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Alves R, Petitjean H, Druzhinenko-Silhan D. Psychological approaches to obesity in young adults: state of the art. Front Nutr 2024; 11:1328386. [PMID: 38385013 PMCID: PMC10879406 DOI: 10.3389/fnut.2024.1328386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 01/25/2024] [Indexed: 02/23/2024] Open
Abstract
Background Obesity has become a significant health concern among young adults aged 18-35 years. Addressing this issue is crucial, and exploring psychological treatments and perspectives specifically for this population is essential. Methods This literature review examines psychological treatments for obesity in young adults over the past decade. It focuses on interventions and discussions particularly relevant to this age group. Discussion Research on obesity often overlooks young adults, with most interventions primarily focusing on weight loss and neglecting emotional aspects. Cognitive-behavioral approaches are commonly used for self-regulation and motivation, but psychodynamic perspectives remain underutilized. While group-based methods lack a detailed analysis of benefits, hybrid approaches demonstrate higher engagement compared to technology-only interventions. There is a notable gap in tailoring obesity interventions to meet the unique needs of young adults during this transitional life phase. It's imperative to shift the focus from merely weight loss to a broader consideration of psychological, emotional, and unconscious factors. Integrating group modalities with psychodynamic approaches might offer additional benefits. Conclusion This review highlights the need for further research into the psychological well-being of young adults with obesity. A more comprehensive approach is required to address their distinct needs and psychological factors.
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Gonçalves-Pereira J, Costa L, Silva I, Simões A, Froes F, Mergulhão P, Varela Ramos P, Leal D, Alves R, Custódio M, Gomes A. The benefit of macrolide therapy in patients with pneumococcal pneumonia is only present in patients with bacteremia. Pulmonology 2023; 29:253-256. [PMID: 36333235 DOI: 10.1016/j.pulmoe.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/04/2022] [Accepted: 08/05/2022] [Indexed: 05/05/2023] Open
Affiliation(s)
- J Gonçalves-Pereira
- Intensive Care Department, Hospital Vila Franca de Xira; Vila Franca de Xira, Portugal; Nova Medical School, Universidade Nova de Lisboa, Lisbon, Portugal; Grupo de Infeção e Desenvolvimento em Sépsis, Oporto, Portugal.
| | - L Costa
- Intensive Care Department, Hospital Braga; Braga, Portugal
| | - I Silva
- Internal Medicine Department, Hospital Cascais; Cascais, Portugal
| | - A Simões
- Intensive Care Department, Hospital Vila Franca de Xira; Vila Franca de Xira, Portugal
| | - F Froes
- Intensive Care Department, Centro Hospitalar S. João, Oporto, Portugal; Chest Department, Hospital Pulido Valente, Centro Hospitalar Lisboa Norte, Lisbon, Portugal
| | - P Mergulhão
- Grupo de Infeção e Desenvolvimento em Sépsis, Oporto, Portugal; Intensive Care Unit, Hospital Lusíadas, Oporto, Portugal; Faculdade de Medicina, Universidade do Porto, Oporto, Portugal
| | - P Varela Ramos
- Intensive Care Department, Hospital Vila Franca de Xira; Vila Franca de Xira, Portugal
| | - D Leal
- Intensive Care Department, Hospital Braga; Braga, Portugal
| | - R Alves
- Intensive Care Department, Hospital Braga; Braga, Portugal
| | - M Custódio
- Internal Medicine Department, Hospital Cascais; Cascais, Portugal
| | - A Gomes
- Grupo de Infeção e Desenvolvimento em Sépsis, Oporto, Portugal; Internal Medicine Department, Hospital Cascais; Cascais, Portugal; Faculdade de Medicina, Universidade do Porto, Oporto, Portugal
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Folchini N, Silva L, Alves R, Consentini C, Silva M, Silva T, Acosta-Galindez J, Drum J, Motta J, Gonzales B, Sartori R. 167 Ovarian response and embryo production of cows superstimulated with different FSH regimens and inseminated with conventional or sex-sorted spermatozoa. Reprod Fertil Dev 2021; 34:322. [PMID: 35231376 DOI: 10.1071/rdv34n2ab167] [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: 11/23/2022] Open
Affiliation(s)
- N Folchini
- University of São Paulo, Piracicaba, SP, Brazil
| | - L Silva
- University of São Paulo, Piracicaba, SP, Brazil
| | - R Alves
- University of São Paulo, Piracicaba, SP, Brazil
| | | | - M Silva
- University of São Paulo, Piracicaba, SP, Brazil
| | - T Silva
- University of São Paulo, Piracicaba, SP, Brazil
| | | | - J Drum
- University of Missouri, Columbia, MO, USA
| | - J Motta
- The Ohio State University, Columbus, OH, USA
| | | | - R Sartori
- University of São Paulo, Piracicaba, SP, Brazil
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4
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Alves R. Mediterranean Diet in Europe: how are mature adults and elderly moving closer to this diet pattern? Eur J Public Health 2021. [PMCID: PMC8574673 DOI: 10.1093/eurpub/ckab164.447] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background The decrease in Mediterranean Diet (MD) adherence during the last decades in Europe has been linked with changes to modern lifestyles, and more recently, to the Great Recession. However, new national efforts to improve dietary habits through fiscal and regulatory policies, and the economic improvement of the second half of the past decade (pre-covid 19 pandemic) might have led to a reversal in this trend. Our goal was to analyze the changes in MD adherence between 2013 and 2019 among a sample of European mature adults and the elderly. Methods Using data from the Survey of Health, Ageing and Retirement in Europe (SHARE) for adults over 50 years old, we design a longitudinal cohort study with a sample of participants from waves 5 (2013) and 8 (2019/20). Logistic regressions were used to model the consumption of MD adherence, meat/fish, fruit/vegetables, legumes/eggs and dairy products as function of the year. We stratified the analyses by educational level and age groups and for transitions in economic status, employed, and self-perceived health. Results There was in 2019/20 a significant increase in the MD adherence (10.8 v. 14.3%, OR = 1.377, P < 0.01). The rise is mainly related to the decrease of meat and fish (38.4 v. 30.5%, OR = 0,703, P < 0.01) and growth of legumes and eggs intake (36.3 v. 41.8%, OR = 1.260 P < 0.01). The results were consistent in all European regions and most sociodemographic groups. Younger people with higher income and education and overall better self-perceived health had a more prevalent rise in M.D adherence. Conclusions Our analysis shows a generalized growth in MD's adherence amongst mature adults and elderly population across Europe. This rise was observed across most socioeconomic subpopulations and European countries, suggesting a shift to healthier diet patterns. Yet, MD adherence increase was more noticeable amongst more affluent, educated and healthy responders, which may further entrench diet and health inequalities. Key messages Mediterranean Diet adherence has been increasing among mature adults and the elderly in Europe (2013-2019). The rise in Mediterranean Diet adherence was more evident amongst more affluent, educated and healthy responders, which may further entrench diet and health inequalities.
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Affiliation(s)
- R Alves
- Comprehensive Health Research Centre, NOVA National School of Public Health, Lisbon, Portugal
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5
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De Almeida Fernandes D, Santos Mira F, Pimenta C, Escada L, Antonio N, Goncalves L, Alves R. Impact of haemodialysis in the development of atrial fibrillation: a retrospective cross-sectional study. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Chronic kidney disease (CKD) is a very common co-morbidity in patients with cardiovascular disease, particularly in those with atrial fibrillation (AF). There is an increasing number of patients on haemodialysis who have AF and its impact is not fully understood.
Purpose
To assess the prevalence of AF in patients on haemodialysis, trying to identify predictors of AF development.
Methods
Unicentric, retrospective study including all patients admitted to the Nephrology ward from October 2020 to December 2020 who had CKD. Cardiovascular risk factors, known cardiac disease, time on haemodialysis, type of vascular access and demographic data were analysed. The control group was comprised of hospitalized CKD patients who were not on renal replacement therapies.
Results
A total of 126 patients were included, 57 on dialysis. Mean age for the renal replacement therapy group was 71.07±15.68 years and for the control group was 72.59±14.74 years old (p=0.575). There was an increased proportion of patients with type 2 diabetes mellitus in the control group (39 vs 20, p=0.021). No statistically significant differences were found regarding hypertension, heart failure, coronary disease or sleep apnoea between groups.
The prevalence of AF was similar in both the haemodialysis and the control group (26.3% vs 24.6%, p=0.829). Age, heart failure and coronary disease were significant risk factors for AF, irrespective of the studied group (p<0.05). There was also a significant correlation between time on dialysis and a greater likelihood of presenting AF (p<0.05). There was no correlation with type of vascular access.
Using the Youden index, an age of 80.5 years was determined as the cut-off for an increased prevalence of AF, irrespective of the study group (sensitivity of 66.7%; Specificity of 78.8%). Using ROC curves, an area under the curve (AUC) of 0.74 was obtained for age and the likelihood of AF (figure 1). Regarding time on dialysis, a cut-off point of 4.5 years was obtained with an AUC of 0.67 (sensitivity of 73% and specificity of 68.7%) (figure 2).
Conclusion
AF is very common in patients with end-stage renal disease, with a prevalence estimated to be 4 times greater than the general population. Our results suggested that, while haemodialysis may not be a risk factor for AF by itself, a longer time on haemodialysis may contribute to its onset. Age was also a contributing factor. Further prospective studies with more homogeneous groups are needed to clarify its role as an independent risk factor for AF.
Funding Acknowledgement
Type of funding sources: None. Figure 1. Age as predictor of AFFigure 2. Time on dyalisis as predictor of AF
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Affiliation(s)
| | - F Santos Mira
- Coimbra Hospital and University Center, Nephrology, Coimbra, Portugal
| | - C Pimenta
- Coimbra Hospital and University Center, Nephrology, Coimbra, Portugal
| | - L Escada
- Coimbra Hospital and University Center, Nephrology, Coimbra, Portugal
| | - N Antonio
- Coimbra Hospital and University Center, Cardiology, Coimbra, Portugal
| | - L Goncalves
- Coimbra Hospital and University Center, Cardiology, Coimbra, Portugal
| | - R Alves
- Coimbra Hospital and University Center, Nephrology, Coimbra, Portugal
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6
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Alves R, Ngono AE, Wang YT, Ferreira L, Shresta S. Characterization of an immunocompetent animal model for dengue virus infection. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.058] [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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Precioso J, Samorinha C, Alves R. Prevention measures for COVID-19 in retail food stores in Braga, Portugal. Pulmonology 2020; 27:260-261. [PMID: 32690466 PMCID: PMC7346780 DOI: 10.1016/j.pulmoe.2020.06.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 06/13/2020] [Accepted: 06/16/2020] [Indexed: 11/25/2022] Open
Affiliation(s)
- J Precioso
- CIEC - Research Centre Child Studies, Institute of Education, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal.
| | - C Samorinha
- CIEC - Research Centre Child Studies, Institute of Education, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal.
| | - R Alves
- CIEC - Research Centre Child Studies, Institute of Education, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal.
