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Kanniyappan H, Cheng KY, Badhe RV, Neto M, Bijukumar D, Barba M, Pourzal R, Mathew M. Investigation of cell-accelerated corrosion (CAC) on the CoCrMo alloy with segregation banding: Hip implant applications. J Mech Behav Biomed Mater 2024; 152:106449. [PMID: 38387118 DOI: 10.1016/j.jmbbm.2024.106449] [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: 07/19/2023] [Revised: 12/07/2023] [Accepted: 01/29/2024] [Indexed: 02/24/2024]
Abstract
Metal alloy microstructure plays a crucial role in corrosion associated with total hip replacement (THR). THR is a prominent strategy that uses metal implants such as cobalt-chromium-molybdenum (CoCrMo) alloys due to their advantageous biological and mechanical properties. Despite all benefits, these implants undergo corrosion and wear processes in-vivo in a synergistic manner called tribocorrosion. Also, the implant retrieval findings reported that fretting corrosion occurred in-vivo, evidenced by the damage patterns that appeared on the THR junction interfaces. There is no scientific data on the studies reporting the fretting corrosion patterns of CoCrMo microstructures in the presence of specific biological treatments to date. In the current study, Flat-on-flat fretting corrosion set-up was customized and used to study the tribocorrosion patterns of fretting corrosion to understand the role of alloy microstructure. Alloy microstructural differences were created with the implant stock metal's longitudinal and transverse cutting orientations. As a result, the transverse created the non-banded, homogenous microstructure, whereas the longitudinal cut resulted in the banded, non-homogenous microstructure on the surface of the alloy (in this manuscript, the terms homogenous and banded were used). The induced currents were monitored using a three-electrode system. Three different types of electrolytes were utilized to study the fretting corrosion patterns with both homogeneous and banded microstructures: 1. Control media 2. Spent media (the macrophage cell cultured media) 3. Challenged media (media collected after the macrophage was treated with CoCrMo particles). From the electrochemical results, in the potentiostat conditions, the banded group exhibited a higher induced current in both challenged and spent electrolyte environments than in control due to the synergistic activity of CoCrMo particles and macrophage demonstrating more corrosion loss. Additionally, both Bode and Nyquist plots reported a clear difference between the banded and homogeneous microstructure, especially with challenged electrolytes becoming more corrosion-resistant post-fretting than pre-fretting results. The banded microstructure showed a unique shape of the fretting loop, which may be due to tribochemical reactions. Therefore, from the electrochemical, mechanical, and surface analysis data results, the transverse/homogenous/non-banded alloy microstructure groups show a higher resistance to fretting-corrosion damage.
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Affiliation(s)
- Hemalatha Kanniyappan
- Regenerative Medicine and Disability Research (RMDR) Lab, Department of Biomedical Sciences, UICOM, Rockford, IL, USA
| | - Kai-Yuan Cheng
- Regenerative Medicine and Disability Research (RMDR) Lab, Department of Biomedical Sciences, UICOM, Rockford, IL, USA
| | - Ravindra V Badhe
- Regenerative Medicine and Disability Research (RMDR) Lab, Department of Biomedical Sciences, UICOM, Rockford, IL, USA; Marathwada Mitra Mandal's College of Pharmacy, Pune, India
| | | | - Divya Bijukumar
- Regenerative Medicine and Disability Research (RMDR) Lab, Department of Biomedical Sciences, UICOM, Rockford, IL, USA
| | - Mark Barba
- Dept of Orthopedics, Rush University Medical Center, Chicago, IL, USA
| | | | - Mathew Mathew
- Regenerative Medicine and Disability Research (RMDR) Lab, Department of Biomedical Sciences, UICOM, Rockford, IL, USA.
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Esteves Caldeira L, Paulino M, Coutinho C, Neto M, Pereira Barbosa M, Costa C. Clinical experience of a specialized urticaria outpatient clinic from a Portuguese UCARE. Eur Ann Allergy Clin Immunol 2023; 55:9-18. [PMID: 33949172 DOI: 10.23822/eurannaci.1764-1489.209] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Summary Background. Chronic urticaria (CU) is a frequent disease, with a prevalence of at least 1%. It is characterized by pruritic wheals, angioedema or both for a period longer than 6 weeks. Objective. Identify the demographic, clinical, laboratory and therapeutic profile of patients treated in a Portuguese Urticaria Center of Reference and Excellence (UCARE) and compare it with international series. Methods. Retrospective analysis of database of patients observed in a specialized urticaria outpatient clinic, from January 2017 through September 2019, of a UCARE center in Portugal. Demographic and clinical features, laboratory findings and pharmacological treatment were obtained from the records. Descriptive analyses were performed for all variables. Chi square and fisher's exact tests were applied to analyze the independence of variables and the fit of distribution. P less than 0.05 was considered significant. Results. During this period, 477 patients were observed, of whom 429 (90%) were diagnosed with chronic urticaria. Mean age (years) at the onset of symptoms was 43.7 (standard deviation (SD) 17.6, range 6-88) and at diagnosis 46.7 (SD 17.8, range 6-88) resulting in an average diagnostic delay of 3 years (range 0-25). Median follow-up period since first attendance in the specialized outpatient clinic was 1.7 years (interquartile range (IQR) 0.79, range 0.1-2.75) . Concerning the whole group of CU patients, 347 (81%) had chronic spontaneous urticaria (CSU) - 79% female, 39 (9%) had isolated chronic inducible urticaria (CIndU) and 43 (10%) had CSU with CIndU. Autologous serum skin test (ASST) was done in 76 patients (positive in 24 (32%)) and basophil activation test (BAT) was done in 38 (positive in 13 (34%)). At the moment of study, 204 (48%) of CU patients were medicated with a second-generation H1-antihistamine (sgAH) daily (first-line therapy), 99 (23%) with sgAH up to four times the standard dose (second-line therapy) and 126 (29%) with omalizumab (third-line therapy). Additionally, 7 (2%) patients were completing a short course of systemic corticosteroids for management of disease exacerbation. Disease control was achieved in 316 of CSU patients (81%). Conclusions. Referral to a specialized urticaria outpatient clinic is important for a proper assessment of the disease and adequately symptom control.
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Affiliation(s)
- L Esteves Caldeira
- Immunoallergology Service, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), EPE, Lisbon, Portugal
| | - M Paulino
- Immunoallergology Service, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), EPE, Lisbon, Portugal
| | - C Coutinho
- Immunoallergology Service, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), EPE, Lisbon, Portugal
| | - M Neto
- 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
| | - C Costa
- 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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Varandas C, Esteves Caldeira L, Silva SL, Costa C, Limão R, Silva MI, Lopes A, Caiado J, Cosme J, Alonso E, Marcelino J, Cabral Duarte F, Fernandes NP, Neto M, Pedro E, Branco Ferreira M, Spínola Santos A. Hereditary angioedema: 24 years of experience in a Portuguese Reference Center. Eur Ann Allergy Clin Immunol 2022. [PMID: 36515257 DOI: 10.23822/eurannaci.1764-1489.278] [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: 12/15/2022]
Abstract
Summary Hereditary angioedema (HAE) poses a high burden of disease, being its epidemiological and clinical data heterogeneous among countries, with no recent published studies concerning Portuguese patients. Therefore, we aimed to raise awareness of HAE and to contribute to clinical knowledge. An observational, descriptive, retrospective, and cross-sectional study was performed, that included a cohort of 126 patients followed in a single Portuguese Center. We observed a high prevalence of HAE-C1-INH type II (45.2% of patients). Most HAE patients (67.4%) presented the initial manifestations of the disease before adulthood, at a mean age of 12.6 ± 8.4 years. However, we found a long delay in HAE diagnosis, especially in those without family history (mean 20.7 ± 17.3 years). Stress was the most common trigger, followed by trauma and infection. Symptoms involving different systems were increasingly reported with increased disease duration. Cutaneous symptoms (95.0%) were more frequent, followed by gastrointestinal (80.7%), and respiratory symptoms (50.4%). HAE symptoms led to abdominal surgery in 22 (17.5%) patients and induced laryngeal edema requiring intubation/tracheostomy in 8 (6.3%) patients. Most patients were under long-term prophylaxis, mainly with attenuated androgens (62.7% of patients).The correct distinction between HAE and other common causes of angioedema is critical, allowing reduction of diagnostic delay, improvement of adequate management, and ultimately improving outcomes and quality of life of HAE patients.
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Affiliation(s)
- C Varandas
- Department of Immunoallergology, Santa Maria Hospital, Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Lisboa, Lisbon, Portugal
| | - L Esteves Caldeira
- Department of Immunoallergology, Santa Maria Hospital, Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Lisboa, Lisbon, Portugal
| | - S L Silva
- Department of Immunoallergology, Santa Maria Hospital, Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Lisboa, Lisbon, Portugal
- Immunoallergology University Clinic, Faculty of Medicine, Lisbon University, Lisbon, Portugal
| | - C Costa
- Department of Immunoallergology, Santa Maria Hospital, Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Lisboa, Lisbon, Portugal
- Immunoallergology University Clinic, Faculty of Medicine, Lisbon University, Lisbon, Portugal
| | - R Limão
- Department of Immunoallergology, Santa Maria Hospital, Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Lisboa, Lisbon, Portugal
| | - M I Silva
- Department of Immunoallergology, Santa Maria Hospital, Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Lisboa, Lisbon, Portugal
| | - A Lopes
- Department of Immunoallergology, Santa Maria Hospital, Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Lisboa, Lisbon, Portugal
- Immunoallergology University Clinic, Faculty of Medicine, Lisbon University, Lisbon, Portugal
| | - J Caiado
- Department of Immunoallergology, Santa Maria Hospital, Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Lisboa, Lisbon, Portugal
- Immunoallergology University Clinic, Faculty of Medicine, Lisbon University, Lisbon, Portugal
| | - J Cosme
- Department of Immunoallergology, Santa Maria Hospital, Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Lisboa, Lisbon, Portugal
- Immunoallergology University Clinic, Faculty of Medicine, Lisbon University, Lisbon, Portugal
| | - E Alonso
- Department of Immunoallergology, Santa Maria Hospital, Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Lisboa, Lisbon, Portugal
| | - J Marcelino
- Department of Immunoallergology, Santa Maria Hospital, Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Lisboa, Lisbon, Portugal
| | - F Cabral Duarte
- Department of Immunoallergology, Santa Maria Hospital, Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Lisboa, Lisbon, Portugal
| | - N P Fernandes
- Department of Immunoallergology, Santa Maria Hospital, Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Lisboa, Lisbon, Portugal
| | - M Neto
- Department of Immunoallergology, Santa Maria Hospital, Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Lisboa, Lisbon, Portugal
| | - E Pedro
- Department of Immunoallergology, Santa Maria Hospital, Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Lisboa, Lisbon, Portugal
| | - M Branco Ferreira
- Department of Immunoallergology, Santa Maria Hospital, Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Lisboa, Lisbon, Portugal
- Immunoallergology University Clinic, Faculty of Medicine, Lisbon University, Lisbon, Portugal
| | - A Spínola Santos
- Department of Immunoallergology, Santa Maria Hospital, Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Lisboa, Lisbon, Portugal
- Immunoallergology University Clinic, Faculty of Medicine, Lisbon University, Lisbon, Portugal
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Manthe J, Cheng KY, Bijukumar D, Barba M, Pourzal R, Neto M, Mathew MT. Hip implant modular junction: The role of CoCrMo alloy microstructure on fretting-corrosion. J Mech Behav Biomed Mater 2022; 134:105402. [PMID: 36041275 PMCID: PMC10507884 DOI: 10.1016/j.jmbbm.2022.105402] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 07/09/2022] [Accepted: 07/24/2022] [Indexed: 11/29/2022]
Abstract
Cobalt-chromium-molybdenum (CoCrMo) alloy is one of the most used metals in total hip replacement (THR) due to the alloy's superior corrosion qualities and biocompatibility. Over time these prostheses may undergo wear and corrosion processes in a synergistic process known as tribocorrosion. Implant retrieval studies have shown that damage patterns on THR modular junction surfaces indicating specifically in vivo fretting-corrosion to take place. To date, there have been no studies on the fretting-corrosion behaviors of CoCrMo alloy under the consideration of specific microstructural features. A custom-built flat-on-flat fretting-corrosion setup was utilized to test the synergistic tribocorrosion behavior of fretting-corrosion. The difference in microstructure was generated through the cutting orientations of the transverse and the longitudinal direction of the bar stock material, where the longitudinal cut exhibits a characteristic banded microstructure (banded group) and the transverse cut a homogenous microstructure (unbanded group). A three-electrode system was employed to monitor the induced currents. Two different types of electrolytes were used in the current study: 1. Bovine calf serum (BCS-30 g/L protein) (normal conditions) 2. BCS with Lipopolysaccharide (LPS, 0.15 μg/ml) (simulated infectious conditions). In the free potential mode, banded samples showed an increased potential compared to the unbanded samples. In potentiostatic conditions, the banded group also exhibited a higher induced current in both electrolyte environments, indicating more corrosion loss. Both Nyquist and Bode plots showed both orientations of metal becoming more corrosion resistant post-fretting when compared to pre-fretting data. The longitudinal group at OCP demonstrated a unique shape of the fretting-loop, which might be related to tribochemical reactions. Based on the mechanical, electrochemical, and surface characterization data, the transverse group (unbanded) microstructures demonstrates a higher resistance to fretting-corrosion damage.
