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Mirnezami AH, Drami I, Glyn T, Sutton PA, Tiernan J, Behrenbruch C, Guerra G, Waters PS, Woodward N, Applin S, Charles SJ, Rose SA, Denys A, Pape E, van Ramshorst GH, Baker D, Bignall E, Blair I, Davis P, Edwards T, Jackson K, Leendertse PG, Love-Mott E, MacKenzie L, Martens F, Meredith D, Nettleton SE, Trotman MP, van Hecke JJM, Weemaes AMJ, Abecasis N, Angenete E, Aziz O, Bacalbasa N, Barton D, Baseckas G, Beggs A, Brown K, Buchwald P, Burling D, Burns E, Caycedo-Marulanda A, Chang GJ, Coyne PE, Croner RS, Daniels IR, Denost QD, Drozdov E, Eglinton T, Espín-Basany E, Evans MD, Flatmark K, Folkesson J, Frizelle FA, Gallego MA, Gil-Moreno A, Goffredo P, Griffiths B, Gwenaël F, Harris DA, Iversen LH, Kandaswamy GV, Kazi M, Kelly ME, Kokelaar R, Kusters M, Langheinrich MC, Larach T, Lydrup ML, Lyons A, Mann C, McDermott FD, Monson JRT, Neeff H, Negoi I, Ng JL, Nicolaou M, Palmer G, Parnaby C, Pellino G, Peterson AC, Quyn A, Rogers A, Rothbarth J, Abu Saadeh F, Saklani A, Sammour T, Sayyed R, Smart NJ, Smith T, Sorrentino L, Steele SR, Stitzenberg K, Taylor C, Teras J, Thanapal MR, Thorgersen E, Vasquez-Jimenez W, Waller J, Weber K, Wolthuis A, Winter DC, Brangan G, Vimalachandran D, Aalbers AGJ, Abdul Aziz N, Abraham-Nordling M, Akiyoshi T, Alahmadi R, Alberda W, Albert M, Andric M, Angeles M, Antoniou A, Armitage J, Auer R, Austin KK, Aytac E, Baker RP, Bali M, Baransi S, Bebington B, Bedford M, Bednarski BK, Beets GL, Berg PL, Bergzoll C, Biondo S, Boyle K, Bordeianou L, Brecelj E, Bremers AB, Brunner M, Bui A, Burgess A, Burger JWA, Campain N, Carvalhal S, Castro L, Ceelen W, Chan KKL, Chew MH, Chok AK, Chong P, Christensen HK, Clouston H, Collins D, Colquhoun AJ, Constantinides J, Corr A, Coscia M, Cosimelli M, Cotsoglou C, Damjanovic L, Davies M, Davies RJ, Delaney CP, de Wilt JHW, Deutsch C, Dietz D, Domingo S, Dozois EJ, Duff M, Egger E, Enrique-Navascues JM, Espín-Basany E, Eyjólfsdóttir B, Fahy M, Fearnhead NS, Fichtner-Feigl S, Fleming F, Flor B, Foskett K, Funder J, García-Granero E, García-Sabrido JL, Gargiulo M, Gava VG, Gentilini L, George ML, George V, Georgiou P, Ghosh A, Ghouti L, Giner F, Ginther N, Glover T, Golda T, Gomez CM, Harris C, Hagemans JAW, Hanchanale V, Harji DP, Helbren C, Helewa RM, Hellawell G, Heriot AG, Hochman D, Hohenberger W, Holm T, Holmström A, Hompes R, Hornung B, Hurton S, Hyun E, Ito M, Jenkins JT, Jourand K, Kaffenberger S, Kapur S, Kanemitsu Y, Kaufman M, Kelley SR, Keller DS, Kersting S, Ketelaers SHJ, Khan MS, Khaw J, Kim H, Kim HJ, Kiran R, Koh CE, Kok NFM, Kontovounisios C, Kose F, Koutra M, Kraft M, Kristensen HØ, Kumar S, Lago V, Lakkis Z, Lampe B, Larsen SG, Larson DW, Law WL, Laurberg S, Lee PJ, Limbert M, Loria A, Lynch AC, Mackintosh M, Mantyh C, Mathis KL, Margues CFS, Martinez A, Martling A, Meijerink WJHJ, Merchea A, Merkel S, Mehta AM, McArthur DR, McCormick JJ, McGrath JS, McPhee A, Maciel J, Malde S, Manfredelli S, Mikalauskas S, Modest D, Morton JR, Mullaney TG, Navarro AS, Neto JWM, Nguyen B, Nielsen MB, Nieuwenhuijzen GAP, Nilsson PJ, Nordkamp S, O’Dwyer ST, Paarnio K, Pappou E, Park J, Patsouras D, Peacock O, Pfeffer F, Piqeur F, Pinson J, Poggioli G, Proud D, Quinn M, Oliver A, Radwan RW, Rajendran N, Rao C, Rasheed S, Rasmussen PC, Rausa E, Regenbogen SE, Reims HM, Renehan A, Rintala J, Rocha R, Rochester M, Rohila J, Rottoli M, Roxburgh C, Rutten HJT, Safar B, Sagar PM, Sahai A, Schizas AMP, Schwarzkopf E, Scripcariu D, Scripcariu V, Seifert G, Selvasekar C, Shaban M, Shaikh I, Shida D, Simpson A, Skeie-Jensen T, Smart P, Smith JJ, Solbakken AM, Solomon MJ, Sørensen MM, Spasojevic M, Steffens D, Stocchi L, Stylianides NA, Swartling T, Sumrien H, Swartking T, Takala H, Tan EJ, Taylor D, Tejedor P, Tekin A, Tekkis PP, Thaysen HV, Thurairaja R, Toh EL, Tsarkov P, Tolenaar J, Tsukada Y, Tsukamoto S, Tuech JJ, Turner G, Turner WH, Tuynman JB, Valente M, van Rees J, van Zoggel D, Vásquez-Jiménez W, Verhoef C, Vierimaa M, Vizzielli G, Voogt ELK, Uehara K, Wakeman C, Warrier S, Wasmuth HH, Weiser MR, Westney OL, Wheeler JMD, Wild J, Wilson M, Yano H, Yip B, Yip J, Yoo RN, Zappa MA. The empty pelvis syndrome: a core data set from the PelvEx collaborative. Br J Surg 2024; 111:znae042. [PMID: 38456677 PMCID: PMC10921833 DOI: 10.1093/bjs/znae042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 01/15/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND Empty pelvis syndrome (EPS) is a significant source of morbidity following pelvic exenteration (PE), but is undefined. EPS outcome reporting and descriptors of radicality of PE are inconsistent; therefore, the best approaches for prevention are unknown. To facilitate future research into EPS, the aim of this study is to define a measurable core outcome set, core descriptor set and written definition for EPS. Consensus on strategies to mitigate EPS was also explored. METHOD Three-stage consensus methodology was used: longlisting with systematic review, healthcare professional event, patient engagement, and Delphi-piloting; shortlisting with two rounds of modified Delphi; and a confirmatory stage using a modified nominal group technique. This included a selection of measurement instruments, and iterative generation of a written EPS definition. RESULTS One hundred and three and 119 participants took part in the modified Delphi and consensus meetings, respectively. This encompassed international patient and healthcare professional representation with multidisciplinary input. Seventy statements were longlisted, seven core outcomes (bowel obstruction, enteroperineal fistula, chronic perineal sinus, infected pelvic collection, bowel obstruction, morbidity from reconstruction, re-intervention, and quality of life), and four core descriptors (magnitude of surgery, radiotherapy-induced damage, methods of reconstruction, and changes in volume of pelvic dead space) reached consensus-where applicable, measurement of these outcomes and descriptors was defined. A written definition for EPS was agreed. CONCLUSIONS EPS is an area of unmet research and clinical need. This study provides an agreed definition and core data set for EPS to facilitate further research.
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West CT, West MA, Mirnezami AH, Drami I, Denys A, Glyn T, Sutton PA, Tiernan J, Behrenbruch C, Guerra G, Waters PS, Woodward N, Applin S, Charles SJ, Rose SA, Pape E, van Ramshorst GH, Aalbers AGJ, Abdul AN, Abecasis N, Abraham-Nordling M, Akiyoshi T, Alahmadi R, Alberda W, Albert M, Andric M, Angeles M, Angenete E, Antoniou A, Armitage J, Auer R, Austin KK, Aytac E, Aziz O, Bacalbasa N, Baker RP, Bali M, Baransi S, Baseckas G, Bebington B, Bedford M, Bednarski BK, Beets GL, Berg PL, Bergzoll C, Biondo S, Boyle K, Bordeianou L, Brecelj E, Bremers AB, Brown K, Brunner M, Buchwald P, Bui A, Burgess A, Burger JWA, Burling D, Burns E, Campain N, Carvalhal S, Castro L, Caycedo-Marulanda A, Ceelen W, Chan KKL, Chang GJ, Chew MH, Chok AK, Chong P, Christensen HK, Clouston H, Collins D, Colquhoun AJ, Constantinides J, Corr A, Coscia M, Cosimelli M, Cotsoglou C, Coyne PE, Croner RS, Damjanovic L, Daniels IR, Davies M, Davies RJ, Delaney CP, de Wilt JHW, Denost QD, Deutsch C, Dietz D, Domingo S, Dozois EJ, Drozdov E, Duff M, Egger E, Eglinton T, Enrique-Navascues JM, Espín-Basany E, Evans MD, Eyjólfsdóttir B, Fahy M, Fearnhead NS, Fichtner-Feigl S, Flatmark K, Fleming F, Flor B, Folkesson J, Foskett K, Frizelle FA, Funder J, Gallego MA, García-Granero E, García-Sabrido JL, Gargiulo M, Gava VG, Gentilini L, George ML, George V, Georgiou P, Ghosh A, Ghouti L, Gil-Moreno A, Giner F, Ginther N, Glover T, Goffredo P, Golda T, Gomez CM, Griffiths B, Gwenaël F, Harris C, Harris DA, Hagemans JAW, Hanchanale V, Harji DP, Helbren C, Helewa RM, Hellawell G, Heriot AG, Hochman D, Hohenberger W, Holm T, Holmström A, Hompes R, Hornung B, Hurton S, Hyun E, Ito M, Iversen LH, Jenkins JT, Jourand K, Kaffenberger S, Kandaswamy GV, Kapur S, Kanemitsu Y, Kaufman M, Kazi M, Kelley SR, Keller DS, Kelly ME, Kersting S, Ketelaers SHJ, Khan MS, Khaw J, Kim H, Kim HJ, Kiran R, Koh CE, Kok NFM, Kokelaar R, Kontovounisios C, Kose F, Koutra M, Kraft M, Kristensen HØ, Kumar S, Kusters M, Lago V, Lakkis Z, Lampe B, Langheinrich MC, Larach T, Larsen SG, Larson DW, Law WL, Laurberg S, Lee PJ, Limbert M, Loria A, Lydrup ML, Lyons A, Lynch AC, Mackintosh M, Mann C, Mantyh C, Mathis KL, Margues CFS, Martinez A, Martling A, Meijerink WJHJ, Merchea A, Merkel S, Mehta AM, McArthur DR, McCormick JJ, McDermott FD, McGrath JS, McPhee A, Maciel J, Malde S, Manfredelli S, Mikalauskas S, Modest D, Monson JRT, Morton JR, Mullaney TG, Navarro AS, Neeff H, Negoi I, Neto JWM, Nguyen B, Nielsen MB, Nieuwenhuijzen GAP, Nilsson PJ, Nordkamp S, O’Dwyer ST, Paarnio K, Palmer G, Pappou E, Park J, Patsouras D, Peacock A, Pellino G, Peterson AC, Pfeffer F, Piqeur F, Pinson J, Poggioli G, Proud D, Quinn M, Oliver A, Quyn A, Radwan RW, Rajendran N, Rao C, Rasheed S, Rasmussen PC, Rausa E, Regenbogen SE, Reims HM, Renehan A, Rintala J, Rocha R, Rochester M, Rohila J, Rothbarth J, Rottoli M, Roxburgh C, Rutten HJT, Safar B, Sagar PM, Sahai A, Saklani A, Sammour T, Sayyed R, Schizas AMP, Schwarzkopf E, Scripcariu D, Scripcariu V, Seifert G, Selvasekar C, Shaban M, Shaikh I, Shida D, Simpson A, Skeie-Jensen T, Smart NJ, Smart P, Smith JJ, Smith T, Solbakken AM, Solomon MJ, Sørensen MM, Spasojevic M, Steele SR, Steffens D, Stitzenberg K, Stocchi L, Stylianides NA, Swartling T, Sumrien H, Swartking T, Takala H, Tan EJ, Taylor C, Taylor D, Tejedor P, Tekin A, Tekkis PP, Teras J, Thanapal MR, Thaysen HV, Thorgersen E, Thurairaja R, Toh EL, Tsarkov P, Tolenaar J, Tsukada Y, Tsukamoto S, Tuech JJ, Turner G, Turner WH, Tuynman JB, Valente M, van Rees J, van Zoggel D, Vásquez-Jiménez W, Verhoef C, Vierimaa M, Vizzielli G, Voogt ELK, Uehara K, Wakeman C, Warrier S, Wasmuth HH, Weber K, Weiser MR, Westney OL, Wheeler JMD, Wild J, Wilson M, Wolthuis A, Yano H, Yip B, Yip J, Yoo RN, Zappa MA, Winter DC. Empty pelvis syndrome: PelvEx Collaborative guideline proposal. Br J Surg 2023; 110:1730-1731. [PMID: 37757457 PMCID: PMC10805575 DOI: 10.1093/bjs/znad301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/22/2023] [Accepted: 08/28/2023] [Indexed: 09/29/2023]
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Kocillari L, Rocha R, Coletta L, Gozzi A, Panzeri S. FV 4 Mouse resting-state functional neuroimaging displays signatures of criticality. Clin Neurophysiol 2023. [DOI: 10.1016/j.clinph.2023.02.005] [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: 03/08/2023]
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Fahy MR, Kelly ME, Aalbers AGJ, Abdul Aziz N, Abecasis N, Abraham-Nordling M, Akiyoshi T, Alberda W, Albert M, Andric M, Angeles MA, Angenete E, Antoniou A, Auer R, Austin KK, Aytac E, Aziz O, Bacalbasa N, Baker RP, Bali M, Baransi S, Baseckas G, Bebington B, Bedford M, Bednarski BK, Beets GL, Berg PL, Bergzoll C, Beynon J, Biondo S, Boyle K, Bordeianou L, Brecelj E, Bremers AB, Brunner M, Buchwald P, Bui A, Burgess A, Burger JWA, Burling D, Burns E, Campain N, Carvalhal S, Castro L, Caycedo-Marulanda A, Ceelan W, Chan KKL, Chang GJ, Chang M, Chew MH, Chok AY, Chong P, Clouston H, Codd M, Collins D, Colquhoun AJ, Constantinides J, Corr A, Coscia M, Cosimelli M, Cotsoglou C, Coyne PE, Croner RS, Damjanovich L, Daniels IR, Davies M, Delaney CP, de Wilt JHW, Denost Q, Deutsch C, Dietz D, Domingo S, Dozois EJ, Drozdov E, Duff M, Eglinton T, Enriquez-Navascues JM, Espín-Basany E, Evans MD, Eyjólfsdóttir B, Fearnhead NS, Ferron G, Flatmark K, Fleming FJ, Flor B, Folkesson J, Frizelle FA, Funder J, Gallego MA, Gargiulo M, García-Granero E, García-Sabrido JL, Gargiulo M, Gava VG, Gentilini L, George ML, George V, Georgiou P, Ghosh A, Ghouti L, Gil-Moreno A, Giner F, Ginther DN, Glyn T, Glynn R, Golda T, Griffiths B, Harris DA, Hagemans JAW, Hanchanale V, Harji DP, Helewa RM, Hellawell G, Heriot AG, Hochman D, Hohenberger W, Holm T, Hompes R, Hornung B, Hurton S, Hyun E, Ito M, Iversen LH, Jenkins JT, Jourand K, Kaffenberger S, Kandaswamy GV, Kapur S, Kanemitsu Y, Kazi M, Kelley SR, Keller DS, Ketelaers SHJ, Khan MS, Kiran RP, Kim H, Kim HJ, Koh CE, Kok NFM, Kokelaar R, Kontovounisios C, Kose F, Koutra M, Kristensen HØ, Kroon HM, Kumar S, Kusters M, Lago V, Lampe B, Lakkis Z, Larach JT, Larkin JO, Larsen SG, Larson DW, Law WL, Lee PJ, Limbert M, Loria A, Lydrup ML, Lyons A, Lynch AC, Maciel J, Manfredelli S, Mann C, Mantyh C, Mathis KL, Marques CFS, Martinez A, Martling A, Mehigan BJ, Meijerink WJHJ, Merchea A, Merkel S, Mehta AM, Mikalauskas S, McArthur DR, McCormick JJ, McCormick P, McDermott FD, McGrath JS, Malde S, Mirnezami A, Monson JRT, Navarro AS, Negoi I, Neto JWM, Ng JL, Nguyen B, Nielsen MB, Nieuwenhuijzen GAP, Nilsson PJ, Nordkamp S, Nugent T, Oliver A, O’Dwyer ST, O’Sullivan NJ, Paarnio K, Palmer G, Pappou E, Park J, Patsouras D, Peacock O, Pellino G, Peterson AC, Pinson J, Poggioli G, Proud D, Quinn M, Quyn A, Rajendran N, Radwan RW, Rajendran N, Rao C, Rasheed S, Rausa E, Regenbogen SE, Reims HM, Renehan A, Rintala J, Rocha R, Rochester M, Rohila J, Rothbarth J, Rottoli M, Roxburgh C, Rutten HJT, Safar B, Sagar PM, Sahai A, Saklani A, Sammour T, Sayyed R, Schizas AMP, Schwarzkopf E, Scripcariu D, Scripcariu V, Selvasekar C, Shaikh I, Simpson A, Skeie-Jensen T, Smart NJ, Smart P, Smith JJ, Solbakken AM, Solomon MJ, Sørensen MM, Sorrentino L, Steele SR, Steffens D, Stitzenberg K, Stocchi L, Stylianides NA, Swartling T, Spasojevic M, Sumrien H, Sutton PA, Swartking T, Takala H, Tan EJ, Taylor C, Tekin A, Tekkis PP, Teras J, Thaysen HV, Thurairaja R, Thorgersen EB, Toh EL, Tsarkov P, Tsukada Y, Tsukamoto S, Tuech JJ, Turner WH, Tuynman JB, Valente M, van Ramshorst GH, van Zoggel D, Vasquez-Jimenez W, Vather R, Verhoef C, Vierimaa M, Vizzielli G, Voogt ELK, Uehara K, Urrejola G, Wakeman C, Warrier SK, Wasmuth HH, Waters PS, Weber K, Weiser MR, Wheeler JMD, Wild J, Williams A, Wilson M, Wolthuis A, Yano H, Yip B, Yip J, Yoo RN, Zappa MA, Winter DC. Minimum standards of pelvic exenterative practice: PelvEx Collaborative guideline. Br J Surg 2022; 109:1251-1263. [PMID: 36170347 DOI: 10.1093/bjs/znac317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 07/18/2022] [Accepted: 08/18/2022] [Indexed: 12/31/2022]
Abstract
This document outlines the important aspects of caring for patients who have been diagnosed with advanced pelvic cancer. It is primarily aimed at those who are establishing a service that adequately caters to this patient group. The relevant literature has been summarized and an attempt made to simplify the approach to management of these complex cases.