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Coelho ID, Romãozinho C, Teixeira AC, Rodrigues L, Ferreira E, Santos L, Macário F, Alves R, Figueiredo A. A Rare Manifestation of Tuberculosis in a Renal Transplant Patient: A Case Report. Transplant Proc 2019; 51:1618-1620. [PMID: 31155204 DOI: 10.1016/j.transproceed.2019.02.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Cutaneous lesions in the presence of fever in patients undergoing immunosuppressive therapy are a diagnostic challenge and may represent manifestations of multiple diseases, such as fungal infections, nocardiosis, lymphoproliferative diseases, zoonosis, and tuberculosis. The authors report a case of a 66-year-old white man with chronic kidney disease since 2014 (chronic pyelonephritis) who had a renal transplant in the previous 6 months. Induction therapy was performed with thymoglobulin, and his current immunosuppression scheme included tacrolimus, mycophenolate mofetil, and prednisolone. The patient had no history of pulmonary tuberculosis. The patient presented with 2 cutaneous lesions, localized on the back and abdomen, that appeared to be firm, painful, subcutaneous, erythematous nodules with an approximately 5 cm diameter overlying an infected focus and purulent material inside. The patient also had a fever and fatigue. Blood analysis showed pancytopenia with an elevation of inflammatory markers and graft dysfunction. Tissue cultures and skin biopsy with histological analysis were performed. Histopathology of the lesion showed a nonspecific inflammatory infiltrate without granulomas, and acid-fast bacillus staining was negative. Nevertheless, serum QuantiFERON testing was positive. But polymerase chain reaction finally confirmed the presence of Mycobacterium tuberculosis, which confirmed the diagnosis of cutaneous tuberculosis. A chest computed tomography scan showed a lung pattern of miliary tuberculosis. The patient was treated with multidrug tuberculosis therapy, resulting in lesion clearance after 3 weeks. Tuberculosis is a serious infection, especially in high-risk patients, such as those in an immunocompromised state. The incidence of cutaneous tuberculosis is rare, but it should be considered in patients presenting with atypical skin lesions suggestive of an underlying infectious etiology.
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Affiliation(s)
- I D Coelho
- Nephrology Department, Amato Lusitano Hospital, Castelo Branco, Portugal.
| | - C Romãozinho
- Nephrology Department, Coimbra University Hospital Center, Faculty of Medicine of the University of Coimbra, Coimbra, Portugal
| | - A C Teixeira
- Nephrology Department, Coimbra University Hospital Center, Coimbra, Portugal
| | - L Rodrigues
- Nephrology Department, Coimbra University Hospital Center, Faculty of Medicine of the University of Coimbra, Coimbra, Portugal
| | - E Ferreira
- Nephrology Department, Coimbra University Hospital Center, Coimbra, Portugal
| | - L Santos
- Nephrology Department, Coimbra University Hospital Center, Faculty of Medicine of the University of Coimbra, Coimbra, Portugal
| | - F Macário
- Nephrology Department, Coimbra University Hospital Center, Faculty of Medicine of the University of Coimbra, Coimbra, Portugal
| | - R Alves
- Nephrology Department, Coimbra University Hospital Center, Faculty of Medicine of the University of Coimbra, Coimbra, Portugal
| | - A Figueiredo
- Urology and Kidney Transplantation Department, Coimbra University Hospital Center, Faculty of Medicine of the University of Coimbra, Coimbra, Portugal
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Teixeira AC, Ferreira E, Marques MG, Rodrigues L, Santos L, Romãozinho C, Afonso N, Sousa V, Ferreira C, Macário F, Alves R, Figueiredo A. Pretransplant Biopsy of Marginal Kidneys: Is It Necessary? Transplant Proc 2019; 51:1585-1589. [PMID: 31155197 DOI: 10.1016/j.transproceed.2019.02.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Pretransplant kidney biopsy from marginal donors is used to guide the decision of whether to accept or discard organs for transplantation; however, there is controversy about this procedure, and the need for a pretransplant biopsy is still a debate. We sought to determine if histologic evaluation before implantation of marginal kidneys would influence the outcome. METHODS A retrospective observational cohort study of marginal donor transplants at Centro Hospitalar e Universitário de Coimbra was done. From 2009 to 2016, 650 marginal kidney transplants were analyzed. We evaluated long-term graft survival in a cohort of patients who received marginal kidneys. The recipients were divided into 2 groups based on whether a pretransplant donor biopsy was performed. Continuous variables were summarized by mean and standard deviation or median and range, as applicable. Categorical variables were summarized by relative and absolute frequencies. The survival analysis was obtained and plotted using the Kaplan-Meier method and compared with the log-rank test. RESULTS The median age of recipients and donors were statistically different between both groups (P < .001), with the donors and the recipients being younger in the group without a pretransplant biopsy. The median cold ischemia time was higher in the biopsy group (P = .01). The survival analysis showed that graft survival didn't differ between the groups (P = .2). CONCLUSIONS Selection of kidneys based on histological findings may not influence the graft survival and implies a higher cold ischemia time. More data are necessary to provide insight into which clinical, histologic, and biochemical parameters are necessary for decision making on kidney acceptance.
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Affiliation(s)
- A C Teixeira
- Urology and Transplantation Department, Coimbra Hospital and Universitary Centre, Coimbra, Portugal; Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
| | - E Ferreira
- Urology and Transplantation Department, Coimbra Hospital and Universitary Centre, Coimbra, Portugal; Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - M G Marques
- Urology and Transplantation Department, Coimbra Hospital and Universitary Centre, Coimbra, Portugal; Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - L Rodrigues
- Urology and Transplantation Department, Coimbra Hospital and Universitary Centre, Coimbra, Portugal; Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - L Santos
- Urology and Transplantation Department, Coimbra Hospital and Universitary Centre, Coimbra, Portugal; Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - C Romãozinho
- Urology and Transplantation Department, Coimbra Hospital and Universitary Centre, Coimbra, Portugal; Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - N Afonso
- Urology and Transplantation Department, Coimbra Hospital and Universitary Centre, Coimbra, Portugal; Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - V Sousa
- Pathology Department, Coimbra Hospital and Universitary Centre, Coimbra, Portugal
| | - C Ferreira
- Urology and Transplantation Department, Coimbra Hospital and Universitary Centre, Coimbra, Portugal
| | - F Macário
- Urology and Transplantation Department, Coimbra Hospital and Universitary Centre, Coimbra, Portugal; Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - R Alves
- Urology and Transplantation Department, Coimbra Hospital and Universitary Centre, Coimbra, Portugal; Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - A Figueiredo
- Urology and Transplantation Department, Coimbra Hospital and Universitary Centre, Coimbra, Portugal
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Frontini R, Sousa P, Carvalho M, Alves R, Ferreira R, Figueiredo M. A mobile-based monitoring sleep system integrated in a mHealth program. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz034.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- R Frontini
- School of Health Sciences, Polytechnic Institute of Leiria, Portugal
- CiTechCare – Centre for Innovative Care and Health Technology, Polytechnic Institute of Leiria, Portugal
| | - P Sousa
- School of Health Sciences, Polytechnic Institute of Leiria, Portugal
- CiTechCare – Centre for Innovative Care and Health Technology, Polytechnic Institute of Leiria, Portugal
| | - M Carvalho
- CiTechCare – Centre for Innovative Care and Health Technology, Polytechnic Institute of Leiria, Portugal
| | - R Alves
- CiTechCare – Centre for Innovative Care and Health Technology, Polytechnic Institute of Leiria, Portugal
| | - R Ferreira
- School of Health Sciences, Polytechnic Institute of Santarém, Portugal
- Indicators Monitoring Unit in Health, Polytechnic Institute of Santarém, Portugal
| | - M Figueiredo
- School of Health Sciences, Polytechnic Institute of Santarém, Portugal
- Indicators Monitoring Unit in Health, Polytechnic Institute of Santarém, Portugal
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11
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Sousa P, Frontini R, Luís L, Carvalho M, Alves R. A mobile-based food diversity monitoring system for promoting healthy dietary habits. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz034.002] [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: 11/15/2022] Open
Affiliation(s)
- P Sousa
- Escola Superior de Saúde, Instituto Politécnico de Leiria, Portugal
- CiTechCare – Centro de Inovação em Tecnologias e Cuidados de Saúde, IPLeiria, Portugal
| | - R Frontini
- Escola Superior de Saúde, Instituto Politécnico de Leiria, Portugal
- CiTechCare – Centro de Inovação em Tecnologias e Cuidados de Saúde, IPLeiria, Portugal
| | - L Luís
- Escola Superior de Saúde, Instituto Politécnico de Leiria, Portugal
- CiTechCare – Centro de Inovação em Tecnologias e Cuidados de Saúde, IPLeiria, Portugal
| | - M Carvalho
- CiTechCare – Centro de Inovação em Tecnologias e Cuidados de Saúde, IPLeiria, Portugal
| | - R Alves
- CiTechCare – Centro de Inovação em Tecnologias e Cuidados de Saúde, IPLeiria, Portugal
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12
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Catarina S, Caiado A, Oom R, Cunha C, Santos A, Costa C, Moniz J, Alves R, Abecasis N. Skin-sparing and nipple-sparing mastectomies are oncologically safe compared to classical total mastectomies. Eur J Surg Oncol 2019. [DOI: 10.1016/j.ejso.2018.10.145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Pereira T, Betriu A, Alves R. Non-invasive imaging techniques and assessment of carotid vasa vasorum neovascularization: Promises and pitfalls. Trends Cardiovasc Med 2018; 29:71-80. [PMID: 29970286 DOI: 10.1016/j.tcm.2018.06.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 06/12/2018] [Accepted: 06/14/2018] [Indexed: 12/17/2022]
Abstract
Carotid adventitia vasa vasorum neovascularization (VVn) is associated with the initial stages of arteriosclerosis and with the formation of unstable plaque. However, techniques to accurately quantify that neovascularization in a standard, fast, non-invasive, and efficient way are still lacking. The development of such techniques holds the promise of enabling wide, inexpensive, and safe screening programs that could stratify patients and help in personalized preventive cardiovascular medicine. In this paper, we review the recent scientific literature pertaining to imaging techniques that could set the stage for the development of standard methods for quantitative assessment of atherosclerotic plaque and carotid VVn. We present and discuss the alternative imaging techniques being used in clinical practice and we review the computational developments that are contributing to speed up image analysis and interpretation. We conclude that one of the greatest upcoming challenges will be the use of machine learning techniques to develop automated methods that assist in the interpretation of images to stratify patients according to their risk.