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Affiliation(s)
- Jacob Manthe
- RMDR Lab, Department of Biomedical Sciences, University of Illinois College of Medicine, Rockford, IL, USA
| | - Kai Yuan Cheng
- RMDR Lab, Department of Biomedical Sciences, University of Illinois College of Medicine, Rockford, IL, USA
| | - Divya Bijukumar
- RMDR Lab, Department of Biomedical Sciences, University of Illinois College of Medicine, Rockford, IL, USA
| | | | - Robin Pourzal
- Department of Orthopedics, Rush University Medical Center, Chicago, IL, USA
| | - Mozart Neto
- Department of Orthopedics, Rush University Medical Center, Chicago, IL, USA
| | - Mathew T Mathew
- RMDR Lab, Department of Biomedical Sciences, University of Illinois College of Medicine, Rockford, IL, USA; Department of Orthopedics, Rush University Medical Center, Chicago, IL, USA.
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Alves T, Rodrigues E, Neto M, Mexia R, Matias-Dias C. Falls in older people at home and leisure time during the COVID-19 pandemic in Portugal. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Falls are one of the most common mechanisms of injury namely at home and in leisure time reaching one of the most vulnerable groups of the population such as the older ones, with expression in morbidity and mortality. The pandemic context we are experiencing it has had effects on the physical, mental and social wellbeing of populations but also on the use of health care whose magnitude and reasons are subject of discussion. The aim of this study is to understand the evolution of falls episodes in victims aged 65 and over, which needed attendance in the emergency room of the Health National Service Hospitals in Portugal based on hospital records, through EVITA system, between 2017 and 2020. A descriptive analysis of the data was performed, with the determination of absolute and relative frequencies (percentages). Bivariate comparisons were performed using Pearson's chi-square test with a significance level of 5%. In this analysis, the statistical program SPSS V.24 was used. In the four years between 2017 and 2020 the older people aged 65 and over represented 27% of the total of attendances in the emergency room. Considering the total of ED attendances in this age group 10% occurred due to fall at home or during leisure time. In the last four years there were 462 953 falls in people victims aged 65+, constituting 46% of hospital ED attendances by fall. From march to december 2020, falls episodes have remained below the values of similar periods in the previous four years (p < 0,01). The largest percentage decrease in falls in 2020 compared to the same period in 2019 occurred in april, with a decrease of 41%. Most of this falls in the study population occurred at home (61%), followed by falls in outdoor spaces (11%). Globally, this reality regarding to the decrease of the ED attendances during this pandemic context is not exclusive to Portugal.
Key messages
The older people represented 27% of the total of attendances in the emergency room in the four years in analysis. 10% of ED attendances occurred due to fall at home or during leisure time. From march to december 2020, was observed a significant decrease of falls episodes compared with the previous four years.
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Affiliation(s)
- T Alves
- Epidemiology Department, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - E Rodrigues
- Epidemiology Department, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - M Neto
- Epidemiology Department, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - R Mexia
- Epidemiology Department, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - C Matias-Dias
- Epidemiology Department, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
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Pedrosa B, Neto M, Namorado S, Leite A. Relation between depression and chronic physical disease and healthcare utilisation in the Portuguese. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Previous studies show high chronic physical disease/depression comorbidity and higher healthcare use in these patients. Most studies focus on a single physical disease and do not consider number of diseases or depression severity. We aimed to characterise the chronic physical disease/depression relation in the Portuguese and analyse its association with healthcare use.
Methods
We undertook a cross-sectional study, using data (2019/2020) from an existing family panel (Em Casa Observamos Saúde), with “chronic physical disease” as exposure and “depression” and “healthcare use need” as outcomes. The sociodemographic characteristics of the sample were described. Logistic and multinomial regression analysis between depression (presence/severity) and chronic physical disease (presence/type/number) and between this comorbidity and healthcare use need were conducted. Adjusted odds ratio (OR) and 95% confidence intervals (CI95%) were calculated for each analysis. Analyses were weighted to account for complex sample design.
Results
1068 individuals were included. In the population, 8.9% had depression and 72.1% had chronic physical disease. There was no statistically significant relation between general physical disease and depression (OR = 1.68 [CI95%:0.55;5.15]), but there was between allergy (OR = 2.08 [CI95%:1.02;4.25]) and COPD (OR = 3.04 [CI95%:1.21;7.61]). The risk of depression was smaller in those with two physical diseases (vs. three or more, OR = 0.32 [CI95%:0.15;0.68]). A relation between chronic physical disease and depression with healthcare use need was not observed with wide confidence intervals.
Conclusions
This study suggests a relation between COPD, allergy and a higher number of physical diseases and depression in the Portuguese. No evidence of an increased need for healthcare services was identified. Clinicians should be aware of this relation and more research needs to be conducted after the pandemic context.
Key messages
Depression is common in patients with physical diseases and should be treated. Improving coordination between services should be prioritised. No evidence of an increased need for healthcare services was identified but research outside the pandemic context should be pursued.
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Affiliation(s)
- B Pedrosa
- Comprehensive Health Research Center, Universidade Nova de Lisboa, Lisbon, Portugal
| | - M Neto
- Department of Epidemiology, National Institute of Health, Lisbon, Portugal
| | - S Namorado
- Department of Epidemiology, National Institute of Health, Lisbon, Portugal
| | - A Leite
- Comprehensive Health Research Center, Universidade Nova de Lisboa, Lisbon, Portugal
- Public Health Research Center, Universidade Nova de Lisboa, Lisbon, Portugal
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Paulino M, Costa C, Neto M, Pedro E. Cold Urticaria. Characterizing the population from an urticaria outpatient clinic. Actas Dermosifiliogr (Engl Ed) 2021; 112:S1578-2190(21)00182-7. [PMID: 34052427 DOI: 10.1016/j.adengl.2021.05.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 04/15/2021] [Indexed: 01/23/2023] Open
Abstract
INTRODUCTION Cold Urticaria (ColdU) is a type of chronic inducible urticaria (CIndU) where recurrent pruritic wheals and/or angioedema occur after exposure to cold stimulus. Although it usually only affects exposed areas, systemic reactions can occur in severe cases. In this study, we seek to characterize the ColdU cases within our Centre's population of patients. MATERIAL AND METHODS Retrospective study based on clinical files of patients diagnosed with ColdU followed in an urticaria outpatient clinic in Portugal prior to October 2020. RESULTS We included 52 patients total (40 women) with median age of 35 years, 19 patients with symptom onset before 18 years-old. ColdU was classified as acquired in all patients. Cold provocation tests were negative in 9 patients and these were classified as atypical ColdU. No significant differences were found between those with pediatric or adult onset of disease. Most of the patients had a localized form of the disease (52%). Despite not being statistically significant, it was found that patient's temperature threshold, assessed with TempTest® 4.0, was higher and stimulation time was shorter in more severe groups. All patients were treated with non-sedating antihistamines (daily or on-demand), finding that those controlled with standard dosages had lower temperature thresholds than those needing higher dosages (p < 0.01). One patient was under treatment with omalizumab. CONCLUSION ColdU is an heterogenous disease that can have life-threatening event consequences. Cold provocation tests and threshold assessment can be an important tool in the management treatment and in identifying severity groups.
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Affiliation(s)
- M Paulino
- Immunoallergology Department, Hospital de Santa Maria - Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal.
| | - C Costa
- Immunoallergology Department, Hospital de Santa Maria - Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - M Neto
- Immunoallergology Department, Hospital de Santa Maria - Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - E Pedro
- Immunoallergology Department, Hospital de Santa Maria - Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
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Santos H, Santos M, Almeida I, Paula S, Miranda H, Figueiredo M, Neto M, Sa C, Sousa C, Chin J, Almeida S, Almeida L. Endocardial left ventricular pacing Where are we a systematic review. Europace 2021. [DOI: 10.1093/europace/euab116.433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Endocardial left ventricular pacing is a technique used in cardiac resynchronization therapy (CRT), when a coronary sinus implant is not possible, conventional CRT was an unsuccess and in CRT nonresponders. We performed a systemic review to evaluate its risks and benefits.
Objective
Review the evidence regarding the efficacy and safety of endocardial left ventricular pacing.
Methods
A systemic research on MEDLINE and PUBMED with the term "endocardial left ventricular pacing", "biventricular pacing" or "endocardial left pacing". 1038 results were identified, however, just publish papers (excluding abstract) with more than 16 patients was admitted in these analyses. Comparisons pre and post CRT regard New York Heart Association (NYHA) functional classification, left ventricular ejection fraction (LVEF) and QRS width was performed. Mean differences (MD) and confidence interval (CI) was used as a measurement of treatment.
Results
Eleven studies were selected, including a total of 560 patients. The studies were performed with different techniques, trans-atrial septal technique, trans-ventricular septal technique and transapical technique. Mean age 66.93 years old, 90.54% male, median ejection fraction of 28.86%, NYHA class of 3.03, QRS width 167,50 mseg. Ischemic etiologic in 43.88%, atrial fibrillation in 45.35% and left bundle branch block in 55.20%. Was reported several complications after the procedure, 8 pocket infection (7 studies), 17 transient ischemic attacks (10 papers), 17 ischemic stroke (all), 35 tromboembolic events (all) and 115 deaths, nevertheless, follow up in the different studies was diverse and heterogeneous. Significant improvement was registered in NYHA class (MD 0.64, CI 0.56-0.72, p < 0.00001, I2 = 89%) (reported in 7 studies), LVEF (MD 6.20, CI 5.09-7.32, p = 0.002, I2 = 69%) %) (reported in 8 studies) and QRS width (MD 31.35, CI 26.11-36.60, p < 0.00001, I2 = 89%) %) (reported in 5 studies), (all p < 0.00001).
Conclusions
Left ventricular endocardial pacing is a feasible alternative to conventional CRT, when the last one is not possible. With clinical, electrocardiogram and echocardiogram improvement in several series. First data regarding this procedure were associated with higher stroke incidence, something contrary to the last study’s results. Nevertheless, at the moment just small series present this technique with heterogenous results and different approaches, being important further investigation.
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Affiliation(s)
- H Santos
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - M Santos
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - I Almeida
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - S Paula
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - H Miranda
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - M Figueiredo
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - M Neto
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - C Sa
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - C Sousa
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - J Chin
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - S Almeida
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - L Almeida
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
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Santos H, Almeida I, Santos M, Paula S, Miranda H, Figueiredo M, Neto M, Sousa C, Sa C, Chin J, Almeida S, Almeida L. Septal vs apical defibrillator electrode placement a systematic review. Europace 2021. [DOI: 10.1093/europace/euab116.405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
The optimal right ventricular defibrillator lead placement is still a debatable matter. We attempt to performed a systemic review to evaluate whether septal and apical placement had significant differences in the follow-up with an indication for implantation of these devices.
Objective
Review the evidence regarding the efficacy and safety of right ventricular apical and septal defibrillator lead placement.
Methods
A systemic research on MEDLINE and PUBMED with the term "septal pacing", "apical pacing" "septal defibrillation" or "apical defibrillation". 309 results were identified, however, after a serious analysis, several articles were excluded. Comparisons between apical and septal placement were performed regarding R wave amplitude, pacing threshold at 0.5 ms, lead impedance, left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD) and lead complication that produced lead re-placement. Mean differences (MD) and confidence interval (CI) was used as a measurement of treatment.
Results
Six studies were selected, including a total of 2180 patients. The studies were performed with different techniques, analyses and goals. The studies presented heterogeneous and diverse results, with a varied follow-up period, that resulted in the exclusion of one of the studies. Mean age 64.51 years old, 76.86% male, a median ejection fraction of 27.84%, NYHA class of 2.65, ischemic etiologic in 51.10% and a follow-up period of 26.49 months. Septal defibrillator lead placement was established in 772 patients, while the apical defibrillator lead placement was performed in 1399 patients. No differences regarding the lead performance on apical and septal placement were detected regarding the R-wave (MD -0.36, CI -0.75 - +0.03, p = 0.68, I2 = 0%) (reported in 3 studies) and lead impedance (MD -23.83, CI -51.36 - +3.69, p = 0.003, I2 = 82%) (reported in 3 studies). Pacing threshold seems to be favor a septal defibrillator lead implantation (MD -0.05, CI -0.09 - -0.02, p = 0.12, I2 = 53%) (reported in 3 studies). Concerning echocardiography parameters during the follow up period, LVEF (MD -0.83, CI -3.05 - +1.38, p = 0.10, I2 = 57%) (reported in 3 studies) and LVEDD (MD -0.51, CI -2.13 - +1.10, p = 0.20, I2 = 38%) (reported in 3 studies) were not significant influenced for the defibrillator lead placement. Lead complications that provoke a lead replacement was not significant between the lead placement (MD 1.25, CI 0.53 – 2.94, p = 0.71, I2 = 0%) (reported in 3 studies).
Conclusions
Just pacing threshold proved to improve the septal defibrillator lead placement. Neither the other lead parameters or the echocardiography results during the follow-up were influenced by the lead placement. For a definitive conclusion is important to further investigation.
