left ventricle end-diastolic volume (38.6 ± 7.8 to 46.5 ± 10.3 ml/m2, p<.001) and a reduction of LVEF (65.1 ± 5.4 to 59.3 ± 6.2%, p < 0.001), GLS (-21.2 ± 2.7 to -17.9 ± 2.8%, p<.001) and right ventricle S’ (14.4 ± 13.1 to 12.2 ± 1.6 cm/s, p<.001) compared to baseline. There was no change in diastolic function parameters.
CT occurred in 23 (46%) pts, the majority based on GLS criteria (18; 78%). Heart failure symptoms were reported in 4 (8%) of these pts (1 in the GLS group and 3 in the EF group) and 3 (6%) pts had to permanently suspend therapy with T due to CT.
Patients with CT had a lower BMI (25 ± 4 vs 29 ± 4 kg/m2), but were otherwise similar to pts without CT. No association was found between pre-treatment with anthracyclines or radiotherapy with the risk of CT.
An echocardiographic revaluation at 2 years from treatment with T revealed a tendency for LVEF improvement (58.7 ± 7.1 to 61.2 ± 6.3%, p=.059) and a significative recovery of GLS (-17.4 ± 3.5 to -19.1 ± 3.3%, p=.026). No significative variations were found on right ventricular systolic function indexes or on diastolic parameters.
During a follow-up of 43 (IQR 32–47) months, 7 (14%) pts had tumor relapse and 1 (2%) died. CT was not associated with the composite endpoint of tumor relapse or death (p = 0.585).
Conclusion
T therapy is associated with a significative reduction on left and right ventricle systolic indexes during treatment. Although left ventricle systolic function tends to normalize over time, this does not happen with the right ventricle. CT induced by T had clinical impact leading to overt heart failure in 8% of pts and treatment discontinuation in 6% of pts. A lower BMI was associated with CT, which may be taken into account when defining the treatment strategy.
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Affiliation(s)
- A Cardoso
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - M Tinoco
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - P Von Hafe
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - G Dias
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - T Pereira
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - L Oliveira
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - M Fernandes
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - O Azevedo
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - A Lourenco
- Hospital Senhora da Oliveira, Guimaraes, Portugal
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22
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Fernandes M, Miranda M, Castro A, Lopes F, Garcia R, Pereira S, Palma Reis J. Is transurethral resection alone accurate enough for the diagnosis of variant histology bladder cancer compared with radical cystectomy? A 12-year retrospective study. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)03189-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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23
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Cardoso A, Faria B, Von Hafe P, Dias G, Pereira T, Ribeiro S, Calvo L, Oliveira M, Fernandes M, Sanfins V, Lourenco A. Family screening in brugada syndrome patients. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0635] [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
Brugada syndrome (BS) is a rare inherited channelopathy associated with sudden cardiac death (SCD) and family screening (FS) of index patients (pts) is recommended. However, data about pts identified through FS is lacking.
Aim
To compare index pts to non-index pts identified through systematic FS.
Methods
Single-center retrospective study of BS pts followed by the Arrhythmology Department. FS was offered to 1st degree relatives of all index pts through primary care services and a once-weekly voluntary open appointment. Genetic counselling was performed when indicated. Index and non-index pts were compared regarding baseline characteristics and events during the follow-up (syncope of probable arrhythmic origin, ventricular tachycardia/ventricular fibrillation (VT/VF) and SCD).
Results
We included 165 pts (61% males, mean age 47±15 years) and 72 (44%) were identified through FS. Non-index pts were diagnosed at a younger age (42±14 vs 51±14 years, p <.001), were more often female (57% vs 25%, p<.001), were diagnosed predominantly through provocative test with ajmaline/flecainide (88% vs 47%, p<.001) and had less documented spontaneous type 1 ECG pattern (17% vs 59%, p<.001). A type 2 pattern was identified in 18 (25%) non-index pts.
Genetic testing was performed in 38 (53%) non-index pts: 6 had a pathogenic SCN5A mutation, 18 a likely pathogenic SCN5A mutation and 12 a mutation of uncertain significance.
At diagnosis, 24 (33%) non-index pts had history of syncope, 3 (4%) had nocturnal agonal respiration and 11 (15%) had palpitations with no differences between both groups (p=.119). Non-index pts were less likely to implant a cardioverterdefibrillator (14% vs 38%, p=.001).
During a median follow-up of 28 (IQR 16–41) months, 10 (6%) pts had an event - 2 (3%) in the non-index group (2 syncope) and 8 (9%) in the index group (1 syncope; 7 VT/VF) - with no significative differences between groups (p=.432). There were nocardiovascular deaths.
Conclusions
FS identified a considerable proportion of BS pts. Non-index pts were younger at the time of the diagnosis and had less spontaneous type 1 pattern. No differences were found in events between index and non-index pts, however, the event rate was low. Systematic FS can identify individuals at risk of SCD earlier, allowing close monitoring and, when indicated, appropriate treatment.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- A Cardoso
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - B Faria
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - P Von Hafe
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - G Dias
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - T Pereira
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - S Ribeiro
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - L Calvo
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - M Oliveira
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - M Fernandes
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - V Sanfins
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - A Lourenco
- Hospital Senhora da Oliveira, Guimaraes, Portugal
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24
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Cardoso A, Faria B, Von Hafe P, Dias G, Pereira T, Ribeiro S, Calvo L, Oliveira M, Fernandes M, Sanfins V, Lourenco A. Gender related differences in brugada syndrome. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0636] [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
Brugada syndrome (BS) is a heritable channelopathy with male predominance. Males (M) seem to have a higher risk of arrhythmic events, although, there is limited data regarding gender differences in BS.
Aim
To compare the differences between genders in a Portuguese sample of BS patients (pts).
Methods
Single-center retrospective study of BS pts followed by the Arrhythmology Department. Pts were divided according to gender and compared regarding baseline characteristics and electrocardiographic (ECG) parameters that possibly predict the arrhythmic risk (significative S wave in DI, R wave sign, Tpeak-Tend interval and fragmented QRS). The events during follow-up were syncope of probable arrhythmic origin, ventricular tachycardia/ventricular fibrillation (VT/VF) and sudden cardiac death (SCD).