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Affiliation(s)
- T Pereira
- Institute for Biomedical Research in Lleida Dr. Pifarré Foundation, Catalonia, Spain; Departament de Ciències Mèdiques Bàsiques, University of Lleida, Catalonia, Spain.
| | - A Betriu
- Unit for the Detection and Treatment of Atherothrombotic Diseases, Hospital Universitari Arnau de Vilanova de Lleida, Catalonia, Spain; Vascular and Renal Translational Research Group - IRBLleida, Catalonia, Spain
| | - R Alves
- Institute for Biomedical Research in Lleida Dr. Pifarré Foundation, Catalonia, Spain; Departament de Ciències Mèdiques Bàsiques, University of Lleida, Catalonia, Spain
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14
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Cascais de Sá D, Rodrigues L, Santos L, Romãozinho C, Macário F, Marinho C, Pratas J, Alves R, Figueiredo A. Staphylococcus Infection-Associated Glomerulonephritis in a Kidney Transplant Patient: Case Report. Transplant Proc 2018; 50:853-856. [PMID: 29661452 DOI: 10.1016/j.transproceed.2018.02.005] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Staphylococcus infection-associated glomerulonephritis is a rare cause of graft dysfunction in kidney transplant. Suspicion should be high in the setting of elevation of serum creatinine, active urinary sediment, with or without hypocomplementemia, and simultaneous Staphylococcus aureus infection. A kidney biopsy is usually diagnostic. CASE REPORT A 56-year-old man, who received a kidney transplant in 1998, with basal serum creatinine of 1.2 mg/dL and normal urinary sediment, was admitted to our kidney transplantation unit with graft dysfunction and a urinary tract infection caused by S aureus with septicemia, treated with antibiotics, in the context of recently intensified immunosuppression for a primary immune thrombocytopenia diagnosed 3 weeks earlier. After antibiotic treatment, the patient persisted with graft dysfunction, edema, and hypertension, with a S aureus isolation in the urine culture, active urinary sediment, and low C3. A kidney biopsy was performed, showing diffuse proliferative endocapillary and mesangial glomerulonephritis, with IgA(++) and C3(++) mesangial and endocapillary deposits in immunofluorescence. The patient was treated symptomatically and maintained his regular immunosuppression. At the last follow-up, his serum creatinine value was stable at 2.5 mg/dL. CONCLUSIONS The onset of a nephritic syndrome with a simultaneous S aureus infection should lead to suspicion of this uncommon entity, confirmed histologically. Despite its association with poor graft survival, our patient's graft survival remained stable.
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Affiliation(s)
- D Cascais de Sá
- Nephrology Department, Coimbra's University Hospital Center, Coimbra, Portugal; Nephrology Clinic, Coimbra's University Faculty of Medicine, Coimbra, Portugal.
| | - L Rodrigues
- Nephrology Department, Coimbra's University Hospital Center, Coimbra, Portugal; Nephrology Clinic, Coimbra's University Faculty of Medicine, Coimbra, Portugal
| | - L Santos
- Nephrology Department, Coimbra's University Hospital Center, Coimbra, Portugal; Nephrology Clinic, Coimbra's University Faculty of Medicine, Coimbra, Portugal
| | - C Romãozinho
- Nephrology Department, Coimbra's University Hospital Center, Coimbra, Portugal; Nephrology Clinic, Coimbra's University Faculty of Medicine, Coimbra, Portugal
| | - F Macário
- Nephrology Department, Coimbra's University Hospital Center, Coimbra, Portugal; Nephrology Clinic, Coimbra's University Faculty of Medicine, Coimbra, Portugal
| | - C Marinho
- Pathology Department, Coimbra's University Hospital Center, Coimbra, Portugal
| | - J Pratas
- Nephrology Department, Coimbra's University Hospital Center, Coimbra, Portugal; Nephrology Clinic, Coimbra's University Faculty of Medicine, Coimbra, Portugal
| | - R Alves
- Nephrology Department, Coimbra's University Hospital Center, Coimbra, Portugal; Nephrology Clinic, Coimbra's University Faculty of Medicine, Coimbra, Portugal
| | - A Figueiredo
- Urology and Kidney Transplantation Department, Coimbra's University Hospital Center, Coimbra, Portugal
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15
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Leal R, Pinto H, Galvão A, Rodrigues L, Santos L, Romãozinho C, Macário F, Alves R, Campos M, Mota A, Figueiredo A. Early Rehospitalization Post-Kidney Transplant Due to Infectious Complications: Can We Predict the Patients at Risk? Transplant Proc 2017; 49:783-786. [PMID: 28457394 DOI: 10.1016/j.transproceed.2017.01.062] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
INTRODUCTION Rehospitalization early post-kidney transplant is common and has a negative impact in morbidity, graft survival, and health costs. Infection is one the most common causes, and identifying the risk factors for early readmission due to infectious complications may guide a preventive program and improve outcome. The aim of this study was to evaluate the incidence, characterize the population, and identify the risk factors associated with early readmission for infectious complications post-kidney transplantation. METHODS We performed a retrospective cohort study of all the kidney transplants performed during 2015. The primary outcome was readmission in the first 3 months post-transplant due to infectious causes defined by clinical and laboratory parameters. RESULTS We evaluated 141 kidney transplants; 71% of subjects were men, with an overall mean age of 50.8 ± 15.4 years. Prior to transplant, 98% of the patients were dialysis dependent and 2% underwent pre-emptive living donor kidney transplant. The global readmission rate was 49%, of which 65% were for infectious complications. The most frequent infection was urinary tract infection (n = 28, 62%) and the most common agent detected by blood and urine cultures was Klebsiella pneumonia (n = 18, 40%). The risk factors significantly associated with readmission were higher body mass index (P = .03), diabetes mellitus (P = .02), older donor (P = .007), and longer cold ischemia time (P = .04). There were 3 graft losses, but none due to infectious complications. CONCLUSION There was a high incidence of early rehospitalization due to infectious complications, especially urinary tract infections to nosocomial agents. The risk factors identified were similar to other series.
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Affiliation(s)
- R Leal
- Nephrology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - H Pinto
- Nephrology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
| | - A Galvão
- Nephrology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - L Rodrigues
- Nephrology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - L Santos
- Nephrology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - C Romãozinho
- Nephrology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - F Macário
- Nephrology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - R Alves
- Nephrology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - M Campos
- Nephrology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - A Mota
- Urology and Kidney Transplantation Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - A Figueiredo
- Urology and Kidney Transplantation Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
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Ferreira E, Costa J, Romãozinho C, Santos L, Macário F, Bastos C, Alves R, Figueiredo A. Long-Term Outcomes of Kidney Transplantation From Expanded-Criteria Deceased Donors: A Single-Center Experience. Transplant Proc 2017; 49:770-776. [PMID: 28457392 DOI: 10.1016/j.transproceed.2017.01.051] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Organ shortage has prompted the use of expanded-criteria donors (ECDs). Our objective was to compare long-term outcomes of kidney transplants from ECDs with those from concurrent standard-criteria donors (SCDs). In addition, we evaluated variables associated with graft survival in both groups. METHODS We retrospectively reviewed all 617 deceased-donor kidney transplantations performed from 2005 to 2009 in our department. The population was divided according to donor status into ECD or SCD. Patients were followed until 5 years after transplantation, death, graft failure, or loss to follow-up. RESULTS We transplanted 150 deceased-donor kidneys from ECDs and 467 from SCDs. ECD were older, more frequently women, had a lower pre-retrieval glomerular filtration rate, and more frequently died due to cerebrovascular accident. ECD recipients were older, presented a lower proportion of black race, more frequently were on hemodialysis, and presented a higher rate of first kidney transplants. Mean glomerular filtration rate was consistently lower in the ECD group. Patient and graft survivals were lower in the ECD group, but statistical significance was present only in graft survival censored for death with a functioning graft at 3 years and graft survival noncensored for death with a functioning graft at 5 years. Younger recipient ages, longer time on dialysis, acute rejection episodes, and glomerular filtration rate at 1 year after transplantation were independent risk factors for lower graft survival. CONCLUSIONS Transplantation with the use of ECD kidneys provide quite satisfactory patient and graft survival rates despite their poorer long-term outcomes.
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Affiliation(s)
- E Ferreira
- Department of Nephrology, Centro Hospitalar e Universitário de Coimbra-Hospitais da Universidade de Coimbra, Coimbra, Portugal.
| | - J Costa
- Department of Nephrology, Centro Hospitalar e Universitário de Coimbra-Hospitais da Universidade de Coimbra, Coimbra, Portugal
| | - C Romãozinho
- Department of Nephrology, Centro Hospitalar e Universitário de Coimbra-Hospitais da Universidade de Coimbra, Coimbra, Portugal
| | - L Santos
- Department of Nephrology, Centro Hospitalar e Universitário de Coimbra-Hospitais da Universidade de Coimbra, Coimbra, Portugal
| | - F Macário
- Department of Nephrology, Centro Hospitalar e Universitário de Coimbra-Hospitais da Universidade de Coimbra, Coimbra, Portugal
| | - C Bastos
- Department of Urology and Renal Transplantation, Centro Hospitalar e Universitário de Coimbra-Hospitais da Universidade de Coimbra, Coimbra, Portugal
| | - R Alves
- Department of Nephrology, Centro Hospitalar e Universitário de Coimbra-Hospitais da Universidade de Coimbra, Coimbra, Portugal
| | - A Figueiredo
- Department of Urology and Renal Transplantation, Centro Hospitalar e Universitário de Coimbra-Hospitais da Universidade de Coimbra, Coimbra, Portugal
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Costa JS, Ferreira E, Leal R, Bota N, Romãozinho C, Sousa V, Marinho C, Santos L, Macário F, Alves R, Pratas J, Campos M, Figueiredo A. Polyomavirus Nephropathy: Ten-Year Experience. Transplant Proc 2017; 49:803-808. [PMID: 28457399 DOI: 10.1016/j.transproceed.2017.01.072] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Polyomavirus nephropathy (BKVN) is an important cause of chronic allograft dysfunction (CAD). Recipient determinants (male sex, white race, and older age), deceased donation, high-dose immunosuppression, diabetes, delayed graft function (DGF), cytomegalovirus infection, and acute rejection (AR) are risk factors. Reducing immunosuppression is the best strategy in BKVN. The objective of our study was to evaluate CAD progression after therapeutic strategies in BKVN and risk factors for graft loss (GL). METHODS Retrospective analysis of 23 biopsies, from patients with CAD and histological evidence of BKVN, conducted over a period of 10 years. Glomerular filtration rate was <30 mL/min in 16 patients at the time of the BKVN diagnosis. RESULTS BKVN was histologically diagnosed in 23 recipients (19 men, 4 women). All patients were white, with age of 51.2 ± 12.1 years (6 patients, age >60 years), and 22 had a deceased donor. Diabetes affected 4 patients, DGF occurred in 3, cytomegalovirus infection in 2, and AR in 15. All patients were medicated with calcineurin inhibitors (CNI) (95.7% tacrolimus) and corticoids, and 16 also received an antimetabolite. One year after antimetabolite reduction/discontinuation and/or CNI reduction/switching and/or antiviral agents, graft function was decreased in 11 patients, increased/stabilized in 10, and unknown in 2. GL occurred in 9 patients. Older age (hazard ratio, 1.76; 95% confidence interval, 0.94-3.28) and DGF (hazard ratio, 2.60; 95% confidence interval, 0.54-12.64) were the main risk factors for GL. The lower GFR at the time of the BKVN diagnosis was associated with an increased risk of initiation of dialysis. CONCLUSIONS GL occurred in 39.1% of patients with BKVN and DGF; older age and lower GFR at the time of diagnosis were important risk factors. Early diagnosis of BKVN is essential to prevent GL.