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Affiliation(s)
- H Santos
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - I Almeida
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - M Santos
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - S Paula
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - H Miranda
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - M Figueiredo
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - M Neto
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - C Sousa
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - C Sa
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - J Chin
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - S Almeida
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
| | - L Almeida
- Hospital N.S. Rosario, Cardiology, Barreiro, Portugal
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10
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Paulino M, Costa C, Neto M, Pedro E. Cold Urticaria. Characterizing the Population From an Urticaria Outpatient Clinic. Actas Dermosifiliogr (Engl Ed) 2021; 112:S0001-7310(21)00143-5. [PMID: 33901484 DOI: 10.1016/j.ad.2021.04.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 02/21/2021] [Accepted: 04/15/2021] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Cold Urticaria (ColdU) is a type of chronic inducible urticaria (CIndU) where recurrent pruritic wheals and/or angioedema occur after exposure to cold stimulus. Although it usually only affects exposed areas, systemic reactions can occur in severe cases. In this study, we seek to characterize the ColdU cases within our Centre's population of patients. MATERIAL AND METHODS Retrospective study based on clinical files of patients diagnosed with ColdU followed in an urticaria outpatient clinic in Portugal prior to October 2020. RESULTS We included 52 patients total (40 women) with median age of 35 years, 19 patients with symptom onset before 18 years-old. ColdU was classified as acquired in all patients. Cold provocation tests were negative in 9 patients and these were classified as atypical ColdU. No significant differences were found between those with pediatric or adult onset of disease. Most of the patients had a localized form of the disease (52%). Despite not being statistically significant, it was found that patient's temperature threshold, assessed with TempTest® 4.0, was higher and stimulation time was shorter in more severe groups. All patients were treated with non-sedating antihistamines (daily or on-demand), finding that those controlled with standard dosages had lower temperature thresholds than those needing higher dosages (p<0.01). One patient was under treatment with omalizumab. CONCLUSION ColdU is an heterogenous disease that can have life-threatening event consequences. Cold provocation tests and threshold assessment can be an important tool in the management treatment and in identifying severity groups.
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Affiliation(s)
- M Paulino
- Immunoallergology Department, Hospital de Santa Maria - Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal.
| | - C Costa
- Immunoallergology Department, Hospital de Santa Maria - Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal
| | - M Neto
- Immunoallergology Department, Hospital de Santa Maria - Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal
| | - E Pedro
- Immunoallergology Department, Hospital de Santa Maria - Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal
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11
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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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12
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Sousa J, Monteiro J, Mendonca F, Santos M, Temtem M, Neto M, Alves J, Andrade G, Pereira A, Freitas S, Pereira D, Mendonca M, Freitas A. KAsH score beyond myocardial infarction: a new risk stratification tool for myocardial injury? Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Introduction
Our group has recently validated and published a new score - KAsH score. KAsH consists of a continuous, multiplicative score based on 4 simple clinical variables available at first medical contact, proven to be a robust predictor of in-hospital mortality and all-cause mortality at 1 year follow-up in patients with myocardial infarction, putting it next to other well established risk scores. However, the role of KAsH in patients with myocardial injury (Mi), a largely uncharacterized group in the literature, remains unknown.
Purpose
We aim to assess the predictive power of KAsH in patients with myocardial injury (Mi), regarding in-hospital mortality and at 1 year follow-up.
Methods
Prospective registry of 250 patients admitted consecutively through the emergency department from January 2018 onward, with higher than P99th high-sensitive troponin assay. The kit used was Roche's Elecsys hsSTAT, and the P99th appointed by the manufacturer was 14 ng/L. All patients with chronic kidney disease ClCr<15ml/min and myocardial infarction, were excluded from the analysis. We were left with 236 patients diagnosed with Mi.
KAsH = (Killip Kimbal × Age × Heart Rate) / Systolic BP
We used a simplified Killip classification: without heart failure (1 point), with heart failure (2 points) and in shock (3 points). We assessed the score's association to mortality and its predictive value through ROC curves and their respective area under the curve (AUC).
Results
Both Killip and KAsH had a significant and positive association with in-hospital mortality (KK: p=0.02; KAsH: p<0.001) and cumulative mortality (KK: p=0.002; KAsH: p=0.008). In multivariate analysis, KAsH score as a continuous variable proved to be an independent predictor of in-hospital mortality (p=0.004) but not KK classification (p=0.96). We then categorized KAsH in its 4 different strata (1–4). Multivariate analysis indentified categorized KAsH as the only significant predictor of in-hospital mortality (OR 4.1, CI 2.1–8.1, p<0.001), with the predictive power of KAsH being even mildly superior (AUCs: KAsHcont 0.767, KAsHcat 0.743, KK 0.685). However, the same trend was not observed during follow-up, as none of them were significant predictors of mortality (all p>0.1).
Conclusions
KAsH seems to maintain its in-hospital predictive value even in patients with Mi. To our knowledge, this is the first study that tries to apply risk scores and stratification tools to such a heterogeneous group of patients. By comprising hemodynamic variables, KAsH may actually be a better risk stratification tool than just the severity of heart failure on admission. However, unlike previously proven in myocardial infarction (MI), KAsH score and its hemodynamic variables do not seem to justify the high mortality on the long run behind these patients. More studies will be needed to address the complex causes behind long-term mortality of Mi patients.
KASH table graph
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- J Sousa
- Hospital Dr. Nélio Mendonça, Cardiology, Funchal, Portugal
| | - J.P Monteiro
- Hospital Dr. Nélio Mendonça, Cardiology, Funchal, Portugal
| | - F Mendonca
- Hospital Dr. Nélio Mendonça, Cardiology, Funchal, Portugal
| | - M Santos
- Hospital Dr. Nélio Mendonça, Cardiology, Funchal, Portugal
| | - M Temtem
- Hospital Dr. Nélio Mendonça, Cardiology, Funchal, Portugal
| | - M Neto
- Hospital Dr. Nélio Mendonça, Cardiology, Funchal, Portugal
| | - J Alves
- Hospital Dr. Nelio Mendonca, Clinical Pathology, Funchal, Portugal
| | - G Andrade
- Hospital Dr. Nelio Mendonca, Clinical Pathology, Funchal, Portugal
| | - A Pereira
- Hospital Dr. Nélio Mendonça, Cardiology, Funchal, Portugal
| | - S Freitas
- Hospital Central do Funchal, Drª. Mª Isabel Mendonça Investigation Unit, Funchal, Portugal
| | - D.H Pereira
- Hospital Dr. Nélio Mendonça, Cardiology, Funchal, Portugal
| | - M.I Mendonca
- Hospital Central do Funchal, Drª. Mª Isabel Mendonça Investigation Unit, Funchal, Portugal
| | - A.D Freitas
- Hospital Dr. Nélio Mendonça, Cardiology, Funchal, Portugal
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13
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Rosenblum JS, Tunacao JM, Chandrashekhar V, Jha A, Neto M, Weiss C, Smirniotopoulos J, Rosenblum BR, Heiss JD. Tentorial Venous Anatomy: Variation in the Healthy Population. AJNR Am J Neuroradiol 2020; 41:1825-1832. [PMID: 33023913 DOI: 10.3174/ajnr.a6775] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 07/02/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE A new transtentorial venous system consisting of medial, intermediate, and lateral tentorial veins, connecting infra- and supratentorial compartments, was recently shown in 2 cadaver dissections and 2 patient scans. We sought to characterize the venous patterns within the tentorium and their relation to measures of skull development in a cohort of healthy adults. MATERIALS AND METHODS We retrospectively reviewed tentorial venous anatomy of the head using CTA/CTV performed for routine care or research purposes in 238 patients. Included studies had adequate contrast opacification of venous structures and a section thickness of ≤2 mm; we excluded cases with space-occupying lesions and vascular pathologies. Tentorial angle, dural sinus configurations, and measures of skull base development were assessed as predictors of tentorial venous anatomy variation via Cramér V association, the binary encoded Pearson correlation, and nearest-point algorithm with the Euclidean distance metric for clustering. RESULTS Tentorial vein development was related to the ringed configuration of the tentorial sinuses (P < .005). There were 3 configurations. Groups 1A and 1B (n = 50/238) had ringed configuration, while group 2 did not (n = 188/238). Group 1A (n = 38/50) had a medialized ringed configuration, and group 1B had a lateralized ringed configuration (n = 12/50). Measurements of skull base development were predictive of these groups. The ringed configuration of group 1 was related to the presence of a split confluens, which correlated with a decreased internal auditory canal-petroclival fissure angle. Configuration 1A was related to the degree of petrous apex pneumatization (P value = .010). CONCLUSIONS Variations in the transtentorial venous system directly correlate with cranial development.
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Affiliation(s)
- J S Rosenblum
- Surgical Neurology Branch (J.S.R., J.D.H.), National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland .,Neuro-Oncology Branch (J.S.R.), National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - J M Tunacao
- Department of Radiology and Radiological Science (J.M.T., C.W.), The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | | - A Jha
- Section on Medical Neuroendocrinology (A.J.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
| | - M Neto
- Department of Neurosurgery (M.N.), Hospital Beneficência Portuguesa de São Paulo, Institute of Neurological Science of São Paulo Bela Vista, São Paulo, Brazil
| | - C Weiss
- Department of Radiology and Radiological Science (J.M.T., C.W.), The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - J Smirniotopoulos
- Department of Radiology (J.S.), George Washington University, Washington, DC.,MedPix® (J.S.), National Library of Medicine, Bethesda, Maryland
| | - B R Rosenblum
- Department of Neurosurgery (B.R.R.), Riverview Medical Center, Red Bank, New Jersey
| | - J D Heiss
- Surgical Neurology Branch (J.S.R., J.D.H.), National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland
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14
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Alves T, Rodrigues E, Mexia R, Neto M, Matias-Dias C. Home and Leisure Accidents in children and young people from 0 to 19 years old in Portugal 2018. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.1377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Injuries and accidents are a challenge for public health considering their impact on victims and their families, especially in the younger, and also the potential for prevention and predictability. Due to specific characteristics of children and young persons related to the need of exploration and curiosity injuries namely those occur in domestic and leisure time, including the school setting are a topic of particular interest and study. This study aimed to characterize the occurrence of Home and Leisure Accidents (HLA) using hospital Emergency Department (ED) registered in EVITA system, in victims between 0 and 19 years old considering the injury mechanism, place of occurrence and products involved in the accident, in 2018, in Portugal.
Methods
Were analysed data from the EVITA system, fed by the HLA registry at the ED of the Hospitals National Health that participate in this system. The frequency and distribution of HLA were analysed according to the injury mechanism, place of occurrence and products involved.
Results and Discussion
In 2018, there were 38 528 ED attendances due to HLA 35,0% of the victims were between 10-14 years old; 23,7% had 5-9 years; 22,8% between 15 and 19 years old and 18,5% had under 4 years old. The results show more frequently HLA in males (59,0%) than in females (41,0%). In children under 4 years old 67,8% of the HLA occurred at home, due to fall (68,6%), having as products most involved the bed (10,2%) and chair or bench (7,5%). Between 5 and 9 years old, most HLA occurred at school (44,5%) due to fall (62,9%), involving ball (15,1%) and scooter/tricycle/bike (6,8%). In young people between 10 and 19 years old 47,7% of HLA occurred at school, due to fall (54,6%), having as main agents involved ball (28,7%) and scooter/tricycle/bike (20,3%). This information reinforces the importance of this problem but it is necessary future lines of research in order to point out the determinants of this mechanisms of injury.
Key messages
The National Injury Surveillance System provides information that allows to know the characteristics and underlying causes of HLA that occur in children and young people. These data provide useful information for public health professionals working in the field of injury prevention among this vulnerable group of young people.
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Affiliation(s)
- T Alves
- National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - E Rodrigues
- National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - R Mexia
- National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - M Neto
- National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - C Matias-Dias
- National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
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15
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Alves T, Rodrigues E, Neto M, Mexia R, Matias-Dias C. Proportion of Home and Leisure Accidents in mainland Portugal, in 2019. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.1374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Unintentional injuries are recognized by the World Health Organization and the European Union as a preventable public health problem contributing to mortality and morbidity burden and expression in the emergency department (ED). According to EuroSafe injury is the fourth most common cause of death within the EU, being the leading cause of death in the youngest.
Whereas injury related fatalities is only a part of the problem and more patients require hospital treatment it is essential measure the size of the injury problem and characteristics of these non-fatal injuries. Information from Injury Data-Base reveals that the majority of injury related ED attendances and hospital admissions result from accidents occur in home and during leisure times. So, the aim of this study it was to know the proportion of Home and Leisure Accidents (HLA) which needed attendance in the emergency rooms of the Hospitals National Health, in Portugal Mailand, in 2019.
For the analysis were considered the total number of NHS health entities that have an ED, SONHO information system and National injury surveillance system - EVITA System. Based on hospital emergency records in 2019, was obtained the total number of victims by HLA who needed assistance in this health services. In 2019, there were 526 786 ED attendances due to HLA, so about 11,3% of hospital ED attendances in mainland Portugal were caused by HLA. Globally, it was observed a proportion of HLA with admission in ED higher in males (12,9%) than females (10,1%). Disaggregating the data by age group, it was possible to observe a preponderance of males in victims aged less than or equal to 54 years. On the other hand, females showed a higher proportion in individuals aged 55 and over.
Additionally, victims aged 75 and over had the highest proportion of hospital admissions by HLA, both in females (15,5%) and males (13,1%). This study represented a relevant advance contributing to the revelation of the dimension of this problem in Portugal.
Key messages
The National Injury Surveillance System provides information that allows to know the dimension of this health problem in mainland Portugal. HLA represents 11,3 % of the total hospital ED attendances. HLA are the predominant cause of injury related ED attendances. Males and females have a different proportions of injury. Males aged 54 years and over have higher proportion of HLA than females.
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Affiliation(s)
- T Alves
- Epidemiology, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - E Rodrigues
- Epidemiology, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - M Neto
- Epidemiology, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - R Mexia
- Epidemiology, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - C Matias-Dias
- Epidemiology, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
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16
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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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17
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Sousa J, Mendonca M, Pereira A, Mendonca F, Monteiro J, Neto M, Sousa AC, Henriques E, Freitas S, Guerra G, Borges S, Ornelas I, Drumond A, Palma Dos Reis R. P3399Influence of TCF21 rs12190287 in the coronary artery disease risk prediction. An association study in a Portuguese population. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0275] [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
TCF21 is a member of the basic-helix-loop-helix (bHLH) transcriptor factor family, being critical for embryogenesis of the heart, kidney and spleen. TCF21 also regulates epicardium-derived cells differentiation into smooth muscle and fibroblast lineages.