Results
A total of 165 pts were included; 64 (39%) were female (F) and the mean age at diagnosis was 47±15 years. The diagnosis was made by family screening (FS) in 72 (44%) pts. Sixty-seven pts (41%) had spontaneous type 1 pattern, 59 (36%) had history of syncope and 5 (3%) had history of aborted SCD. A positive genetic test was identified in 41 (25%) pts. Sixty-three (38%) pts were referred for an electrophysiological study (EEF) which was positive in 17 (27%) pts. A cardioverter-defibrillator was implanted in 45 (27%) pts. Females were more often diagnosed by FS (64% vs 31%, p <.001), had less type 1 spontaneous pattern (22% vs 53%, p<.001) and had no atrial fibrillation (0% vs 7%, p=.043). They performed EEF less frequently (22% vs 49%, p<.001) and had less spontaneous pattern during treadmill stress test (8% vs 33%, p=.004).
Regarding ECG parameters, females had shorter QRS interval (104±12 vs 115±18 ms, p<0.001), less frequent aVR sign (3% vs 27%, p<0.001), less significative S wave in DI (31% vs 55%, p=0.004), and a tendency for a shorter Tp-Te interval (80 vs 100 ms, p=0.051). Corrected QT interval was longer in females (396 vs 392ms, p=0.044). During a median follow-up of 28 (IQR 16–41) months, 7 pts had VT/VF (2F, 5M) and 3 had syncope (3M), with no differences between gender (p=0.287). There were no cardiovascular deaths.
Conclusion
In BS, female pts are more often diagnosed by FS and have less spontaneous type 1 pattern. Gender appears to affect basal ECG characteristics in BS, namely in parameters that may predict arrhythmic risk. Further studies are important to clarify the role of gender in prognosis and risk stratification of BS pts.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- A Cardoso
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - B Faria
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - P Von Hafe
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - G Dias
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - T Pereira
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - S Ribeiro
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - L Calvo
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - M Oliveira
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - M Fernandes
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - V Sanfins
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - A Lourenco
- Hospital Senhora da Oliveira, Guimaraes, Portugal
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Abstract
OBJECTIVES To assess whether regulatory guidance on the use of dexamethasone in hospitalised COVID-19 patients is applicable to the larger population of COVID-19 cases. The surge in worldwide demand for dexamethasone suggests that the guidance, although correct, has not emphasised the danger of its wider use. STUDY DESIGN Data from the Randomised Evaluation of COVID-19 Therapy (RECOVERY) trial and the World Health Organisation (WHO) prospective meta-analysis have been deconstructed and analysed. METHODS To provide context, relevant publications were identified in PubMed using the following keywords: COVID-19, RECOVERY trial, WHO meta-analysis, variants, immunity, public health. RESULTS The WHO guidance 'Corticosteroids for COVID-19' was based on their prospective meta-analysis. This meta-analysis was weighted by data from the RECOVERY trial. CONCLUSIONS In terms of COVID-19, dexamethasone has value in a narrow indication, namely, in hospitalised patients requiring respiratory support. The media blitz likely resulted in the wider use of dexamethasone in outpatients and as a preventive medication. This is reflected in the surge in worldwide demand for dexamethasone. We ask whether the use of steroids, beyond regulatory indications, may be responsible for the recent increase in mortality and especially the emergence of mucormycosis? From the public health standpoint, the current guidance for use of dexamethasone in COVID-19 could benefit from clarification and the addition of a cautionary note.
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Affiliation(s)
- M Fernandes
- Medbase, 114 Milton Avenue, Chapel Hill, NC, 27514, USA.
| | - J Brábek
- Department of Cell Biology, Charles University, Viničná 7, Prague, Czech Republic; Biotechnology and Biomedicine Centre of the Academy of Sciences and Charles University (BIOCEV), Průmyslová 595, Vestec U Prahy, 25242, Czech Republic
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26
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Kalmuk L, Fernandes M, Morabito A, Grumolato L, Tulasne D, Kherrouche Z, Cortot A. Implication des mutations de MET dans la résistance aux inhibiteurs de l’EGFR des cancers bronchiques non à petites cellules. Rev Mal Respir 2021. [DOI: 10.1016/j.rmr.2021.02.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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27
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Lourenço T, Fernandes M, Lopes A, Pereira Barbosa M. Acute Pancreatitis in the Context of Abdominal Attack of Hereditary Angioedema. J Investig Allergol Clin Immunol 2021; 30:281-283. [PMID: 32723700 DOI: 10.18176/jiaci.0490] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- T Lourenço
- Serviço de Imunoalergologia, Hospital de Santa Maria, Centro Hospitalar Universitário de Lisboa Norte (CHULN), Lisboa, Portugal
| | - M Fernandes
- Serviço de Imunoalergologia, Hospital de Santa Maria, Centro Hospitalar Universitário de Lisboa Norte (CHULN), Lisboa, Portugal.,Unidade de Imunoalergologia, Hospital Dr. Nélio Mendonça, SESARAM, EPE, Funchal, Portugal
| | - A Lopes
- Serviço de Imunoalergologia, Hospital de Santa Maria, Centro Hospitalar Universitário de Lisboa Norte (CHULN), Lisboa, Portugal
| | - M Pereira Barbosa
- Serviço de Imunoalergologia, Hospital de Santa Maria, Centro Hospitalar Universitário de Lisboa Norte (CHULN), Lisboa, Portugal.,Clínica Universitária de Imunoalergologia, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
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28
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Coutinho C, Lourenço T, Fernandes M, Neto M, Lopes A, Spínola Santos A, Pereira Barbosa M. Subcutaneous immunotherapy with aeroallergens - Safety profile assessment. Eur Ann Allergy Clin Immunol 2021; 54:77-83. [PMID: 33728836 DOI: 10.23822/eurannaci.1764-1489.194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Summary Introduction. Severe systemic reactions (SR) to allergen subcutaneous immunotherapy (SCIT) are rare but local reactions (LR) are common. We aimed to characterize the type of reactions and safety profile. Methods. Retrospective analysis of medical record from patients under SCIT between 2013-2016. Results. Total of 7372 SCIT injections in 323 patients: 52% female; mean age 30 years (SD 13); mean treatment time 19 months (SD 13). There were 57 patients (17.6% of population, 70% female) with at least one adverse reaction, for 93 reactions described (1.3% injections). There were 79 LR (1.1% injections) in 46(14.2%) patients: 36 in build-up, 43 in maintenance. There were 14 SR (0.19% injections) in 12(3.7%) patients: 12 in build-up, 2 in maintenance. All SR were grade 1. The majority of reactions were caused by mite SCIT (69.9%). Conclusions. SCIT is safe and well tolerated, with no report of SR grade > 1.