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Affiliation(s)
- J S Costa
- Department of Nephrology, Coimbra Hospital and Universitary Center, Coimbra, Portugal.
| | - E Ferreira
- Department of Nephrology, Coimbra Hospital and Universitary Center, Coimbra, Portugal
| | - R Leal
- Department of Nephrology, Coimbra Hospital and Universitary Center, Coimbra, Portugal
| | - N Bota
- Department of Nephrology, Clínica Sagrada Esperança, Luanda, Angola
| | - C Romãozinho
- Department of Nephrology, Coimbra Hospital and Universitary Center, Coimbra, Portugal
| | - V Sousa
- Department of Anatomic Pathology, Coimbra Hospital and Universitary Center, Coimbra, Portugal
| | - C Marinho
- Department of Anatomic Pathology, Coimbra Hospital and Universitary Center, Coimbra, Portugal
| | - L Santos
- Department of Nephrology, Coimbra Hospital and Universitary Center, Coimbra, Portugal
| | - F Macário
- Department of Nephrology, Coimbra Hospital and Universitary Center, Coimbra, Portugal
| | - R Alves
- Department of Nephrology, Coimbra Hospital and Universitary Center, Coimbra, Portugal
| | - J Pratas
- Department of Nephrology, Coimbra Hospital and Universitary Center, Coimbra, Portugal
| | - M Campos
- Department of Nephrology, Coimbra Hospital and Universitary Center, Coimbra, Portugal
| | - A Figueiredo
- Department of Urology and Kidney Transplantation, Coimbra Hospital and Universitary Center, Coimbra, Portugal
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19
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Perelman J, Alves R. The impact of the Great Recession on diet habits in Portugal, 2005-2014. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx187.481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- J Perelman
- Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - R Alves
- Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisboa, Portugal
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Macedo B, Jorge J, Alves R, Gonçalves AC, Sarmento-Ribeiro AB. ALDHs as potential biomarkers in myeloid neoplasms - Preliminary study: PS165. Porto Biomed J 2017; 2:182. [PMID: 32258631 DOI: 10.1016/j.pbj.2017.07.018] [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)
- B Macedo
- Department of Chemistry, University of Aveiro, Portugal
| | - J Jorge
- Laboratory of Oncobiology and Hematology, University Clinic of Hematology and Applied Molecular Biology, Faculty of Medicine, University of Coimbra, Portugal.,Center for Neuroscience and Cell Biology, IBILI, University of Coimbra, Portugal
| | - R Alves
- Laboratory of Oncobiology and Hematology, University Clinic of Hematology and Applied Molecular Biology, Faculty of Medicine, University of Coimbra, Portugal.,Center for Neuroscience and Cell Biology, IBILI, University of Coimbra, Portugal
| | - A C Gonçalves
- Laboratory of Oncobiology and Hematology, University Clinic of Hematology and Applied Molecular Biology, Faculty of Medicine, University of Coimbra, Portugal.,Center for Neuroscience and Cell Biology, IBILI, University of Coimbra, Portugal.,CIMAGO - Center of Investigation on Environment Genetics and Oncobiology, Faculty of Medicine, University of Coimbra, Portugal
| | - A B Sarmento-Ribeiro
- Laboratory of Oncobiology and Hematology, University Clinic of Hematology and Applied Molecular Biology, Faculty of Medicine, University of Coimbra, Portugal.,Center for Neuroscience and Cell Biology, IBILI, University of Coimbra, Portugal.,CIMAGO - Center of Investigation on Environment Genetics and Oncobiology, Faculty of Medicine, University of Coimbra, Portugal.,Clinical Hematology Service, University Hospital of Coimbra, Portugal
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Santos K, Monteiro A, Paiva C, Amparo F, Moreira P, Alves R, Kovacs C, Magnoni D. SUN-P125: Application of the Findrisc Questionnaire to Screening the Risk of Diabetes Mellitus in Patients with Cardiovascular Disease. Clin Nutr 2017. [DOI: 10.1016/s0261-5614(17)30502-2] [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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22
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Ribau B, Jorge J, Alves R, Ribeiro PI, Gonçalves AC, Carreira IM, Sarmento-Ribeiro AB. Epigenetic modifications as targets to new therapies for Chronic Lymphocytic leukaemia - A preliminary study: PS186. Porto Biomed J 2017; 2:223. [PMID: 32258725 DOI: 10.1016/j.pbj.2017.07.112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- B Ribau
- Department of Chemistry, University of Aveiro, Portugal.,Laboratory of Oncobiology and Hematology (LOH), University Clinic of Hematology and Applied Molecular Biology, FMUC, Portugal
| | - J Jorge
- Laboratory of Oncobiology and Hematology (LOH), University Clinic of Hematology and Applied Molecular Biology, FMUC, Portugal.,CIMAGO - Center of Investigation on Environment Genetics and Oncobiology, Faculty of Medicine, University of Coimbra, Portugal
| | - R Alves
- Laboratory of Oncobiology and Hematology (LOH), University Clinic of Hematology and Applied Molecular Biology, FMUC, Portugal.,Center for Neuroscience and Cell Biology, IBILI (CNC.IBILI), University of Coimbra, Portugal
| | - P I Ribeiro
- CIMAGO - Center of Investigation on Environment Genetics and Oncobiology, Faculty of Medicine, University of Coimbra, Portugal.,Laboratory of Cytogenetics and Genomics (LCG), Faculty of Medicine, University of Coimbra, Portugal
| | - A C Gonçalves
- Laboratory of Oncobiology and Hematology (LOH), University Clinic of Hematology and Applied Molecular Biology, FMUC, Portugal.,Center for Neuroscience and Cell Biology, IBILI (CNC.IBILI), University of Coimbra, Portugal.,CIMAGO - Center of Investigation on Environment Genetics and Oncobiology, Faculty of Medicine, University of Coimbra, Portugal
| | - I M Carreira
- CIMAGO - Center of Investigation on Environment Genetics and Oncobiology, Faculty of Medicine, University of Coimbra, Portugal.,Laboratory of Cytogenetics and Genomics (LCG), Faculty of Medicine, University of Coimbra, Portugal
| | - A B Sarmento-Ribeiro
- Laboratory of Oncobiology and Hematology (LOH), University Clinic of Hematology and Applied Molecular Biology, FMUC, Portugal.,Center for Neuroscience and Cell Biology, IBILI (CNC.IBILI), University of Coimbra, Portugal.,CIMAGO - Center of Investigation on Environment Genetics and Oncobiology, Faculty of Medicine, University of Coimbra, Portugal.,Clinical Hematology Service, University Hospital of Coimbra, Portugal
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Pinto H, Leal R, Rodrigues L, Santos L, Romãozinho C, Macário F, Alves R, Pratas J, Sousa V, Marinho C, Prado E Castro L, Costa F, Campos M, Mota A, Figueiredo A. What Can We Do When All Collapses? Fatal Outcome of Collapsing Glomerulopathy and Systemic Lupus Erythematosus With Diffuse Alveolar Hemorrhage: Case Report. Transplant Proc 2017; 49:913-915. [PMID: 28457424 DOI: 10.1016/j.transproceed.2017.03.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Collapsing glomerulopathy (CG) is a rare form of glomerular injury. Although commonly associated with human immunodeficiency virus (HIV) infection, it can occur in association with systemic lupus erythematosus (SLE). CASE REPORT We present the case of a 50-year-old man, with chronic kidney disease secondary to focal and segmental glomerulosclerosis, who received a cadaveric kidney transplant in 2007. There were no relevant intercurrences until May 2015, when he presented with nephrotic range proteinuria (± 4 g/d). A graft biopsy was performed and it did not show any significant pathological changes. In September, he developed a full nephrotic syndrome (proteinuria 19 g/d) and a graft biopsy was repeated. CG features were evident with a rich immunofluorescence. Antinuclear antibodies (ANA) and anti-double-stranded DNA (anti-dsDNA) antibodies were positive; the remaining immunologic study was normal. Viral markers for HIV, hepatitis C virus (HCV), and hepatitis B virus (HBV) were negative. The patient was treated with corticosteroid pulses and plasmapheresis (seven treatments). A rapid deterioration of kidney function was seen and he became dialysis dependent. He was discharged with a low-dose immunosuppressive treatment. In October, he was hospitalized with diffuse alveolar hemorrhage (DAH). The auto-immune study was repeated, revealing complement consumption and positive titers of ANA and Anti-dsDNA antibodies. Anti-neutrophil cytoplasmic antibodies (ANCAs) and antiglomerular basement membrane antibody (anti-GBM) were negative. Treatment with intravenous corticosteroids, plasmapheresis, and human immunoglobulin was ineffective and the outcome was fatal. CONCLUSION This case report highlights the possible association of CG and SLE. To our knowledge, it is the first case of SLE presenting with CG and DAH, with the singularity of occurring in a kidney transplant recipient receiving immunosuppression.
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Affiliation(s)
- H Pinto
- Nephrology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
| | - R Leal
- Nephrology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - L Rodrigues
- Nephrology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - L Santos
- Nephrology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - C Romãozinho
- Nephrology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - F Macário
- Nephrology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - R Alves
- Nephrology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - J Pratas
- Nephrology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - V Sousa
- Pathology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - C Marinho
- Pathology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - L Prado E Castro
- Pathology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - F Costa
- Nephrology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - M Campos
- Nephrology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - A Mota
- Urology and Renal Transplantation Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - A Figueiredo
- Urology and Renal Transplantation Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
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Pinto H, Leal R, Rodrigues L, Santos L, Romãozinho C, Macário F, Alves R, Bastos C, Roseiro A, Costa F, Campos M, Mota A, Figueiredo A. Surgical Complications in Early Post-transplant Kidney Recipients. Transplant Proc 2017; 49:821-823. [DOI: 10.1016/j.transproceed.2017.03.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Alves R, Sentanin F, Sabadini R, Pawlicka A, Silva M. Innovative electrolytes based on chitosan and thulium for solid state applications: Synthesis, structural, and thermal characterization. J Electroanal Chem (Lausanne) 2017. [DOI: 10.1016/j.jelechem.2017.02.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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26
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Monteiro A, dos Santos K, Alves R, Moreira P, Paiva C, Amparo F, Magnoni C, Kovacs C. SUN-P010: Lipid Targets and Effect of Nutritional Intervation in Patients with Cardiovascular Risk. Clin Nutr 2016. [DOI: 10.1016/s0261-5614(16)30353-3] [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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27
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Amparo F, Magnoni D, Gama K, Monteiro A, Moreira P, Paiva C, Alves R, Kovacs C. SUN-P099: Association the Chronic Kidney Disease (CKD) and Changes in Cardiovascular Risk Factors in Patients from Nutrition Service. Clin Nutr 2016. [DOI: 10.1016/s0261-5614(16)30442-3] [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: 11/27/2022]
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Abstract
There have been few reports of lupus erythematosus tumidus (LET) in the literature. Most of textbooks of dermatology or dermatopathology mention this entity only briefly, if at all. The authors describe an additional case of this underdiagnosed disorder that further supports its existence as a separate entity in the spectrum of the variants of chronic cutaneous lupus erythematosus. Although most cases are reported in the European countries, to our knowledge, this is the first case documented in Portugal. The clinical, photobiological and histological features as well as differential diagnosis, treatment and prognosis are also discussed.