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Albuquerque DC, Barros E Silva PG, Lopes RD, Hoffmann C, Nogueira PR, Reis H, Nishijuka FA, De Figueiredo Neto JA, De Souza Neto JD, Rohde LEP, Simoes MV, Rocha RM, Moura LZ, Marcondes-Braga FG, Mesquita ET. Main results of the first Brazilian Registry of Heart Failure (BREATHE). Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Heart failure represents a common cause of hospitalization associated with poor short-term clinical outcomes. Little is known about the long-term prognosis of these patients in Latin America.
Methods
The rationale and design of the study were previously published (1). Briefly, BREATHE was the first nation-wide prospective observational study that included patients hospitalized due to acute heart failure in Brazil. In-hospital management as well as 12-month clinical outcomes were assessed. Patients were included during two time periods: from February 2011 to December 2012 (BREATHE I) and from June 2016 to July 2018 (BREATHE Extension). Adherence to evidence-based therapies was also evaluated.
Results
A total of 3,013 patients were included in 71 centers in Brazil. The median follow-up was 346 days. The BREATHE population included 39.3% of women, had a mean age of 65.2 (± 15.6) with a mean ejection fraction of 39.7% (± 17.5). Among the comorbidities, systemic arterial hypertension was the most common, present in almost 75% of the sample. At hospital admission, 83.8% of patients had clear signs of pulmonary congestion and the main cause of decompensation was poor adherence to heart failure medications, representing 27.8% of cases. Among patients with reduced ejection fraction, the concomitant use of renin-angiotensin-aldosterone inhibitors, beta-blocker and spironolactone at hospital discharge was 44.5% and decreased to 35.2% after 3 months (p<0.01). Mortality rate at 12 months was 28.9 for every 100 patient years with 26.2% readmission at 90 days and 46.4% at 365 days. The most common etiology of heart failure was ischemic disease (Figure 1) but the worst prognosis was associated with Chagas disease (Figure 2) including an analysis of a composite outcome encompassing death, myocardial infarction, stroke or cardiac arrest after discharge.
Conclusions
In this large national prospective registry of patients hospitalized with acute heart failure, mortality and readmission were higher than what have been reported globally. Poor adherence to evidence-based therapies was a common both at hospital discharge and 1-year of follow-up.
Funding Acknowledgement
Type of funding sources: Other. Main funding source(s): Brazilian Society of Cardiology
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Affiliation(s)
- D C Albuquerque
- Sociedade Brasileira de Cardiologia, Departamento de Insuficiência Cardíaca - DEIC , Rio de Janeiro , Brazil
| | | | - R D Lopes
- Duke Clinical Research Institute , Durham , United States of America
| | - C Hoffmann
- Hospital Regional Hans Dieter Schmidt , Joinville , Brazil
| | - P R Nogueira
- Fundação Faculdade Regional de Medicina de São José do Rio Preto , São José do Rio Preto , Brazil
| | - H Reis
- Hospital de Clinicas Gaspar Viana , Belem , Brazil
| | - F A Nishijuka
- Hospital Naval Marcilio Dias , Rio de Janeiro , Brazil
| | - J A De Figueiredo Neto
- Centro de Pesquisa Clínica do Hospital Universitário da Universidade Federal do Maranhão (CEPEC-HUUF , Sao Luis , Brazil
| | | | - L E P Rohde
- Hospital de Clínicas de Porto Alegre , Porto Alegre , Brazil
| | - M V Simoes
- Hospital Das Clinicas Fmrp-Usp , Ribeirao Preto , Brazil
| | - R M Rocha
- Pedro Ernesto University Hospital , Rio de Janeiro , Brazil
| | | | - F G Marcondes-Braga
- Sociedade Brasileira de Cardiologia, Departamento de Insuficiência Cardíaca - DEIC , Rio de Janeiro , Brazil
| | - E T Mesquita
- Sociedade Brasileira de Cardiologia, Departamento de Insuficiência Cardíaca - DEIC , Rio de Janeiro , Brazil
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Ferrari G, Giannichi B, Resende B, Paiva L, Rocha R, Falbel F, Rache B, Adami F, Rezende L. The economic burden of overweight and obesity in Brazil: perspectives for the Brazilian Unified Health System. Public Health 2022; 207:82-87. [DOI: 10.1016/j.puhe.2022.03.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 03/21/2022] [Accepted: 03/22/2022] [Indexed: 02/06/2023]
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Rodrigues R, Vieira J, Vasconcelos G, Marinho L, Neto J, Siqueira R, Rocha R, Almeida G. Association of ANK2 Mutation and Massive Myocardial Calcification: A Case Report. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Montanari E, Bokor A, Szabó G, Kondo W, Trippia CH, Malzoni M, Di Giovanni A, Tinneberg HR, Oberstein A, Rocha RM, Leonardi M, Condous G, Alsalem H, Keckstein J, Hudelist G. Accuracy of sonography for non-invasive detection of ovarian and deep endometriosis using #Enzian classification: prospective multicenter diagnostic accuracy study. Ultrasound Obstet Gynecol 2022; 59:385-391. [PMID: 34919760 DOI: 10.1002/uog.24833] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 11/30/2021] [Accepted: 12/01/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To compare the preoperative detection of endometriosis using transvaginal sonography (TVS) supplemented by transabdominal sonography (TAS) with surgical assessment of disease, using the #Enzian classification for endometriosis. METHODS This was a prospective multicenter diagnostic accuracy study of women undergoing TVS/TAS and radical surgery for deep endometriosis (DE) at different tertiary referral centers. The localization and grade of severity of the endometriotic lesions and adhesions were described according to the criteria of the #Enzian classification, both at preoperative ultrasound examination and during surgery. According to the #Enzian classification, the small pelvis is divided into three compartments for DE: A (rectovaginal septum and vagina); B (uterosacral and cardinal ligaments, parametrium and pelvic sidewalls); and C (rectum). In addition, further locations (F) are classified as adenomyosis (FA), urinary bladder involvement (FB) and ureteric involvement with signs of obstruction (FU). Other intestinal locations (FI) and other extragenital locations (FO) are also included. Ovarian endometriosis and adhesions at the level of the tubo-ovarian unit are listed as O and T, respectively. The #Enzian grade of severity (Grade 1-3) was determined for #Enzian compartments O, T, A, B and C based on the size of the lesion or the severity of the adhesions. Concordance between preoperative assessment using TVS/TAS and evaluation at surgery was assessed. The sensitivity, specificity, positive and negative predictive values and accuracy of TVS/TAS in the detection of endometriotic lesions/adhesions in the different #Enzian compartments were calculated. RESULTS In total, 745 women were included in the analysis. Preoperative TVS/TAS and surgical findings showed a concordance rate ranging between 86% and 99% for the presence or absence of endometriotic lesions/adhesions, depending on the evaluated #Enzian compartment. The concordance rate between TVS and surgery ranged between 71% and 92% for different severity grades, in #Enzian compartments O, T, A, B and C. Determining the presence or absence of adhesions at the level of the tubo-ovarian unit and classifying them accurately as Grade 1, 2 or 3 on TVS was more difficult than determining the presence and severity of endometriotic lesions in #Enzian compartments O, A, B and C. The sensitivity of TVS/TAS for the detection of endometriotic lesions ranged from 50% (#Enzian compartment FI) to 95% (#Enzian compartment A), specificity from 86% (#Enzian compartment Tleft ) to 99% (#Enzian compartment FI) and 100% (#Enzian compartments FB, FU and FO), positive predictive value from 90% (#Enzian compartment Tright ) to 100% (#Enzian compartment FO), negative predictive value from 74% (#Enzian compartment Bleft ) to 99% (#Enzian compartments FB and FU) and accuracy from 88% (#Enzian compartment Bright ) to 99% (#Enzian compartment FB). CONCLUSIONS The localization and severity of endometriotic lesions/adhesions, as described and classified according to the #Enzian classification, can be diagnosed accurately and non-invasively using TVS/TAS. The #Enzian classification provides a uniform classification system for describing endometriotic lesions, which can be used both at TVS/TAS and during surgical evaluation. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- E Montanari
- Department of Gynecology, Center for Endometriosis, Hospital St John of God, Vienna, Austria
| | - A Bokor
- Department of Obstetrics and Gynecology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - G Szabó
- Department of Obstetrics and Gynecology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - W Kondo
- Department of Gynecology and Minimally Invasive Unit, Vita Batel Hospital, Curitiba, Brazil
| | - C H Trippia
- Department of Radiology, Roentgen Diagnóstico Institute, Curitiba, Brazil
| | - M Malzoni
- Endoscopica Malzoni, Centre for Advanced Pelvic Surgery, Avellino, Italy
| | - A Di Giovanni
- Endoscopica Malzoni, Centre for Advanced Pelvic Surgery, Avellino, Italy
| | - H R Tinneberg
- Department of Obstetrics and Gynecology, Nordwest Hospital, Frankfurt, Germany
| | - A Oberstein
- Department of Obstetrics and Gynecology, Nordwest Hospital, Frankfurt, Germany
| | - R M Rocha
- Acute Gynaecology, Early Pregnancy and Advanced Endoscopy Surgery Unit, Nepean Hospital, Kingswood, NSW, Australia
- Sydney Medical School Nepean, University of Sydney, Sydney, NSW, Australia
| | - M Leonardi
- Sydney Medical School Nepean, University of Sydney, Sydney, NSW, Australia
- Department of Obstetrics and Gynecology, McMaster University, Hamilton, Canada
| | - G Condous
- Acute Gynaecology, Early Pregnancy and Advanced Endoscopy Surgery Unit, Nepean Hospital, Kingswood, NSW, Australia
- Sydney Medical School Nepean, University of Sydney, Sydney, NSW, Australia
| | - H Alsalem
- Department of Obstetrics and Gynecology, McMaster University, Hamilton, Canada
| | - J Keckstein
- Stiftung Endometrioseforschung (SEF), Westerstede, Germany
| | - G Hudelist
- Department of Gynecology, Center for Endometriosis, Hospital St John of God, Vienna, Austria
- Stiftung Endometrioseforschung (SEF), Westerstede, Germany
- Rudolfinerhaus Private Clinic, Vienna, Austria
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9
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Rocha R, Matos M, Pinto J, Sarmento A. Zoonotic foodborne diseases in a tertiary healthcare setting: diagnostics, resistance and underreporting of campylobacteriosis in Northern Portugal. Int J Infect Dis 2022. [DOI: 10.1016/j.ijid.2021.12.192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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10
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Carvalho R, Rodrigues T, Rocha R, Ribeiro J, Silva G, Carpinteiro L, Cortez-Dias N, Sousa J. Real-world comparison of different periprocedural antithrombotic strategies for atrial fibrillation catheter ablation. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0535] [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
Atrial Fibrillation (AF) catheter ablation carries high bleeding and thromboembolic risks, requiring a detailed assessment of overall risk-benefit profile regarding antithrombotic strategy. Vitamin K Anticoagulant (VKA) and Non-Vitamin K Antagonist Oral Anticoagulant (NOAC) have been used in the latest years in this setting, and with different interruption protocols periprocedural. Our goal was to evaluate the rate of acute adverse events (AAE) and compare them according to antithrombotic strategy used periprocedural, in a real-world basis.