Aim
Investigate the impact of TCF21 rs12190287 in the prediction and discrimination of CAD risk, individually or into a genetic risk score (GRS) formed by a set of 13 genetic variants.
Methods
We performed a case-control study with 3050 subjects (1619 coronary patients with 53.3±8 years; 78.9% male and 1431 controls with 52.8±8 years; 76.6% male) from GENEMACOR study. We investigated all traditional risk factors (TRF), as well as 13 genetic variants from GWAS with unknown pathophysiological pathway so far, including TCF21 (rs12190287), ZC3HC1 (rs11556924), PSRC1/SORTI (rs599839), PHACTR1 (rs1332844), MIA3 (rs17465637), SMAD3 (rs17228212), ZNF259 (rs964184), ADAMTS7 (rs3825807), CDKN2B (rs4977574), 9p21.3 (rs1333049), KIF6 (rs20455), PCSK9 (rs2114580) and GJA4 (rs618675). A multiplicative genetic risk score with these 13 genetic variants (m13GRS), was calculated. Subsequently, two logistic regressions were performed; primarily with all the TRF and all the genes individually and the second with TRF and m13GRS.
Results
The first multivariate analysis shows that, besides the strong association of the TRF with CAD risk (with smoking status on the top of the list, with an OR of 3.2; p<0.0001), TCF21 rs12190287 was the most significant variant from all the studied genetic set with a CAD risk of 1.5 (95% CI: 1.1–1.9; p=0.004), followed by the well-known genetic determinant CDKN2B rs4977574 (OR=1.4; 95% CI: 1.1–1.7; p<0.002) and ZC3HC1 rs11556924 (OR=1.3; 95% CI: 1.0–1.7; p=0.034). When GRS is included to the model, all the TRF remain in the equation by the same order, and the m13GRS persisted as an independent predictor for CAD risk (OR=1.7; 95% CI: 1.4–2.0; p<0.0001).
Conclusion
TCF21 rs12190287 is a risk factor for CAD in the Portuguese population, either individually or incorporated in a m13GRS. TCF21 risk is independent from TRF. In the future, TCF21 can provide a new clues to identify patients at high cardiovascular risk and become a potential target for gene therapy.
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Affiliation(s)
- J Sousa
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - M Mendonca
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - A Pereira
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - F Mendonca
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - J Monteiro
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - M Neto
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - A C Sousa
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - E Henriques
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - S Freitas
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - G Guerra
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - S Borges
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - I Ornelas
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - A Drumond
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - R Palma Dos Reis
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
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18
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Borges S, Palma Dos Reis R, Pereira A, Mendonca F, Sousa J, Monteiro J, Neto M, Sousa AC, Rodrigues M, Henriques E, Ornelas I, Freitas AI, Drumond A, Mendonca MI. P6200Effect of LPA gene on CAD risk among diabetic patients. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Previous research reported that LPA gene is a strong and independent predictor of CAD in non-diabetic patients but not in patients with type 2 diabetes. These results suggest that LPA gene might contribute less to CAD risk in patients with T2DM than in general population.
Objective
Investigate, in our population, the association between LPA gene CT variant and CAD risk among diabetic patients.
Methods
3050 individuals (1619 coronary patients and 1431 controls) were genotyped for LPA rs3798220 TT/CT. Pearson's chi-squared test was applied to evaluate the association between LPA variants and CAD, firstly, in the general population and, secondly, in the group of patients with T2DM (n=735). Multivariate logistic regression was performed with LPA CT variant and 6 traditional risk factors (TRF) (smoking, dyslipidemia, diabetes, hypertension, family history of CAD and physical inactivity) in both general and diabetic population.
Results
In total population, LPA CT variant was found to be strongly and significantly associated with CAD with an OR of 2.32 (95% CI: 1.56–3.45; p<0.0001). However, this association was less pronounced in the diabetic population with a CAD risk of 1.38 (95% CI: 0.56–3.43) without statistical significance (p=0.485). In the presence of 6 major TRF, multivariate analysis showed that LPA CT remained a strong and independent predictor of CAD risk (OR= 2.34; 95% CI: 1.52–3.62; p<0.0001). In diabetic population, LPA was no longer an independent predictor for CAD by multivariate analysis.
Conclusions
Our results show that the effect of LPA gene on CAD risk among diabetic patients might be different from that in the general population. Diabetes status is such a strong risk factor that may attenuate the genetic effects of LPA on CAD risk. This may indicate a complex role of Lp (a) and diabetes interaction in cardiometabolic diseases.
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Affiliation(s)
- S Borges
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - R Palma Dos Reis
- New University of Lisbon, Faculty of Medical Sciences, Lisbon, Portugal
| | - A Pereira
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - F Mendonca
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - J Sousa
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - J Monteiro
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - M Neto
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - A C Sousa
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - M Rodrigues
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - E Henriques
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - I Ornelas
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - A I Freitas
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | | | - M I Mendonca
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
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19
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Sa Mendes G, Durazzo A, Moreno L, Santos S, Neto M, Mendes M. P6324Contribution of muscle efficiency in heart failure patients post phase 2 cardiac rehabilitation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0921] [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
Muscle efficiency (ME), can help explain the observed improvement in patients without increase in oxygen uptake (VO2) after cardiac rehabilitation programme (CRP). The better use of energy, independent to the oxygen delivery to muscle, may improve the functional capacity in Heart failure (HF) patients. Our aim was to evaluate the contribution of muscle efficiency improvement after CR on functional capacity.
Methods
We analyse consecutive patients data that had their phase 2 CR concluded, with HF as admission indication with no medical therapy changes and CRT implantation during this period. The aetiology of HF and biometric data, functional class, BNP, Minnesotta and EuroQol questionnaires and cardiorespiratory test pre and post 4 months of CRP were collected. The average of the exercise load in the first two and last two training sessions were recorded. ME was calculated at peak exercise during cardiopulmonary exercise test in pre and post CRP (see formula above).
Results
From 55 HF patients sequentially admitted in our CRP, during the last 24 months, 45 were included, since 2 were transplanted, 1 died and the 7 didn't concluded the program or not had all the data mentioned in the methods. The mean age was 60,5±10,3 years and 78% were male. Ischemic aetiology with depressed ejection fraction (64%) was the main admission indication, followed by cardiomyopathies (18%). Betablockers, ACEi or ARBs or ARNi and MRA were taken in 91%, 93%, 46%, respectively. ICD and CRT were previously implanted in 44% of the patients. Comparing pre and post CRP VO2 at peak exercise and aerobic threshold levels no statically differences were found. In this cohort 27 (60%) patients increased ME. At the end of the CRP, this group had a higher improvement in METs (p=0,021), higher gain in lean mass (p=0,041), in EuroQoL (p=0,002) and in physical dimension of Minnesotta questionnaire (p=0,032), when compared with patients that didn't improve the ME in at least 5%. In 22 patients that increased ME, the VO2 at aerobic threshold level didn't improve by at least 5% and in this group the same benefits were confirmed.
Formula of Muscle Efficiency
Conclusions
The improvement in exercise load reached in the post CRP cardiopulmonary test, independently of possible cardiac output changes (VO2 peak), seems to be explained in part by the increase in ME improvement.
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Affiliation(s)
| | - A Durazzo
- Hospital de Santa Cruz, Lisbon, Portugal
| | - L Moreno
- Hospital de Santa Cruz, Lisbon, Portugal
| | - S Santos
- Hospital de Santa Cruz, Lisbon, Portugal
| | - M Neto
- Hospital de Santa Cruz, Lisbon, Portugal
| | - M Mendes
- Hospital de Santa Cruz, Lisbon, Portugal
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20
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Santos MR, Pereira A, Mendonca F, Sousa J, Neto M, Monteiro J, Sousa AC, Freitas S, Henriques E, Ornelas I, Drumond A, Palma Dos Reis R, Mendonca M. P6196Lipoprotein (a) and cardiovascular risk: are women at increased risk? Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Coronary artery disease (CAD) is the leading cause of death worldwide, placing a major economic and resource burden on health and public health systems, so efforts are being made to accurately predict risk for major adverse cardiac events (MACE). The field of risk prediction and CAD prevention continues to evolve with the identification of novel risk factors and biomarkers, such as lipoprotein a [Lp)a]. Almost 20% of the population has elevated circulating levels of Lp(a), which is recognized as an independent risk factor for CAD, stroke, peripheral arterial disease, and aortic stenosis. Importantly, studies showed that this was particularly true for women.
Objective
To evaluate if the elevation of Lp(a) is associated with MACE in female, male or both.
Materials and methods
Case control study of 3050 subjects from the GENEMACOR study population. In female population (n=676): cases were 341 patients with at least one >75% coronary stenosis (median age 55.7±7.2) and 335 normal controls (median age 55.8±6) adjusted by age with cases. In male population (n=2374): 1278 patients with at least one >75% coronary stenosis (median age 52.7±8) and 1096 controls (median age 51.9±8) also adjusted by age. χ2 and T student tests were used to analyze the demographic, laboratorial, angiographic and anthropometric characteristics of the population. Lipoprotein (a) was determined by immunoturbidimetry. High Lp(a) level was considered if superior to 30 mg/dl. Logistic regression was used to evaluate Lp(a) as a risk factor for CAD in total, female and male populations.
Results
In female population 44.0% patients vs 21.2% controls (p<0.000) had Lp(a)>30mg/dl. In male population 39.4% patients vs 23.8% controls (p<0.000) had Lp(a)>30mg/dl. In total population Lp(a)>30mg/dl was a predictor for CAD (OR 2.24, 95% CI: 1.91–2.62, p<0.0001). Analyzing by gender, Lp(a)>30mg/dl was also a predictor for CAD either in male (OR 2.08, 95% CI: 1.74–2.5, p<0.0001) or female population (OR 2.92, 95% CI: 2.08–4.09, p<0.0001).
Conclusions
As opposed to other studies, in our population elevated Lp(a) levels (>30mg/dl) were associated with elevated CAD risk, in both men and women. We conclude that Lp(a) can be considered an independent risk factor for CAD disease in our population, and further strategies for Lp(a) reduction may indeed translate in improved outcomes in CAD disease.
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Affiliation(s)
- M R Santos
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - A Pereira
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - F Mendonca
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - J Sousa
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - M Neto
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - J Monteiro
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - A C Sousa
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - S Freitas
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - E Henriques
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - I Ornelas
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | | | - R Palma Dos Reis
- New University of Lisbon, Faculty of Medical Sciences, Lisbon, Portugal
| | - M Mendonca
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
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21
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Pereira A, Mendonca M, Monteiro J, Sousa J, Mendonca F, Neto M, Rodrigues R, Sousa AC, Freitas S, Rodrigues M, Freitas AI, Borges S, Ornelas I, Drumond A, Palma Dos Reis R. P2486The association between genetic variant ZNF259 and decreased kidney function in the diabetic patients. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0816] [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
Type 2 Diabetes (T2D) is a risk factor for dysregulation of glomerular filtration rate (GFR) and albuminuria. However, it remains unclear whether this association is only causal. Genetic variants are inherited independent of potential confounding factors and represent a lifetime exposure.
Aim
Investigate whether the reduction of GFR is a direct consequence of T2D or there are other genetic mechanisms involved in the pathophysiology of the evolution to chronic kidney disease.
Methods
Cross-sectional study with a total of 2579 individuals was performed, of which 735 patients had T2D. Subjects were classified as `'diabetic” if they were taking oral anti-diabetic medication or insulin or if their fasting plasma glucose was higher than 7.0 mmol/l or 126 mg/dl. Within the diabetic group, we considered those with (n=63) and without (n=627) decreased GFR. GFR was calculated through the Cockcroft and Gault formula and decreased GFR was defined as GFR<60 ml/min/1.73m2. Twenty-four genetic variants associated with T2D, metabolic syndrome, dyslipidemia and hypertension were investigated for its impact on GFR, namely: MTHFR 677 and 1298; MTHFD1L; PON 55, 192 and 108; ATIR A/C; AGT M235T; ACE I/D; TCF7L2; SLC30A8; MC4R; ADIPOQ; FTO; TAS2R50; HNF4A; IGF2BP2; PPARG; PCSK9; KIF6; ZNF259; LPA; APOE; PSRS1. Risk factors for decreased GFR were also evaluated (essential hypertension, glycaemia >120 mg/ml, dyslipidemia, alcohol consumption, CAD diagnosis). A logistic regression was performed firstly with the risk factors solely; and secondly adding the genetic variants in order to evaluate the independent predictors of progression to renal failure in T2D.
Results
After the first multivariate logistic regression with all the risk factors for decreased GFR, only CAD remained in the equation, showing to be an independent risk factor for progression to renal failure, in T2D (OR=4.17; 95% CI: 1.64–10.59; p=0.003). In the second logistic regression, including risk factors and the genetic variants, only ZNF259 rs964184 showed an independent and significant association with the risk of decreased GFR (OR=3.03; 95% CI: 1.06–8.70; p=0.039).
Conclusion
This study shows that the variant ZNF259 rs964184 is associated with decreased kidney function, independently of other risk factors. This finding needs further investigation to clarify the genetic mechanism behind the association of rs964184 with decreased GFR, in Type 2 diabetes.