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Affiliation(s)
- M Teixeira
- Department of Dermatology, Hospital Geral de Santo António, Porto, Portugal.
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Child F, Ortiz-Romero PL, Alvarez R, Bagot M, Stadler R, Weichenthal M, Alves R, Quaglino P, Beylot-Barry M, Cowan R, Geskin LJ, Pérez-Ferriols A, Hellemans P, Elsayed Y, Phelps C, Forslund A, Kamida M, Zinzani PL. Phase II multicentre trial of oral quisinostat, a histone deacetylase inhibitor, in patients with previously treated stage IB-IVA mycosis fungoides/Sézary syndrome. Br J Dermatol 2016; 175:80-8. [PMID: 26836950 DOI: 10.1111/bjd.14427] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2016] [Indexed: 01/13/2023]
Abstract
BACKGROUND Quisinostat is a hydroxamate, second-generation, orally available pan-histone deacetylase inhibitor. OBJECTIVES To evaluate the efficacy and safety of oral quisinostat in patients with previously treated cutaneous T-cell lymphoma (CTCL). METHODS Patients received quisinostat 8 mg or 12 mg on days 1, 3 and 5 of each week in 21-day treatment cycles. Primary efficacy end point was cutaneous response rate (RR) based on the modified Severity Weighted Assessment Tool (mSWAT). Secondary end points included global RR, duration of response (DOR) in skin, progression-free survival (PFS), pruritus relief, safety and pharmacodynamic markers. RESULTS Eight of 26 (25 evaluable) patients achieved ≥ 50% reduction in mSWAT score at least once, with confirmed cutaneous response in six (RR 24%). There was a low global RR of 8%. DOR in skin ranged from 2·8 to 6·9 months. Median PFS was 5·1 months. Pruritus relief was more frequent in cutaneous responders (67%) than nonresponders (32%). Serial tumour biopsies revealed an increase in acetylated tubulin, indicating a target effect of histone deacetylase 6. Twenty-one of 26 (81%) patients were withdrawn from the study before or at clinical cut-off; five (19%) continued to receive treatment with quisinostat. The most common drug-related adverse events were nausea, diarrhoea, asthenia, hypertension, thrombocytopenia and vomiting. Grade 3 drug-related adverse events included hypertension, lethargy, pruritus, chills, hyperkalaemia and pyrexia. CONCLUSIONS Quisinostat 12 mg three times weekly is active in the treatment of patients with relapsed or refractory CTCL, with an acceptable safety profile. Combination therapy with other drugs active in CTCL may be appropriate.
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Affiliation(s)
- F Child
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, U.K
| | - P L Ortiz-Romero
- Department of Dermatology, 12 de Octubre Hospital, Institute i+12, Medical School, Complutense University, Madrid, Spain
| | - R Alvarez
- Portuguese Institute of Oncology, Lisbon, Portugal
| | - M Bagot
- Department of Dermatology, Saint-Louis Hospital, Paris 7 University, Paris, France
| | - R Stadler
- Department of Dermatology, Johannes Wesling Medical Center, Minden, Germany
| | - M Weichenthal
- Department of Dermatology, University Hospital of Schleswig-Holstein, Kiel, Germany
| | - R Alves
- Department of Dermatology, Hospital de Santo António - Centro Hospitalar do Porto, Porto, Portugal
| | - P Quaglino
- Department of Medical Sciences, Dermatologic Clinic, University of Turin, Turin, Italy
| | - M Beylot-Barry
- Department of Dermatology, University Hospital of Bordeaux, Bordeaux, France
| | - R Cowan
- Manchester Academic Health Science Centre, Christie Hospital, Manchester, U.K
| | - L J Geskin
- School of Medicine, Department of Dermatology, University of Pittsburgh, Pittsburgh, PA, U.S.A
| | - A Pérez-Ferriols
- Department of Dermatology, University General Hospital, Valencia, Spain
| | - P Hellemans
- Janssen Research & Development, Beerse, Belgium
| | - Y Elsayed
- Janssen Research & Development, Titusville, NJ, U.S.A
| | - C Phelps
- Janssen Research & Development, Titusville, NJ, U.S.A
| | - A Forslund
- Janssen Research & Development, Spring House, PA, U.S.A
| | - M Kamida
- Janssen Pharmaceutical K.K., Tokyo, Japan
| | - P L Zinzani
- Institute of Hematology 'Seràgnoli', University of Bologna, Bologna, Italy
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Agostinho C, Duarte M, Alves R, Cunha I, Batista A. Electroconvulsive therapy in elderly - a preliminary study. Eur Psychiatry 2016. [DOI: 10.1016/j.eurpsy.2016.01.572] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
IntroductionStudies with electroconvulsive therapy (ECT) in elderly focus mainly on the assessment of possible side effects on the cognitive functioning; there are few studies that evaluate the effectiveness.ObjectiveEvaluate the effectiveness of this treatment in the population over 65 years.AimsPerform a preliminary study to evaluate the response to ECT of ≥ 65 years patients with depression.MethodsWe carry out a descriptive study based on patients treated in the last 10 years in the ECT Unit of Centro Hospitalar Psiquiátrico de Lisboa.ResultsOur initial sample consisted of 457 patients. We select patients aged ≥ 65 years with depression, and with complete data, including electroconvulsive parameters, and initial and final Hamilton Rating Scale for Depression (HRSD) scores (n = 59). Of this, 81.36% (n = 48) had unipolar depression, and 18.64% (n = 11) had bipolar depression. In the first group, the mean variation between the initial and final scores in HRSD was 13.88 points, and 27.10% (n = 13) of the patients ended the treatment in the normal range of HRSD score. In the second group, the mean variation was 12.82, and 63.60% (n = 7) ended the treatment in the normal range of HRSD. Considering the initial and final HRSD scores, it appears that unipolar depression group presents higher values (severe depression) (P < 0.05). When we compare the mean variation between the initial and final HRSD scores, we didn’t observe a statistically significant difference between the two groups. There was a clinical improvement in both.ConclusionsThe acute treatment with ECT appears to improve depressive symptoms in bipolar and unipolar depression, when considering an elderly population.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Santos T, Aguiar B, Santos L, Romaozinho C, Tome R, Macario F, Alves R, Campos M, Mota A. Invasive Fungal Infections After Kidney Transplantation: A Single-center Experience. Transplant Proc 2016; 47:971-5. [PMID: 26036497 DOI: 10.1016/j.transproceed.2015.03.040] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Invasive fungal infections (IFI) affecting transplant recipients are associated with increased mortality and graft dysfunction. OBJECTIVE Describe the frequency, clinical features, and outcomes of IFI (except pneumocystis infection) in kidney transplant recipients. METHOD Single-center descriptive study including every kidney transplant recipient with a culture-proven or probable IFI between 2003 and 2013, according to the EORTC-MSG criteria. RESULTS We identified 45 IFI. There were 13 cases of invasive candidiasis (C. albicans: 6 and non-C. albicans candidial spp.: 7), 11 cases of pulmonary aspergillosis (A. fumigatus: 9 and A. flavus: 2); 11 cases of subcutaneous mycosis (Alternaria spp.: 9, Paecilomyces spp.: 1, and Pseudallescheria spp.: 1); 7 cases of cryptococcosis; 2 cases of pneumonia by non-Aspergillus molds (Mucor spp.: 1 and Cunninghamella spp.: 1); and 1 case of Geotrichum capitatum pneumonia. All patients were recipients from deceased donors. Six cases occurred in the first 3 months post-transplant, 15 cases between the third and twelfth months, and 21 cases after the twelfth month. Treatment options were fluconazole for Candida infections, voriconazole or caspofungin for aspergillosis, liposomal amphotericin for cryptococcosis, and itraconazole plus excision or cryotherapy for subcutaneous mycosis. Fifteen patients died (33%). Mortality rates were 15% for invasive candidiasis, 45% for aspergillosis, 71% for cryptococcosis, 100% for non-Aspergillus molds and G. capitatum pneumonia, and 0% for subcutaneous mycosis. Six patients who survived (14%) started regular hemodialysis. CONCLUSION IFI still have a high mortality and morbidity in kidney transplant recipients, as verified in this report. We reinforce the need for a high index of suspicion and prompt treatment.
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Affiliation(s)
- T Santos
- Kidney Transplant Unit, Urology and Kidney Transplant Department, Coimbra University Hospital, Coimbra, Portugal.
| | - B Aguiar
- Kidney Transplant Unit, Urology and Kidney Transplant Department, Coimbra University Hospital, Coimbra, Portugal
| | - L Santos
- Kidney Transplant Unit, Urology and Kidney Transplant Department, Coimbra University Hospital, Coimbra, Portugal
| | - C Romaozinho
- Kidney Transplant Unit, Urology and Kidney Transplant Department, Coimbra University Hospital, Coimbra, Portugal
| | - R Tome
- Clinical Pathology Department, Coimbra University Hospital, Coimbra, Portugal
| | - F Macario
- Kidney Transplant Unit, Urology and Kidney Transplant Department, Coimbra University Hospital, Coimbra, Portugal
| | - R Alves
- Kidney Transplant Unit, Urology and Kidney Transplant Department, Coimbra University Hospital, Coimbra, Portugal
| | - M Campos
- Nephrology Department, Coimbra University Hospital, Coimbra, Portugal
| | - A Mota
- Kidney Transplant Unit, Urology and Kidney Transplant Department, Coimbra University Hospital, Coimbra, Portugal
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Grenha V, Parada B, Ferreira C, Figueiredo A, Macário F, Alves R, Coelho H, Sepúlveda L, Freire MJ, Retroz E, Mota A. Hepatitis B virus, hepatitis C virus, and kidney transplant acute rejection and survival. Transplant Proc 2016; 47:942-5. [PMID: 26036490 DOI: 10.1016/j.transproceed.2015.04.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The effect of hepatitis Bs-antigen (AgHBs) and anti-hepatitis C virus (HCV) positivity on renal transplant outcomes is still controversial. Some studies describe higher rates of acute rejection and allograft loss, and greater mortality in transplant recipients with hepatitis. We retrospectively evaluated data from 2284 allograft recipients who underwent transplantation at our hospital between July 1980 and December 2012. Statistical analysis was made using chi-square and Student t tests, Kaplan-Meier curves, and survival analysis. We identified 62 AgHBs+ patients, 99 anti-HCV+ patients, and 14 AgHBs+/anti-HCV+ patients; 2109 patients had "no hepatitis." Mean follow-up time was 7.93 years. No statistical differences were identified on allograft acute rejection rate or patient survival between groups. AgHBs+ patients had, however, an inferior allograft survival, with statistical significance. According to our study, hepatitis B has a harmful impact on allograft survival, although it does not compromise the patient survival.