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Affiliation(s)
- C Coutinho
- Immunoallergology Service, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), EPE, Lisbon, Portugal
| | - T Lourenço
- Immunoallergology Service, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), EPE, Lisbon, Portugal
| | - M Fernandes
- Immunoallergology Service, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), EPE, Lisbon, Portugal.,Immunoallergology Unit, Hospital Dr. Nélio Mendonça, SESARAM, EPE, Funchal, Portugal
| | - M Neto
- Immunoallergology Service, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), EPE, Lisbon, Portugal
| | - A Lopes
- Immunoallergology Service, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), EPE, Lisbon, Portugal
| | - A Spínola Santos
- Immunoallergology Service, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), EPE, Lisbon, Portugal
| | - M Pereira Barbosa
- Immunoallergology Service, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), EPE, Lisbon, Portugal.,Clinical University of Immunoallergology, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
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Rodríguez S, Rocha J, Fernandes M, Ravishankar AP, Steinbrück N, Cruz R, Bacelar E, Kickelbick G, Anand S, Crespí AL, Casal S, de Zea Bermudez V. The Surfaces of the Ceratonia siliqua L. (Carob) Leaflet: Insights from Physics and Chemistry. Langmuir 2021; 37:2011-2028. [PMID: 33533623 DOI: 10.1021/acs.langmuir.0c02806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The production of superhydrophobic coatings inspired by the surface of plant leaves is a challenging goal. Such coatings hold a bright technological future in niche markets of the aeronautical, space, naval, building, automobile, and biomedical sectors. This work is focused on the adaxial (top) and abaxial (bottom) surfaces of the leaflet of the Ceratonia silique L. (carob), a high-commercial-value Mediterranean tree cultivated in many regions of the world. The adaxial and abaxial surfaces feature hydrophobic and superhydrophobic behaviors, respectively. Their chemical composition is very simple: monopalmitin ester and palmitic acid are protuberant in the epicuticular and intracuticular wax layers of the adaxial surface, respectively, whereas 1-octacosanol dominates in the abaxial wax layers. In both surfaces, epicuticular wax is organized along a randomly oriented and intricate network of nanometer-thick and micrometer-long plates, whose density and degree of interconnection are significantly higher in the abaxial surface. The measured tilting angles for the abaxial surface (12-70°) reveal unusual variable density and water adhesion of the nanostructured plate-based texture. Optical measurements demonstrate that light reflectance/absorbance of the glaucous abaxial surface is significantly higher/lower than that of the nonglaucous adaxial surface. In both surfaces, diffuse reflectance is dominant, and the absorbance is weakly dependent on the light incidence angle. We show that the highly dense nanostructured platelike texture of the epicuticular abaxial layer of the C. siliqua leaflet works as a sophisticated light and water management system: it reflects solar radiation diffusely to lower the surface temperature, and it has superhydrophobic character to keep the surface dry. Such attributes enable efficient gas exchange (photosynthesis and respiration), transpiration, and evaporation. To mimic for the first time the abaxial surface, a templation approach was adopted using poly(dimethylsiloxane) (PDMS)/poly(methylphenylsiloxane) (PMPS) positive/negative replicas and a soft polymer/siloxane negative replica produced by the sol-gel process. Because high topographical variations of the biotemplate and wax adhesion to the biohybrid film affected the replication quality, the reproduction of the wax texture via the synthesis of 1-octacosanol-grafted siloxane-based hybrid materials is proposed as a suitable route to duplicate the abaxial surface with high fidelity. The natural chemical/physical strategy adopted by the C. siliqua leaflet to face the harsh Mediterranean climate is a powerful source of bioinspiration for the development of diffuse reflecting and superhydrophobic material systems with foreseen applications as dual-functional antiglare and water-repelling coatings.
