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Bock PM, Martins AF, Ramalho R, Telo GH, Leivas G, Maraschin CK, Schaan BD. The impact of dietary, surgical, and pharmacological interventions on gut microbiota in individuals with diabetes mellitus: A systematic review. Diabetes Res Clin Pract 2022; 189:109944. [PMID: 35697155 DOI: 10.1016/j.diabres.2022.109944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 05/09/2022] [Accepted: 06/06/2022] [Indexed: 11/03/2022]
Abstract
AIMS To conduct a systematic review assessing the association between dietary, surgical, and pharmacological interventions and changes in the gut microbiota of individuals with diabetes. METHODS The MEDLINE, EMBASE, and Cochrane Library databases were searched focusing on the effects of dietary, bariatric surgery, and pharmacological interventions on gut microbiota in adults with diabetes. Studies were classified based on qualitative changes using a simple vote-counting method, evaluating reduction, no effect, or an increase in the gut microbiota outcomes. RESULTS 6,004 studies were retained to review their titles and abstracts. A total of 149 full-text articles were reassessed, of which 49 were included in the final analysis. This review indicates that dietary, surgical, and pharmacological interventions increase or decrease bacterial populations from more than 60 families, genera, or species. In general, the interventions led to an increase in the bacterial population from phylum Firmicutes, mainly Lactobacillus species, compared to the gram-negative bacterial population from phylum Bacteroidetes. CONCLUSIONS The results of the included studies suggest that interventions aimed at reducing species related to uncontrolled diabetes and increasing species related to the healthy gut are potential adjuvants in treating diabetes; however, well-conducted interventional studies targeting gut microbiota are necessary.
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Affiliation(s)
- Patricia M Bock
- Universidade Federal do Rio Grande do Sul, Faculty of Medicine, Department of Internal Medicine, Graduate Program in Medical Sciences: Endocrinology, Porto Alegre, Brazil; Faculdades Integradas de Taquara, Taquara, Brazil; National Institute of Science and Technology for Health Technology Assessment (IATS) - CNPq/Brazil, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
| | - Andreza F Martins
- Universidade Federal do Rio Grande do Sul, Department of Microbiology, Immunology, and Parasitology, Porto Alegre, Brazil
| | - Rafaela Ramalho
- Universidade Federal do Rio Grande do Sul, Department of Microbiology, Immunology, and Parasitology, Porto Alegre, Brazil
| | - Gabriela H Telo
- Pontifícia Universidade Católica do Rio Grande do Sul, School of Medicine, Internal Medicine Division, Porto Alegre, Brazil
| | - Gabriel Leivas
- Universidade Federal do Rio Grande do Sul, Faculty of Medicine, Department of Internal Medicine, Graduate Program in Medical Sciences: Endocrinology, Porto Alegre, Brazil
| | - Clara K Maraschin
- Universidade Federal do Rio Grande do Sul, Faculty of Medicine, Department of Internal Medicine, Graduate Program in Medical Sciences: Endocrinology, Porto Alegre, Brazil
| | - Beatriz D Schaan
- Universidade Federal do Rio Grande do Sul, Faculty of Medicine, Department of Internal Medicine, Graduate Program in Medical Sciences: Endocrinology, Porto Alegre, Brazil; National Institute of Science and Technology for Health Technology Assessment (IATS) - CNPq/Brazil, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Endocrine Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
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Ramalho R, Mezzomo LC, Machado W, da Silva Morais Hein C, Müller CZ, da Silva TCB, Jank L, Lamas AE, da Costa Ballestrin RA, Wink PL, Lima AAD, Corção G, Martins AF. The occurrence of antimicrobial residues and antimicrobial resistance genes in urban drinking water and sewage in Southern Brazil. Braz J Microbiol 2022; 53:1483-1489. [PMID: 35764766 DOI: 10.1007/s42770-022-00786-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 06/18/2022] [Indexed: 11/25/2022] Open
Abstract
Antimicrobial resistance (AMR) is currently discussed as an important issue worldwide, and the presence of antimicrobial residues (ARs) and antimicrobial resistance genes (ARGs) in the environment, especially in the water sources, is a challenge for public health. This study was conducted to evaluate the occurrence and diversity of AR and ARG in water sources from an urban center, in Southern Brazil. A total of thirty-two water samples from drinking water treatment plants (24) and sewage systems (8) were collected during two annual samplings, winter and summer. The PCR was performed by 18 ARGs, and the detection of 47 ARs was performed by LC-MS/MS. All sewage samples presented carbapenemases, ESBL, and mcr-1 genes as well as quinolones and sulfamethoxazole residues. In drinking water, we just detected blaTEM and tetB genes and doxycycline residues in samples before treatment. This study provides data about AR and ARG in drinking water and sewage systems showing that these sources are important reservoirs of both. The limited effectiveness of wastewater treatment processes to remove mainly AR demonstrates the need to implement better protocols of disinfection, in order to limit the spread of AMR in the environment.