Methods
A single-center retrospective study, including adult patients admitted to first AF catheter ablation, from 2004 to 2020. Different antithrombotic strategies (anticoagulation with VKA uninterrupted, anticoagulation with NOAC uninterrupted, no therapy or antiaggregation/interrupted ACO) were compared concerning the rate of any clinically relevant AAE; the composite of major AAE (hemopericardium and stroke/transient ischemic attack [TIA]) and minor AAE associated with vascular access. Descriptive statistics and logistic regression were used to compare groups according to the antithrombotic strategy with an alpha level of 0.05.
Results
Among the 868 patients included (mean age 59±12 yo, 67,5% [n=586] men), pulmonary vein isolation was performed under uninterrupted anticoagulation in 640 (73,7%), of which 595 patients with NOAC (68,5%) and 45 with VKA (5,2%). AF was paroxysmal, persistent and long-standing persistent in 63,4% (n=550), 21,4% (n=185) and 15,4% (n=133) patients, respectively. Mean CHADS-VASc score was 1,86±1,48. Over time there was a shift in the distribution of the type of antithrombotic therapy used, consistent with changes in recommendations (Graph 1).
The composite outcome occurred in 6,8% (n=62), including hemopericardium in 1,8% (n=16), stroke/TIA in 0,7% (n=6) and events related to vascular access in 1,4% (n=13) [Table 1]. No anticoagulation therapy or antiaggregation/interrupted ACO was more associated to the outcome, driven by major AAE, although the difference did not meet statistical significance (p=0,06) [Table 1]. No difference was found between VKA and NOAC group. Additionally, there was no diference in the incidence of hemorrhagic AAE since the implementation of an uninterrupted anticoagulation strategy periprocedural.
Conclusion
In our population of patients submitted to AF catheter ablation, an uninterrupted anticoagulation strategy is associated with lower rate of AAE, either with VKA or NOAC. Our real-world results are reassuring of the benefit of an uninterrupted strategy, and consistent with recent controlled trials.
Funding Acknowledgement
Type of funding sources: None. Antithrombotic therapies over timeClinically relevant acute adverse events
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Affiliation(s)
- R Carvalho
- Hospital Santo Andre, Cardiology, Leiria, Portugal
| | - T Rodrigues
- Centro Hospitalar Universitário Lisboa Norte, Cardiology, Lisbon, Portugal
| | - R Rocha
- Hospital Espirito Santo de Evora, Cardiology, Evora, Portugal
| | - J Ribeiro
- Centro Hospitalar Universitário Lisboa Norte, Cardiology, Lisbon, Portugal
| | - G.L Silva
- Centro Hospitalar Universitário Lisboa Norte, Cardiology, Lisbon, Portugal
| | - L Carpinteiro
- Centro Hospitalar Universitário Lisboa Norte, Cardiology, Lisbon, Portugal
| | - N Cortez-Dias
- Centro Hospitalar Universitário Lisboa Norte, Cardiology, Lisbon, Portugal
| | - J Sousa
- Centro Hospitalar Universitário Lisboa Norte, Cardiology, Lisbon, Portugal
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Dias Claudio F, Rocha R, Carrington M, Pais J, Guerreiro R, Hyde-Congo K, Neves D, Santos AR, Picarra B. Characterization and quality of care indicators in patients with acute myocardial infarction without ST segment elevation. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1318] [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
The definition of the quality of care in healthcare services is paramount to implement the resources necessary to grant the best quality of care according to the current guidelines. Recently, the European Society of Cardiology's guidelines for the management of acute coronary syndromes without ST segment elevation (NSTEMI) were published, and defined the quality indicators to be evaluated in such patients.
Purpose
To characterize the level of care given to the population of patients with NSTEMI included in the a national registry since 2011, according to the new guidelines directives.
Population and methods
We evaluated 12193 patients with NSTEMI. For each year the following variables were analyzed: age, gender, cardiovascular and non-cardiovascular comorbidities, clinical presentation (rhythm, blood pressure, Killip-Kimball Class), left ventricular ejection fraction (LVEF), treatment during admission and discharge, and time to invasive coronary angiography (ICA). Besides this, a comparing between years was made to analyze differences according to the quality indicators established in the guidelines.
Results
In 2019, 83.9% of patient with LVEF <40% were treated with IECA/ARA II and 80.6% were prescribed a betablocker at discharge. No statistically significant differences were found across the year with respect to IECA/ARA II at discharge (p=0.495), and beta-blocker at discharge (p=0.812). In terms of P2Y12 inhibitors during the hospital admission, there was a statistically significant increase in its use when comparing 2019 to 2014, 2015, 2016 and 2017 (p=0.019 for 2014 and p<0,001 the following years), with prescription in 90.4% of the patients in 2019. At discharge 88.3% of the patients were prescribed a P2Y12 inhibitor in 2019 and there was also a statistically significant increase in its prescription when compared to the previous years (from 2011 to 2017 with a p<0.001). When it comes to the prescription of statins at discharge there was a statistically significant difference between groups, driven mostly by an increase compared to the year 2012 (95.6% vs 90.8%, p=0.005). Only 16% of patients were subjected to ICA within 24h of admission during the year 2019. No statistically significant difference was found between other years (p>0.100 when comparing between years).
Discussion
The most striking feature that can be improved is the amount of patients subject to ICA within the first 24h after diagnosis. When it comes to the P2Y12 inhibitors it is also clear that there has been an increase in its prescription during the admission and at discharge. To sum up, it is clear that there is still some margin to improve care, of at least 10–20% in most parameters. This data portrays a picture of the measures and steps to take in order to provide the adequate care according to the latest guidelines.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
| | - R Rocha
- Hospital Espirito Santo de Evora, Evora, Portugal
| | - M Carrington
- Hospital Espirito Santo de Evora, Evora, Portugal
| | - J Pais
- Hospital Espirito Santo de Evora, Evora, Portugal
| | - R Guerreiro
- Hospital Espirito Santo de Evora, Evora, Portugal
| | - K Hyde-Congo
- Hospital Espirito Santo de Evora, Evora, Portugal
| | - D Neves
- Hospital Espirito Santo de Evora, Evora, Portugal
| | - A R Santos
- Hospital Espirito Santo de Evora, Evora, Portugal
| | - B Picarra
- Hospital Espirito Santo de Evora, Evora, Portugal
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Dias Claudio F, Carias M, Rocha R, Picarra B, Neves D, Trinca M. Iron deficiency – a factor in left ventricular ejection fraction depression post-myocardial infarction. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1310] [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
Iron deficiency was shown to affect functional capacity and ejection fraction in patients with heart failure and reduced ejection fraction. Myocardial infarction is an important cause of reduced left ventricular ejection fraction (LVEF). Moreover, there is some evidence of the iron deficiency as a factor to predict cardiovascular and non-cardiovascular mortality.
Purpose
Evaluate the presence of iron deficiency in patients with acute coronary syndromes (ACS) admitted to the intensive cardiac care unit and its eventual association with LVEF and mortality.
Population and methods
We performed a prospective study in which ACS patients were divided into groups according to the presence or absence of iron deficiency. We collected demographic data, comorbidities, as well as determination of troponin I, haemoglobin and criteria for absolute and functional iron deficiency (ID) and other data related to the use of mechanical ventilation, need for aminergic support, LVEF and death.
Results
From 148 patients we included 78 patients who met the criteria for being analysed. 49 patients had iron deficiency (51% had absolute iron deficiency and 49% had relative iron deficiency). There were no differences between groups in terms of myocardial infarction with or without ST segment elevation (p=0.609 and p=0.329, respectively), hypertension (p=0.926), diabetes (p=0.882), obesity (p=0.343), dyslipidaemia (p=0.482), smoking (p=0.876), valvular heart disease (p=0.888), acute and chronic renal failure (p=0.800 and p=0.888, respectively) and LVEF (p=0.886). There were no differences in need for aminergic support (p=0.984), ventilation (p=0.315) and death (p=0.704).
We found that in the sub-population of patients without anaemia (Hb>12g/dL), the proportion of patients with depressed LVEF (inferior to 50%) and relative iron deficiency was significantly higher than those with preserved LVEF (48.1 vs 13.8%, p=0.005). Furthermore, we also found that in this sub-population, patients with myocardial infarction without ST segment elevation had higher proportion of absolute iron deficiency (45.0 vs 19.4%, p=0.043).
Conclusion
Our study showed that the prevalence of iron deficiency in ACS patients is 62.9% (n=49). Moreover, in patients without anaemia, this results seems to point out that the presence of iron deficiency may be related with LVEF, at least during the acute event. Further studies with a higher sample size are warranted to either establish or discard this association. Furthermore, a follow-up of this patients can further enlighten us as to the role of iron deficiency in long term LVEF and mortality.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
| | - M Carias
- Hospital Espirito Santo de Evora, Evora, Portugal
| | - R Rocha
- Hospital Espirito Santo de Evora, Evora, Portugal
| | - B Picarra
- Hospital Espirito Santo de Evora, Evora, Portugal
| | - D Neves
- Hospital Espirito Santo de Evora, Evora, Portugal
| | - M Trinca
- Hospital Espirito Santo de Evora, Evora, Portugal
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13
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Elbatarny M, Petrushko D, Rocha R, Hussein N, Mazine A, Van Arsdell G, Haller C. CARDIOPULMONARY BYPASS RE-INSTITUTION AND INTRAOPERATIVE REVISIONS ARE ASSOCIATED WITH INCREASED PERIOPERATIVE RISK IN CONGENITAL CARDIAC SURGERY. Can J Cardiol 2021. [DOI: 10.1016/j.cjca.2021.07.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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14
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Leonardi M, Rocha R, Tun-Ismail AN, Robledo KP, Armour M, Condous G. Assessing the knowledge of endometriosis diagnostic tools in a large, international lay population: an online survey. BJOG 2021; 128:2084-2090. [PMID: 34403184 DOI: 10.1111/1471-0528.16865] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2021] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To assess the general population's knowledge regarding the utility and availability of tools to diagnosis endometriosis, with a focus on ultrasound. DESIGN An international cross-sectional online survey study was performed between August and October 2019. SETTING AND POPULATION 5301 respondents, representing 73 countries. METHODS In all, 23 questions survey focused on knowledge of endometriosis diagnosis distributed globally via patient- and community-endometriosis groups using social media. MAIN OUTCOMES AND MEASURES Descriptive data of the knowledge of diagnostic tools for diagnosing endometriosis, including details about diagnosis using ultrasound. RESULTS In all, 84.0% of respondents had been previously diagnosed with endometriosis, 71.5% of whom had been diagnosed at the time of surgery. Ultrasound and MRI were the methods of diagnosis in 6.5% and 1.8%, respectively. A total of 91.8%, 28.8% and 16.6% of respondents believed surgery, ultrasound and MRI could diagnose endometriosis, respectively (more than one answer allowed). In those diagnosed by surgery, 21.7% knew about ultrasound as a diagnosis method, whereas in those diagnosed non-surgically, 51.5% knew (P < 0.001). In all, 14.7%, 31.1% and 18.2% stated superficial, ovarian and deep endometriosis could be diagnosed with ultrasound (32.9% stated they did not know which phenotypes of endometriosis could be diagnosed). Lastly, 58.4% of respondents do not believe they could access an advanced ultrasound in their region. CONCLUSIONS There is a limited appreciation for the role of non-surgical diagnostic tests for endometriosis among lay respondents to this survey. TWEETABLE ABSTRACT International survey shows limited awareness of lay respondents about non-surgical endometriosis diagnostic tools.
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Affiliation(s)
- M Leonardi
- Acute Gynaecology, Early Pregnancy, and Advanced Endosurgery Unit, Nepean Hospital, Kingswood, NSW, Australia.,The University of Sydney Nepean Clinical School, Sydney, NSW, Australia.,Department of Obstetrics and Gynecology, McMaster University, Hamilton, ON, Canada
| | - R Rocha
- Acute Gynaecology, Early Pregnancy, and Advanced Endosurgery Unit, Nepean Hospital, Kingswood, NSW, Australia.,The University of Sydney Nepean Clinical School, Sydney, NSW, Australia
| | - A N Tun-Ismail
- Acute Gynaecology, Early Pregnancy, and Advanced Endosurgery Unit, Nepean Hospital, Kingswood, NSW, Australia.,The University of Sydney Nepean Clinical School, Sydney, NSW, Australia
| | - K P Robledo
- NHMRC Clinical Trials Centre, University of Sydney, Sydney, NSW, Australia
| | - M Armour
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia.,Translational Health Research Institute (THRI), Western Sydney University, Penrith, NSW, Australia
| | - G Condous
- Acute Gynaecology, Early Pregnancy, and Advanced Endosurgery Unit, Nepean Hospital, Kingswood, NSW, Australia.,The University of Sydney Nepean Clinical School, Sydney, NSW, Australia.,OMNI Ultrasound & Gynaecological Care, St Leonards, NSW, Australia
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15
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Appel G, López‐Baucells A, Rocha R, Meyer CFJ, Bobrowiec PED. Habitat disturbance trumps moonlight effects on the activity of tropical insectivorous bats. Anim Conserv 2021. [DOI: 10.1111/acv.12706] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- G. Appel
- Programa de Pós‐graduação em Ecologia Instituto Nacional de Pesquisas da Amazônia Manaus Brazil
- Biological Dynamics of Forest Fragments Project Instituto Nacional de Pesquisas da Amazônia Manaus Brazil
| | - A. López‐Baucells
- Biological Dynamics of Forest Fragments Project Instituto Nacional de Pesquisas da Amazônia Manaus Brazil
- BiBio (Biodiversity and Bioindicators Research Group) Natural Sciences Museum of Granollers Granollers Spain
- Centre for Ecology, Evolution and Environmental Changes University of Lisbon Lisbon Portugal
| | - R. Rocha
- Biological Dynamics of Forest Fragments Project Instituto Nacional de Pesquisas da Amazônia Manaus Brazil
- Centre for Ecology, Evolution and Environmental Changes University of Lisbon Lisbon Portugal
- CIBIO‐InBIO, Research Center in Biodiversity and Genetic Resources University of Porto Vairão Portugal
- CIBIO‐InBIO, Research Center in Biodiversity and Genetic Resources Institute of Agronomy, University of Lisbon Lisbon Portugal
| | - C. F. J. Meyer
- Biological Dynamics of Forest Fragments Project Instituto Nacional de Pesquisas da Amazônia Manaus Brazil
- School of Science, Engineering and Environment University of Salford Salford UK
| | - P. E. D. Bobrowiec
- Programa de Pós‐graduação em Ecologia Instituto Nacional de Pesquisas da Amazônia Manaus Brazil
- Biological Dynamics of Forest Fragments Project Instituto Nacional de Pesquisas da Amazônia Manaus Brazil
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16
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Tam D, Dharma C, Rocha R, Farkouh M, Abdel-Qadir H, Sun L, Gaudino M, Wijeysundera H, Austin P, Udell J, Fremes S, Lee D. Improved long-term survival with coronary artery bypass graft surgery compared to percutaneous coronary intervention in diabetics with multivessel disease. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
While randomized clinical trials have demonstrated the superiority of coronary artery bypass grafting (CABG) over percutaneous coronary intervention (PCI) in patients with diabetes and multivessel coronary artery disease (CAD), there remains a paucity of observational evidence comparing these two modalities.