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Affiliation(s)
- S Rodríguez
- CQ-VR, University of Trás-os-Montes e Alto Douro, 5000-811 Vila Real, Portugal
| | - J Rocha
- CQ-VR, University of Trás-os-Montes e Alto Douro, 5000-811 Vila Real, Portugal
- Herbarium and Botanical Garden, University of Trás-os-Montes e Alto Douro, 5000-811 Vila Real, Portugal
| | - M Fernandes
- CQ-VR, University of Trás-os-Montes e Alto Douro, 5000-811 Vila Real, Portugal
- Department of Chemistry, University of Trás-os-Montes e Alto Douro, 5000-811 Vila Real, Portugal
| | - A P Ravishankar
- Department of Applied Physics, School of Engineering Sciences, KTH Royal Institute of Technology, Albanova University Centre, Roslagstullsbacken 21, SE-106 91 Stockholm, Sweden
| | - N Steinbrück
- Inorganic Solid State Chemistry, Saarland University, Campus Building C4 1, 66123 Saarbrücken, Germany
| | - R Cruz
- LAQV-REQUIMTE, Department of Chemical Sciences, Faculty of Pharmacy, Laboratory of Bromatology and Hydrology, University of Porto, 4050-313 Porto, Portugal
| | - E Bacelar
- CITAB, Department of Biological and Environmental Engineering, University of Trás-os-Montes e Alto Douro, 5000-811 Vila Real, Portugal
| | - G Kickelbick
- Inorganic Solid State Chemistry, Saarland University, Campus Building C4 1, 66123 Saarbrücken, Germany
| | - S Anand
- Department of Applied Physics, School of Engineering Sciences, KTH Royal Institute of Technology, Albanova University Centre, Roslagstullsbacken 21, SE-106 91 Stockholm, Sweden
| | - A L Crespí
- Herbarium and Botanical Garden, University of Trás-os-Montes e Alto Douro, 5000-811 Vila Real, Portugal
- CITAB, Department of Biological and Environmental Engineering, University of Trás-os-Montes e Alto Douro, 5000-811 Vila Real, Portugal
| | - S Casal
- LAQV-REQUIMTE, Department of Chemical Sciences, Faculty of Pharmacy, Laboratory of Bromatology and Hydrology, University of Porto, 4050-313 Porto, Portugal
| | - V de Zea Bermudez
- CQ-VR, University of Trás-os-Montes e Alto Douro, 5000-811 Vila Real, Portugal
- Department of Chemistry, University of Trás-os-Montes e Alto Douro, 5000-811 Vila Real, Portugal
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30
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Rodrigues GR, Rao MV, Fernandes M, Mendonca T. Diabetes and vision loss. Diabet Med 2021; 38:e14402. [PMID: 32946617 DOI: 10.1111/dme.14402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 07/09/2020] [Accepted: 09/03/2020] [Indexed: 11/29/2022]
Affiliation(s)
- G R Rodrigues
- Department of Ophthalmology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education(MAHE), India
| | - M V Rao
- Department of Ophthalmology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education(MAHE), India
| | - M Fernandes
- Department of Ophthalmology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education(MAHE), India
| | - T Mendonca
- Department of Ophthalmology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education(MAHE), India
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Cardoso A, Faria B, Von Hafe P, Dias G, Pereira T, Ribeiro S, Calvo L, Rodrigues B, Alves A, Fernandes M, Sanfins V, Lourenco A. Device therapy guided by implantable loop recorders: predictors of bradyarrhythmic events. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Implantable loop recorders (ILR) improved diagnostic yield in unexplained syncope patients (pts). Data on possible predictive factors for bradycardia requiring device implantation in these pts is limited. We aim to identify clinical predictors for device implantation due to a significant bradyarrhythmia in patients who underwent ILR insertion for the study of syncopal/presyncopal (S/pS) events.
Methods
Single-center retrospective study of patients who implanted an ILR for the study of unexplained S/pS episodes between 2013 and 2018. The primary endpoint was a documented bradyarrhythmia requiring device implantation during the follow-up.
Results
A total of 251 pts were included. Mean age was 68±15 years and 53% were female. The majority of pts (220; 88%) had normal ejection fraction. Fifty-two (21%) pts had atrial fibrillation (AF). Regarding basal electrocardiographic characteristics, 34 (14%) pts had 1st degree auriculo-ventricular block (AVB), 31 (12%) pts had left bundle branch block (L-BBB), 22 (9%) pts had R-BBB and 13 (5%) pts had bifascicular block.
During a median follow-up of 20 (IQR 9–34) months, 74 (29%) pts required device implantation because of a significant bradyarrhythmia (92% pacemaker, 4% CRT, 4% ICD). Median duration from ILR until device implantation was 5 (IQR 1–10) months. The indications were sick-sinus-syndrome in 47 (64%) pts, advanced AV block in 23 (31%) pts and symptomatic slow AF in 4 (5%) pts.
Patients who required device implantation were older (73±12 vs 66±15 years, p <0.001), had more hypertension (73% vs 59% p=0.048), a higher prevalence of AF (34% vs 15% p=0.001) and a lower glomerular filtration rate (GFR<60 ml/min: 32% vs 21%, p=0.047). They also had more 1st AVB (22% vs 11%, p=0.026) and intraventricular conduction disturbances (38% vs 25%, p=0.025). There was a trend for a higher device implantation in pts with concomitant 1st AVB and left anterior fascicular block (7% vs 2%, p=0.063)
In a logistic regression model, age >75 years (HR: 1.7; 95% CI: 1.1–2.8) and the presence of AF (HR: 1.8; 95% CI: 1.1–3.0) were independent predictors for device implantation.
Conclusion
An older age and the presence of AF were independent predictors for device therapy in pts who implanted an ILR for the study of S/pS. These factors may identify a higher risk group and should be considered in the initial workup of these pts.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- A Cardoso
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - B Faria
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - P Von Hafe
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - G Dias
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - T Pereira
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - S Ribeiro
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - L Calvo
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - B Rodrigues
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - A Alves
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - M Fernandes
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - V Sanfins
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - A Lourenco
- Hospital Senhora da Oliveira, Guimaraes, Portugal
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Fernandes M, Teuwen J, Wijsman R, Stam B, Moriakov N, Bussink J, Monshouwer R. PO-1747: Segmentation of the heart using a Residual Unet model. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01765-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Linthorst C, Wijsman R, Fernandes M, Barbara S, Teuwen J, Bosboom D, Monshouwer R, Bussink J. PO-0992: Pericardial effusion after radiotherapy for Non-Small Cell Lung Cancer. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01009-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Cardoso A, Dias G, Von Hafe P, Faria B, Fernandes M, Azevedo O, Leite S, Machado I, Lourenco A. P1456 Pacemaker and percutaneous aortic valve endocarditis - a complex decision. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
CASE REPORT
We describe the case of a 64-year-old man who was referred because of a fever. He had history of hypertension, dyslipidemia, atrial fibrillation, chronic obstructive pulmonary disease and a right lung pneumectomy due to epidermoid lung cancer diagnosed twenty-five years ago. He implanted dual-chamber definite pacemaker ten years ago and had a transcatheter aortic valve implantation (TAVI) in the previous year due to severe aortic stenosis and a high surgical risk.
He was hospitalized 2 months ago because of a respiratory infection. Blood cultures were positive for an Enterococcus faecalis. A transthoracic echocardiogram was performed and had no evidence of vegetations.