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Affiliation(s)
- Rafaela Ramalho
- Programa de Pós-Graduação Em Ciências Farmacêuticas, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil
| | - Lisiane Cervieri Mezzomo
- Programa de Pós-Graduação Em Ciências Farmacêuticas, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil
| | - William Machado
- Programa de Pós-Graduação Em Microbiologia Agrícola E Do Ambiente, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil
| | - Camila da Silva Morais Hein
- Programa de Pós-Graduação Em Microbiologia Agrícola E Do Ambiente, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil
| | | | | | - Louise Jank
- Laboratório Federal de Defesa Agropecuária - LFDA/RS, Ministério da Agricultura, Pecuária e Abastecimento,, Porto Alegre, Brazil
| | | | | | - Priscila Lamb Wink
- Laboratório de Pesquisa Em Resistência Bacteriana, LABRESIS, Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | | | - Gertrudes Corção
- Programa de Pós-Graduação Em Microbiologia Agrícola E Do Ambiente, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil
| | - Andreza Francisco Martins
- Programa de Pós-Graduação Em Ciências Farmacêuticas, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil.
- Programa de Pós-Graduação Em Microbiologia Agrícola E Do Ambiente, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil.
- Laboratório de Pesquisa Em Resistência Bacteriana, LABRESIS, Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil.
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Pinto B, Pereira P, Ramalho R. Characterization of food intake in patients with psoriasis. Clin Nutr ESPEN 2021. [DOI: 10.1016/j.clnesp.2021.09.242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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4
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Ullah I, Shabbir D, Ramalho R, Irfan M, de Filippis R. COVID-19 & psychiatric care: Need of a plan to prevent follow-up discontinuation. Encephale 2021; 48:105-106. [PMID: 33814170 PMCID: PMC7951559 DOI: 10.1016/j.encep.2021.01.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 01/11/2021] [Indexed: 01/09/2023]
Affiliation(s)
- I Ullah
- Kabir Medical College, Gandhara University, Peshawar, Pakistan.
| | - D Shabbir
- Jinnah Medical and Dental College, Karachi, Pakistan.
| | - R Ramalho
- Department of Social and Community Health, School of Population Health, University of Auckland, Auckland, New Zealand.
| | - M Irfan
- Internal Medicine, Hayatabad Medical Complex, Peshawar, Pakistan.
| | - R de Filippis
- Psychiatry Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Viale Europa, 88100 Catanzaro, Italy.