Methods
Clinical and administrative databases for Canada's most populous province, Ontario, were linked to obtain records of all patients with angiographic evidence of multivessel CAD (defined as: 2-vessel and 3-vessel disease) treated with either isolated CABG or PCI from October 2008 to March 2017. Left main disease was excluded in the primary analysis. Baseline characteristics of patients undergoing CABG and PCI were compared and 1:1 propensity score matching was performed to account for baseline differences. 30-day mortality was compared in the matched groups. Late mortality and the composite of major cardiovascular and cerebrovascular events (MACCE, consisting of stroke, myocardial infarction (MI), repeat revascularization, and death) were compared between the matched groups using a stratified log rank test and Cox-proportional hazards model. The individual non-fatal components of MACCE were compared using the Fine-Gray model that accounted for death as a competing risk. A secondary analysis that included patients with left main disease was also performed for the outcome of late mortality. A sensitivity analysis that excluded patients with acute coronary syndrome was also conducted for late mortality.
Results
A total of 9,395 and 4,016 patients underwent CABG and PCI respectively. Prior to matching, CABG patients were younger (65.7 vs 68.5 years, p<0.001), more likely male (78% vs 73%, p<0.001) and with more severe CAD. Propensity score matching based on 24 baseline covariates yielded 3,782 well-balanced pairs. There was no difference in early mortality between CABG and PCI (2.3% vs 2.5%, p=0.65). The rate of all-cause mortality over 8-years was significantly higher with PCI compared to CABG (Figure- HR: 1.35, 95% CI: 1.23–1.50). The cumulative incidence of MI (HR 1.91, 95% CI: 1.66–2.20) and need for repeat revascularization (HR: 4.06, 95% CI: 3.54–4.66) were significantly higher with PCI over 8 years. There was no difference in late stroke between PCI and CABG (stroke (HR: 0.85, 95% CI: 0.68–1.07). Overall MACCE was higher in PCI compared to CABG (HR: 1.94, 95% CI: 1.80–2.09). In our secondary analysis that included patients with left main disease, findings were robust and late mortality remained higher with PCI compared to CABG (HR: 1.42, 95% CI: 1.30–1.54). In a sensitivity analysis where patients with acute coronary syndrome at the time of presentation were excluded, late mortality remained higher with PCI (HR: 1.30, 95% CI: 1.12–1.49) in 2,028 matched pairs.
Conclusions
In patients with multivessel CAD and diabetes we observed improved long-term mortality and freedom from MACCE at 8-years with CABG compared to PCI.
Figure 1
Funding Acknowledgement
Type of funding source: Foundation. Main funding source(s): Canadian Institutes of Health Research
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Affiliation(s)
- D Tam
- Sunnybrook Health Sciences Centre, Toronto, Canada
| | - C Dharma
- Institute for Clinical Evaluative Sciences, Toronto, Canada
| | - R Rocha
- Toronto General Hospital, Toronto, Canada
| | - M Farkouh
- Toronto General Hospital, Toronto, Canada
| | | | - L.Y Sun
- Ottawa Heart Institute, Ottawa, Canada
| | - M Gaudino
- Weill Cornell Medicine, New York, United States of America
| | | | - P.C Austin
- Institute for Clinical Evaluative Sciences, Toronto, Canada
| | - J Udell
- Women's College Hospital, Toronto, Canada
| | - S Fremes
- Sunnybrook Health Sciences Centre, Toronto, Canada
| | - D.S Lee
- Institute for Clinical Evaluative Sciences, Toronto, Canada
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Kelly ME, Aalbers AGJ, Abdul Aziz N, Abecasis N, Abraham‐Nordling M, Akiyoshi T, Alberda W, Albert M, Andric M, Angenete E, Antoniou A, Auer R, Austin KK, Aziz O, Baker RP, Bali M, Baseckas G, Bebington B, Bednarski BK, Beets GL, Berg PL, Beynon J, Biondo S, Boyle K, Bordeianou L, Bremers AB, Brunner M, Buchwald P, Bui A, Burgess A, Burger JWA, Burling D, Burns E, Campain N, Carvalhal S, Castro L, Caycedo‐Marulanda A, Chan KKL, Chang GJ, Chew MH, Chong PC, Christensen HK, Clouston H, Codd M, Collins D, Colquhoun A, Corr A, Coscia M, Coyne PE, Creavin B, Croner RS, Damjanovic L, Daniels IR, Davies M, Davies RJ, Delaney CP, Denost Q, Deutsch C, Dietz D, Domingo S, Dozois EJ, Duff M, Eglinton T, Enrique‐Navascues JM, Espin‐Basany E, Evans MD, Fearnhead NS, Flatmark K, Fleming F, Frizelle FA, Gallego MA, Garcia‐Granero E, Garcia‐Sabrido JL, Gentilini L, George ML, Ghouti L, Giner F, Ginther N, Glynn R, Golda T, Griffiths B, Harris DA, Hagemans JAW, Hanchanale V, Harji DP, Helewa RM, Heriot AG, Hochman D, Hohenberger W, Holm T, Hompes R, Jenkins JT, Kaffenberger S, Kandaswamy GV, Kapur S, Kanemitsu Y, Kelley SR, Keller DS, Khan MS, Kiran RP, Kim H, Kim HJ, Koh CE, Kok NFM, Kokelaar R, Kontovounisios C, Kristensen HØ, Kroon HM, Kusters M, Lago V, Larsen SG, Larson DW, Law WL, Laurberg S, Lee PJ, Limbert M, Lydrup ML, Lyons A, Lynch AC, Mantyh C, Mathis KL, Margues CFS, Martling A, Meijerink WJHJ, Merkel S, Mehta AM, McArthur DR, McDermott FD, McGrath JS, Malde S, Mirnezami A, Monson JRT, Morton JR, Mullaney TG, Negoi I, Neto JWM, Nguyen B, Nielsen MB, Nieuwenhuijzen GAP, Nilsson PJ, O’Connell PR, O’Dwyer ST, Palmer G, Pappou E, Park J, Patsouras D, Pellino G, Peterson AC, Poggioli G, Proud D, Quinn M, Quyn A, Radwan RW, van Ramshorst GH, Rasheed S, Rasmussen PC, Regenbogen SE, Renehan A, Rocha R, Rochester M, Rohila J, Rothbarth J, Rottoli M, Roxburgh C, Rutten HJT, Ryan ÉJ, Safar B, Sagar PM, Sahai A, Saklani A, Sammour T, Sayyed R, Schizas AMP, Schwarzkopf E, Scripcariu V, Selvasekar C, Shaikh I, Hellawell G, Shida D, Simpson A, Smart NJ, Smart P, Smith JJ, Solbakken AM, Solomon MJ, Sørensen MM, Steele SR, Steffens D, Stitzenberg K, Stocchi L, Stylianides NA, Sumrien H, Sutton PA, Swartking T, Taylor C, Tekkis PP, Teras J, Thurairaja R, Toh EL, Tsarkov P, Tsukada Y, Tsukamoto S, Tuech JJ, Turner WH, Tuynman JB, Vasquez‐Jimenez W, Verhoef C, Vizzielli G, Voogt ELK, Uehara K, Wakeman C, Warrier S, Wasmuth HH, Weber K, Weiser MR, Wheeler JMD, Wild J, Wilson M, de Wilt JHW, Wolthuis A, Yano H, Yip B, Yip J, Yoo RN, van Zoggel D, Winter DC. Simultaneous pelvic exenteration and liver resection for primary rectal cancer with synchronous liver metastases: results from the PelvEx Collaborative. Colorectal Dis 2020; 22:1258-1262. [PMID: 32294308 DOI: 10.1111/codi.15064] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 03/24/2020] [Indexed: 02/08/2023]
Abstract
AIM At presentation, 15-20% of patients with rectal cancer already have synchronous liver metastases. The aim of this study was to determine the surgical and survival outcomes in patients with advanced rectal cancer who underwent combined pelvic exenteration and liver (oligometastatic) resection. METHOD Data from 20 international institutions that performed simultaneous pelvic exenteration and liver resection between 2007 and 2017 were accumulated. Primarily, we examined perioperative outcomes, morbidity and mortality. We also assessed the impact that margin status had on survival. RESULTS Of 128 patients, 72 (56.2%) were men with a median age of 60 years [interquartile range (IQR) 15 years]. The median size of the liver oligometastatic deposits was 2 cm (IQR 1.8 cm). The median duration of surgery was 406 min (IQR 240 min), with a median blood loss of 1090 ml (IQR 2010 ml). A negative resection margin (R0 resection) was achieved in 73.5% of pelvic exenterations and 66.4% of liver resections. The 30-day mortality rate was 1.6%, and 32% of patients had a major postoperative complication. The 5-year overall survival for patients in whom an R0 resection of both primary and metastatic disease was achieved was 54.6% compared with 20% for those with an R1/R2 resection (P = 0.006). CONCLUSION Simultaneous pelvic exenteration and liver resection is feasible, with acceptable morbidity and mortality. Simultaneous resection should only be performed where an R0 resection of both pelvic and hepatic disease is anticipated.
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Almeida J, Rocha R, Signorelli M, Silva V, Prado S, Evans D. The House of the Brazilian Woman: impacts of a cross-sectoral public health policy for abused women. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.945] [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] [Indexed: 11/12/2022] Open
Abstract
Abstract
Issue
Violence against women is a serious public health concern in Brazil; the country ranks 5th globally for femicide and has high rates of intimate partner violence. In response, a national policy created the House of the Brazilian Woman (HBW). HBWs aimed at caring for abused women, are staffed 24/7 with multi-disciplinary teams; cross-sectoral services include: psychosocial support; healthcare; specialized police; courts; public attorney's offices; temporary shelter; and access to financial support.
Description of the Problem
The purpose of this study was to characterize the preliminary impacts of the HBW of Curitiba. Based on mixed-methods participatory action-research, data were collected between 2018-2020. We present quantitative measures describing the individuals served and a thematic analysis of in-depth interviews with HBW staff.
Results
Since its opening, in 2016, the HBW of Curitiba has served around 50,000 users, including women and perpetrators. The most prevalent type of violence reported was psychological (67%, n = 14,343), followed by physical (25.8%, n = 5,531), economic (5.2%, n = 1,104) and sexual (2%, n = 428). Positive qualitative impacts perceived by staff were: 1) improved women's empowerment; 2) the importance of centralized resources; 3) acting as a support to ensure existing legal protections. The main challenges were: 1) high demand; 2) discontinuous care; 3) negative impacts on staff's health.
Lessons
The HBW of Curitiba is a key cross-sectoral service for abused women, part of a greater national policy to prevent violence and support women. Despite serving a large number of women in a short period of time challenges remain including integration with other parts of the network and considerations of staff burnout.
Key messages
Effective cross-sectoral policies for abused women are paramount for comprehensive women’s health. Having cross-sectoral services in just one place operating 24/7 has high impact for abused women.
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Affiliation(s)
- J Almeida
- Chamber of Public Health, Federal University of Parana, Matinhos, Brazil
| | - R Rocha
- Post Graduation in Public Health, Federal University of Parana, Curitiba, Brazil
| | - M Signorelli
- Chamber of Public Health, Federal University of Parana, Matinhos, Brazil
- Post Graduation in Public Health, Federal University of Parana, Curitiba, Brazil
| | - V Silva
- Chamber of Public Health, Federal University of Parana, Matinhos, Brazil
| | - S Prado
- House of the Brazilian Woman, Curitiba, Brazil
| | - D Evans
- Department of Public Health, Emory University, Atlanta, USA
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Rocha R, Aziz SA, Brook CE, Carvalho WD, Cooper‐Bohannon R, Frick WF, Huang JC, Kingston T, López‐Baucells A, Maas B, Mathews F, Medellin RA, Olival KJ, Peel AJ, Plowright RK, Razgour O, Rebelo H, Rodrigues L, Rossiter SJ, Russo D, Straka TM, Teeling EC, Treuer T, Voigt CC, Webala PW. Bat conservation and zoonotic disease risk: a research agenda to prevent misguided persecution in the aftermath of COVID‐19. Anim Conserv 2020. [DOI: 10.1111/acv.12636] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- R. Rocha
- CIBIO/InBIO‐UP Research Centre in Biodiversity and Genetic Resources University of Porto Vairão Portugal
- CEABN‐InBIO Centre for Applied Ecology “Prof. Baeta Neves” Institute of Agronomy University of Lisbon Tapada da Ajuda Lisbon Portugal
| | - S. A. Aziz
- Project Pteropus Rimba Kuala Lumpur Malaysia
| | - C. E. Brook
- Department of Integrative Biology University of California, Berkeley Berkeley CA USA
| | - W. D. Carvalho
- Programa de Pós‐Graduação em Biodiversidade Tropical Universidade Federal do Amapá Macapá‐AP Brazil
| | - R. Cooper‐Bohannon
- School of Biological and Environmental Sciences University of Stirling Stirling UK
- Bats without Borders Blantyre Malawi
| | - W. F. Frick
- Bat Conservation International Austin Texas USA
- Ecology and Evolutionary Biology University of California, Santa Cruz Santa Cruz California USA
| | - J. C.‐C. Huang
- Formosan Golden Bat’s Home Shuilin Township Yunlin County Taiwan
| | - T. Kingston
- Department of Biological Sciences Texas Tech University Lubbock Texas USA
| | | | - B. Maas
- Department of Botany and Biodiversity Research University of Vienna Vienna Austria
- Institute of Zoology University of Natural Resources and Life Sciences Vienna Austria
| | | | - R. A. Medellin
- Instituto de Ecología Universidad Nacional Autónoma de México México City México
| | | | - A. J. Peel
- Environmental Futures Research Institute Griffith University Nathan Queensland Australia
| | - R. K. Plowright
- Department of Microbiology and Immunology Montana State University Bozeman MT USA
| | - O. Razgour
- Biosciences University of Exeter Hatherly Laboratories Exeter UK
| | - H. Rebelo
- CIBIO/InBIO‐UP Research Centre in Biodiversity and Genetic Resources University of Porto Vairão Portugal
- CEABN‐InBIO Centre for Applied Ecology “Prof. Baeta Neves” Institute of Agronomy University of Lisbon Tapada da Ajuda Lisbon Portugal
| | - L. Rodrigues
- Instituto da Conservação da Natureza e das Florestas Lisboa Portugal
| | - S. J. Rossiter
- School of Biological and Chemical Sciences Queen Mary University of London London UK
| | - D. Russo
- Dipartimento di Agraria Università degli Studi di Napoli Federico II via Università 100 Portici (Napoli) Italy
| | - T. M. Straka
- Institute of Ecology Technische Universität Berlin Berlin Germany
| | - E. C. Teeling
- School of Biology and Environmental Science University College Dublin Dublin Ireland
| | - T. Treuer
- College of Engineering and Mathematical Sciences University of Vermont Burlington Vermont USA
| | - C. C. Voigt
- Leibniz Institute for Zoo and Wildlife Research Berlin Germany
| | - P. W. Webala
- Department of Forestry and Wildlife Management Maasai Mara University Narok Kenya
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20
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Santiago KM, Castro LP, Neto JPD, de Nóbrega AF, Pinto CAL, Ashton-Prolla P, Pinto E Vairo F, de Medeiros PFV, Ribeiro EM, Ribeiro BFR, do Valle FF, Doriqui MJR, Leite CHB, Rocha RM, Moura LMS, Munford V, Galante PAF, Menck CFM, Rogatto SR, Achatz MI. Comprehensive germline mutation analysis and clinical profile in a large cohort of Brazilian xeroderma pigmentosum patients. J Eur Acad Dermatol Venereol 2020; 34:2392-2401. [PMID: 32239545 DOI: 10.1111/jdv.16405] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 03/05/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Xeroderma pigmentosum (XP) patients present a high risk of developing skin cancer and other complications at an early age. This disease is characterized by mutations in the genes related to the DNA repair system. OBJECTIVES To describe the clinical and molecular findings in a cohort of 32 Brazilian individuals who received a clinical diagnosis of XP. METHODS Twenty-seven families were screened for germline variants in eight XP-related genes. RESULTS All patients (N = 32) were diagnosed with bi-allelic germline pathogenic or potentially pathogenic variants, including nine variants previously undescribed. The c.2251-1G>C XPC pathogenic variant, reported as the founder mutation in Comorian and Pakistani patients, was observed in 15 cases in homozygous or compound heterozygous. Seven homozygous patients for POLH/XPV variants developed their symptoms by an average age of 7.7 years. ERCC2/XPD, DDB2/XPE and ERCC5/XPG variants were found in a few patients. Aside from melanoma and non-melanoma skin tumours, a set of patients developed skin sebaceous carcinoma, leiomyosarcoma, angiosarcoma, mucoepidermoid carcinoma, gastric adenocarcinoma and serous ovarian carcinoma. CONCLUSIONS We reported a high frequency of XPC variants in 32 XP Brazilian patients. Nine new variants in XP-related genes, unexpected non-skin cancer lesions and an anticipation of the clinical manifestation in POLH/XPV cases were also described.