After one month, he had recurrence of fever and was again admitted. On physical examination he was hemodynamically stable, with signs of peripheral congestion and no heart murmur on cardiac auscultation. Blood cultures were again positive for Enterococcus faecalis. The transesophageal echocardiogram (TEE) showed a biologic aortic valve with thickened leaflets and small nodular structures suggestive of vegetations. There was a small periprosthetic leak and no obstruction or suspected perivalvular abscesses. There was also a small vegetation with 0,45*0,3 cm in the auricular pacemaker lead. A thoraco-abdomino-pelvic computed tomography scan showed no embolic complications. A diagnosis of pacemaker and TAVI endocarditis was made. The patient started directed antibiotic therapy (ceftriaxone and ampicillin).
The case was discussed in Heart Team and because of high surgical risk, medical treatment was decided. The patient completed antibiotic treatment with negative blood cultures and apyrexia. A repeated TEE showed persistence of vegetations, without development of local complications.
It was decided to discharge the patient under palliative suppressive antibiotic treatment with levofloxacin after discussion with the infectious disease doctor. In a follow-up evaluation, he remained clinically stable, without recurrence of fever.
DISCUSSION
As TAVI procedures are performed more frequently, a higher number of late complications are expected. Prosthetic valve endocarditis after TAVI is a complex situation, whose treatment strategy is not well-defined, particularly because these patients are usually of high surgical risk. This case describes a complex clinical picture and highlights the difficulty in decision-making in these situations. Also, it pretends to reinforce the need to discuss in a Heart Team the best treatment options.
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Affiliation(s)
- A Cardoso
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - G Dias
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - P Von Hafe
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - B Faria
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - M Fernandes
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - O Azevedo
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - S Leite
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - I Machado
- Hospital Senhora da Oliveira, Guimaraes, Portugal
| | - A Lourenco
- Hospital Senhora da Oliveira, Guimaraes, Portugal
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35
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Faia Carvalho Dias G, Faria B, Von Hafe P, Cardoso AF, Azevedo O, Fernandes M, Leite S, Cordeiro F, Castro F, Lourenco M, Almeida F, Lourenco A. P199 Mitral valve annular disjunction prevalence and significance amongst patients with mitral valve prolapse. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Mitral valve prolapse (MVP) is a common and usually benign entity. Occasionally, patients with MVP present with mitral annular disjunction (MAD), whose prevalence and clinical significance are still not clearly established.
Purpose
This study aimed to define the prevalence of MAD in a population of patients with MVP and study its echocardiographic and clinical implication.
Methods
A total of 31 patients with MVP who underwent echocardiographic evaluation in our laboratory were retrospectively evaluated. Echocardiographic, demographic and clinical variables were assessed. Disjunction amplitude (DA) was measured in parasternal long axis view (PLAX) and MAD was considered present if a separation of ≥ 5mm was verified. Annular diameter was measured in PLAX and apical four chamber view (A4C) both in systole and diastole.
Results
MAD was identified in 9 patients (29%), having a mean DA of 12.3 ± 3.2 mm. The group of patients with MAD was significantly younger than the group without MAD (mean age of 54 ± 18 vs 67 ± 15 years; p = 0.001), but there were no significant differences regarding gender, height, weight or cardiovascular risk factors. DA was inversely correlated with body surface area (r=-0.8, p = 0.009). Systolic annular diameters in PLAX and A4C views were increased in patients with MAD (4.2 ± 0.6 vs 3.6 ± 0.7 mm, p= 0.04 and 4.8 ± 0.7 vs 4.1 ± 0.7 mm, p = 0.025, respectively). The difference between systolic and diastolic diameters in PLAX was also greater in MAD (0.5 ± 0.2 vs 0.1 ± 0.3 mm, p = 0.007). Posterior wall thickness (8.5 ± 1.1 vs 9.7 ± 1.4 mm, p = 0.035), indexed left ventricular mass (89.0 ± 15.8 vs 110.6 ± 40,2 g/m2, p = 0.04) and ascending aortic dimensions (28.7 ± 6.7 vs 37.4 ± 3.6 mm, p = 0.018) were notably inferior in MAD patients, as was left ventricle ejection fraction (LVEF) (57.5 ± 5.8 vs 62.6 ± 4.9 %, p = 0.0023). No differences were found in chamber volumes. Similarly, eletrocardiographic parameters were identical in both groups. Five patients (56%) in the group with MAD had documentation of events (palpitations, dizziness, syncope or sudden cardiac death), in contrast with just 3 (21%) in the group without MAD, although statistical significance was not achieved (p = 0.078).
Conclusion
This study revealed that MAD is common among patients with MVP and is associated with altered annulus dynamics during the cardiac cycle. Its association with younger individuals, lower LVEF and, apparently, more clinical events highlight the importance of this entity.
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Affiliation(s)
| | - B Faria
- Hospital Guimaraes, Guimaraes, Portugal
| | | | | | - O Azevedo
- Hospital Guimaraes, Guimaraes, Portugal
| | | | - S Leite
- Hospital Guimaraes, Guimaraes, Portugal
| | | | - F Castro
- Hospital Guimaraes, Guimaraes, Portugal
| | | | - F Almeida
- Hospital Guimaraes, Guimaraes, Portugal
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Fernandes M. Child developmental follow up in obstetric RCTs: a unique opportunity. BJOG 2019; 127:518. [PMID: 31849172 DOI: 10.1111/1471-0528.16050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- M Fernandes
- Department of Paediatrics, Faculty of Medicine, Southampton Children's Hospital, University of Southampton, Southampton, UK.,Nuffield Department of Women's & Reproductive Health, John Radcliffe Hospital, University of Oxford, Oxford, UK
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Lourenco T, Fernandes M, Coutinho C, Lopes A, Spinola Santos A, Neto M, Pereira Barbosa M. Subcutaneous immunotherapy with aeroallergens Evaluation of adherence in real life. Eur Ann Allergy Clin Immunol 2019; 52:84-90. [PMID: 31789490 DOI: 10.23822/eurannaci.1764-1489.122] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Summary Introduction. Adherence in allergen immunotherapy is crucial for its efficacy. At least 3 years of treatment are recommended for achieving a long-term modifying effect. Objectives. To assess patient's adherence and to identify determinant factors for allergen subcutaneous immunotherapy (SCIT) suspension in patients with respiratory allergy. Methods. Retrospective analysis of the medical record of patients submitted to SCIT between January 2013 and December 2016 in our Department. Results. 323 patients were included: 52% female; mean age 30±13 years; average treatment time 19±13 months. 52 patients (16%) stopped SCIT: 54% female; mean age 30±9 years; average treatment time 12±6 months; 67% dropped the treatment during the 1st year, 27% in the 2nd and 6% during the 3rd year of treatment. Adherence rate determined was 77%. The most frequent reasons for withdrawal were due to economic reasons (47.9%), followed by patients' perception of no clinical improvement (23%) and change to sublingual immunotherapy (11.6%). Conclusion. Adherence rate in our study was 77%. Economic reasons were the main cause of abandonment in the first year, while the perception of non improvement was the main reason for abandonment in subsequent years. Adequate information on SCIT prescribing and rigorous monitoring of patients during the treatment can improve adherence.