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Affiliation(s)
- V Grenha
- Serviço de Urologia e Transplantação Renal, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
| | - B Parada
- Serviço de Urologia e Transplantação Renal, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - C Ferreira
- Serviço de Urologia e Transplantação Renal, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - A Figueiredo
- Serviço de Urologia e Transplantação Renal, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - F Macário
- Serviço de Nefrologia, Centro Hospitalar e Universitário de Coimbra, Praceta Prof. Mota Pinto, Coimbra, Portugal
| | - R Alves
- Serviço de Nefrologia, Centro Hospitalar e Universitário de Coimbra, Praceta Prof. Mota Pinto, Coimbra, Portugal
| | - H Coelho
- Serviço de Urologia e Transplantação Renal, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - L Sepúlveda
- Serviço de Urologia e Transplantação Renal, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - M J Freire
- Serviço de Urologia e Transplantação Renal, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - E Retroz
- Serviço de Urologia e Transplantação Renal, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - A Mota
- Serviço de Urologia e Transplantação Renal, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
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Mamede AC, Guerra S, Laranjo M, Carvalho MJ, Oliveira RC, Gonçalves AC, Alves R, Prado Castro L, Sarmento-Ribeiro AB, Moura P, Abrantes AM, Maia CJ, Botelho MF. Selective cytotoxicity and cell death induced by human amniotic membrane in hepatocellular carcinoma. Med Oncol 2015; 32:257. [PMID: 26507652 DOI: 10.1007/s12032-015-0702-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 10/12/2015] [Indexed: 12/20/2022]
Abstract
Hepatocellular carcinoma (HCC) has a worldwide high incidence and mortality. For this reason, it is essential to invest in new therapies for this type of cancer. Our team already proved that human amniotic membrane (hAM) is able to inhibit the metabolic activity of several human cancer cell lines, including HCC cell lines. Taking into account the previously performed work, this experimental study aimed to investigate the pathways by which hAM protein extracts (hAMPEs) act on HCC. Our results showed that hAMPE reduce the metabolic activity, protein content and DNA content in a dose- and time-dependent manner in all HCC cell lines. This therapy presents selective cytotoxicity, since it was not able to inhibit a non-tumorigenic human cell line. In addition, hAMPE induced cell morphology alterations in all HCC cell lines, but death type is cell line dependent, as proved by in vitro and in vivo studies. In conclusion, hAMPE have a promising role in HCC therapy, since it is capable of inducing HCC cytotoxicity and cell death.
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Affiliation(s)
- A C Mamede
- Biophysics Unit, Faculty of Medicine, University of Coimbra, Azinhaga de Santa Comba - Celas, 3000-548, Coimbra, Portugal. .,CICS-UBI, Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal. .,CIMAGO, Faculty of Medicine, University of Coimbra, Coimbra, Portugal. .,CNC.IBILI, University of Coimbra, Coimbra, Portugal.
| | - S Guerra
- Biophysics Unit, Faculty of Medicine, University of Coimbra, Azinhaga de Santa Comba - Celas, 3000-548, Coimbra, Portugal.
| | - M Laranjo
- Biophysics Unit, Faculty of Medicine, University of Coimbra, Azinhaga de Santa Comba - Celas, 3000-548, Coimbra, Portugal.,CIMAGO, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,CNC.IBILI, University of Coimbra, Coimbra, Portugal
| | - M J Carvalho
- Biophysics Unit, Faculty of Medicine, University of Coimbra, Azinhaga de Santa Comba - Celas, 3000-548, Coimbra, Portugal.,CIMAGO, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,CNC.IBILI, University of Coimbra, Coimbra, Portugal.,Obstetrics Service, Coimbra Hospital and University Centre, Coimbra, Portugal
| | - R C Oliveira
- Biophysics Unit, Faculty of Medicine, University of Coimbra, Azinhaga de Santa Comba - Celas, 3000-548, Coimbra, Portugal.,Anatomic Pathology Service, Coimbra Hospital and University Centre, Coimbra, Portugal
| | - A C Gonçalves
- CIMAGO, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,CNC.IBILI, University of Coimbra, Coimbra, Portugal.,Applied Molecular Biology and Hematology Group, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - R Alves
- CNC.IBILI, University of Coimbra, Coimbra, Portugal.,Applied Molecular Biology and Hematology Group, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - L Prado Castro
- Anatomic Pathology Service, Coimbra Hospital and University Centre, Coimbra, Portugal
| | - A B Sarmento-Ribeiro
- CIMAGO, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,CNC.IBILI, University of Coimbra, Coimbra, Portugal.,Applied Molecular Biology and Hematology Group, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - P Moura
- Obstetrics Service, Coimbra Hospital and University Centre, Coimbra, Portugal
| | - A M Abrantes
- Biophysics Unit, Faculty of Medicine, University of Coimbra, Azinhaga de Santa Comba - Celas, 3000-548, Coimbra, Portugal.,CIMAGO, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,CNC.IBILI, University of Coimbra, Coimbra, Portugal
| | - C J Maia
- CICS-UBI, Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
| | - M F Botelho
- Biophysics Unit, Faculty of Medicine, University of Coimbra, Azinhaga de Santa Comba - Celas, 3000-548, Coimbra, Portugal.,CIMAGO, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,CNC.IBILI, University of Coimbra, Coimbra, Portugal
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Alves R, Melo L, Kiso K, Sprovieri S. Profile of patients with acute coronary syndrome in public hospital of São Paulo, Brazil. Atherosclerosis 2015. [DOI: 10.1016/j.atherosclerosis.2015.04.474] [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: 12/01/2022]
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Santos T, Santos L, Macário F, Romãozinho C, Alves R, Campos M, Mota A. New Recipes With Known Ingredients: Combined Therapy of Everolimus and Low-dose Tacrolimus in De Novo Renal Allograft Recipients. Transplant Proc 2015; 47:906-10. [PMID: 26036483 DOI: 10.1016/j.transproceed.2015.03.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Calcineurin inhibitors (CNIs) are the cornerstones of immunosuppressive management in renal allograft recipients even though their nephrotoxicity may contribute to a reduced long-term graft survival. This has created a great interest in improving immunosuppressive strategies in the early post-transplantation period. Proliferation signal inhibitors (PSIs), such as everolimus, are promising alternatives, although their side effects may have a drawback in de novo renal transplant recipients, for instance, delaying renal function in the presence of renal ischemia/acute tubular necrosis and predisposing to lymphocele development. STUDY AND METHODS A retrospective study was developed to compare the combined therapy of low-dose tacrolimus and everolimus (study group) with mycophenolate mofetil/mycophenolic acid and standard-dose tacrolimus (control group) in the first 3 months post-transplantation. The study's end-points concerned renal graft function, proteinuria, incidence of biopsy-proven acute rejection, surgical complication rates, and incidence of new-onset diabetes after renal transplantation. RESULTS There was no more delayed graft function in the study group and graft function distribution was similar between groups. Median serum creatinine and eGFR were comparable as well as proteinuria levels. Generally, adverse events were rare in both groups and there were no significant statistical differences between them in terms of biopsy-proven acute rejection, surgical complication, and new-onset diabetes after renal transplantation rates. CONCLUSION Despite the slightly lower tendency for serum creatinine in the study group, renal allograft function wasn't statistically different between groups. Moreover, there weren't more metabolic or surgical complications in the study group. Everolimus may be a choice in tacrolimus-sparing strategies, but a larger study and a longer follow-up are still required.
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Affiliation(s)
- T Santos
- Nephrology Department, CHUC, Coimbra, Portugal.
| | - L Santos
- Nephrology Department, CHUC, Coimbra, Portugal
| | - F Macário
- Nephrology Department, CHUC, Coimbra, Portugal
| | | | - R Alves
- Nephrology Department, CHUC, Coimbra, Portugal
| | - M Campos
- Nephrology Department, CHUC, Coimbra, Portugal
| | - A Mota
- Urology and Kidney Transplantation Department, CHUC, Coimbra, Portugal
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Aguiar B, Santos Amorim T, Romãozinho C, Santos L, Macário F, Alves R, Campos M, Mota A. Malignancy in Kidney Transplantation: A 25-Year Single-center Experience in Portugal. Transplant Proc 2015; 47:976-80. [DOI: 10.1016/j.transproceed.2015.03.039] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Guedes-Marques M, Romãozinho C, Santos L, Macário F, Alves R, Mota A. Kidney Transplantation: Which Variables Should Be Improved? Transplant Proc 2015; 47:914-9. [DOI: 10.1016/j.transproceed.2015.03.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Dinis P, Nunes P, Marconi L, Furriel F, Parada B, Moreira P, Figueiredo A, Bastos C, Roseiro A, Dias V, Rolo F, Alves R, Mota A. Small Kidneys for Large Recipients: Does Size Matter in Renal Transplantation? Transplant Proc 2015; 47:920-5. [DOI: 10.1016/j.transproceed.2015.03.035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Sereno J, Vala H, Nunes S, Rocha-Pereira P, Carvalho E, Alves R, Teixeira F, Reis F. Cyclosporine A-induced nephrotoxicity is ameliorated by dose reduction and conversion to sirolimus in the rat. J Physiol Pharmacol 2015; 66:285-299. [PMID: 25903959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 02/13/2015] [Indexed: 06/04/2023]
Abstract
Side-effect minimization strategies to avoid serious side-effects of cyclosporine A (CsA), such as nephrotoxicity, have been mainly based on dose reduction and conversion to other putatively less nephrotoxic drugs, such as sirolimus (SRL), an inhibitor of the mammalian target of rapamycin. This study intended to evaluate the impact of protocols based on CsA dose reduction and further conversion to SRL on kidney function and lesions, based on serum, urine and renal tissue markers. The following 3 groups (n=6) were tested during a 9-week protocol: control (vehicle); CsA (5 mg/kg/day) and Red + Conv (CsA 30 mg/kg/day during 3 weeks + 3 weeks with CsA 5 mg/kg/day + SRL 1 mg/kg/day during the last 3 weeks). The following parameters were analysed: blood pressure, heart rate and biochemical data; serum and urine contents and clearances of creatinine, urea and neutrophil gelatinase-associated lipocalin (NGAL), as well as, glomerular filtration rate; kidney lipid peroxidation and clearance; kidney lesions were evaluated and protein expression was performed by immunohistochemistry. After the first 3 weeks of CsA (30 mg/kg/day) treatment animals showed body weight loss, hypertension, tachycardia, as well as, increased serum levels of non-HDL cholesterol, glucose, triglycerides, creatinine and urea, accompanied by decreased GFR and insulin levels. In addition, a significant increase in the expression of connective tissue growth factor, kidney injury molecule-1 (KIM-1), mammalian target of rapamycin, nuclear factor-κβ1 and transforming growth factor-β was found in the kidney, accompanied by extensive renal damage. The following 3 weeks with CsA dose reduction revealed amelioration of vascular and glomerular lesions, but without significant tubular improvement. The last 3 weeks with the conversion to sirolimus revealed high serum and urine NGAL contents but the CsA-evoked renal damage was substantially ameliorated, by reduced of connective tissue growth factor, mammalian target of rapamycin, nuclear factor-κβ1 protein expression. In conclusion, CsA nephrotoxicity is dose dependent and moderate dysfunction could be ameliorated/prevented by SRL conversion, which could be pivotal for the preservation of kidney function and structure.