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Affiliation(s)
- K M Santiago
- Department of Oncogenetics, A.C.Camargo Cancer Center, São Paulo, São Paulo, Brazil.,International Research Center (CIPE), A.C.Camargo Cancer Center, São Paulo, São Paulo, Brazil
| | - L P Castro
- Department of Microbiology, Institute of Biomedical Sciences, University of Sao Paulo, São Paulo, São Paulo, Brazil
| | - J P D Neto
- Department of Skin Cancer, A.C.Camargo Cancer Center, São Paulo, São Paulo, Brazil
| | - A F de Nóbrega
- Department of Oncogenetics, A.C.Camargo Cancer Center, São Paulo, São Paulo, Brazil.,International Research Center (CIPE), A.C.Camargo Cancer Center, São Paulo, São Paulo, Brazil
| | - C A L Pinto
- Department of Pathology, A.C.Camargo Cancer Center, São Paulo, São Paulo, Brazil
| | - P Ashton-Prolla
- Medical Genetics Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.,Department of Genetics, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - F Pinto E Vairo
- Center for Individualized Medicine and Department of Clinical Genomics, Mayo Clinic, Rochester, MN, USA
| | - P F V de Medeiros
- University Hospital Alcides Carneiro, Federal University of Campina Grande, Campina Grande, Paraíba, Brazil
| | - E M Ribeiro
- Associação Cearense de Doenças Genéticas, Fortaleza, Ceará, Brazil
| | - B F R Ribeiro
- Children's Hospital, Secretaria de Estado de Saúde do Acre, Rio Branco, Acre, Brazil
| | - F F do Valle
- Amazonas Federal University, Manaus, Amazonas, Brazil
| | - M J R Doriqui
- Hospital Infantil Dr Juvêncio Mattos, São Luís, Maranhão, Brazil
| | - C H B Leite
- Department of Radiation Oncology, Instituto do Câncer do Ceará, Fortaleza, Ceará, Brazil
| | - R M Rocha
- Gynecology Department, Paulista Medicine School, Federal University of São Paulo (UNIFESP), São Paulo, São Paulo, Brazil
| | - L M S Moura
- Department of Microbiology, Institute of Biomedical Sciences, University of Sao Paulo, São Paulo, São Paulo, Brazil
| | - V Munford
- Department of Microbiology, Institute of Biomedical Sciences, University of Sao Paulo, São Paulo, São Paulo, Brazil
| | - P A F Galante
- Molecular Oncology Center, Hospital Sírio-Libanês, São Paulo, São Paulo, Brazil
| | - C F M Menck
- Department of Microbiology, Institute of Biomedical Sciences, University of Sao Paulo, São Paulo, São Paulo, Brazil
| | - S R Rogatto
- Department of Clinical Genetics, University Hospital, Institute of Regional Health Research, University of Southern Denmark, Vejle, Denmark
| | - M I Achatz
- Centro de Oncologia, Hospital Sírio-Libanês, São Paulo, São Paulo, Brazil
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21
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Rocha R, Fernandes R, Carvalho J, Pais J, Bras D, Guerreiro R, Aguiar J. P840 A surprising outcome. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.489] [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
infective endocarditis(IE) is a high morbidity and mortality disease, and heart failure,central nervous system embolization and annular abscess account for common complications.Nevertheless,intracardiac fistula is rare and predicts higher mortality and urgency for surgery.
Case
84years old male patient,with an aortic bioprosthesis valve Perimount n23 since 2015,was admitted to internal medicine ward 3months before,due to Enterococcus faecalis bacteremia.at that time,transoesophageal echocardiography(TEE) revealed moderate to severe mitral valve(MV) regurgitation(vena contracta 0.7cm) and trivial tricuspid regurgitation,but did not showed any suggestive images of endocarditis.the patient was treated with 14days of amoxicillin-clavulanate.
On the current presentation,due to fadigue to mild physical activity and fever for 2weeks,he was admitted to cardiology ward for further investigation.blood cultures were positive for the previous agent,so antibiotherapy with ampicillin 12g/day and gentamicin 240mg id was started.TEE revealed thickening of aortic bioprosthesis’ leaflets with preserved systolic opening.aortic valve annulus thickening,mainly near the non-coronary cusp,was evident, without characteristic features of peri-annular abscess.on ventricular side of the prosthesis,there was a vegetation(10.7x10.8mm). a small nodule lesion,coherent with a second vegetation,was present on the MV’s posterior leaflet,without regurgitation’s worsening. a third one was observed on the septal leaflet of the tricuspid valve(7.3x6.5mm),which also caused an increasement in severity of the regurgitation,quantified as moderate.
On the sixth day,the patient presented with right arm paresis,so a brain CT was performed,showing an ischemic lesion on the left middle cerebral artery.Reevaluation,5days later,owing to new neurological changes,showed multiple acute vertebrobasilar embolic strokes.
As a result of poor medical response and embolic strokes,the patient was referred to surgical treatment. however, due to prohibitive surgical risk (euroscore 59%), the patient was refused.
After 6weeks of blood culture driven antibiotherapy,a reevaluation TEE revealed a periprosthetic pseudoaneurysm with small aorta-to-right atrium fistula.no vegetations were found.
Conclusion
rate complication of cardiac fistulae is high,60%of the patients develop heart failure and mortality rate is higher than 40%.although conservative treatment was addressed,after 8months discharge,the patient remains with few heart failure symptoms(NYHA classII).
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Affiliation(s)
- R Rocha
- Hospital Espirito Santo de Evora, Cardiology, Evora, Portugal
| | - R Fernandes
- Hospital Espirito Santo de Evora, Cardiology, Evora, Portugal
| | - J Carvalho
- Hospital Espirito Santo de Evora, Cardiology, Evora, Portugal
| | - J Pais
- Hospital Espirito Santo de Evora, Cardiology, Evora, Portugal
| | - D Bras
- Hospital Espirito Santo de Evora, Cardiology, Evora, Portugal
| | - R Guerreiro
- Hospital Espirito Santo de Evora, Cardiology, Evora, Portugal
| | - J Aguiar
- Hospital Espirito Santo de Evora, Cardiology, Evora, Portugal
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22
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Kroon HM, Dudi-Venkata N, Bedrikovetski S, Thomas M, Kelly M, Aalbers A, Abdul Aziz N, Abraham-Nordling M, Akiyoshi T, Alberda W, Andric M, Antoniou A, Austin K, Baker R, Bali M, Baseckas G, Bednarski B, Beets G, Berg P, Beynon J, Biondo S, Bordeianou L, Brunner M, Buchwald P, Burger J, Burling D, Campain N, Chan K, Chang G, Chew M, C Chong P, Christensen H, Codd M, Colquhoun A, Corr A, Coscia M, Coyne P, Creavin B, Damjanovic L, Daniels I, Davies M, Davies R, de Wilt J, Denost Q, Dietz D, Dozois E, Duff M, Eglinton T, Enriquez-Navascues J, Evans M, Fearnhead N, Frizelle F, Garcia-Granero E, Garcia-Sabrido J, Gentilini L, George M, Glynn R, Golda T, Griffiths B, Harris D, Evans M, Hagemans J, Harji D, Heriot A, Hohenberger W, Holm T, Jenkins J, Kapur S, Kanemitsu Y, Kelley S, Keller D, Kim H, Koh C, Kok N, Kokelaar R, Kontovounisios C, Kusters M, Larson D, Law W, Laurberg S, Lee P, Lydrup M, Lynch A, Mantyh C, Mathis K, Martling A, Meijerink W, Merkel S, Mehta A, McDermott F, McGrath J, Mirnezami A, Morton J, Mullaney T, Mesquita-Neto J, Nielsen M, Nieuwenhuijzen G, Nilsson P, O'Connell P, Palmer G, Patsouras D, Pellino G, Poggioli G, Quinn M, Quyn A, Radwan R, Rasheed S, Rasmussen P, Regenbogen S, Rocha R, Rothbarth J, Roxburgh C, Rutten H, Ryan É, Sagar P, Saklani A, Schizas A, Schwarzkopf E, Scripcariu V, Shaikh I, Shida D, Simpson A, Smart N, Smith J, Solomon M, Sørensen M, Steele S, Steffens D, Stocchi L, Stylianides N, Tekkis P, Taylor C, Tsarkov P, Tsukamoto S, Turner W, Tuynman J, van Ramshorst G, van Zoggel D, Vasquez-Jimenez W, Verhoef C, Verstegen M, Wakeman C, Warrier S, Wasmuth H, Weiser M, Wheeler J, Wild J, Yip J, Winter D, Sammour T. Palliative pelvic exenteration: A systematic review of patient-centered outcomes. Eur J Surg Oncol 2019; 45:1787-1795. [DOI: 10.1016/j.ejso.2019.06.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 06/02/2019] [Accepted: 06/07/2019] [Indexed: 12/13/2022] Open
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Ambrosy A, Braunwald E, Morrow D, Devore A, McCague K, Duffy C, Rocha R, Velazquez E. 1135Angiotensin receptor-neprilysin inhibition in patients with de novo acute decompensated heart failure: a prespecified subgroup analysis of the PIONEER-HF trial. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The efficacy, safety, and tolerability of an angiotensin receptor-neprilysin inhibitor (ARNi) in patients presenting with de novo heart failure (HF) has not been previously well-defined.
Methods
The PIONEER-HF trial was a prospective, multicenter, double-blind, active-controlled, randomized clinical trial which enrolled 887 patients (pts) at 129 sites in the United States. Pts with or without a history of prior HF and an ejection fraction (EF) <40% and a NT-proBNP >1600 pg/mL or BNP >400 pg/mL were eligible for participation no earlier than 24 hours while still hospitalized for acute decompensated HF (ADHF). Pts were randomly assigned 1:1 to in-hospital initiation of sacubitril/valsartan (S/V) titrated to 97/103 mg vs. enalapril titrated to 10 mg both by mouth twice daily for 8 weeks. We performed a pre-specified analysis in pts with de novo HF (i.e., defined as pts without a history of HF prior to the qualifying ADHF event).
Results
At the time of enrollment, 34% (N=303) had de novo HF. These pts experienced a similar improvement in NT-proBNP with S/V vs. enalapril (Ratio of geometric means 0.65, 95% Confidence Interval [CI] 0.53–0.81; p-value = 0.0002) compared to pts with worsening chronic HF (ratio 0.72 (0.63–0.83, p-value <0.0001) (Figure). In addition, the incidence of worsening renal function, hyperkalemia, and hypotension was comparable with S/V vs. enalapril regardless of whether they were hospitalized for de novo or worsening chronic HF. Finally, there was no interaction (p-value = 0.350) between previous HF status and the effect of S/V on the composite of cardiovascular death or rehospitalization for HF (de novo HF: Hazard Ratio [HR] 0.34, 95% CI 0.11–1.05 vs. worsening chronic HF: HR 0.60, 95% CI 0.39–0.93).
Conclusion
Among patients admitted for ADHF, irrespective of prior HF history, in-hospital initiation of an ARNi led to a greater reduction in natriuretic peptide levels, a comparable safety profile, and a significant improvement in clinical outcomes.
Acknowledgement/Funding
Novartis
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Affiliation(s)
- A Ambrosy
- Kaiser Permanente Northern California, San Francisco, United States of America
| | - E Braunwald
- Brigham and Womens Hospital, Boston, United States of America
| | - D Morrow
- Brigham and Womens Hospital, Boston, United States of America
| | - A Devore
- Duke Clinical Research Institute, Durham, United States of America
| | - K McCague
- Novartis Pharmaceuticals Corporation, East Hanover, United States of America
| | - C Duffy
- Novartis Pharmaceuticals Corporation, East Hanover, United States of America
| | - R Rocha
- Novartis Pharmaceuticals Corporation, East Hanover, United States of America
| | - E Velazquez
- Yale New Haven Hospital, New Haven, United States of America
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Carrington M, Santos R, Pais J, Picarra B, Rocha R, Bras D, Azevedo-Guerreiro R, Hyde-Congo K, Aguiar J. P603Cardiac Magnetic Resonance evaluation and risk stratification of patients with unexplained or suspected arrhythmias. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0212] [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 etiological diagnosis of cardiac arrhythmias is often difficult. Cardiac Magnetic Resonance (CMR) is the gold standard exam for anatomical and functional cardiac evaluation and it may be indicated in patients with ventricular arrhythmias when echocardiography does not provide an accurate assessment of left and right ventricles (LV, RV).
Purpose
The aim of this study was to determine the impact of CMR in the diagnosis and stratification of arrhythmic risk in patients with confirmed or suspected arrhythmias, as well as to describe the changes observed.
Methods
We performed a prospective registry over a 5-year period of all the patients with arrhythmias who underwent CMR for diagnostic and risk stratification purposes. We followed a protocol to evaluate both anatomically and functionally the ventricles and to look for the presence of late gadolinium enhancement (LGE).