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5
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Bock PM, Telo GH, Ramalho R, Sbaraini M, Leivas G, Martins AF, Schaan BD. The effect of probiotics, prebiotics or synbiotics on metabolic outcomes in individuals with diabetes: a systematic review and meta-analysis. Diabetologia 2021; 64:26-41. [PMID: 33047170 DOI: 10.1007/s00125-020-05295-1] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 08/12/2020] [Indexed: 02/07/2023]
Abstract
AIMS/HYPOTHESIS The aim was to conduct a systematic review and meta-analysis of randomised controlled clinical trials assessing the effect of probiotic, prebiotic or synbiotic supplementation on gut microbiota and glucose control and lipid levels in individuals with diabetes. METHODS MEDLINE, EMBASE and the Cochrane Library were searched. The eligibility criteria for the studies was involvement of participants with a diagnosis of type 1 or type 2 diabetes. Metabolic outcomes (glucose control, insulinaemia, and lipid profile) of any probiotic, prebiotic or synbiotic supplementation related to modification of gut microbiota (prebiotics, probiotics and synbiotics) were analysed. We provided a narrative synthesis and meta-analysis of the findings on metabolic outcomes from the studies. Metabolic outcomes were extracted post-intervention and expressed as mean differences (MDs) and 95% CIs between treatment and comparator groups. We pooled the results using a random-effects meta-analysis. The meta-analysis was conducted using Review Manager (RevMan) software. RESULTS After the removal of duplicates and ineligible studies, 5219 studies were retained for review of titles and abstracts. The number of articles was reduced to 130 by review, for which the full-text articles were obtained and reassessed, 38 of which were included in the final meta-analysis. Overall, the use of prebiotics, probiotics or synbiotics reduced HbA1c levels, but did not reach the threshold for significance (-2.17 mmol/mol, 95% CI -4.37, 0.03; p = 0.05, [-0.20%, 95% CI -0.40 to 0.00; p = 0.05, I2 = 66%]) and had no effect on LDL-cholesterol levels (-0.05 mmol/l; 95% CI -0.14, 0.05, p = 0.35, I2 = 37%). However, their consumption decreased levels of fasting blood glucose (-0.58 mmol/l; 95% CI -0.86, -0.30; p < 0.01, I2 = 60%), total cholesterol (-0.14 mmol/l; 95% CI -0.26, -0.02, p = 0.02, I2 = 39%), triacylglycerols (-0.11 mmol/l; 95% CI -0.20, -0.02, p = 0.01, I2= 21%) and insulinaemia (-10.51 pmol/l; 95% CI -16.68,-4.33, p < 0.01, I2 = 74%), and increased HDL-cholesterol levels (0.04 mmol/l; 95% CI 0.01, 0.07, p < 0.01, I2= 24%). CONCLUSIONS/INTERPRETATION In individuals with diabetes mellitus, supplementation with probiotics, prebiotics or synbiotics improved metabolic variables, although the magnitude of this effect is low. Our results suggest that consumption of probiotics, prebiotics or synbiotics may be a potential adjuvant treatment for improving metabolic outcomes. REGISTRATION PROSPERO ID CRD42017080071. Graphical abstract.
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Affiliation(s)
- Patricia M Bock
- Department of Internal Medicine, Faculty of Medicine, Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
- Faculdades Integradas de Taquara, Taquara, Brazil.