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Affiliation(s)
- A Pereira
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - M Mendonca
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - J Monteiro
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - J Sousa
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - F Mendonca
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - M Neto
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - R Rodrigues
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - A C Sousa
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - S Freitas
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - M Rodrigues
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - A I Freitas
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - S Borges
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - I Ornelas
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | | | - R Palma Dos Reis
- New University of Lisbon, Faculty of Medical Sciences, Lisbon, Portugal
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22
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Sousa J, Mendonca M, Pereira A, Mendonca F, Neto M, Monteiro J, Sousa AC, Rodrigues M, Henriques E, Guerra G, Borges S, Ornelas I, Drumond A, Palma Dos Reis R. P3423The contribution of genetics to premature CAD through different degrees of lifestyle factors: a matter of relative significance? Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Coronary artery disease (CAD) is a multifactorial process with substantial genetic contribution. However, genetic predisposition among patients with a different number of lifestyle factors and premature CAD, remains a complex and thoroughly unexplored topic.
Objective
To evaluate, in a young population, the importance of conventional risk factors as well as of a genetic risk score in the appearance of CAD.
Methods
A case-control study was conducted with 1075 patients from the GENEMACOR study population, under 50 years-old (555 cases, 86.8% male, mean age 44.1±4.9 years and 520 controls, 86.2% male, mean age 44.3±4.8 years). Univariate analysis addressed the association of different modifiable risk factors with premature CAD. Genetic risk score (GRS) was computed comprising 33 genetic risk variants in a multiplicative method. GRS was evaluated according to the number of traditional risk factors and risk for premature CAD was estimated and its independent predictive value estimated by logistic regression.
Results
72.6% of patients had ≥3 risk factors vs 31.2% of controls (p<0.0001). In comparison with having no risk factors (rf), patients with 1 rf had an OR of 2.79 (1.19–6.53; p=0.015), patients with 2 risk factors had a OR of 6.87 (3.03–15–57, p<0.0001) and patients with 3 modifiable risk factors had a OR of 24.17 (10.87–53.73, p<0.0001) – graph 1. In this young population, mean GRS level was consistently higher among patients with coronary artery disease comparing with a healthy population (0.6±0.6 vs 0.4±0.4, p<0.0001, respectively) – graph 2. GRS in multivariate analysis, proved to be an independent predictor for premature CAD (OR 1.71, CI95% 1.25–2.34, p=0.001).
Conclusion
In our population, GRS was an independent predictor for premature CAD. In young patients with ≥3 risk factors, genetics play a less decisive role in the development of CAD. Even in young patients, modifiable risk factors should be addressed aggressively as they may represent a higher burden than genetic predisposition itself.
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Affiliation(s)
- J Sousa
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - M Mendonca
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - A Pereira
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - F Mendonca
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - M Neto
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - J Monteiro
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - A C Sousa
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - M Rodrigues
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - E Henriques
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - G Guerra
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - S Borges
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - I Ornelas
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | | | - R Palma Dos Reis
- New University of Lisbon, Faculty of Medical Sciences, Lisbon, Portugal
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23
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Sousa J, Mendonca M, Pereira A, Mendonca F, Neto M, Monteiro J, Sousa AC, Freitas S, Henriques E, Freitas AI, Borges S, Ornelas I, Drumond A, Palma Dos Reis R. P4455The controversial role of genetics behind premature CAD: a plausible excuse for the young? Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Introduction
The complex interaction between genes and environmental factors contribute to individual-level risk of coronary artery disease (CAD), often resulting in premature CAD. The role for genetic risk scores in premature CAD is still controversial.
Objective
To evaluate the importance of conventional risk factors and of a genetic risk score in younger and older patients with coronary artery disease
Methods
From a group of 1619 pts with angiographic documented CAD from the GENEMACOR study, we selected 1276 pts admitted for ACS and analysed them in 2 groups (group A: ≤50 years, n=491 pts, 87.2% male, mean age 44±4.9 and group B: >50 years, n=785 pts, 75.2% male, mean age 57±4.2). Univariate analysis was used to characterize the traits of each group and we used ROC curves and respective AUCs to evaluate the power of genetics in the prediction of CAD, through a Genetic Risk Score (GRS).
Results
99.3% of the young patients had at least one modifiable risk factor, 18.4% had 2 modifiable risk factors and 75.2% had 3 or more modifiable risk factors. The pattern of risk factors contributing to CAD were different among groups: family history (A: 27.5%, B: 21.4%, p=0.015) and smoking habits (A: 64.8%, B: 42.9%, p<0.001) were more frequent among patients under 50, and traditional age-linked factors like hypertension (A: 58%, B: 75.7%, p<0.001), diabetes (A: 21.6%, B: 38.6%, p<0.001) were more common in the older group. Acute ST-elevation myocardial infarction was more frequent among the young (A: 55.4%, B: 47.4%, p=0.006), as non-ST clinical presentation was higher among elder patients. Regarding angiographic presentation, single vessel CAD was higher in group A (A: 50.3%, B: 40.9%, p<0.001), while multivessel diasease was higher in group B (A: 33.3%, B: 53.9%, p<0.001). At a mean follow-up of 5 years, older patients had a worst prognosis, registering a higher rate of cardiovascular death (A: 4.1%, B: 8.6%, p=0.002) and higher MACE (A: 26.8%, B: 31%, p=0.128),. Adding the genetic risk score (GRS), we achieved only a slight improvement in the AUC for predicting CAD (0.796->0.805, p=0.0178 and 0.748->0.761, p=0.0007 in patients under and over 50, respectively).
Conclusion
Coronary artery disease is not all the same, as premature CAD shares a unique and specific pattern of risk factors, clinical presentation, angiographic severity and prognosis. Genetics should not be used as an excuse to justify premature CAD, as there is frequently more than one potentially reversible risk factor present even in young patients and the additive predictive value of GRS is modest.
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Affiliation(s)
- J Sousa
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - M Mendonca
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - A Pereira
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - F Mendonca
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - M Neto
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - J Monteiro
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - A C Sousa
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - S Freitas
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - E Henriques
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - A I Freitas
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - S Borges
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - I Ornelas
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | | | - R Palma Dos Reis
- New University of Lisbon, Faculty of Medical Sciences, Lisbon, Portugal
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24
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Pereira A, Mendonca M, Sousa JA, Mendonca F, Neto M, Rodrigues R, Sousa AC, Freitas AI, Henriques E, Rodrigues M, Ornelas I, Drumond A, Palma Dos Reis R. P4459The influence of the polymorphism BUD13-ZNF259 rs964184 on coronary disease according to age. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0856] [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
A recent GWAS study found a significant association between the BUD13-ZNF259 rs964184 polymorphism, dyslipidemia and the onset of coronary disease (CAD). This variant encoding zinc finger protein (ZPR1) interacts with the receptor tyrosine kinase at cellular level, increasing oxidative stress, inflammatory response and atherogenesis. There are no studies of the effect of this variant on the Portuguese population.
Objective
Investigate the association of BUD13-ZNF259 rs964184 with dyslipidemia and its impact on CAD risk. Evaluate its impact in different age groups of our population.
Methods
A case-control study was performed with 3050 subjects (1619 coronary patients with 53.3±8 years; 78.9% male and 1431 controls with 52.8±8 years; 76.6% male) from the GENEMACOR study population. Traditional risk factors (smoking, dyslipidemia, diabetes, family history, hypertension, body mass index, alcohol consumption, physical inactivity) and others considered new, such as creatinine clearance, pulse wave velocity, homocysteine, fibrinogen, lipoprotein (a), APOB and PCR (hs) were investigated. BUD13-ZNF259 variant was genotyped and analyzed using the dominant model (CG + GG vs. CC). Bivariate and multivariate analyzes (logistic regression) were used to estimate the ORs and 95% CI, after adjusting for potential confounding factors, in 3 different age groups (<45; 45–55; >55).
Results
BUD13-ZNF259 polymorphism presented an independent and significant risk of CAD (OR=1.58; 95% CI: 1.07–2.32; p=0.019) only in the group of young coronary patients <45 years (n=482 patients), as well as dyslipidemia (OR=2.04; 95% CI: 1.26–3.31; p=0.003). After binary logistic regression entering with the interaction between dyslipidemia and the dominant model ZNF259 (CG + GG vs. CC), we verified an association with CAD risk (OR= 1.78; 95% CI: 1.08–2.95; p=0.025).
Conclusion
BUD13-ZNF259 rs964184 variant showed a significant risk for the onset of CAD in the young population (<45 years). The impact of the interaction of ZPR1 protein with tyrosine kinase (Syk) at the cellular level seems to be more relevant in young patients. This aspect may represent a possible prophylactic and therapeutic target, especially in coronary disease in young people.
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Affiliation(s)
- A Pereira
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - M Mendonca
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - J A Sousa
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - F Mendonca
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - M Neto
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - R Rodrigues
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - A C Sousa
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - A I Freitas
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - E Henriques
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - M Rodrigues
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - I Ornelas
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | | | - R Palma Dos Reis
- New University of Lisbon, Faculty of Medical Sciences, Lisbon, Portugal
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Abstract
Background The promotion and maintenance of workers' mental health is an increasingly important issue, both for employers and society. Previous research has shown that job characteristics (i.e. demands, control and support) are significantly associated with employees' mental well-being. However, changes in work characteristics have given rise to the emergence of new job demands, leading to work-family life conflict. Aims To investigate the association between work-family life conflict and employee mental well-being. Methods A cross-sectional study with two samples: one sample comprising clothes store sales employees and the other comprising call centre operators. Logistic regression models were used to examine the effects of work-family life conflict on employee well-being. Results After controlling for job demands, job control, supervisory support and co-workers support, work-family life conflict was associated with employee mental well-being. Conclusions Work-family life conflict is an important factor to explain employee well-being and productivity and should be addressed as well as work factors.