Results
A total of 78 patients were included, of which 65% were male and a mean age of 46±17 years-old was observed. The indications for CMR evaluation of patients with confirmed or suspected arrhythmias were as follows: 33% (n=26) of the patients had very frequent premature ventricular complexes (PVC), 23% (n=18) had sustained ventricular tachycardia (VT), 17% (n=13) suspected structural heart disease with high arrhythmic potential, 12% (n=9) unexplained recurrent syncope, 6% (n=5) supraventricular tachycardia, 5% (n=4) non-sustained VT and 4% (n=3) aborted sudden cardiac death. Depressed ventricular ejection fraction (<50%) was present in 9% (n=7) for the LV and in 14% (n=11)for the RV. Dilation of the LV was found in 24% of the patients (n=19, mean LV volume: 115±4ml/m2) and RV dilation was present in only 1 patient who had right ventricle arrhythmogenic dysplasia (RVAD) (RV volume: 152ml/m2). Cardiac synchronization artifacts due to the presence of very frequent PVC compromised the calculation of v volumes in only 4% (n=3) of the patients. In total, 6% (n=5) had interventricular septum hypertrophy (mean 15±6g/m2), 10% (n=8) had a slight prolapse of the anterior leaflet of the mitral valve and 19% (n=15) had a dilated left auricle. LGE was present in 13% (n=10) and slight pericardium effusion was detected in 12% (n=9). CMR was considered normal in 65% (n=51), in 15% (n=12) we found nonspecific changes deserving follow-up and in 20% (n=15) it was possible to establish a diagnosis which was previously unknown: 5% (n=4) had hypertrophic cardiomyopathy, 4% (n=3) LV non-compaction, 4% (n=3) a myocarditis sequelae, 3% (n=2) RVAD, 3% (n=2) a myocardial infarction scar and 1 had non-ischemic dilated cardiomyopathy.
Conclusions
CMR is a technique with high spatial resolution, feasible and safe, which allowed an increase in diagnosis in 20% of the patients, thus contributing to the risk stratification of our study population with suspected high arrhythmic potential when the first-line complementary exams were inconclusive.
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Affiliation(s)
- M Carrington
- Hospital Espirito Santo de Evora, Cardiology, Evora, Portugal
| | - R Santos
- Hospital Espirito Santo de Evora, Cardiology, Evora, Portugal
| | - J Pais
- Hospital Espirito Santo de Evora, Cardiology, Evora, Portugal
| | - B Picarra
- Hospital Espirito Santo de Evora, Cardiology, Evora, Portugal
| | - R Rocha
- Hospital Espirito Santo de Evora, Cardiology, Evora, Portugal
| | - D Bras
- Hospital Espirito Santo de Evora, Cardiology, Evora, Portugal
| | | | - K Hyde-Congo
- Hospital Espirito Santo de Evora, Cardiology, Evora, Portugal
| | - J Aguiar
- Hospital Espirito Santo de Evora, Cardiology, Evora, Portugal
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Garrido C, Palavra F, Cardoso M, Sousa A, Rocha R, Alves D, Santos M, Vila Real M, Vieira J, Coelho T, Fineza I, Moreno T, Santos M. DUCHENNE MUSCULAR DYSTROPHY – CLINICAL. Neuromuscul Disord 2018. [DOI: 10.1016/j.nmd.2018.06.045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Rocha R, Tam D, Karkhanis R, Nedadur R, Fang J, Tu J, Gaudino M, Royse A, Fremes S. CORONARY ARTERY BYPASS GRAFTING WITH THREE ARTERIAL GRAFTS DOES NOT IMPROVE OUTCOMES COMPARED TO TWO ARTERIAL GRAFTS AT EIGHT-YEAR FOLLOW-UP. Can J Cardiol 2018. [DOI: 10.1016/j.cjca.2018.07.387] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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27
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Elbatarny M, Tam D, Edelman J, Rocha R, Chu M, Peterson M, El-Hamamsy I, Apoo J, Friedrich J, Boodhwani M, Yanagawa B, Ouzounian M. VALVE-SPARING ROOT REPLACEMENT VERSUS COMPOSITE VALVE GRAFT PROCEDURES IN THE MANAGEMENT OF AORTIC ROOT DILATION. Can J Cardiol 2018. [DOI: 10.1016/j.cjca.2018.07.238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Castellanos-Iglesias S, Cabral AC, Martins CC, Di Domenico M, Rocha RM, Haddad MA. Organic contamination as a driver of structural changes of hydroid's assemblages of the coral reefs near to Havana Harbour, Cuba. Mar Pollut Bull 2018; 133:568-577. [PMID: 30041351 DOI: 10.1016/j.marpolbul.2018.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 05/31/2018] [Accepted: 06/02/2018] [Indexed: 06/08/2023]
Abstract
Hydroid assemblage's responses to organic contamination were evaluated using sedimentary sterols as explanatory variables. At seven coral reef sites in the Havana west coast, hydroids were collected along three 10 m × 1 m, 10 m deep transects. Five sterols were analysed, i.e., coprostanol, an indicator of faecal contamination, and cholestanol, cholesterol, stigmasterol and brassicasterol, indicators of biogenic organic matter inputs. The sampling sites were classified by level of contamination. A total of 65 species comprised the hydroid assemblages. Hydroids community abundance and richness decreased in the contaminated sites. Coprostanol had the highest relative importance for these variables and also for Plumularia floridana and Clytia gracilis abundances. Obelia dichotoma and Halecium bermudense were relatively abundant in the contaminated sites. The results indicate that faecal contamination negatively affected the hydroid assemblages, highlighting the importance of integrated biological and chemical indicators to evaluate the environmental conditions of the Havana coral reef.
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Affiliation(s)
- Susel Castellanos-Iglesias
- Post-graduate Program in Zoology, Universidade Federal do Paraná, Centro Politécnico, Caixa Postal 19020, 81531-980 Curitiba, PR, Brazil.
| | - Ana Caroline Cabral
- Post-graduate Course on Estuarine and Ocean Systems (PGSISCO), Universidade Federal do Parana, Caixa Postal 61, 83255-976 Pontal do Paraná, PR, Brazil
| | - César C Martins
- Centro de Estudos do Mar, Universidade Federal do Paraná, Caixa Postal 61, 83255-976 Pontal do Paraná, PR, Brazil
| | - Maikon Di Domenico
- Post-graduate Course on Estuarine and Ocean Systems (PGSISCO), Universidade Federal do Parana, Caixa Postal 61, 83255-976 Pontal do Paraná, PR, Brazil; Centro de Estudos do Mar, Universidade Federal do Paraná, Caixa Postal 61, 83255-976 Pontal do Paraná, PR, Brazil
| | - R M Rocha
- Post-graduate Program in Zoology, Universidade Federal do Paraná, Centro Politécnico, Caixa Postal 19020, 81531-980 Curitiba, PR, Brazil; Zoology Department, Universidade Federal do Paraná, Centro Politécnico, Caixa Postal 19020, 81531-980 Curitiba, PR, Brazil
| | - Maria Angélica Haddad
- Post-graduate Program in Zoology, Universidade Federal do Paraná, Centro Politécnico, Caixa Postal 19020, 81531-980 Curitiba, PR, Brazil; Zoology Department, Universidade Federal do Paraná, Centro Politécnico, Caixa Postal 19020, 81531-980 Curitiba, PR, Brazil.
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João A, Rocha R, Pignatelli N, Carneiro C, Nunes V. Liver abscess in terminal neoplastic disease. Int J Surg 2018. [DOI: 10.1016/j.ijsu.2018.05.303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Logullo AF, Rocha RM, Stiepcich M, Soares FA, Pasini FS, Nonogaki S, Brentani MM. Abstract P2-07-08: Prognostic relevance of claudins 4 and 7 in invasive breast carcinoma (NOS) subtypes: A large tissue microarray study. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p2-07-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Molecular phenotyping has improved the understanding of a wide range of breast cancer disease. Recently, a new molecular subtype denominated “claudin-low” (CL) was described in breast cancer and correlated to worse prognosis and to CD44+/24- stem cell profile. Among 19 known claudin proteins, isotypes 4 (CL4) and 7 (CL7) are the most common in the breast biology. Objective: To verify differences in CL4 and CL7 immunoexpression between Luminal A, HER-2, and triple negative breast cancer phenotypes; and their association to CD44/24 status and tumor prognosis. Design: Estrogen and progesterone receptor status (ER/PR), HER-2, CL4 and CL7 expression and CD44/24 profiles were evaluated in 803 invasive ductal breast carcinomas arranged into four tissue microarrays (TMA) and results were correlated with prognosis and important clinical data. Results: 503 (62.6%) cases were positive for CL4 and 369 (46.0%) cases for CL7. The majority (199/283, 70.3%) of CL4 negative cases were clustered in the luminal A subtype whereas 63 (22.3%) showed triple negative profile and the remaining 21 cases (7.4%) exhibited positive HER-2 expression (p<0.001). Claudin 7 negative samples (44.2%) tended to follow the same pattern. CL4 positive expression was significantly associated to HER-2 expression, presence of lymph nodes and increased tumor grades and inversely correlated to ER and PR expression. However, there was no association between CL7 expression and any of these features. Both CL4 and CL7 did not show correlation to the stem cell markers (CD44+/CD24-) or worse prognosis (survival and disease-free interval). Conclusion: Claudins 4 and 7 immunoexpression did not provide additional prognostic information within breast cancer subtypes.
Citation Format: Logullo AF, Rocha RM, Stiepcich M, Soares FA, Pasini FS, Nonogaki S, Brentani MM. Prognostic relevance of claudins 4 and 7 in invasive breast carcinoma (NOS) subtypes: A large tissue microarray study [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P2-07-08.
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Affiliation(s)
- AF Logullo
- Escola Paulista de Medicina UNIFESP- EPM, Sao Paulo, Brazil; A.C.Camargo Cancer Center, Sao Paulo, Brazil; PhD Patologia Cirúrgica e Molecular, Sao Paulo, Brazil; Laboratório Fleury, Sao Paulo, Brazil; 2Departamento de Radiologia e Oncologia (LIM24)FMUSP, Sao Paulo, Brazil
| | - RM Rocha
- Escola Paulista de Medicina UNIFESP- EPM, Sao Paulo, Brazil; A.C.Camargo Cancer Center, Sao Paulo, Brazil; PhD Patologia Cirúrgica e Molecular, Sao Paulo, Brazil; Laboratório Fleury, Sao Paulo, Brazil; 2Departamento de Radiologia e Oncologia (LIM24)FMUSP, Sao Paulo, Brazil
| | - M Stiepcich
- Escola Paulista de Medicina UNIFESP- EPM, Sao Paulo, Brazil; A.C.Camargo Cancer Center, Sao Paulo, Brazil; PhD Patologia Cirúrgica e Molecular, Sao Paulo, Brazil; Laboratório Fleury, Sao Paulo, Brazil; 2Departamento de Radiologia e Oncologia (LIM24)FMUSP, Sao Paulo, Brazil
| | - FA Soares
- Escola Paulista de Medicina UNIFESP- EPM, Sao Paulo, Brazil; A.C.Camargo Cancer Center, Sao Paulo, Brazil; PhD Patologia Cirúrgica e Molecular, Sao Paulo, Brazil; Laboratório Fleury, Sao Paulo, Brazil; 2Departamento de Radiologia e Oncologia (LIM24)FMUSP, Sao Paulo, Brazil
| | - FS Pasini
- Escola Paulista de Medicina UNIFESP- EPM, Sao Paulo, Brazil; A.C.Camargo Cancer Center, Sao Paulo, Brazil; PhD Patologia Cirúrgica e Molecular, Sao Paulo, Brazil; Laboratório Fleury, Sao Paulo, Brazil; 2Departamento de Radiologia e Oncologia (LIM24)FMUSP, Sao Paulo, Brazil
| | - S Nonogaki
- Escola Paulista de Medicina UNIFESP- EPM, Sao Paulo, Brazil; A.C.Camargo Cancer Center, Sao Paulo, Brazil; PhD Patologia Cirúrgica e Molecular, Sao Paulo, Brazil; Laboratório Fleury, Sao Paulo, Brazil; 2Departamento de Radiologia e Oncologia (LIM24)FMUSP, Sao Paulo, Brazil
| | - MM Brentani
- Escola Paulista de Medicina UNIFESP- EPM, Sao Paulo, Brazil; A.C.Camargo Cancer Center, Sao Paulo, Brazil; PhD Patologia Cirúrgica e Molecular, Sao Paulo, Brazil; Laboratório Fleury, Sao Paulo, Brazil; 2Departamento de Radiologia e Oncologia (LIM24)FMUSP, Sao Paulo, Brazil
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Abrão F, Rocha R, Abreu I, Rodrigues J, Munhoz F, Batista B. P1.06-010 Interaction between Treatment Delivery Delay and Stage on the Mortality from Non-Small Cell Lung Cancer. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.904] [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: 10/18/2022]
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Lima CA, Lyra AC, Mendes CMC, Lopes MB, Coqueiro FG, Rocha R, Santana GO. Bone mineral density and inflammatory bowel disease severity. Braz J Med Biol Res 2017; 50:e6374. [PMID: 29069227 PMCID: PMC5649869 DOI: 10.1590/1414-431x20176374] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 07/27/2017] [Indexed: 02/08/2023] Open
Abstract
Inflammatory bowel disease (IBD) is associated with low bone mineral density (BMD). In this study, the association between disease severity and BMD in patients with IBD was evaluated. Associations between BMD and the Montreal classification, disease activity and drug therapy were also tested. A cross-sectional prevalence study with a comparison group was conducted. One hundred and twenty-eight patients were evaluated: 68 patients with ulcerative colitis (UC), and 60 with Crohn's disease (CD). The control group consisted of 67 healthy subjects. All patients and controls had BMD measured and in IBD patients, current medications, hospitalization, and disease location, extent and phenotype, according to the Montreal classification, were recorded. Multiple correspondence analysis was applied to evaluate categorical variables. In the CD group, most patients were diagnosed between 17–40 years of age. Ileocolonic and non-stricturing non-penetrating disease were the most frequent disease location and behavior, respectively. In UC patients, extensive colitis was the most frequent disease location. UC and CD patients were more likely to have osteopenia than controls (OR=14.93/OR=24.38, respectively). In the CD group, male patients, perianal disease, penetrating behavior and age at diagnosis >40 years were associated with low BMD. Taking azathioprine and infliximab also seemed to be associated with osteopenia. In the UC group, we observed an association between low BMD and male patients, left colitis, corticosteroid use and hospitalization. Disease activity was not associated with osteopenia or osteoporosis in CD and UC patients. Disease severity seems to be associated with osteopenia in IBD patients.