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Affiliation(s)
- J Sereno
- Laboratory of Pharmacology and Experimental Therapeutics, Institute for Biomedical Imaging and Life Sciences, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
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Jesus G, Alves R, Cotta C. Perioperative Management of Psychotropics. Eur Psychiatry 2015. [DOI: 10.1016/s0924-9338(15)31456-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Maia JM, Alves R, Faria R, Farinha F. She could no longer wear a hat: Paget's disease. Case Reports 2014; 2014:bcr-2014-207515. [DOI: 10.1136/bcr-2014-207515] [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: 11/04/2022] Open
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Nabais Sá MJ, Storey H, Flinter F, Nagel M, Sampaio S, Castro R, Araújo JA, Gaspar MA, Soares C, Oliveira A, Henriques AC, da Costa AG, Abreu CP, Ponce P, Alves R, Pinho L, Silva SE, de Moura CP, Mendonça L, Carvalho F, Pestana M, Alves S, Carvalho F, Oliveira JP. Collagen type IV-related nephropathies in Portugal: pathogenic COL4A3 and COL4A4 mutations and clinical characterization of 25 families. Clin Genet 2014; 88:456-61. [PMID: 25307543 DOI: 10.1111/cge.12521] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2014] [Revised: 10/04/2014] [Accepted: 10/06/2014] [Indexed: 12/22/2022]
Abstract
Pathogenic mutations in genes COL4A3/COL4A4 are responsible for autosomal Alport syndrome (AS) and thin basement membrane nephropathy (TBMN). We used Sanger sequencing to analyze all exons and splice site regions of COL4A3/COL4A4, in 40 unrelated Portuguese probands with clinical suspicion of AS/TBMN. To assess genotype-phenotype correlations, we compared clinically relevant phenotypes/outcomes between homozygous/compound heterozygous and apparently heterozygous patients. Seventeen novel and four reportedly pathogenic COL4A3/COL4A4 mutations were identified in 62.5% (25/40) of the probands. Regardless of the mutated gene, all patients with ARAS manifested chronic renal failure (CRF) and hearing loss, whereas a minority of the apparently heterozygous patients had CRF or extrarenal symptoms. CRF was diagnosed at a significantly younger age in patients with ARAS. In our families, the occurrence of COL4A3/COL4A4 mutations was higher, while the prevalence of XLAS was lower than expected. Overall, a pathogenic COL4A3/COL4A4/COL4A5 mutation was identified in >50% of patients with fewer than three of the standard diagnostic criteria of AS. With such a population background, simultaneous next-generation sequencing of all three genes may be recommended as the most expedite approach to diagnose collagen IV-related glomerular basement membrane nephropathies.
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Affiliation(s)
- M J Nabais Sá
- Department of Genetics, Faculty of Medicine, Porto, Portugal.,Unit of Research and Development of Nephrology (FCT-725), Faculty of Medicine, University of Porto, Porto, Portugal
| | - H Storey
- Molecular Genetics Laboratory, Viapath, UK
| | - F Flinter
- Genetics Centre, Guy's and St. Thomas' Hospital National Health Service Foundation Trust, London, UK
| | - M Nagel
- Center for Nephrology and Metabolic Diseases, Weisswasser, Germany
| | - S Sampaio
- Unit of Research and Development of Nephrology (FCT-725), Faculty of Medicine, University of Porto, Porto, Portugal.,Department of Nephrology, Hospital de São João, Porto, Portugal
| | - R Castro
- Department of Nephrology, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - J A Araújo
- Department of Nephrology, Hospital dos Marmeleiros, Funchal, Portugal
| | - M A Gaspar
- Dialysis Clinic, NephroCare Restelo, Fresenius Medical Care, Lisboa, Portugal
| | - C Soares
- Department of Nephrology, Hospital de Braga, Braga, Portugal
| | - A Oliveira
- Dialysis Clinic Paredes, Diaverum, Paredes, Portugal
| | - A C Henriques
- Dialysis Clinic, NephroCare Braga, Fresenius Medical Care, Braga, Portugal
| | - A G da Costa
- Department of Nephrology, Hospital de Santa Maria, Lisboa, Portugal
| | - C P Abreu
- Dialysis Clinic Lumiar, Diaverum, Lisboa, Portugal
| | - P Ponce
- Dialysis Clinic, NephroCare Lumiar, Fresenius Medical Care, Lisboa, Portugal
| | - R Alves
- Dialysis Clinic, NephroCare Viseu, Fresenius Medical Care, Viseu, Portugal
| | - L Pinho
- Dialysis Clinic Paredes, Diaverum, Paredes, Portugal
| | - S E Silva
- Department of Ophthalmology, Porto, Portugal
| | - C P de Moura
- Department of Otolaryngology, Porto, Portugal.,Medical Genetics Outpatient Clinic, Hospital de São João, Porto, Portugal
| | - L Mendonça
- Department of Ophthalmology, Hospital de Braga, Braga, Portugal
| | - F Carvalho
- Unit of Renal Morphology, Department of Nephrology, Hospital Curry Cabral, Lisboa, Portugal
| | - M Pestana
- Unit of Research and Development of Nephrology (FCT-725), Faculty of Medicine, University of Porto, Porto, Portugal.,Department of Nephrology, Hospital de São João, Porto, Portugal
| | - S Alves
- Department of Genetics, Faculty of Medicine, Porto, Portugal
| | - F Carvalho
- Department of Genetics, Faculty of Medicine, Porto, Portugal
| | - J P Oliveira
- Department of Genetics, Faculty of Medicine, Porto, Portugal.,Unit of Research and Development of Nephrology (FCT-725), Faculty of Medicine, University of Porto, Porto, Portugal.,Medical Genetics Outpatient Clinic, Hospital de São João, Porto, Portugal
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Nabais Sá MJ, Sampaio S, Oliveira A, Alves S, Moura CP, Silva SE, Castro R, Araújo JA, Rodrigues M, Neves F, Seabra J, Soares C, Gaspar MA, Tavares I, Freitas L, Sousa TC, Henriques AC, Costa FT, Morgado E, Sousa FT, Sousa JP, da Costa AG, Filipe R, Garrido J, Montalban J, Ponce P, Alves R, Faria B, Carvalho MF, Pestana M, Carvalho F, Oliveira JP. Collagen type IV-related nephropathies in Portugal: pathogenic COL4A5 mutations and clinical characterization of 22 families. Clin Genet 2014; 88:462-7. [PMID: 25307721 DOI: 10.1111/cge.12522] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Revised: 10/08/2014] [Accepted: 10/08/2014] [Indexed: 11/28/2022]
Abstract
Alport syndrome (AS) is caused by pathogenic mutations in the genes encoding α3, α4 or α5 chains of collagen IV (COL4A3/COL4A4/COL4A5), resulting in hematuria, chronic renal failure (CRF), sensorineural hearing loss (SNHL) and ocular abnormalities. Mutations in the X-linked COL4A5 gene have been identified in 85% of the families (XLAS). In this study, 22 of 60 probands (37%) of unrelated Portuguese families, with clinical diagnosis of AS and no evidence of autosomal inheritance, had pathogenic COL4A5 mutations detected by Sanger sequencing and/or multiplex-ligation probe amplification, of which 12 (57%) are novel. Males had more severe and earlier renal and extrarenal complications, but microscopic hematuria was a constant finding irrespective of gender. Nonsense and splice site mutations, as well as small and large deletions, were associated with younger age of onset of SNHL in males, and with higher risk of CRF and SNHL in females. Pathogenic COL4A3 or COL4A4 mutations were subsequently identified in more than half of the families without a pathogenic mutation in COL4A5. The lower than expected prevalence of XLAS in Portuguese families warrants the use of next-generation sequencing for simultaneous COL4A3/COL4A4/COL4A5 analysis, as first-tier approach to the genetic diagnosis of collagen type IV-related nephropathies.