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Affiliation(s)
- M Neto
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal.,Instituto de Saúde Ambiental, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
| | - M J Chambel
- CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, Lisbon, Portugal
| | - V S Carvalho
- Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, Lisbon, Portugal
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Zeymer U, Ludman P, Danchin N, Kala P, Maggioni AP, Weidinger F, Gale CP, Beleslin B, Budaj A, Chioncel O, Dagres N, Danchin N, Emberson J, Erlinge D, Glikson M, Gray A, Kayikcioglu M, Maggioni AP, Nagy VK, Nedoshivin A, Petronio AS, Roos-Hesselink J, Wallentin L, Zeymer U, Weidinger F, Zeymer U, Danchin N, Ludman P, Sinnaeve P, Kala P, Ferrari R, Maggioni AP, Goda A, Zelveian P, Weidinger F, Karamfilov K, Motovska Z, Zeymer U, Raungaard B, Marandi T, Shaheen SM, Lidon RM, Karjalainen PP, Kereselidze Z, Alexopoulos D, Becker D, Quinn M, Iakobishvili Z, Al-Farhan H, Sadeghi M, Caporale R, Romeo F, Mirrakhimov E, Serpytis P, Erglis A, Kedev S, Balbi MM, Moore AM, Dudek D, Legutko J, Mimoso J, Tatu-Chitoiu G, Stojkovic S, Shlyakhto E, AlHabib KF, Bunc M, Studencan M, Mourali MS, Bajraktari G, Konte M, Larras F, Lefrancq EF, Mekhaldi S, Laroche C, Maggioni AP, Goda A, Shuka N, Pavli E, Tafaj E, Gishto T, Dibra A, Duka A, Gjana A, Kristo A, Knuti G, Demiraj A, Dado E, Hasimi E, Simoni L, Siqeca M, Sisakian H, Hayrapetyan H, Markosyan S, Galustyan L, Arustamyan N, Kzhdryan H, Pepoyan S, Zirkik A, Von Lewinski D, Paetzold S, Kienzl I, Matyas K, Neunteufl T, Nikfardjam M, Neuhold U, Mihalcz A, Glaser F, Steinwender C, Reiter C, Grund M, Hrncic D, Hoppe U, Hammerer M, Hinterbuchner L, Hengstenberg C, Delle Karth G, Lang I, Weidinger F, Winkler W, Hasun M, Kastner J, Havel C, Derntl M, Oberegger G, Hajos J, Adlbrecht C, Publig T, Leitgeb MC, Wilfing R, Jirak P, Ho CY, Puskas L, Schrutka L, Spinar J, Parenica J, Hlinomaz O, Fendrychova V, Semenka J, Sikora J, Sitar J, Groch L, Rezek M, Novak M, Kramarikova P, Stasek J, Dusek J, Zdrahal P, Polasek R, Karasek J, Seiner J, Sukova N, Varvarovsky I, Lazarák T, Novotny V, Matejka J, Rokyta R, Volovar S, Belohlavek J, Motovska Z, Siranec M, Kamenik M, Kralik R, Raungaard B, Ravkilde J, Jensen SE, Villadsen A, Villefrance K, Schmidt Skov C, Maeng M, Moeller K, Hasan-Ali H, Ahmed TA, Hassan M, ElGuindy A, Farouk Ismail M, Ibrahim Abd El-Aal A, El-sayed Gaafar A, Magdy Hassan H, Ahmed Shafie M, Nabil El-khouly M, Bendary A, Darwish M, Ahmed Y, Amin O, AbdElHakim A, Abosaif K, Kandil H, Galal MAG, El Hefny EE, El Sayed M, Aly K, Mokarrab M, Osman M, Abdelhamid M, Mantawy S, Ali MR, Kaky SD, Khalil VA, Saraya MEA, Talaat A, Nabil M, Mounir WM, Mahmoud K, Aransa A, Kazamel G, Anwar S, Al-Habbaa A, Abd el Monem M, Ismael A, Amin Abu-Sheaishaa M, Abd Rabou MM, Hammouda TMA, Moaaz M, Elkhashab K, Ragab T, Rashwan A, Rmdan A, AbdelRazek G, Ebeid H, Soliman Ghareeb H, Farag N, Zaki M, Seleem M, Torki A, Youssef M, AlLah Nasser NA, Rafaat A, Selim H, Makram MM, Khayyal M, Malasi K, Madkour A, Kolib M, Alkady H, Nagah H, Yossef M, Wafa A, Mahfouz E, Faheem G, Magdy Moris M, Ragab A, Ghazal M, Mabrouk A, Hassan M, El-Masry M, Naseem M, Samir S, Marandi T, Reinmets J, Allvee M, Saar A, Ainla T, Vaide A, Kisseljova M, Pakosta U, Eha J, Lotamois K, Sia J, Myllymaki J, Pinola T, Karjalainen PP, Paana T, Mikkelsson J, Ampio M, Tsivilasvili J, Zurab P, Kereselidze Z, Agladze R, Melia A, Gogoberidze D, Khubua N, Totladze L, Metreveli I, Chikovani A, Eitel I, Pöss J, Werner M, Constantz A, Ahrens C, Zeymer U, Tolksdorf H, Klinger S, Sack S, Heer T, Lekakis J, Kanakakis I, Xenogiannis I, Ermidou K, Makris N, Ntalianis A, Katsaros F, Revi E, Kafkala K, Mihelakis E, Diakakis G, Grammatikopoulos K, Voutsinos D, Alexopoulos D, Xanthopoulou I, Mplani V, Foussas S, Papakonstantinou N, Patsourakos N, Dimopoulos A, Derventzis A, Athanasiou K, Vassilikos VP, Papadopoulos C, Tzikas S, Vogiatzis I, Datsios A, Galitsianos I, Koutsampasopoulos K, Grigoriadis S, Douras A, Baka N, Spathis S, Kyrlidis T, Hatzinikolaou H, Kiss RG, Becker D, Nowotta F, Tóth K, Szabó S, Lakatos C, Jambrik Z, Ruzsa J, Ruzsa Z, Róna S, Toth J, Vargane Kosik A, Toth KSB, Nagy GG, Ondrejkó Z, Körömi Z, Botos B, Pourmoghadas M, Salehi A, Massoumi G, Sadeghi M, Soleimani A, Sarrafzadegan N, Roohafza H, Azarm M, Mirmohammadsadeghi A, Rajabi D, Rahmani Y, Siabani S, Najafi F, Hamzeh B, Karim H, Siabani H, Saleh N, Charehjoo H, Zamzam L, Al-Temimi G, Al-Farhan H, Al-Yassin A, Mohammad A, Ridha A, Al-Saedi G, Atabi N, Sabbar O, Mahmood S, Dakhil Z, Yaseen IF, Almyahi M, Alkenzawi H, Alkinani T, Alyacopy A, Kearney P, Twomey K, Iakobishvili Z, Shlomo N, Beigel R, Caldarola P, Rutigliano D, Sublimi Saponetti L, Locuratolo N, Palumbo V, Scherillo M, Formigli D, Canova P, Musumeci G, Roncali F, Metra M, Lombardi C, Visco E, Rossi L, Meloni L, Montisci R, Pippia V, Marchetti MF, Congia M, Cacace C, Luca G, Boscarelli G, Indolfi C, Ambrosio G, Mongiardo A, Spaccarotella C, De Rosa S, Canino G, Critelli C, Caporale R, Chiappetta D, Battista F, Gabrielli D, Marziali A, Bernabò P, Navazio A, Guerri E, Manca F, Gobbi M, Oreto G, Andò G, Carerj S, Saporito F, Cimmino M, Rigo F, Zuin G, Tuccillo B, Scotto di Uccio F, Irace L, Lorenzoni G, Meloni I, Merella P, Polizzi GM, Pino R, Marzilli M, Morrone D, Caravelli P, Orsini E, Mosa S, Piovaccari G, Santarelli A, Cavazza C, Romeo F, Fedele F, Mancone M, Straito M, Salvi N, Scarparo P, Severino P, Razzini C, Massaro G, Cinque A, Gaudio C, Barillà F, Torromeo C, Porco L, Mei M, Iorio R, Nassiacos D, Barco B, Sinagra G, Falco L, Priolo L, Perkan A, Strana M, Bajraktari G, Percuku L, Berisha G, Mziu B, Beishenkulov M, Abdurashidova T, Toktosunova A, Kaliev K, Serpytis P, Serpytis R, Butkute E, Lizaitis M, Broslavskyte M, Xuereb RG, Moore AM, Mercieca Balbi M, Paris E, Buttigieg L, Musial W, Dobrzycki S, Dubicki A, Kazimierczyk E, Tycinska A, Wojakowski W, Kalanska-Lukasik B, Ochala A, Wanha W, Dworowy S, Sielski J, Janion M, Janion-Sadowska A, Dudek D, Wojtasik-Bakalarz J, Bryniarski L, Peruga JZ, Jonczyk M, Jankowski L, Klecha A, Legutko J, Michalowska J, Brzezinski M, Kozmik T, Kowalczyk T, Adamczuk J, Maliszewski M, Kuziemka P, Plaza P, Jaros A, Pawelec A, Sledz J, Bartus S, Zmuda W, Bogusz M, Wisnicki M, Szastak G, Adamczyk M, Suska M, Czunko P, Opolski G, Kochman J, Tomaniak M, Miernik S, Paczwa K, Witkowski A, Opolski MP, Staruch AD, Kalarus Z, Honisz G, Mencel G, Swierad M, Podolecki T, Marques J, Azevedo P, Pereira MA, Gaspar A, Monteiro S, Goncalves F, Leite L, Mimoso J, Manuel Lopes dos Santos W, Amado J, Pereira D, Silva B, Caires G, Neto M, Rodrigues R, Correia A, Freitas D, Lourenco A, Ferreira F, Sousa F, Portugues J, Calvo L, Almeida F, Alves M, Silva A, Caria R, Seixo F, Militaru C, Ionica E, Tatu-Chitoiu G, Istratoaie O, Florescu M, Lipnitckaia E, Osipova O, Konstantinov S, Bukatov V, Vinokur T, Egorova E, Nefedova E, Levashov S, Gorbunova A, Redkina M, Karaulovskaya N, Bijieva F, Babich N, Smirnova O, Filyanin R, Eseva S, Kutluev A, Chlopenova A, Shtanko A, Kuppar E, Shaekhmurzina E, Ibragimova M, Mullahmetova M, Chepisova M, Kuzminykh M, Betkaraeva M, Namitokov A, Khasanov N, Baleeva L, Galeeva Z, Magamedkerimova F, Ivantsov E, Tavlueva E, Kochergina A, Sedykh D, Kosmachova E, Skibitskiy V, Porodenko N, Namitokov A, Litovka K, Ulbasheva E, Niculina S, Petrova M, Harkov E, Tsybulskaya N, Lobanova A, Chernova A, Kuskaeva A, Kuskaev A, Ruda M, Zateyshchikov D, Gilarov M, Konstantinova E, Koroleva O, Averkova A, Zhukova N, Kalimullin D, Borovkova N, Tokareva A, Buyanova M, Khaisheva L, Pirozhenko A, Novikova T, Yakovlev A, Tyurina T, Lapshin K, Moroshkina N, Kiseleva M, Fedorova S, Krylova L, Duplyakov D, Semenova Y, Rusina A, Ryabov V, Syrkina A, Demianov S, Reitblat O, Artemchuk A, Efremova E, Makeeva E, Menzorov M, Shutov A, Klimova N, Shevchenko I, Elistratova O, Kostyuckova O, Islamov R, Budyak V, Ponomareva E, Ullah Jan U, Alshehri AM, Sedky E, Alsihati Z, Mimish L, Selem A, Malik A, Majeed O, Altnji I, AlShehri M, Aref A, AlHabib K, AlDosary M, Tayel S, Abd AlRahman M, Asfina KN, Abdin Hussein G, Butt M, Markovic Nikolic N, Obradovic S, Djenic N, Brajovic M, Davidovic A, Romanovic R, Novakovic V, Dekleva M, Spasic M, Dzudovic B, Jovic Z, Cvijanovic D, Veljkovic S, Ivanov I, Cankovic M, Jarakovic M, Kovacevic M, Trajkovic M, Mitov V, Jovic A, Hudec M, Gombasky M, Sumbal J, Bohm A, Baranova E, Kovar F, Samos M, Podoba J, Kurray P, Obona T, Remenarikova A, Kollarik B, Verebova D, Kardosova G, Studencan M, Alusik D, Macakova J, Kozlej M, Bayes-Genis A, Sionis A, Garcia Garcia C, Lidon RM, Duran Cambra A, Labata Salvador C, Rueda Sobella F, Sans Rosello J, Vila Perales M, Oliveras Vila T, Ferrer Massot M, Bañeras J, Lekuona I, Zugazabeitia G, Fernandez-Ortiz A, Viana Tejedor A, Ferrera C, Alvarez V, Diaz-Castro O, Agra-Bermejo RM, Gonzalez-Cambeiro C, Gonzalez-Babarro E, Domingo-Del Valle J, Royuela N, Burgos V, Canteli A, Castrillo C, Cobo M, Ruiz M, Abu-Assi E, Garcia Acuna JM. The ESC ACCA EAPCI EORP acute coronary syndrome ST-elevation myocardial infarction registry. European Heart Journal - Quality of Care and Clinical Outcomes 2019; 6:100-104. [DOI: 10.1093/ehjqcco/qcz042] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Accepted: 07/24/2019] [Indexed: 12/20/2022]
Abstract
Abstract
Aims
The Acute Cardiac Care Association (ACCA)–European Association of Percutaneous Coronary Intervention (EAPCI) Registry on ST-elevation myocardial infarction (STEMI) of the EurObservational programme (EORP) of the European Society of Cardiology (ESC) registry aimed to determine the current state of the use of reperfusion therapy in ESC member and ESC affiliated countries and the adherence to ESC STEMI guidelines in patients with STEMI.
Methods and results
Between 1 January 2015 and 31 March 2018, a total of 11 462 patients admitted with an initial diagnosis of STEMI according to the 2012 ESC STEMI guidelines were enrolled. Individual patient data were collected across 196 centres and 29 countries. Among the centres, there were 136 percutaneous coronary intervention centres and 91 with cardiac surgery on-site. The majority of centres (129/196) were part of a STEMI network. The main objective of this study was to describe the demographic, clinical, and angiographic characteristics of patients with STEMI. Other objectives include to assess management patterns and in particular the current use of reperfusion therapies and to evaluate how recommendations of most recent STEMI European guidelines regarding reperfusion therapies and adjunctive pharmacological and non-pharmacological treatments are adopted in clinical practice and how their application can impact on patients’ outcomes. Patients will be followed for 1 year after admission.
Conclusion
The ESC ACCA-EAPCI EORP ACS STEMI registry is an international registry of care and outcomes of patients hospitalized with STEMI. It will provide insights into the contemporary patient profile, management patterns, and 1-year outcome of patients with STEMI.