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Affiliation(s)
- C A Lima
- Programa de Pós-Graduação em Medicina e Saúde, Universidade Federal da Bahia, Salvador, BA, Brasil
| | - A C Lyra
- Departamento de Gastroenterologia e Hepatologia, Universidade Federal da Bahia, Salvador, BA, Brasil
| | - C M C Mendes
- Instituto de Ciências e Saúde, Universidade Federal da Bahia, Salvador, BA, Brasil
| | - M B Lopes
- Programa de Pós-Graduação em Medicina e Saúde, Universidade Federal da Bahia, Salvador, BA, Brasil
| | - F G Coqueiro
- Programa de Pós-Graduação em Medicina e Saúde, Universidade Federal da Bahia, Salvador, BA, Brasil
| | - R Rocha
- Escola de Nutrição, Universidade Federal da Bahia, Salvador, BA, Brasil
| | - G O Santana
- Programa de Pós-Graduação em Medicina e Saúde, Universidade Federal da Bahia, Salvador, BA, Brasil.,Departamento de Ciências da Saúde, Universidade do Estado da Bahia, Salvador, BA, Brasil
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Elbatarny M, Mazine A, Rocha R, Fan C, Christie S, Rao V, Ouzounian M. LONG-TERM OUTCOMES OF CONSERVATIVE VS NON-CONSERVATIVE ROOT MANAGEMENT IN ACUTE TYPE A DISSECTIONS: A PROPENSITY MATCHED STUDY. Can J Cardiol 2017. [DOI: 10.1016/j.cjca.2017.07.174] [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: 11/24/2022] Open
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34
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Rocha R, Almeida-Coelho J, Leite-Moreira AM, Neves JS, Hamdani N, Falcão-Pires I, Lourenço AP, Paulus WJ, Linke WA, Leite-Moreira AF. Titin phosphorylation by protein kinase G as a novel mechanism of diastolic adaptation to acute load: PS146. Porto Biomed J 2017; 2:185. [PMID: 32258637 DOI: 10.1016/j.pbj.2017.07.024] [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: 11/29/2022] Open
Affiliation(s)
- R Rocha
- Department of Physiology and Cardiothoracic Surgery & Cardiovascular Research Center, Faculty of Medicine, University of Porto, Portugal
| | - J Almeida-Coelho
- Department of Physiology and Cardiothoracic Surgery & Cardiovascular Research Center, Faculty of Medicine, University of Porto, Portugal
| | - A M Leite-Moreira
- Department of Physiology and Cardiothoracic Surgery & Cardiovascular Research Center, Faculty of Medicine, University of Porto, Portugal
| | - J S Neves
- Department of Physiology and Cardiothoracic Surgery & Cardiovascular Research Center, Faculty of Medicine, University of Porto, Portugal.,Department of Endocrinology, São João Hospital Center, Porto, Portugal
| | - N Hamdani
- Department of Cardiovascular Physiology, Ruhr University Bochum, Germany
| | - I Falcão-Pires
- Department of Physiology and Cardiothoracic Surgery & Cardiovascular Research Center, Faculty of Medicine, University of Porto, Portugal
| | - A P Lourenço
- Department of Physiology and Cardiothoracic Surgery & Cardiovascular Research Center, Faculty of Medicine, University of Porto, Portugal.,Department of Physiology, Institute for Cardiovascular Research, VU University Medical Center, Amsterdam, The Netherlands
| | - W J Paulus
- Department of Anesthesiology, São João Hospital Center, Porto, Portugal
| | - W A Linke
- Department of Cardiovascular Physiology, Ruhr University Bochum, Germany
| | - A F Leite-Moreira
- Department of Physiology and Cardiothoracic Surgery & Cardiovascular Research Center, Faculty of Medicine, University of Porto, Portugal.,Department of Cardiothoracic Surgery, São João Hospital Center, Porto, Portugal
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Mendes YA, Ferreira MAP, Lobato CMC, Silva GMF, Montag LFA, Rocha RM. Reproductive characteristics of pike-characids Boulengerella cuvieri (Ctenoluciidae) in the middle Xingu River, Eastern Amazon. J Fish Biol 2017; 91:346-353. [PMID: 28543076 DOI: 10.1111/jfb.13339] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 04/21/2017] [Indexed: 06/07/2023]
Abstract
This study evaluated the reproductive characteristics of pike-characids, Boulengerella cuvieri, during the hydrological cycle in the Xingu River, eastern Amazon. The sex ratio was 1:1 and the gonado-somatic index and relative frequency of maturation stages indicate a short breeding season of single phase spawning that coincides with a filling and flood period. Mean standard length at first sexual maturity for female B. cuvieri was estimated to be 22·9 cm.
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Affiliation(s)
- Y A Mendes
- Developmental Biology and Immunohistochemistry Laboratory, Instituto Ciências Biológicas, Universidade Federal do Pará, Rua Augusto Corrêa, 01-Guamá, 66075-110, Belém, Pará, Brazil
- Cellular Ultrastructure Laboratory, Instituto Ciências Biológicas, Universidade Federal do Pará, Rua Augusto Corrêa, 01-Guamá, 66075-110, Belém, Pará, Brazil
| | - M A P Ferreira
- Developmental Biology and Immunohistochemistry Laboratory, Instituto Ciências Biológicas, Universidade Federal do Pará, Rua Augusto Corrêa, 01-Guamá, 66075-110, Belém, Pará, Brazil
| | - C M C Lobato
- Ecology and Conservation Laboratory - Ichthyology, Instituto de Ciências Biológicas, Universidade Federal do Pará, Rua Augusto Corrêa, 01-Guamá, 66075-110, Belém, Pará, Brazil
| | - G M F Silva
- Developmental Biology and Immunohistochemistry Laboratory, Instituto Ciências Biológicas, Universidade Federal do Pará, Rua Augusto Corrêa, 01-Guamá, 66075-110, Belém, Pará, Brazil
| | - L F A Montag
- Ecology and Conservation Laboratory - Ichthyology, Instituto de Ciências Biológicas, Universidade Federal do Pará, Rua Augusto Corrêa, 01-Guamá, 66075-110, Belém, Pará, Brazil
| | - R M Rocha
- Developmental Biology and Immunohistochemistry Laboratory, Instituto Ciências Biológicas, Universidade Federal do Pará, Rua Augusto Corrêa, 01-Guamá, 66075-110, Belém, Pará, Brazil
- Cellular Ultrastructure Laboratory, Instituto Ciências Biológicas, Universidade Federal do Pará, Rua Augusto Corrêa, 01-Guamá, 66075-110, Belém, Pará, Brazil
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Oliveira VA, Ferreira MAP, Rocha RM, Montag LFA. Reproduction of the duck catfish Ageneiosus ucayalensis in a ria river system. J Fish Biol 2017; 90:1062-1069. [PMID: 28181239 DOI: 10.1111/jfb.13209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 10/12/2016] [Indexed: 06/06/2023]
Abstract
A total of 1006 duck catfish Ageneiosus ucayalensis were collected from a ria river system of eastern Amazonia, of which 733 were females and 273 males, a sex ratio 2·69:1. Condition factors of males were higher than those of females and size at first sexual maturity (L50 ) was 12·8 cm for females and 11·8 cm for males. The relative frequency of mature specimens and gonad condition indices indicate that the breeding season is short and coincides with the rainy season.
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Affiliation(s)
- V A Oliveira
- Graduate Programme in Zoology, Universidade Federal do Pará-Museu Paraense Emílio Goeldi, Rua Augusto Corrêa, N° 1, Bairro Guamá, CEP: 66075-110, Belém, Pará, Brazil
| | - M A P Ferreira
- Developmental Biology and Immunohistochemistry Laboratory, Instituto Ciências Biológicas, Universidade Federal do Pará, Rua Augusto Corrêa, 01 - Guamá, 66075-110, Belém, Pará, Brazil
| | - R M Rocha
- Cellular Ultrastructure Laboratory, Instituto Ciências Biológicas, Universidade Federal do Pará, Rua Augusto Corrêa, 01 - Guamá, 66075-110, Belém, Pará, Brazil
| | - L F A Montag
- Ecology and Conservation Laboratory - Ichthyology, Instituto de Ciências Biológicas, Universidade Federal do Pará, Rua Augusto Corrêa, 01 - Guamá, 66075-110, Belém, Pará, Brazil
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Hubert A, De Zuttere D, Slieker MG, Szymczyk E, Sokalskis V, Danilowicz-Szymanowicz L, Nguyen TM, Lashkul D, Unlu S, Dandu RR, Gouda MGM, Kazakov AI, Zito C, Cambronero Cortinas E, Capotosto L, Galli E, Bouzille G, Samset E, Donal E, Lardoux H, Rocha R, Kone A, Meimoun P, Fackoury C, Slorach C, Hui W, Liu P, Kantor PF, Mital S, Nathan PC, Mertens L, Lipiec P, Michalski BW, Szymczyk K, Kasprzak JD, Aruta P, Cherata D, Muraru D, Badano LP, Fijalkowski M, Rozwadowska K, Kaufmann D, Sikorska K, Galaska R, Gruchala M, Raczak G, Melichova D, Grenne B, Sjoli B, Smiseth OA, Haugaa KH, Edvardsen T, Brunvand H, Sahinarslan A, Gokalp G, Seckin O, Cengel A, Raja D, Kumar S, Garg N, Tewari S, Kapoor A, Goel PK, D'angelo M, Daffina MG, Zucco M, Costantino R, Manganaro R, Longobardo L, Albiero F, Cusma Piccione M, Nucifora G, Caprino A, Carerj ML, Antonini Canterin F, Vriz O, Carerj S, Grapsa J, Valle-Munoz A, Corbi-Pascual MJ, Gin-Sing W, Dawson D, Howard L, Ridocci-Soriano F, Gibbs S, Nihoyannopoulos P, Ashurov R, Mangieri E, Gaudio C, Vitarelli A. P697New indices for a best quantification of left ventricular function in heart valve diseasesP698Intrapatient comparison of three echocardiographic techniques of determination of left ventricular (LV) longitudinal strain, and evaluation of their respective relationship to ejection fractionP699Myocardial strain as an early marker of cardiac dysfunction in a large cohort of anthracycline-treated pediatric cancer survivors?P700Resting 2D speckle tracking echocardiography for the prediction of death 5 years after ST- elevation myocardial infarctionP701Use of fully automated software to quantify left ventricular ejection fraction and left ventricular global longitudinal strainP702Can two-dimensional speckle tracking echocardiography be useful for the left ventricular assessment in the early stages of hereditary hemochromatosis?P703Assessment of left ventricular ejection fraction, global longitudinal strain and mechanical dispersion in acute myocardial infarction after revascularization with percutaneous coronary interventionP704Echocardiographic predictors of worse outcome in patients with ischemic chronic heart failure and renal disfunctionP705Impact of volume overload on right ventricular systolic and diastolic functions evaluated by speckle tracking echocardiographyP706Detection and localisation of obstructive coronary artery disease in chronic stable angina by myocardial deformation parmaters using tissue doppler imagingP707The determinants of deleterious effects of diabetes on the myocardiumP708Echocardiographic evaluation of the left atrium function after catheter ablation of long-standing persistent atrial fibrillationP709Early assessment of chemotherapy-related cardiovascular toxicity: an integrated evaluation through global longitudinal strain and arterial stiffness studyP710Prognostic value of right atrial 3-dimensional speckle tracking in different types of pulmonary arterial hypertensionP711Assessment of biventricular strain by 3-dimensional speckle-tracking echocardiography in chronic aortic regurgitation. Eur Heart J Cardiovasc Imaging 2016; 17:ii143-ii147. [DOI: 10.1093/ehjci/jew250.003] [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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Vieira RA, Rocha R, Scapim CA, Amaral Júnior AT, Vivas M. Selection index based on the relative importance of traits and possibilities in breeding popcorn. Genet Mol Res 2016; 15:gmr7719. [PMID: 27173260 DOI: 10.4238/gmr.15027719] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
One of the major difficulties faced by popcorn breeders is the negative correlation between popping expansion (PE) and grain yield (GY). It is necessary to overcome this difficulty to obtain promising genotypes. One helpful tool in this process is a selection index because it allows multiple features of interest to be selected. Thus, the present study proposes a new and comprehensive selection index applied in 169 half-sib families in UEM-Co1 and UEM-Co2 composites during two cycles of recurrent selection. An experiment was conducted in a 13 x 13 lattice square in the 2004/2005 and 2006/2007 crop years in Maringá, Paraná State, and PE and GY were evaluated. To calculate Fi statistics, the following relative importance (RI) assignments were used: 0.5 for both PE and GY, and 0.70 and 0.30 for PE and GY, respectively. Families were classified according to Fi values such that Fi = 0 indicated that genotypes met the average of those selected by direct selection, Fi < 0 indicated that genotypes fell below the average of those selected, and Fi > 0 indicated that genotypes exceeded the average of those selected. Thus, desirable values of Fi were positive, indicating that the selected families were higher than those families that would be selected by direct selection for both traits. Therefore, we concluded that the novel Fi statistic was satisfactory for family selection because simultaneous and higher gains for both traits in both composites were obtained.
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Affiliation(s)
- R A Vieira
- Departmento de Agronomia, Universidade Estadual de Maringá, Maringá, PR, Brasil
| | - R Rocha
- Departmento de Agronomia, Universidade Estadual de Maringá, Maringá, PR, Brasil
| | - C A Scapim
- Departmento de Agronomia, Universidade Estadual de Maringá, Maringá, PR, Brasil
| | - A T Amaral Júnior
- Laboratório de Melhoramento Genético Vegetal, Universidade Estadual do Norte Fluminense Darcy Ribeiro
| | - M Vivas
- Laboratório de Melhoramento Genético Vegetal, Universidade Estadual do Norte Fluminense Darcy Ribeiro
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Rubessa M, Rocha R, Lima L, Winters R, Figueiredo JR, Wheeler MB. 136 COMPARISON OF NCSU-23 AND ALPHA-MINIMAL ESSENTIAL MEDIA IN THE DEVELOPMENT OF ISOLATED PORCINE PREANTRAL FOLLICLES IN VITRO. Reprod Fertil Dev 2016. [DOI: 10.1071/rdv28n2ab136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
To develop a preantral follicular culture system that will support follicular growth and result in fertilizable oocytes, we conducted an experiment designed to determine the best medium for culture. In our preliminary experiment, we compared 2 common base media used for porcine oocytes: α-minimal essential medium and NCSU-23. Ovaries were collected from prepubertal gilts at a local abattoir and transported to the laboratory in saline solution (0.9% NaCl) maintained at 30–35°C. The ovaries were cut into small pieces (1–3 mm), and preantral follicles were isolated mechanically. Preantral follicles from 280 to 300 μm in diameter were collected into a small dish containing medium TCM199 (Lonza 12–117F) supplemented with 5% fetal bovine serum. The follicles were transferred from the collecting medium to the culture medium that consisted of base medium (NCSU23 or α-minimal essential medium) supplemented with 3.5 μg mL–1 of insulin, 10 μg mL–1 of transferrin, 100 μg mL–1 of l-ascorbic acid, 7.5% porcine serum, and 1.5 ng mL–1 of FSH. The follicles were randomly distributed to the different experimental treatments and cultured for 6 days in 24-well cell culture plates, with 3 follicles per well in 280 μL of culture medium. The culture was carried out at 38.5°C in 5% CO2 in air. Culture medium was changed every 2 days with freshly prepared medium. The diameters of follicles were measured every 2 days, and each follicle was photographed and evaluated at 20× magnification. Forty-two follicles per group were analysed and collected in 4 replicates. Data were statistically analysed with ANOVA using the Generalized Linear Model (GLM) procedure (SPSS, version 18, SPSS Inc., Chicago, IL, USA), where the independent variable was the sample (group and day of culture). Tukey's post hoc test was used to perform multiple comparisons; the α level was set at 0.05. All data were expressed as quadratic means with standard error of the means. Only the antrum formation was evaluated by chi-square test. The results, reported in Table 1, show that there was no statistical differences between follicle size between NCSU23 or α-minimal essential media, but at Day 6 there was a positive trend (P = 0.08). Otherwise, when we compared the size inside the groups, we observed that the preantral follicles grew more in α-minimal essential media than in NCSU23. The percentages of antrum formation were 65 v. 76% (NCSU23 and α-minimal essential media, respectively). These results support the use of α-minimal essential media because it had a positive effect on the antrum formation, and that after Day 4 some follicles could undergo a regression phase. Future studies will be necessary to evaluate the molecular status and the hormone production.