- National Institute of Science and Technology for Health Technology Assessment (IATS) - CNPq/Brazil, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
| | - Gabriela H Telo
- Department of Internal Medicine, Faculty of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Rafaela Ramalho
- Department of Microbiology, Immunology and Parasitology, Health Basic Science Institute, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Mariana Sbaraini
- Department of Internal Medicine, Faculty of Medicine, Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Gabriel Leivas
- Department of Internal Medicine, Faculty of Medicine, Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Andreza F Martins
- Department of Microbiology, Immunology and Parasitology, Health Basic Science Institute, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Beatriz D Schaan
- Department of Internal Medicine, Faculty of Medicine, Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- National Institute of Science and Technology for Health Technology Assessment (IATS) - CNPq/Brazil, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Endocrine Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
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Chaves R, Correia L, Ramalho R, Pereira P. Food habits and body image perception changes during Covid-19 pandemic in Portugal. Clin Nutr ESPEN 2020. [DOI: 10.1016/j.clnesp.2020.09.643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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7
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Correia L, Medeiros M, Chaves R, Pereira P, Ramalho R. Nutritional status of children in school age: A look of concern in an era of COVID-19 pandemic. Clin Nutr ESPEN 2020. [PMCID: PMC8490956 DOI: 10.1016/j.clnesp.2020.09.639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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8
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Ramalho R, Medeiros M, Pires J, Ventura L, Coelho F, Pereira P. Nutritionist knocks on the door: A community nutrition program for non-institutionalized seniors. Clin Nutr 2018. [DOI: 10.1016/j.clnu.2018.06.1881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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9
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Ganhão-Arranhado S, Paúl C, Ramalho R, Pereira P. Food insecurity, weight and nutritional status among older adults attending senior centres in Lisbon. Arch Gerontol Geriatr 2018; 78:81-88. [DOI: 10.1016/j.archger.2018.06.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 06/11/2018] [Accepted: 06/12/2018] [Indexed: 10/24/2022]
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10
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Albuquerque A, Pessegueiro Miranda H, Lopes J, Gandara J, Rodrigues S, Gaspar R, Morais R, Ramalho R, Rodrigues-Pinto E, Cardoso H, Barroca H, Dias CC, Carneiro F, Macedo G. Liver transplant recipients have a higher prevalence of anal squamous intraepithelial lesions. Br J Cancer 2017; 117:1761-1767. [PMID: 29093575 PMCID: PMC5729480 DOI: 10.1038/bjc.2017.370] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Revised: 09/26/2017] [Accepted: 09/29/2017] [Indexed: 12/17/2022] Open
Abstract
Background: Anal squamous intraepithelial lesions (ASIL) are precancerous lesions of anal squamous cell carcinoma, with a higher prevalence in immunosuppressed patients. There are some studies in kidney transplant recipients, but there is no information regarding prevalence in liver transplantation. Our aim was to evaluate the prevalence of ASIL in this setting. Methods: Prospective case–control study involving liver transplant recipients without any other known risk factor for ASIL (n=59), which were compared with a healthy control group (n=57). All were submitted to anal cytology and high-resolution anoscopy was performed in those with abnormal results. Results: Ten (17%) of liver transplant recipients had abnormal cytological results, seven patients had atypical squamous cells of undetermined significance (ASC-US), one patient had atypical squamous cells that cannot exclude high-grade (ASC-H) and two patients had high-grade squamous intraepithelial lesions (HSIL). In the control group, one patient (2%) had an ASC-US result (P=0.005). Anal squamous intraepithelial lesions were confirmed in 7 out of 10 of liver transplant patients and 0 out of 1 in the controls (P=0.013) by high-resolution anoscopy with biopsies. Current smoking was the only risk factor for abnormal cytology (odds ratio=5.87, 95% confidence intervals=1.22–28.12, P=0.027). Conclusions: Liver transplant patients have a higher risk of ASIL. Screening should be considered, especially in smokers.