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Affiliation(s)
- T Lourenco
- Servico de Imunoalergologia, Hospital de Santa Maria, Centro Hospitalar Universitario Lisboa Norte (CHULN) EPE, Lisboa
| | - M Fernandes
- Servico de Imunoalergologia, Hospital de Santa Maria, Centro Hospitalar Universitario Lisboa Norte (CHULN) EPE, Lisboa.,Unidade de Imunoalergologia, Hospital Dr. Nelio Mendonca, SESARAM, EPE, Funchal
| | - C Coutinho
- Servico de Imunoalergologia, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN) EPE, Lisboa
| | - A Lopes
- Servico de Imunoalergologia, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN) EPE, Lisboa
| | - A Spinola Santos
- Servico de Imunoalergologia, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN) EPE, Lisboa
| | - M Neto
- Servico de Imunoalergologia, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN) EPE, Lisboa
| | - M Pereira Barbosa
- Servico de Imunoalergologia, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN) EPE, Lisboa.,Clínica Universitária de Imunoalergologia, Faculdade Medicina da Universidade de Lisboa
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Prata C, Pasion R, Fernandes M, Almeida R, Pereira M, Mazer P, Barbosa F. Callousness and meanness traits are associated with increased N2 amplitude in a community sample of adolescents and adults. Neurosci Lett 2019; 706:1-6. [DOI: 10.1016/j.neulet.2019.04.056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 03/26/2019] [Accepted: 04/26/2019] [Indexed: 02/08/2023]
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Cunha C, Fernandes M, Santos M, Ferreira M, Caiado A, Miranda P, Azevedo P, Manso M, Oliveira J, Barreira S, Féria L, Maio R. ERAS® program in the “elderly” - can we still improve even in the extremes? Clin Nutr ESPEN 2019. [DOI: 10.1016/j.clnesp.2019.03.052] [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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Diaz A, Pavel A, Li R, Fernandes M, Peng X, Estrada Y, Krueger J, Paller A, Guttman-Yassky E. 993 Molecular abnormalities of early-onset pediatric atopic dermatitis are captured by tape strips. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.1069] [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: 11/17/2022]
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Lafratta A, Serrano O, Masqué P, Mateo MA, Fernandes M, Gaylard S, Lavery PS. Seagrass soil archives reveal centennial-scale metal smelter contamination while acting as natural filters. Sci Total Environ 2019; 649:1381-1392. [PMID: 30308907 DOI: 10.1016/j.scitotenv.2018.08.400] [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] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 08/26/2018] [Accepted: 08/27/2018] [Indexed: 06/08/2023]
Abstract
The upper Spencer Gulf in South Australia hosts the world's largest single stream Pb-Zn smelter, which has caused environmental and health issues related to elevated metal concentrations in the surrounding environment. The area also has extensive seagrass meadows, occupying >4000 km2. We reconstructed the fluxes of heavy metals over the last ~3000 years through a multi-parameter study of the soil archives formed by the seagrass Posidonia australis. Pb, Zn and Cd concentrations increased up to 9-fold following the onset of smelter operations in the 1880s, and the stable Pb isotopic signatures confirmed the smelter has been the main source of lead pollution in the seagrass soils until present. Preliminary estimates suggest that over the past 15 years seagrass meadows within 70 km2 of the smelter accumulated ~7-15% of the smelter emissions in their soils. Here we demonstrate that seagrass meadows act as pollution filters and sinks while their soils provide a record of environmental conditions, allowing baseline conditions to be identified and revealing the time-course of environmental change.
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Affiliation(s)
- A Lafratta
- School of Science, Centre for Marine Ecosystems Research, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA 6027, Australia.