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Affiliation(s)
- M J Nabais Sá
- Department of Genetics, Faculty of Medicine, Porto, Portugal.,Unit of Research and Development of Nephrology (FCT-725), Faculty of Medicine, University of Porto, Porto, Portugal
| | - S Sampaio
- Unit of Research and Development of Nephrology (FCT-725), Faculty of Medicine, University of Porto, Porto, Portugal.,Department of Nephrology, Porto, Portugal
| | - A Oliveira
- Department of Nephrology, Porto, Portugal
| | - S Alves
- Department of Genetics, Faculty of Medicine, Porto, Portugal
| | - C P Moura
- Department of Otolaryngology, Porto, Portugal.,Medical Genetics Outpatient Clinic, Porto, Portugal
| | - S E Silva
- Department of Ophthalmology, Hospital de São João, Porto, Portugal
| | - R Castro
- Department of Nephrology, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - J A Araújo
- Department of Nephrology, Hospital dos Marmeleiros, Funchal, Portugal
| | - M Rodrigues
- Department of Medical Genetics, Hospital Dona Estefânia, Lisboa, Portugal
| | - F Neves
- Dialysis Clinic of Santarém, NephroCare-Portugal, Santarém, Portugal
| | - J Seabra
- Department of Nephrology, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - C Soares
- Department of Nephrology, Hospital de Braga, Braga, Portugal
| | - M A Gaspar
- Dialysis Clinic of Restelo, NephroCare-Portugal, Lisboa, Portugal
| | - I Tavares
- Unit of Research and Development of Nephrology (FCT-725), Faculty of Medicine, University of Porto, Porto, Portugal.,Dialysis Clinic of Santo Tirso, Uninefro, Santo Tirso, Portugal
| | - L Freitas
- Department of Nephrology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - T C Sousa
- Department of Nephrology, Hospital de São Teotónio, Viseu, Portugal.,Dialysis Clinic of Guarda, NephroCare-Portugal, Guarda, Portugal
| | - A C Henriques
- Dialysis Clinic of Braga, NephroCare-Portugal, Braga, Portugal
| | - F T Costa
- Department of Nephrology, Hospital Garcia de Orta, Almada, Portugal
| | - E Morgado
- Department of Nephrology, Hospital de Faro, Faro, Portugal
| | - F T Sousa
- Dialysis Clinic of Montijo, NephroCare-Portugal, Montijo, Portugal
| | - J P Sousa
- Department of Nephrology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.,Dialysis Clinic of Coimbra, NephroCare-Portugal, Coimbra, Portugal
| | - A G da Costa
- Department of Nephrology, Hospital de Santa Maria, Lisboa, Portugal
| | - R Filipe
- Department of Nephrology, Hospital Amato Lusitano, Castelo Branco, Portugal
| | - J Garrido
- Department of Nephrology, Hospital de São Teotónio, Viseu, Portugal
| | - J Montalban
- Dialysis Clinic of Covilhã, NephroCare-Portugal, Covilhã, Portugal
| | - P Ponce
- Dialysis Clinic of Lumiar, NephroCare-Portugal, Lisboa, Portugal
| | - R Alves
- Dialysis Clinic of Viseu, NephroCare-Portugal, Viseu, Portugal
| | - B Faria
- Dialysis Clinic of Guarda, NephroCare-Portugal, Guarda, Portugal
| | - M F Carvalho
- Unit of Renal Morphology, Department of Nephrology, Hospital Curry Cabral, Lisboa, Portugal
| | - M Pestana
- Unit of Research and Development of Nephrology (FCT-725), Faculty of Medicine, University of Porto, Porto, Portugal.,Department of Nephrology, Porto, Portugal
| | - F Carvalho
- Department of Genetics, Faculty of Medicine, Porto, Portugal
| | - J P Oliveira
- Department of Genetics, Faculty of Medicine, Porto, Portugal.,Unit of Research and Development of Nephrology (FCT-725), Faculty of Medicine, University of Porto, Porto, Portugal.,Medical Genetics Outpatient Clinic, Porto, Portugal
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Jorge J, Cortesão E, Gonçalves A, Pires A, Alves R, Moucho C, Rito L, Magalhães E, Carda J, Geraldes C, Espadana A, Pereira M, Dourado M, Ribeiro L, Nascimento-Costa J, Sarmento-Ribeiro A. Gene Methylation in Myelodysplastic Syndrome – a Comparative Study Between Bone Marrow and Peripheral Blood. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu339.32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Colmán A, da Silva RA, Alves R, Silva M, Barreto RW. First Report of Stigmina palmivora Causing Leaf Spots on Phoenix roebelenii in Brazil. Plant Dis 2014; 98:849. [PMID: 30708661 DOI: 10.1094/pdis-10-13-1030-pdn] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Phoenix roebelenii (Arecaceae), known as dwarf date (tamareira-anã in Brazil), is a palm native to Southeast Asia and widely cultivated worldwide because of its ornamental value and ease of adaptation to a broad range of climates and soil types (4). In June 2012, some individuals were observed in a private garden in the municipality of Viçosa (state of Minas Gerais, Brazil) bearing numerous necrotic lesions on its leaves. Representative samples were taken, dried in a plant press, and brought to the laboratory for examination. A fungus was regularly associated with the leaf spots. Fungal structures were mounted in lactophenol and slides were examined under a microscope (Olympus BX 51). Spores were taken from sporulating colonies with a sterile fine needle and plated on PDA for isolation. A pure culture was deposited in the culture collection of the Universidade Federal de Viçosa (accession COAD1338). A dried herbarium sample was deposited in the local herbarium (VIC39741). The fungus had the following morphology: conidiophores grouped on sporodochia, cylindrical, 12 to 29 × 5 to 6 μm, dark brown; conidiogenous cells, terminal, proliferating percurrently (annellidic), 8 to 20 × 5 to 6 μm, pale to dark brown; conidia obclavate to subcylindrical, straight, 58 to 147 × 5 to 6 μm, 6 to 16 septate, hila thickened and darkened with a thin-walled projecting papilla, dark brown, and verrucose. The morphology of the Brazilian collections agrees well with the description of Stigmina palmivora (2), a species known to cause leaf spots on P. roebelenii in the United States (Florida) and Japan (3). Pathogenicity was demonstrated through inoculation of leaves of healthy plants by placing 6 mm diameter cuture disks of COAD1338 on the leaf surface followed by incubation in a moist chamber for 48 h and then transferred to a greenhouse bench at 21 ± 3°C. Typical leaf spots were observed 15 days after inoculation. DNA was extracted from the isolate growing in pure culture and ITS and LSU sequences were generated and deposited in GenBank under the accession numbers KF656785 and KF656786, respectively. These were compared by BLASTn with other entries in GenBank, and the closest match for each region were Mycosphaerella colombiensis strain X215 and M. irregulariamosa strain CPC 1362 (EU514231, GU2114441) with 93% of nucleotide homology (over 100% query coverage) for ITS and 98% of nucleotide homology (over 100% query coverage) for LSU. There are no sequences for S. palmivora deposited in public databases for comparison, but for Stigmina platani, the type species in this genus, 86% and 96% nucleotide homology for ITS and LSU with S. palmivora were found. The genus Stigmina is regarded as being polyphyletic (1) and this is probably reflected by these low homology levels found in the BLASTn search. To our knowledge, this is the first report of Stigmina palmivora in Brazil. References: (1) P. W. Crous et al. Stud. Mycol. 75:37, 2012. (2) M. B. Ellis. Dematiaceous Hyphomycetes. Commonwealth Mycological Institute, Kew, UK, 1971. (3) D. F. Farr and A. Y. Rossman. Fungal Databases. Syst. Mycol. Microbiol. Lab. ARS, USDA. Retrieved from http://nt.ars-grin.gov/fungaldatabases/ , 2013. (4) H. Lorenzi et al. Palmeira no Brasil: Exóticas e Nativas, 2nd ed. Editora Plantarum, Nova Odessa, Brazil, 2005.
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Affiliation(s)
- A Colmán
- Departamento de Fitopatologia, Universidade Federal de Viçosa, Viçosa, Minas Gerais, 36570-000, Brazil
| | - R A da Silva
- Departamento de Fitopatologia, Universidade Federal de Viçosa, Viçosa, Minas Gerais, 36570-000, Brazil
| | - R Alves
- Departamento de Fitopatologia, Universidade Federal de Viçosa, Viçosa, Minas Gerais, 36570-000, Brazil
| | - M Silva
- Departamento de Fitopatologia, Universidade Federal de Viçosa, Viçosa, Minas Gerais, 36570-000, Brazil
| | - R W Barreto
- Departamento de Fitopatologia, Universidade Federal de Viçosa, Viçosa, Minas Gerais, 36570-000, Brazil
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Pereira Jr J, Hallinan M, Alves R. Therapeutic use of Saint John’s wort in RLS/Willis Ekbom’s disease. Sleep Med 2013. [DOI: 10.1016/j.sleep.2013.11.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Cotovio P, Neves M, Rodrigues L, Alves R, Bastos M, Baptista C, Macário F, Mota A. New-onset diabetes after transplantation: assessment of risk factors and clinical outcomes. Transplant Proc 2013; 45:1079-83. [PMID: 23622631 DOI: 10.1016/j.transproceed.2013.03.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND New-onset diabetes after transplantation (NODAT) is a serious complicatin of kidney transplantation (KT) with adverse impacts on graft and patient survivals. This study aims assess potential risk factors for development of NODAT and compare clinical outcomes of KT recipients with versus without NODAT. METHODS We retrospectively evaluated 648 patients who underwent KT between 2005 and 2009. From the 83 (12.8%) subjects who developed NODAT, we selected 47 for comparison with controls free of diabetes. RESULTS The diagnosis of NODAT was made at 4.3 ± 8.5 months after transplantation in 47 patients, including 76.6% males, with an overall mean age of 54.5 ± 10.8 years. Patients with NODAT presented higher pretransplantation fasting plasma glucose levels (P < .001) as well as cyclosporine and tacrolimus trough levels (P = .003 and P < .001, respectively). On multivariate analysis, higher pretransplantation fasting plasma glucose and higher tacrolimus, but not cyclosporine concentrations were independent predictors of NODAT. No differences were found for other potential risk factors. Upon follow-up at 6, 12, 24, 36, 48, and 60 months, renal function (estimated Glomerular Filtration Rate using Modification of Diet in Renal Disease), 24 hour proteinuria and proportions of patients with hypertension were similar between groups. Patients with NODAT showed comparable numbers of hospitalizations and infections, as well as acute rejection episodes and acute cardiovascular events as their counterparts. Event-free survival (loss of graft function/death with functioning graft) was similar between the groups (P = .418; K-M). DISCUSSION In our population, higher pretransplantation fasting plasma glucose levels and higher tacrolimus concentrations were independent predictors of NODAT. During a mean follow-up of 3 years, NODAT was not associated with worse clinical outcomes.
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Affiliation(s)
- P Cotovio
- Department of Nephrology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
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50
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Planeta CS, Lepsch LB, Alves R, Scavone C. Influence of the dopaminergic system, CREB, and transcription factor-κB on cocaine neurotoxicity. Braz J Med Biol Res 2013; 46:909-915. [PMID: 24141554 PMCID: PMC3854330 DOI: 10.1590/1414-431x20133379] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2013] [Accepted: 08/19/2013] [Indexed: 01/04/2023] Open
Abstract
Cocaine is a widely used drug and its abuse is associated with physical, psychiatric
and social problems. Abnormalities in newborns have been demonstrated to be due to
the toxic effects of cocaine during fetal development. The mechanism by which cocaine
causes neurological damage is complex and involves interactions of the drug with
several neurotransmitter systems, such as the increase of extracellular levels of
dopamine and free radicals, and modulation of transcription factors. The aim of this
review was to evaluate the importance of the dopaminergic system and the
participation of inflammatory signaling in cocaine neurotoxicity. Our study showed
that cocaine activates the transcription factors NF-κB and CREB, which regulate genes
involved in cellular death. GBR 12909 (an inhibitor of dopamine reuptake), lidocaine
(a local anesthetic), and dopamine did not activate NF-κB in the same way as cocaine.
However, the attenuation of NF-κB activity after the pretreatment of the cells with
SCH 23390, a D1 receptor antagonist, suggests that the activation of NF-κB by cocaine
is, at least partially, due to activation of D1 receptors. NF-κB seems to have a
protective role in these cells because its inhibition increased cellular death caused
by cocaine. The increase in BDNF (brain-derived neurotrophic factor) mRNA can also be
related to the protective role of both CREB and NF-κB transcription factors. An
understanding of the mechanisms by which cocaine induces cell death in the brain will
contribute to the development of new therapies for drug abusers, which can help to
slow down the progress of degenerative processes.
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Affiliation(s)
- C S Planeta
- Universidade Estadual Paulista, Laboratório de Neuropsicofarmacologia, Faculdade de Ciências Farmacêuticas, AraraquaraSP, Brasil
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