Table 1.Follicle size (μm) from Day 0 to Day 6
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Deb S, Fremes J, Yamasaki M, Karkhanis R, Rocha R, Singh S, Desai N, Yoon B, Yoon J, Cohen E, Radhakrishnan S, Fremes S. GENDER SPECIFIC DIFFERENCES OF LONG-TERM ANGIOGRAPHIC AND CLINICAL OUTCOMES AFTER CORONARY ARTERY BYPASS GRAFTING SURGERY USING RADIAL ARTERY AND SAPHENOUS VEIN GRAFTS - INSIGHTS FROM THE MULTI-CENTRED RADIAL ARTERY PATENCY STUDY. Can J Cardiol 2015. [DOI: 10.1016/j.cjca.2015.07.389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Deb S, Tu J, Austin P, Ko D, Rocha R, Mazer D, Kiss A, Pazhaniappan N, Fremes S. IMPACT OF ETHNICITY ON LONG-TERM OUTCOMES AFTER CORONARY ARTERY BYPASS GRAFTING SURGERY: A PROPENSITY MATCHED POPULATION-BASED STUDY. Can J Cardiol 2015. [DOI: 10.1016/j.cjca.2015.07.246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Sousa M, Gomes A, Rocha R, Marinho R, Fragoso M, Carneiro C, Pignatelli N, Nunes V. 280. Adjuvant chemotherapy in stage II colon cancer. Eur J Surg Oncol 2014. [DOI: 10.1016/j.ejso.2014.08.272] [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: 10/24/2022] Open
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Carneiro C, Oliveira D, Tavares S, Rocha R, Marinho R, Gomes A, Sousa M, Brandão T, Braga I, Nunes V. 450. Surgical oncological elderly patients – QoL after ICU. Eur J Surg Oncol 2014. [DOI: 10.1016/j.ejso.2014.08.438] [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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Sousa MRD, Feitosa GS, Paola AAVD, Schneider JC, Feitosa-Filho GS, Nicolau JC, Ferreira JFM, Carvalho RCMD, Chalela WA, Malachias MVB, Pena JLB, Somaio-Neto F, Montera MW, Barbosa GV, Bacal F, Jatene IB, Santos RD, Miranda RD, Peixoto JM, Barbosa MR, Fenelon G, Assef AH, Naccarato AFP, Rodrigues Sobrinho CRM, Kohler I, Vasconcelos JNGD, Magalhães MJG, Morais NSD, Rocha RM, Giraldez RRCV, Silva GCD. [First guidelines of the Brazilian Society of Cardiology on processes and skills for education in cardiology in Brazil]. Arq Bras Cardiol 2014; 96:4-24. [PMID: 24043332 DOI: 10.5935/abc.2013s008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Rocha R, Gonçalves F, Marques C, Nunes B. Environmental effects of anticholinesterasic therapeutic drugs on a crustacean species, Daphnia magna. Environ Sci Pollut Res Int 2014; 21:4418-4429. [PMID: 24327113 DOI: 10.1007/s11356-013-2339-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Accepted: 11/04/2013] [Indexed: 06/03/2023]
Abstract
The presence of pharmaceutical drugs in the environment is an important field of toxicology, since such residues can cause deleterious effects on exposed biota. This study assessed the ecotoxicological acute and chronic effects of two anticholinesterasic drugs, neostigmine and pyridostigmine in Daphnia magna. Our study calculated 48 h-EC50 values for the immobilization assay of 167.7 μg L(-1) for neostigmine and 91.3 μg L(-1) for pyridostigmine. In terms of feeding behavior, we calculated a 5 h-EC50 for filtration rates of 7.1 and 0.2 μg L(-1) for neostigmine and pyridostigmine, respectively; for the ingestion rates, the calculated EC50 values were, respectively, 7.5 and 0.2 μg L(-1) for neostigmine and pyridostigmine. In the reproduction assay, the most affected parameter was the somatic growth rate (LOECs of 21.0 and 2.9 μg L(-1) for neostigmine and pyridostigmine, respectively), followed by the fecundity (LOECs of 41.9 and 11.4 μg L(-1) for neostigmine and pyridostigmine, respectively). We also determined a 48 h-IC50 for cholinesterase activity of 1.7 and 4.5 μg L(-1) for neostigmine and pyridostigmine, respectively. These results demonstrated that both compounds are potentially toxic for D. magna at concentrations in the order of the μg L(-1).
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Affiliation(s)
- R Rocha
- Departamento de Biologia & CESAM (Centro de Estudos do Ambiente e do Mar), Universidade de Aveiro, Campus Universitário de Santiago, 3810-193, Aveiro, Portugal
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Bueno RC, Canevari RA, Villacis RAR, Domingues MAC, Caldeira JRF, Rocha RM, Drigo SA, Rogatto SR. ATM down-regulation is associated with poor prognosis in sporadic breast carcinomas. Ann Oncol 2013; 25:69-75. [PMID: 24285016 DOI: 10.1093/annonc/mdt421] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Ataxia telangiectasia-mutated (ATM) gene downexpression has been reported in sporadic breast carcinomas (BC); however, the prognostic value and mechanisms of ATM deregulation remain unclear. PATIENTS AND METHODS ATM and miRNAs (miR-26a, miR-26b, miR-203, miR-421, miR-664, miR-576-5p and miR-18a) expression levels were evaluated by quantitative real-time PCR (RT-qPCR) in 52 BC and 3 normal breast samples. ATM protein expression was assessed by immunohistochemistry in 968 BC and 35 adjacent normal breast tissues. ATM copy number alteration was detected by array comparative genomic hybridization (aCGH) in 42 tumours. RESULTS Low ATM levels were associated with tumour grade. Absence of ATM protein expression was associated with distant metastasis (P < 0.001), reduced disease-free survival (DFS, P < 0.001) and cancer-specific survival (CSS, P < 0.001). Multivariate analysis indicated ATM protein expression as an independent prognostic marker for DFS (P = 0.001, HR = 0.579) and CSS (P = 0.001, HR = 0.554). ATM copy number loss was detected in 12% of tumours and associated with lower mRNA levels. miR-421 over-expression was detected in 36.5% of cases which exhibit lower ATM transcript levels (P = 0.075, r = -0.249). CONCLUSIONS The data suggest that ATM protein expression is an independent prognostic marker in sporadic BC. Gene copy number loss and miR-421 over-expression may be involved in ATM deregulation in BC.
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Affiliation(s)
- R C Bueno
- NeoGene Laboratory, Department of Urology, São Paulo State University, Botucatu
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Faria-Ramos I, Espinar MJ, Rocha R, Santos-Antunes J, Rodrigues AG, Cantón R, Pina-Vaz C. A novel flow cytometric assay for rapid detection of extended-spectrum beta-lactamases. Clin Microbiol Infect 2012; 19:E8-E15. [PMID: 23145853 DOI: 10.1111/j.1469-0691.2012.03986.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The rapid detection of extended-spectrum beta-lactamases (ESBLs) is a challenge for most clinical microbiology laboratories because inaccurate identification of ESBL producers has important clinical implications for both antibiotic treatment and infection control. The aim of our study was to develop a rapid detection assay of ESBL producers based upon flow cytometric analysis. Antimicrobial susceptibility testing followed by molecular characterization of bla(TEM) , bla(SHV) or bla(CTX-M) genes was performed on clinical isolates (41 ESBL positive and 20 ESBL negative) and isolates expressing well-characterized beta-lactamases, including ESBLs (n = 13), plasmid AmpCs (n = 3), oxacillinases (n = 5) and carbapenemases (n = 3). Additionally, two ATCC strains recommended by CLSI for susceptibility testing were used as controls. The flow cytometry analysis protocol involved an incubation of bacterial cells with different concentrations of ceftazidime (1, 2 and 4 mg/L) and cefotaxime (4, 8 and 16 mg/L) for 1 and 2 hours, in the presence and absence of clavulanic acid; subsequently, cells were stained with the fluorescent dye Bis-(1,3-dibutylbarbituric acid) trimethine oxonol [DiBAC(4) (3)], a lipophilic anion able to diffuse across depolarized membranes. Additionally, CFU counts were performed. Susceptible isolates displayed increased fluorescence after 1 hour of incubation; conversely, the increase of the depolarized population was only observed after incubation with clavulanic acid associated with ceftazidime or cefotaxime in ESBL producers. An excellent correlation was obtained between the number of non-depolarized bacteria quantified by flow cytometry and by conventional CFU assays. A novel, accurate and fast flow cytometric assay is available to detect the presence of ESBLs.
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Affiliation(s)
- I Faria-Ramos
- Department of Microbiology, Faculty of Medicine, University of Porto, Porto.
| | - M J Espinar
- Department of Microbiology, Faculty of Medicine, University of Porto, Porto; Cardiovascular Research and Development Unit, Faculty of Medicine, University of Porto, Porto; Department of Microbiology, Hospital S. João, Porto, Portugal
| | - R Rocha
- Department of Microbiology, Faculty of Medicine, University of Porto, Porto
| | - J Santos-Antunes
- Department of Microbiology, Faculty of Medicine, University of Porto, Porto; Gastroenterology Department, Hospital S. João, Porto, Portugal
| | - A G Rodrigues
- Department of Microbiology, Faculty of Medicine, University of Porto, Porto; Cardiovascular Research and Development Unit, Faculty of Medicine, University of Porto, Porto
| | - R Cantón
- Servicio de Microbiología and CIBER en Epidemiología y Salud Pública (CIBERESP), Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS) and Hospital Universitario Ramón y Cajal, Madrid; Unidad de Resistencia a Antibióticos y Virulencia Bacteriana asociada al Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Spain
| | - C Pina-Vaz
- Department of Microbiology, Faculty of Medicine, University of Porto, Porto; Cardiovascular Research and Development Unit, Faculty of Medicine, University of Porto, Porto; Department of Microbiology, Hospital S. João, Porto, Portugal
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Reis A, Coelho J, Rodrigues S, Rocha R, Davidson C, Duarte A, Pereira E. Development and validation of a simple thermo-desorption technique for mercury speciation in soils and sediments. Talanta 2012; 99:363-8. [DOI: 10.1016/j.talanta.2012.05.065] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2012] [Revised: 05/24/2012] [Accepted: 05/29/2012] [Indexed: 11/29/2022]
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De Oliveira L, Rocha RM, Da Silva LL, Rosas CF, Korkes H, Sass N. PP165. Treatment approaches for preeclampsia: A sample from a big city of a developing country. Pregnancy Hypertens 2012; 2:328-9. [PMID: 26105486 DOI: 10.1016/j.preghy.2012.04.276] [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: 10/28/2022]
Abstract
INTRODUCTION Preeclampsia is a major cause of maternal morbidity and mortality worldwide, mainly in developing countries. Here we show an example of how is the clinical condition of these patients when they are referred from first care units to a tertiary care teaching maternity in the city of São Paulo, Brazil. OBJECTIVES To evaluate how has been the approach for preeclamptic women in a big city of Brazil, an example of developing country. METHODS This is a retrospective study that evaluated 41 patients that were referred to our hospital from August 2010 to December 2011. In most of the cases patients were referred due to elevations in blood pressure. The diagnosis of preeclampsia was based on the ISSHP recommendations. The diagnosis of severe preeclampsia was based either on clinical symptoms and/or laboratory parameters. Fetal distress was defined when Doppler velocimetry assessment demonstrated abnormal parameters (centralization with abnormal diastolic blood flow at umbilical arteries). RESULTS Severe preeclampsia was diagnosed in 26 cases (63.4%) and 34 patients were treated with magnesium sulfate (82.9%). One case of eclampsia (2.4%) and five cases of "Abruptio Placentae" (12.1%) were registered. Fetal distress was diagnosed at the moment of admission in 13 cases (31.7%) and two of these fetuses ended in stillbirth (4.8%). Neonatal death occurred in three cases (7.3%), mainly due to extreme preterm delivery. Other outcomes are reported in the following table. ICU: Intensive Care Unit. CONCLUSION This is a good example of how has been the approach of preeclamptic women in a big city of Brazil. Our results suggest that a special concern about the moment of referring these patients to tertiary care units should be taken by doctors at first care units.
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Affiliation(s)
- L De Oliveira
- Obstetrics, School Maternity Vila Nova Cachoeirinha, São Paulo, Brazil
| | - R M Rocha
- Obstetrics, School Maternity Vila Nova Cachoeirinha, São Paulo, Brazil
| | - L L Da Silva
- Obstetrics, School Maternity Vila Nova Cachoeirinha, São Paulo, Brazil
| | - C F Rosas
- Obstetrics, School Maternity Vila Nova Cachoeirinha, São Paulo, Brazil
| | - H Korkes
- Obstetrics, School Maternity Vila Nova Cachoeirinha, São Paulo, Brazil
| | - N Sass
- Obstetrics, School Maternity Vila Nova Cachoeirinha, São Paulo, Brazil
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Santos HF, Carmo FL, Leite DCA, Jesus HE, Maalouf PDC, Almeida C, Soriano AU, Altomari D, Suhett L, Vólaro V, Valoni E, Francisco M, Vieira J, Rocha R, Sardinha BL, Mendes LB, João RR, Lacava B, Jesus RF, Sebastian GV, Pessoa A, van Elsas JD, Rezende RP, Pires DO, Duarte G, Castro CB, Rosado AS, Peixoto RS. Comparison of different protocols for the extraction of microbial DNA from reef corals. Braz J Microbiol 2012; 43:517-27. [PMID: 24031859 PMCID: PMC3768815 DOI: 10.1590/s1517-83822012000200012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2011] [Accepted: 06/07/2012] [Indexed: 02/03/2023] Open
Abstract
This study aimed to test different protocols for the extraction of microbial DNA from the coral Mussismilia harttii. Four different commercial kits were tested, three of them based on methods for DNA extraction from soil (FastDNA SPIN Kit for soil, MP Bio, PowerSoil DNA Isolation Kit, MoBio, and ZR Soil Microbe DNA Kit, Zymo Research) and one kit for DNA extraction from plants (UltraClean Plant DNA Isolation Kit, MoBio). Five polyps of the same colony of M. harttii were macerated and aliquots were submitted to DNA extraction by the different kits. After extraction, the DNA was quantified and PCR-DGGE was used to study the molecular fingerprint of Bacteria and Eukarya. Among the four kits tested, the ZR Soil Microbe DNA Kit was the most efficient with respect to the amount of DNA extracted, yielding about three times more DNA than the other kits. Also, we observed a higher number and intensities of DGGE bands for both Bacteria and Eukarya with the same kit. Considering these results, we suggested that the ZR Soil Microbe DNA Kit is the best adapted for the study of the microbial communities of corals.
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Affiliation(s)
- H F Santos
- Laboratório de Ecologia Molecular Microbiana, Universidade Federal do Rio de Janeiro , Rio de Janeiro, RJ , Brasil
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