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Affiliation(s)
- Uwe Zeymer
- Hospital of the City of Ludwigshafen, Medical Clinic B and Institute of Heart Attack Research, Ludwigshafen on the Rhine, Germany
| | - Peter Ludman
- Institute of Cardiovascular Sciences, Birmingham University, Birmingham, UK
| | - Nicolas Danchin
- Cardiology Department, Georges Pompidou European Hospital, Paris, France
| | - Petr Kala
- Internal Cardiology Department, University Hospital Brno, Czech Republic
| | - Aldo P Maggioni
- EURObservational Research Programme, ESC, Sophia Antipolis, France
- ANMCO Research Center, Florence, Italy
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Ferreira V, Oliveira A, Neto M, Santo M. The relationship between pain and schoolbag use: a cross-sectional study of program “+CooLuna”. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz034.061] [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)
- V Ferreira
- Agrupamento de Centros Saúde Baixo Vouga, Portugal
- Escola Superior Saúde da Universidade Aveiro, Portugal
| | - A Oliveira
- Agrupamento de Centros Saúde Baixo Vouga, Portugal
| | - M Neto
- Agrupamento de Centros Saúde Baixo Vouga, Portugal
| | - M Santo
- Agrupamento de Centros Saúde Baixo Vouga, Portugal
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Lobianco F, Giurini E, Neto M, Chen H, Chaki S, Newson J, Thomas F, Schook L, Schachtschneider K, Gaba R. 03:27 PM Abstract No. 221 Porcine and human hepatocellular carcinoma cell lines present similar drug-metabolizing enzyme expression levels and comparable sorafenib and doxorubicin cytotoxic responses. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Pereira A, Palma Dos Reis R, Monteiro J, Sousa JA, Rodrigues R, Neto M, Sousa AC, Freitas S, Rodrigues M, Freitas AI, Freitas C, Ornelas I, Drumond A, Mendonca MI. P934Gene-gene interaction in ischemic cardiopathy by MDR: beyond logistic regression. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- A Pereira
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - R Palma Dos Reis
- New University of Lisbon, Faculty of Medical Sciences, Lisbon, Portugal
| | - J Monteiro
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - J A Sousa
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - R Rodrigues
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - M Neto
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - A C Sousa
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - S Freitas
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - M Rodrigues
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - A I Freitas
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - C Freitas
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - I Ornelas
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - A Drumond
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - M I Mendonca
- Funchal Hospital, Research Unit, Funchal, Portugal
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Augusto Goncalves M, Tralhao A, Silva C, Gama F, Brizido C, Mendes G, Neto M, Rodrigues G, Ferreira J, Mendes M. P2741Prognostic value of a single cTn measurement vs. absolute change in different patterns of myocardial injury: when one is better than two. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - A Tralhao
- Hospital de Santa Cruz, Lisbon, Portugal
| | - C Silva
- Hospital de Santa Cruz, Lisbon, Portugal
| | - F Gama
- Hospital de Santa Cruz, Lisbon, Portugal
| | - C Brizido
- Hospital de Santa Cruz, Lisbon, Portugal
| | - G Mendes
- Hospital de Santa Cruz, Lisbon, Portugal
| | - M Neto
- Hospital de Santa Cruz, Lisbon, Portugal
| | | | - J Ferreira
- Hospital de Santa Cruz, Lisbon, Portugal
| | - M Mendes
- Hospital de Santa Cruz, Lisbon, Portugal
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Felix-Oliveira A, Campante Teles R, Ferreira A, Tralhao A, Freitas P, Neto M, Mendes GS, Brizido C, Gama F, Abecasis J, Saraiva C, Brito J, Goncalves P, Almeida M, Mendes M. P2259Vascular calcium score: new imaging tool for prediction of major and life-threatening bleeding events in trans-femoral TAVI. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A Felix-Oliveira
- Hospital de Santa Cruz, Department of Cardiology, Lisbon, Portugal
| | - R Campante Teles
- Hospital de Santa Cruz, Department of Cardiology, Lisbon, Portugal
| | - A Ferreira
- Hospital de Santa Cruz, Department of Cardiology, Lisbon, Portugal
| | - A Tralhao
- Hospital de Santa Cruz, Department of Cardiology, Lisbon, Portugal
| | - P Freitas
- Hospital de Santa Cruz, Department of Cardiology, Lisbon, Portugal
| | - M Neto
- Hospital Funchal, Department of Cardiology, Funchal, Portugal
| | - G S Mendes
- Hospital de Santa Cruz, Department of Cardiology, Lisbon, Portugal
| | - C Brizido
- Hospital de Santa Cruz, Department of Cardiology, Lisbon, Portugal
| | - F Gama
- Hospital de Santa Cruz, Department of Cardiology, Lisbon, Portugal
| | - J Abecasis
- Hospital de Santa Cruz, Department of Cardiology, Lisbon, Portugal
| | - C Saraiva
- Hospital de Santa Cruz, Department of Cardiology, Lisbon, Portugal
| | - J Brito
- Hospital de Santa Cruz, Department of Cardiology, Lisbon, Portugal
| | - P Goncalves
- Hospital de Santa Cruz, Department of Cardiology, Lisbon, Portugal
| | - M Almeida
- Hospital de Santa Cruz, Department of Cardiology, Lisbon, Portugal
| | - M Mendes
- Hospital de Santa Cruz, Department of Cardiology, Lisbon, Portugal
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Sousa JA, Mendonca MI, Pereira A, Rodrigues R, Monteiro J, Neto M, Sousa AC, Henriques E, Freitas S, Freitas AI, Borges S, Ornelas I, Drumond A, Palma Dos Reis R. P2513Synergistic association between TCF21 gene variant and smoking. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- J A Sousa
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - M I Mendonca
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - A Pereira
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - R Rodrigues
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - J Monteiro
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - M Neto
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - A C Sousa
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - E Henriques
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - S Freitas
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - A I Freitas
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - S Borges
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - I Ornelas
- Funchal Hospital, Research Unit, Funchal, Portugal
| | - A Drumond
- Funchal Hospital, Research Unit, Cardiology Department, Funchal, Portugal
| | - R Palma Dos Reis
- New University of Lisbon, Faculty of Medical Sciences, Lisbon, Portugal
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Carmo J, Ferreira J, Costa F, Cavaco D, Carmo P, Morgado F, Carvalho MS, Santos I, Volponi C, Mesquita J, Neto M, Adragao P. 523Ischemic stroke and mortality reduction after atrial fibrillation ablation: a propensity matched analysis. Europace 2018. [DOI: 10.1093/europace/euy015.290] [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: 11/14/2022] Open
Affiliation(s)
- J Carmo
- Hospital de Santa Cruz, Lisbon, Portugal
| | - J Ferreira
- Hospital de Santa Cruz, Lisbon, Portugal
| | - F Costa
- Hospital de Santa Cruz, Lisbon, Portugal
| | - D Cavaco
- Hospital de Santa Cruz, Lisbon, Portugal
| | - P Carmo
- Hospital de Santa Cruz, Lisbon, Portugal
| | - F Morgado
- Hospital de Santa Cruz, Lisbon, Portugal
| | | | - I Santos
- Hospital de Santa Cruz, Lisbon, Portugal
| | - C Volponi
- Hospital de Santa Cruz, Lisbon, Portugal
| | - J Mesquita
- Hospital de Santa Cruz, Lisbon, Portugal
| | - M Neto
- Hospital de Santa Cruz, Lisbon, Portugal
| | - P Adragao
- Hospital de Santa Cruz, Lisbon, Portugal
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Carmo J, Cavaco D, Carmo P, Morgado FB, Costa F, Parreira L, Santos I, Volponi C, Mesquita J, Neto M, Adragao P. P409Leadless pacemaker: initial experience of two centres in Portugal. Europace 2018. [DOI: 10.1093/europace/euy015.220] [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: 11/14/2022] Open
Affiliation(s)
- J Carmo
- Hospital de Santa Cruz, Lisbon, Portugal
| | - D Cavaco
- Hospital de Santa Cruz, Lisbon, Portugal
| | - P Carmo
- Hospital de Santa Cruz, Lisbon, Portugal
| | | | - F Costa
- Hospital de Santa Cruz, Lisbon, Portugal
| | | | - I Santos
- Hospital de Santa Cruz, Lisbon, Portugal
| | - C Volponi
- Hospital de Santa Cruz, Lisbon, Portugal
| | - J Mesquita
- Hospital de Santa Cruz, Lisbon, Portugal
| | - M Neto
- Hospital de Santa Cruz, Lisbon, Portugal
| | - P Adragao
- Hospital de Santa Cruz, Lisbon, Portugal
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Sousa J, Monteiro J, Neto M, Correia A, Rodrigues R, Pereira E, Gomes S, Pereira A, Faria A, Silva B, Caires G, Freitas D, Santos N, Serrao M, Pereira D. P6488Diabetes mellitus and acute coronary syndrome: prognostic impact at 5-year follow-up. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p6488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Pereira A, Neto M, Rodrigues R, Monteiro J, Sousa A, Freitas S, Henriques E, Borges S, Freitas A, Ornelas I, Pereira D, Palma Dos Reis R, Mendonca M. 959Coronary artery disease risk according to genetic risk score deciles, Age and cardiovascular risk factors. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Sousa J, Monteiro J, Neto M, Correia A, Rodrigues R, Pereira E, Pereira A, Gomes S, Faria A, Santos N, Serrao M, Silva B, Caires G, Freitas D, Pereira D. P6450Haemorrhagic risk in patients presenting with acute coronary syndrome and renal dysfunction: which score is a better predictor of bleeding risk on a daily-basis? Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p6450] [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: 11/14/2022] Open
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Pereira A, Palma Dos Reis R, Neto M, Rodrigues R, Monteiro J, Henriques E, Rodrigues M, Freitas A, Ornelas I, Borges S, Pereira D, Mendonca M. P6214Genetic risk score, family history of coronary artery disease and cardiovascular risk factors. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p6214] [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: 11/12/2022] Open
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Vale N, Carmo P, Neto M, Cavaco D, Goncalves M, Rodrigues G, Costa F, Morgado F, Adragao P. P1471Novel electroanatomical mapping system in catheter ablation of ventricular tachycardia. Single centre experience. Europace 2017. [DOI: 10.1093/ehjci/eux158.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Assoni A, Coatti G, Beccari M, Gomes J, Cardozo K, Neto M, Carvalho V, Zatz M. Controversial preclinical results in neuromuscular animal models: Are they related to differences in mesenchymal stromal cells (MSCs) secretome? Neuromuscul Disord 2016. [DOI: 10.1016/j.nmd.2016.06.156] [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: 10/21/2022]
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Neto M, Pinto M, Oliveira A, Padrão P, Moreira A, Moreira P. Hydration status and associated dietary factors in children. NUTR HOSP 2015; 32 Suppl 2:10324. [PMID: 26615294 DOI: 10.3305/nh.2015.32.sup2.10324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Affiliation(s)
- M Neto
- Faculty of Nutrition and Food Sciences. University of Porto (FCNAUP). Porto. Portugal
| | - M Pinto
- Department of Immunology. Faculty of Medicine. University of Porto. Porto. Portugal
| | - Ac Oliveira
- Faculty of Nutrition and Food Sciences. University of Porto (FCNAUP). Porto. Portugal
| | - P Padrão
- Faculty of Nutrition and Food Sciences. University of Porto (FCNAUP). Porto. Portugal
| | - A Moreira
- Department of Immunology. Faculty of Medicine. University of Porto. Porto. Portugal
| | - P Moreira
- Faculty of Nutrition and Food Sciences. University of Porto (FCNAUP). Porto. Portugal
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Pinto C, Sá Machado R, Castro A, Marinho C, Neto M, Correia A, Monteiro H. Outbreak Intervention of Human Brucellosis in a rural area of the northern region of Portugal. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv175.239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Gonzaga M, Sousa S, Ribeiro G, Gonçalves L, Neto M. Regional Program on Intervention in Prisons. Eur J Public Health 2014. [DOI: 10.1093/eurpub/cku165.118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Faria E, Rodrigues-Cernadas J, Gaspar A, Botelho C, Castro E, Lopes A, Gomes E, Malheiro D, Cadinha S, Campina-Costa S, Neto M, Sousa N, Rodrigues-Alves R, Romeira A, Caiado J, Morais-Almeida M. Drug-induced anaphylaxis survey in Portuguese Allergy Departments. J Investig Allergol Clin Immunol 2014; 24:40-48. [PMID: 24765880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Drug-induced anaphylaxis is an unpredictable and potentially fatal adverse drug reaction. The aim of this study was to identify the causes of drug-induced anaphylaxis in Portugal. METHODS During a 4-year period a nationwide notification system for anaphylaxis was implemented, with voluntary reporting by allergists. Data on 313 patients with drug anaphylaxis were received and reviewed. Statistical analysis included distribution tests and multiple logistic regression analysis to investigate significance, regression coefficients, and marginal effects. RESULTS The mean (SD) age of the patients was 43.8 (17.4) years, and 8.3% were younger than 18 years. The female to male ratio was 2:1.The main culprits were nonsteroidal anti-inflammatory drugs (NSAIDs) (47.9% of cases), antibiotics (35.5%), and anesthetic agents (6.1%). There was a predominance of mucocutaneous symptoms (92.2%), followed by respiratory symptoms (80.4%) and cardiovascular symptoms (49.0%). Patients with NSAID-induced anaphylaxis showed a tendency towards respiratory and mucocutaneous manifestations. We found no significant associations between age, sex, or atopy and type of drug. Anaphylaxis recurrence was observed in 25.6% of cases, and the risk was higher when NSAIDs were involved. CONCLUSIONS NSAIDs were the most common cause of anaphylaxis in this study and were also associated with a higher rate of recurrence. We stress the need for better therapeutic management and prevention of recurring episodes of drug-induced anaphylaxis.
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Duarte R, Neto M, Carvalho A, Barros H. Improving tuberculosis contact tracing: the role of evaluations in the home and workplace. Int J Tuberc Lung Dis 2012; 16:55-9. [PMID: 22236846 DOI: 10.5588/ijtld.10.0511] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING In 2004, the tuberculosis (TB) contact screening strategy in Vila Nova de Gaia, Portugal, was changed from targeting only close contacts identified by interviews with the index patient (reflecting national policy) to include visits to the patient?s home and workplace. OBJECTIVE To find out 1) whether the new strategy increased adherence to TB screening procedures, 2) whether the strategy identified more at-risk contacts and 3) whether the strategy increased prevention of TB. METHODS We compared TB contact tracing during the periods 2001-2003 and 2004-2006. The numbers of identified and screened contacts and the results of screening procedures (number of patients with active TB and latent TB infection [LTBI] detected per index case) were analysed. The number of instances of active TB prevented and the numbers of contacts that had to be screened to prevent one such instance were calculated and compared for both screening strategies. RESULTS Home and workplace visits helped to identify more at-risk contacts (8.4 per index patient) than interview (2.5 per index patient), and improved adherence (87.3% of identified contacts were screened compared to 67.6% previously). More patients with active TB and LTBI were detected (1.4 per index patient compared with 0.75 per index patient previously), and more TB cases were prevented. CONCLUSION The newly implemented contact screening programme, featuring home and workplace evaluation of TB patient contacts, improved adherence to screening procedures, identified more at-risk contacts and should prevent more TB cases in the future.
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Affiliation(s)
- R Duarte
- Centro de Diagnóstico Pneumológico de Vila Nova de Gaia, Vila Nova Gaia, Portugal.