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Affiliation(s)
- A Albuquerque
- Gastroenterology Department Centro Hospitalar São João, Porto, Portugal.,Faculty of Medicine of the University of Porto, Porto, Portugal
| | - H Pessegueiro Miranda
- Liver and Pancreatic Transplant Unit Centro Hospitalar Porto, Porto, Portugal.,Abel Salazar BioMedical Sciences Institute from University of Porto, Porto, Portugal.,Institute of Public Health, University of Porto, Porto, Portugal
| | - J Lopes
- Pathology Department Centro Hospitalar São João, Porto, Portugal
| | - J Gandara
- Liver and Pancreatic Transplant Unit Centro Hospitalar Porto, Porto, Portugal.,Abel Salazar BioMedical Sciences Institute from University of Porto, Porto, Portugal
| | - S Rodrigues
- Gastroenterology Department Centro Hospitalar São João, Porto, Portugal.,Faculty of Medicine of the University of Porto, Porto, Portugal
| | - R Gaspar
- Gastroenterology Department Centro Hospitalar São João, Porto, Portugal.,Faculty of Medicine of the University of Porto, Porto, Portugal
| | - R Morais
- Gastroenterology Department Centro Hospitalar São João, Porto, Portugal.,Faculty of Medicine of the University of Porto, Porto, Portugal
| | - R Ramalho
- Gastroenterology Department Centro Hospitalar São João, Porto, Portugal.,Faculty of Medicine of the University of Porto, Porto, Portugal
| | - E Rodrigues-Pinto
- Gastroenterology Department Centro Hospitalar São João, Porto, Portugal.,Faculty of Medicine of the University of Porto, Porto, Portugal
| | - H Cardoso
- Gastroenterology Department Centro Hospitalar São João, Porto, Portugal.,Faculty of Medicine of the University of Porto, Porto, Portugal
| | - H Barroca
- Pathology Department Centro Hospitalar São João, Porto, Portugal
| | - C C Dias
- Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine of the University of Porto, Porto, Portugal.,Center for Health Technology and Services Research-CINTESIS, Porto, Portugal
| | - F Carneiro
- Faculty of Medicine of the University of Porto, Porto, Portugal.,Pathology Department Centro Hospitalar São João, Porto, Portugal.,Institute of Molecular Pathology and Immunology of the University of Porto (Ipatimup) and i3S - Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal
| | - G Macedo
- Gastroenterology Department Centro Hospitalar São João, Porto, Portugal.,Faculty of Medicine of the University of Porto, Porto, Portugal
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Ramalho R, Ramalho P, Couto N, Pereira P. Omega-3 therapeutic supplementation in a patient with metastatic adenocarcinoma of the pancreas with muscle mass depletion. Eur J Clin Nutr 2017; 71:795-797. [PMID: 28378854 DOI: 10.1038/ejcn.2017.47] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 02/22/2017] [Accepted: 02/24/2017] [Indexed: 02/07/2023]
Abstract
Pancreatic adenocarcinoma has an extremely poor prognosis. With the best available treatments, the median overall survival duration is still less than 1 year. Most patients develop anorexia and major muscle mass loss that interfere with chemotherapy tolerance and survival. In this paper, we present a case in which these problems were a major concern. A multidisciplinary approach with chemotherapy and close nutritional support permitted better control of the disease and longer survival. We also review the literature on nutritional interventions that show an improvement in quality of life and survival in these patients.
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Affiliation(s)
- R Ramalho
- Instituto Superior de Ciências da Saúde Egas Moniz, Nutrition Consultation, Campus Universitário Quinta da Granja, Monte de Caparica, Portugal
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM). Campus Universitário Quinta da Granja, Monte de Caparica, Portugal
- Grupo de Estudos em Nutrição Aplicada (GENA)-ISCSEM, Campus Universitário Quinta da Granja, Monte de Caparica, Portugal
| | - P Ramalho
- Instituto Superior de Ciências da Saúde Egas Moniz, Nutrition Consultation, Campus Universitário Quinta da Granja, Monte de Caparica, Portugal
- Grupo de Estudos em Nutrição Aplicada (GENA)-ISCSEM, Campus Universitário Quinta da Granja, Monte de Caparica, Portugal
| | - N Couto
- Champalimaud Foundation, Champalimaud Clinic Centre - Digestive Cancer Unit. Avenida Brasília, Lisboa, Portugal
| | - P Pereira
- Instituto Superior de Ciências da Saúde Egas Moniz, Nutrition Consultation, Campus Universitário Quinta da Granja, Monte de Caparica, Portugal
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM). Campus Universitário Quinta da Granja, Monte de Caparica, Portugal
- Grupo de Estudos em Nutrição Aplicada (GENA)-ISCSEM, Campus Universitário Quinta da Granja, Monte de Caparica, Portugal
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Ramalho R, Ramalho P, Formigo I, Órfão F, Caldeira J, Alves P, Pereira P. MON-P181: Fighting Childhood Obesity: Community Nutrition in Action Through Assessment and Intervention in Schools - Preliminary Results. Clin Nutr 2016. [DOI: 10.1016/s0261-5614(16)30815-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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13
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Ramalho R, Pirraco A, Soares R, Palmares C, Delgado L, Moreira A. Neurogenic inflammation in the airways of elite swimmers. J Sports Med Phys Fitness 2014; 54:252-253. [PMID: 24509999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- R Ramalho
- Department of Immunology, Faculty of Medicine, University of Porto, Portugal -
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Affiliation(s)
- A Albuquerque
- Gastroenterology Department Hospital de São João Pathology Department Hospital de São João, Porto, Portugal.