| | - O Serrano
- School of Science, Centre for Marine Ecosystems Research, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA 6027, Australia
| | - P Masqué
- School of Science, Centre for Marine Ecosystems Research, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA 6027, Australia; The UWA Oceans Institute, School of Physics, University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia; Departament de Física, Institut de Ciència i Tecnologia Ambientals, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
| | - M A Mateo
- School of Science, Centre for Marine Ecosystems Research, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA 6027, Australia; Centro de Estudios Avanzados de Blanes, Consejo Superior de Investigaciones Cientificas, Blanes 17300, Spain
| | - M Fernandes
- South Australian Water Corporation (SA Water), GPO Box 1751, Adelaide, SA 5001, Australia; School of the Environment, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia
| | - S Gaylard
- South Australian Environment Protection Authority, GPO Box 2607, Adelaide, SA 5001, Australia
| | - P S Lavery
- School of Science, Centre for Marine Ecosystems Research, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA 6027, Australia; Centro de Estudios Avanzados de Blanes, Consejo Superior de Investigaciones Cientificas, Blanes 17300, Spain
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Dallantonia E, Lage J, Torrecilhas J, Leite R, Ferrari A, Rossi L, Fernandes M, Reis R. PSXI-7 Sustainable intensification of the beef cattle production system in Brazil: animal performance in growing phase in pasture. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.494] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- E Dallantonia
- São Paulo State University (Unesp), School of Agricultural and Veterinarian Sciences,Jaboticabal, Jaboticabal, Brazil
| | - J Lage
- Trouw Nutrition,Campinas, Brazil
| | - J Torrecilhas
- São Paulo State University (Unesp), School of Agricultural and Veterinarian Sciences,Jaboticabal, Jaboticabal, Brazil
| | - R Leite
- Sao Paulo State University,Jaboticabal, Brazil
| | - A Ferrari
- Sao Paulo State University,Jaboticabal, Brazil
| | - L Rossi
- Sao Paulo State University,Jaboticabal, Brazil
| | - M Fernandes
- Sao Paulo State University,Jaboticabal, Brazil
| | - R Reis
- Sao Paulo State University,Jaboticabal, Brazil
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Teixeira I, Vargas J, Almeida A, Souza A, Harter C, Fernandes M, Resende K. 45 Net macromineral requirements for maintenance in male and female Saanen goats: A meta-analytical approach. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - J Vargas
- Unesp,Jaboticabal, Sao Paulo, Brazil
| | - A Almeida
- Unesp,Jaboticabal, Sao Paulo, Brazil
| | - A Souza
- Unesp,Jaboticabal, Sao Paulo, Brazil
| | - C Harter
- Unesp,Jaboticabal, Sao Paulo, Brazil
| | | | - K Resende
- Unesp,Jaboticabal, Sao Paulo, Brazil
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Abstract
Abstract
Introduction: In cerebral palsy the greater neurologically compromised patients have the highest functional involvement of the masticatory system and the highest structural involvement of the temporomandibular joint (TMJ). These conditions contribute to the likelihood of the onset of articular and muscular disorders. These disorders affect the orofacial region and can cause pain, audible noise upon articulation, irregular mandibular functions with deviations, known as Temporomandibular Joint Dysfunctions (TMD). Traditionally, clinical studies have been limited to articular restrictions in detriment to the various neurological and motor clinical aspects. The objective of this research is to examine studies which investigated the prevalence of TMD signs in cerebral palsy, as well as studies about several aspects of the pathology surrounding TMD, including functional, structural, neurological, and clinical aspects. Materials and Methods: We carried out literature review of several studies published between 1976 and 2014. Scielo, MEDLINE, PubMed, EMBASE, CINAHL, DARE, Psych Info, ERIC, AMI, Cochrane, and PEDro databases were used to research literature on TMD using the following keywords without restrictions: cerebral palsy, temporomandibular disorders, and rehabilitation. Results: The literature showed that signs of TMD in cerebral palsy may be prevalent in severe clinical forms which can make cervical control more difficult and lead to postural deviations. Conclusion: Craniometric changes in head circunference may limit TMJ and occlusion movements, worsened by hypertonia and asymmetry in the pterygoid and masseter muscles. Children with swallowing and oropharyngeal dificulties are more likely to show signs of TMD.
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Affiliation(s)
- M. Fernandes
- Biomechanics Laboratory, Universidade São Judas Tadeu - USJT, Rua Taquari, 546, Mooca, CEP 03166-000, São Paulo, SP, Brazil
- Department of Physiotherapy, Universidade São Judas Tadeu - USJT, Rua Taquari, 546, Mooca, CEP 03166-000, São Paulo, SP, Brazil
- Dentistry Section, Associação de Assistência à Criança Deficiente - AACD, Av. Prof. Ascendino Reis, 724, Ibirapuera, CEP 04027-000, São Paulo, SP, Brazil
| | - U. Ervilha
- School of Arts, Sciences and Humanities, Universidade de São Paulo - USP, Av. Arlindo Béttio, 1000, Ermelino Matarazzo, CEP 03828-000, São Paulo, SP, Brazil
| | - L. Maifrino
- Morphology and Histology Laboratory, Universidade São Judas Tadeu - USJT, Rua Taquari, 546, Mooca, CEP 03166-000, São Paulo, SP, Brazil
| | - A. Bartkevicius
- Department of Physiotherapy, Universidade São Judas Tadeu - USJT, Rua Taquari, 546, Mooca, CEP 03166-000, São Paulo, SP, Brazil
| | - M. Santos
- Dentistry Section, Associação de Assistência à Criança Deficiente - AACD, Av. Prof. Ascendino Reis, 724, Ibirapuera, CEP 04027-000, São Paulo, SP, Brazil
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45
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Rocha J, Nunes C, Leonardo A, Correia MJ, Fernandes M, Paúl MC, Almeida V. Women generating narratives after an unwanted prenatal diagnosis result: randomized controlled trial. Arch Womens Ment Health 2018; 21:453-459. [PMID: 29502281 DOI: 10.1007/s00737-018-0822-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 02/20/2018] [Indexed: 10/17/2022]
Abstract
We have defined a psychological intervention based on cognitive narrative therapy and the Ottawa decision framework to reduce adjustment problems following a termination of pregnancy (TOP) after a positive prenatal diagnosis (PND). The intervention is composed of four sessions: decision, subjectivation, metaphorization, and projecting. This study aims to assess the effectiveness of a cognitive narrative intervention to prevent depression and anxiety symptoms after TOP. The intervention was accepted by 24 participants. The outcome is compared with a control group of 67 women who also terminated a pregnancy after PND. Participants were from several Portuguese institutions; 64.4% had a genetic and 35.6% had ultrasound diagnosis; the mean age was 30.0 years and the mean gestational age was 19 weeks. There are two evaluations: a baseline at the 15th day and a sixth month follow-up after TOP, using Beck Depression Inventory, Zung Anxiety Scale, Perinatal Grief Scale, and an instrument capturing participant satisfaction. Six months after TOP, there is a lower mean of anxiety and depression (p < 0.05), between groups, with effect sizes on the follow-up of 0.54 for depression, 0.41 for anxiety, and 0.23 for perinatal grief. This intervention has very positive effects on women mental health, and we emphasize the importance of the meaning-making process in the context of terminating a wanted pregnancy.