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Glenzer SH, MacGowan BJ, Meezan NB, Adams PA, Alfonso JB, Alger ET, Alherz Z, Alvarez LF, Alvarez SS, Amick PV, Andersson KS, Andrews SD, Antonini GJ, Arnold PA, Atkinson DP, Auyang L, Azevedo SG, Balaoing BNM, Baltz JA, Barbosa F, Bardsley GW, Barker DA, Barnes AI, Baron A, Beeler RG, Beeman BV, Belk LR, Bell JC, Bell PM, Berger RL, Bergonia MA, Bernardez LJ, Berzins LV, Bettenhausen RC, Bezerides L, Bhandarkar SD, Bishop CL, Bond EJ, Bopp DR, Borgman JA, Bower JR, Bowers GA, Bowers MW, Boyle DT, Bradley DK, Bragg JL, Braucht J, Brinkerhoff DL, Browning DF, Brunton GK, Burkhart SC, Burns SR, Burns KE, Burr B, Burrows LM, Butlin RK, Cahayag NJ, Callahan DA, Cardinale PS, Carey RW, Carlson JW, Casey AD, Castro C, Celeste JR, Chakicherla AY, Chambers FW, Chan C, Chandrasekaran H, Chang C, Chapman RF, Charron K, Chen Y, Christensen MJ, Churby AJ, Clancy TJ, Cline BD, Clowdus LC, Cocherell DG, Coffield FE, Cohen SJ, Costa RL, Cox JR, Curnow GM, Dailey MJ, Danforth PM, Darbee R, Datte PS, Davis JA, Deis GA, Demaret RD, Dewald EL, Di Nicola P, Di Nicola JM, Divol L, Dixit S, Dobson DB, Doppner T, Driscoll JD, Dugorepec J, Duncan JJ, Dupuy PC, Dzenitis EG, Eckart MJ, Edson SL, Edwards GJ, Edwards MJ, Edwards OD, Edwards PW, Ellefson JC, Ellerbee CH, Erbert GV, Estes CM, Fabyan WJ, Fallejo RN, Fedorov M, Felker B, Fink JT, Finney MD, Finnie LF, Fischer MJ, Fisher JM, Fishler BT, Florio JW, Forsman A, Foxworthy CB, Franks RM, Frazier T, Frieder G, Fung T, Gawinski GN, Gibson CR, Giraldez E, Glenn SM, Golick BP, Gonzales H, Gonzales SA, Gonzalez MJ, Griffin KL, Grippen J, Gross SM, Gschweng PH, Gururangan G, Gu K, Haan SW, Hahn SR, Haid BJ, Hamblen JE, Hammel BA, Hamza AV, Hardy DL, Hart DR, Hartley RG, Haynam CA, Heestand GM, Hermann MR, Hermes GL, Hey DS, Hibbard RL, Hicks DG, Hinkel DE, Hipple DL, Hitchcock JD, Hodtwalker DL, Holder JP, Hollis JD, Holtmeier GM, Huber SR, Huey AW, Hulsey DN, Hunter SL, Huppler TR, Hutton MS, Izumi N, Jackson JL, Jackson MA, Jancaitis KS, Jedlovec DR, Johnson B, Johnson MC, Johnson T, Johnston MP, Jones OS, Kalantar DH, Kamperschroer JH, Kauffman RL, Keating GA, Kegelmeyer LM, Kenitzer SL, Kimbrough JR, King K, Kirkwood RK, Klingmann JL, Knittel KM, Kohut TR, Koka KG, Kramer SW, Krammen JE, Krauter KG, Krauter GW, Krieger EK, Kroll JJ, La Fortune KN, Lagin LJ, Lakamsani VK, Landen OL, Lane SW, Langdon AB, Langer SH, Lao N, Larson DW, Latray D, Lau GT, Le Pape S, Lechleiter BL, Lee Y, Lee TL, Li J, Liebman JA, Lindl JD, Locke SF, Loey HK, London RA, Lopez FJ, Lord DM, Lowe-Webb RR, Lown JG, Ludwigsen AP, Lum NW, Lyons RR, Ma T, MacKinnon AJ, Magat MD, Maloy DT, Malsbury TN, Markham G, Marquez RM, Marsh AA, Marshall CD, Marshall SR, Maslennikov IL, Mathisen DG, Mauger GJ, Mauvais MY, McBride JA, McCarville T, McCloud JB, McGrew A, McHale B, MacPhee AG, Meeker JF, Merill JS, Mertens EP, Michel PA, Miller MG, Mills T, Milovich JL, Miramontes R, Montesanti RC, Montoya MM, Moody J, Moody JD, Moreno KA, Morris J, Morriston KM, Nelson JR, Neto M, Neumann JD, Ng E, Ngo QM, Olejniczak BL, Olson RE, Orsi NL, Owens MW, Padilla EH, Pannell TM, Parham TG, Patterson RW, Pavel G, Prasad RR, Pendlton D, Penko FA, Pepmeier BL, Petersen DE, Phillips TW, Pigg D, Piston KW, Pletcher KD, Powell CL, Radousky HB, Raimondi BS, Ralph JE, Rampke RL, Reed RK, Reid WA, Rekow VV, Reynolds JL, Rhodes JJ, Richardson MJ, Rinnert RJ, Riordan BP, Rivenes AS, Rivera AT, Roberts CJ, Robinson JA, Robinson RB, Robison SR, Rodriguez OR, Rogers SP, Rosen MD, Ross GF, Runkel M, Runtal AS, Sacks RA, Sailors SF, Salmon JT, Salmonson JD, Saunders RL, Schaffer JR, Schindler TM, Schmitt MJ, Schneider MB, Segraves KS, Shaw MJ, Sheldrick ME, Shelton RT, Shiflett MK, Shiromizu SJ, Shor M, Silva LL, Silva SA, Skulina KM, Smauley DA, Smith BE, Smith LK, Solomon AL, Sommer S, Soto JG, Spafford NI, Speck DE, Springer PT, Stadermann M, Stanley F, Stone TG, Stout EA, Stratton PL, Strausser RJ, Suter LJ, Sweet W, Swisher MF, Tappero JD, Tassano JB, Taylor JS, Tekle EA, Thai C, Thomas CA, Thomas A, Throop AL, Tietbohl GL, Tillman JM, Town RPJ, Townsend SL, Tribbey KL, Trummer D, Truong J, Vaher J, Valadez M, Van Arsdall P, Van Prooyen AJ, Vergel de Dios EO, Vergino MD, Vernon SP, Vickers JL, Villanueva GT, Vitalich MA, Vonhof SA, Wade FE, Wallace RJ, Warren CT, Warrick AL, Watkins J, Weaver S, Wegner PJ, Weingart MA, Wen J, White KS, Whitman PK, Widmann K, Widmayer CC, Wilhelmsen K, Williams EA, Williams WH, Willis L, Wilson EF, Wilson BA, Witte MC, Work K, Yang PS, Young BK, Youngblood KP, Zacharias RA, Zaleski T, Zapata PG, Zhang H, Zielinski JS, Kline JL, Kyrala GA, Niemann C, Kilkenny JD, Nikroo A, Van Wonterghem BM, Atherton LJ, Moses EI. Demonstration of ignition radiation temperatures in indirect-drive inertial confinement fusion hohlraums. Phys Rev Lett 2011; 106:085004. [PMID: 21405580 DOI: 10.1103/physrevlett.106.085004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2010] [Indexed: 05/30/2023]
Abstract
We demonstrate the hohlraum radiation temperature and symmetry required for ignition-scale inertial confinement fusion capsule implosions. Cryogenic gas-filled hohlraums with 2.2 mm-diameter capsules are heated with unprecedented laser energies of 1.2 MJ delivered by 192 ultraviolet laser beams on the National Ignition Facility. Laser backscatter measurements show that these hohlraums absorb 87% to 91% of the incident laser power resulting in peak radiation temperatures of T(RAD)=300 eV and a symmetric implosion to a 100 μm diameter hot core.
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Affiliation(s)
- S H Glenzer
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
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Campina Costa S, Neto M, Trindade M. Beta-lactam hypersensitivity: from guidelines to daily practice. J Investig Allergol Clin Immunol 2010; 20:175-176. [PMID: 20461978] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Affiliation(s)
- S Campina Costa
- Division of Imunoallergy, Pulido Valente Hospital, North Lisbon Hospital Center, Lisbon, Portugal.
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Calha IM, Matias A, Neto M, Rocha F. Are Portuguese Echinochloa spp. populations still susceptible to propanil? Commun Agric Appl Biol Sci 2009; 74:515-519. [PMID: 20222612] [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] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Propanil is the most important herbicide for rice weed management both at world and national level. Rice growers complains of poor control of Echinochloa was monitored in Mondego and Sorraia river valleys, Portugal. Seed samples were collected from the affected area and tested. After the first screening of 37 populations, the sensitivity of six Echinochloa spp. populations to propanil was assessed in a growth chamber dose response study (with seven rates: 0- 7200 g a.i. ha(-1)). Fresh weight was assessed 21 days after treatment and data was analysed using non-linear regression analysis and sensitivity indices (SI = ED80, less sensitive/ ED80, most sensitive) calculated for the two regions surveyed. The rates of 50% of plant growth inhibition (ED50) was calculated from the fitted equations. Four populations where confirmed susceptible with ED50 values ranging from 89 to 1866 g a.i. ha(-1). Two other populations presented ED50 values of 6538 and 9536 g a.i. ha(-1). Mondego and Sorraia SI were 2.35 and 53.55 respectively. The pattern of propanil use in the two regions could explain the higher sensitivity of Mondego populations compared to Sorraia populations. The response to a single dose Petri dish bioassay (360 g a.i. L(-1)) was similar among the six populations, denoting that this method was not so sensitive as the whole plant assay to discriminate between Echinochloa spp. populations. Further studies are needed with more doses and populations since this method allows for an answer within six days, compared with 41 days with the whole plant bioassay.
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Affiliation(s)
- I M Calha
- Instituto Nacional de Recursos Biológicos I.P. (INRB), Unidade de Protecção de Plantas, Quinta do Marquês PT-2780-155 Oeiras, Portugal.
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Tarnoff M, Rodriguez L, Escalona A, Ramos A, Neto M, Alamo M, Reyes E, Pimentel F, Ibanez L. Open label, prospective, randomized controlled trial of an endoscopic duodenal-jejunal bypass sleeve versus low calorie diet for pre-operative weight loss in bariatric surgery. Surg Endosc 2008; 23:650-6. [PMID: 19067075 DOI: 10.1007/s00464-008-0125-4] [Citation(s) in RCA: 139] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2008] [Revised: 06/20/2008] [Accepted: 07/24/2008] [Indexed: 01/09/2023]
Abstract
BACKGROUND The duodenal-jejunal bypass sleeve (DJBS) has been shown to achieve a completely endoscopic duodenal exclusion without the need for stapling. This report is the first randomized controlled trial for weight loss. METHODS In a 12-week, prospective, randomized study, subjects received either a low fat diet and the DJBS or a low fat diet control (no device). Twenty-five patients were implanted with the device and 14 received the control. The groups were demographically similar. Both groups received counseling at baseline only, which consisted of a low calorie diet, and exercise/behavior modification advice. No additional counseling occurred in either group. Measurements included starting and monthly body weight and serum blood tests. The device group also had a plain abdominal film post implant, a monthly KUB and a 4-week post explant EGD. RESULTS Twenty device (80%) subjects maintained the DJBS without a significant adverse event for the 12-week duration. At 12 weeks, the mean excess weight loss was 22% and 5% for the device and control groups, respectively (p < 0.001). Five subjects (20%) were endoscopically explanted early secondary to upper GI (UGI) bleeding (n = 3), anchor migration (n = 1) and sleeve obstruction (n = 1). The UGI bleeding occurred at a mean of 13.8 days post implant. EGD was performed in each of these cases with no distinct bleeding source identified. No blood transfusion was required. The migration occurred on day 47 and manifested as abdominal pain. The subject with the sleeve obstruction presented with abdominal pain and vomiting on day 30. Eight subjects (40%) underwent the 4 week post explant EGD at which time mild degrees of residual duodenal inflammation was noted. CONCLUSION The DJBS achieves noninvasive duodenal exclusion and short term weight loss efficacy. Longer term randomized controlled sham trials for weight loss and treatment of T2DM are underway.
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Affiliation(s)
- M Tarnoff
- Department of Surgery, Tufts-New England Medical Center, Boston, MA, USA.
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Abstract
OBJECTIVES To investigate whether fertility is reduced among female shoe manufacturing workers exposed to organic solvents. METHODS A retrospective study was conducted on time to pregnancy (TTP) among 250 Portuguese shoe manufacturing workers exposed to solvents and 250 unexposed women working in stores of food units and storehouses. Data on TTP and related factors were collected by face-to-face interviews. The participation rate was 92%, and 81% of the workers (197 exposed women and 209 unexposed women) provided data for the analyses. Exposure assessment was based on hygienic measurements in the workplaces. TTP data were analysed with discrete proportional hazards regression. RESULTS Female exposure to solvents was associated with reduced fertility (adjusted fecundability density ratio (FDR) 0.55, CI 0.40 to 0.74 for low exposure, and FDR 0.70, CI 0.52 to 0.94 for high exposure). The findings were robust in different sensitivity analyses. A slightly stronger association was found among women with regular menstrual cycles. Exposure for less than 6 years was more strongly associated with reduced fertility (FDR 0.50, CI 0.30 to 0.83 and FDR 0.50, CI 0.28 to 0.90 for low and high exposure, respectively) than at least 6 years of exposure (FDR 0.60, CI 0.39 to 0.92 and FDR 0.86, CI 0.57 to 1.29 for low and high exposure, respectively). There was an interaction between solvent exposure and female smoking or use of coffee, the exposed women who smoke or use coffee being highly fecund. CONCLUSIONS The findings provide further evidence that exposure to organic solvents is hazardous for female reproduction. The observed association may be related to any of the following solvents commonly used in shoe manufacturing: n-hexane and hexane isomers, toluene, methyl ethyl ketone, acetone, ethyl acetate and dichloromethane.
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Affiliation(s)
- M Sallmén
- Centre of Expertise for Health and Work Ability, Finnish Institute of Occupational Health, Topeliuksenkatu 41 aA, FI-00250 Helsinki, Finland.
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