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Affiliation(s)
- José Rocha
- IINFACTS, CESPU, Gandra, Portugal. .,Centro de Psicologia do Trauma e do Luto, Porto, Portugal.
| | - C Nunes
- IINFACTS, CESPU, Gandra, Portugal
| | | | | | | | - M C Paúl
- Universidade do Porto, Porto, Portugal
| | - V Almeida
- IINFACTS, CESPU, Gandra, Portugal.,Centro de Psicologia do Trauma e do Luto, Porto, Portugal
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Grano C, Fernandes M, Bucci S, Aminoff D, Lucidi F, Violani C. Self-efficacy beliefs, faecal incontinence and health-related quality of life in patients born with anorectal malformations. Colorectal Dis 2018; 20:711-718. [PMID: 29751372 DOI: 10.1111/codi.14259] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 12/30/2017] [Indexed: 12/13/2022]
Abstract
AIM Anorectal malformations (ARMs) are rare congenital colorectal anomalies with long lasting consequences, among which faecal incontinence is one of the most relevant since it may strongly affect patients' health-related quality of life (HRQoL). Although a growing body of literature supports the importance of self-efficacy in chronic disease health outcomes, only few studies have focused on self-efficacy in ARMs and in faecal incontinence. The purpose of the present study is to examine the mediational role of self-efficacy in the path between faecal incontinence and HRQoL in patients born with ARMs. METHOD Ninety-eight adult patients from the Italian Association for Anorectal Malformations (AIMAR) responded to measures of faecal incontinence, self-efficacy for managing ARM consequences, and physical and mental HRQoL (SF-36). Data were analysed by means of structural equation models. RESULTS The tested model provides support for the guiding hypothesis. Fit indices indicate that the model fits the data well (χ2 = 33.48, df = 23, P = 0.07; comparative fit index [CFI] = 0.97; root mean square error of approximation [RMSEA] = 0.07; standardized root mean square residual [SRMR] = 0.05). Faecal incontinence has negative effects on both physical and mental HRQoL, as well on self-efficacy. In turn, self-efficacy has a positive and direct effect on mental HRQoL. CONCLUSION Faecal incontinence is the most relevant and negative factor influencing HRQoL; in addition, self-efficacy contributes in reducing emotional distress and in improving mental health outcomes. Longitudinal and controlled studies may be helpful to evaluate the effectiveness of self-efficacy interventions in improving mental HRQoL in patients with faecal incontinence.
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Affiliation(s)
- C Grano
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - M Fernandes
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - S Bucci
- Italian Parents and Patients Organization for Anorectal Malformation (AIMAR), Rome, Italy
| | - D Aminoff
- Italian Parents and Patients Organization for Anorectal Malformation (AIMAR), Rome, Italy
| | - F Lucidi
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
| | - C Violani
- Department of Psychology, Sapienza University of Rome, Rome, Italy
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Chilukuri H, Kulkarni MJ, Fernandes M. Revisiting amino acids and peptides as anti-glycation agents. Medchemcomm 2018; 9:614-624. [PMID: 30108952 PMCID: PMC6071831 DOI: 10.1039/c7md00514h] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 02/09/2018] [Indexed: 12/15/2022]
Abstract
The importance of controlling or preventing protein glycation cannot be overstated and is of prime importance in the treatment of diabetes and associated complications including Alzheimer's disease, cataracts, atherosclerosis, kidney aliments among others. In this respect, simple molecules such as amino acids and peptides hold much promise both in terms of ease and scale-up of synthesis as well as in relation to negligible/low associated toxicity. In view of this, a comprehensive account of literature reports is presented, that documents the anti-glycation activity of natural and non-natural amino acids and peptides. This review also discusses the chemical reactions involved in glycation and the formation of advanced glycation end-products (AGEs) and possible/probable intervention sites and mechanism of action of the reported amino acids/peptides. This aspect of amino acids/peptides adds to their growing importance in medicinal and therapeutic applications.
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Affiliation(s)
- H Chilukuri
- Organic Chemistry Division , CSIR-National Chemical Laboratory , Dr. Homi Bhabha Road , Pune 411008 , India . ;
- Academy of Scientific and Innovative Research (AcSIR) , CSIR-NCL Campus , Pune -411008 , India
| | - M J Kulkarni
- Academy of Scientific and Innovative Research (AcSIR) , CSIR-NCL Campus , Pune -411008 , India
- Proteomics Facility , Division of Biochemical Sciences , CSIR-National Chemical Laboratory , Dr. Homi Bhabha Road , Pune 411008 , India
| | - M Fernandes
- Organic Chemistry Division , CSIR-National Chemical Laboratory , Dr. Homi Bhabha Road , Pune 411008 , India . ;
- Academy of Scientific and Innovative Research (AcSIR) , CSIR-NCL Campus , Pune -411008 , India
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Machado J, Reis J, Fernandes M, Silva R, Cirnes L, Chaudhary R, Carneiro F, Costa J. Determining tumor mutation load using an NGS-based, target gene panel. Eur J Cancer 2018. [DOI: 10.1016/j.ejca.2018.01.013] [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: 10/17/2022]
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Machado J, Reis J, Fernandes M, Silva R, Cirnes L, Carneiro F, Costa J. Tumor-specific neoantigens drive T-cell clonotype convergence. Eur J Cancer 2018. [DOI: 10.1016/j.ejca.2018.01.029] [Citation(s) in RCA: 1] [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: 10/17/2022]
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50
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Pereira E, Correia J, Fernandes M. Epidural catheter breakage. ACTA ACUST UNITED AC 2017; 65:124. [PMID: 29122332 DOI: 10.1016/j.redar.2017.09.006] [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: 08/24/2017] [Revised: 09/15/2017] [Accepted: 09/19/2017] [Indexed: 10/18/2022]
Affiliation(s)
- E Pereira
- Department of Anesthesiology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
| | - J Correia
- Department of Anesthesiology, Instituto Português de Oncologia do Porto, Porto, Portugal
| | - M Fernandes
- Department of Anesthesiology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
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