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15
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Ramalho R, Almeida J, Beltrão M, Pirraco A, Costa R, Sokhatska O, Guardão L, Palmares C, Guimarães JT, Delgado L, Moreira A, Soares R. Substance P antagonist improves both obesity and asthma in a mouse model. Allergy 2013; 68:48-54. [PMID: 23176443 DOI: 10.1111/all.12052] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2012] [Indexed: 11/30/2022]
Abstract
BACKGROUND Evidence suggests a causal relationship between obesity and asthma; however, the underlying mechanisms remain unknown. Substance P (SP), involved in neurogenic inflammation by acting through its receptor NK1-R, seems to participate in obese-asthma phenotype in mice. OBJECTIVES To evaluate the effect of a selective substance P receptor antagonist on a mouse model of diet-induced obesity and asthma. METHODS Diet-induced obese Balb/c mice were sensitized and challenged with ovalbumin (OVA) and treated with a selective NK1-R antagonist or placebo. Serum glucose, insulin, IL-6, resistin, and OVA-specific IgE levels were quantified. A score for peribronchial inflammation in lung histology was used. Cells were counted in bronchoalveolar lavage fluid. Adipocyte sizes were measured. RESULTS Ovalbumin-obese mice treated with NK1-R antagonist had lower weight (P = 0.0002), reduced daily food intake (P = 0.0021), reduced daily energy intake (P = 0.0021), reduced surface adipocyte areas (P < 0.0001), lower serum glucose (P = 0.04), lower serum insulin (P = 0.03), lower serum IL-(P = 0.0022), lower serum resistin (P = 0.0043), lower serum OVA-specific IgE (P = 0.035), and lower peribronchial inflammation score (P < 0.0001) than nontreated OVA-obese mice. We observed an interaction between obesity, allergen sensitization, and treatment with NK1-R antagonist for metabolic and systemic biomarkers, and for allergen sensitization and bronchial inflammation, showing a synergy between these variables. CONCLUSION & CLINICAL RELEVANCE In an experimental model of obesity and asthma in mice, NK1-R blockade improved metabolic and systemic biomarkers, as well as allergen sensitization and bronchial inflammation. These positive effects support a common pathway in the obese-asthma phenotype and highlight SP as a target with potential clinical interest in the obese-asthma epidemics.
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Affiliation(s)
- R. Ramalho
- Immunology; Faculty of Medicine; University of Porto; Porto; Portugal
| | - J. Almeida
- Ciências Químicas e das Biomoléculas; Escola Superior de Tecnologia da Saúde do Porto; Instituto Politécnico do Porto; Porto; Portugal
| | - M. Beltrão
- Immunology; Faculty of Medicine; University of Porto; Porto; Portugal
| | - A. Pirraco
- Biochemistry (U38-FCT); Faculty of Medicine; University of Porto; Porto; Portugal
| | - R. Costa
- Biochemistry (U38-FCT); Faculty of Medicine; University of Porto; Porto; Portugal
| | - O. Sokhatska
- Immunology; Faculty of Medicine; University of Porto; Porto; Portugal
| | - L. Guardão
- Animal House Unit; Faculty of Medicine; University of Porto; Porto; Portugal
| | - C. Palmares
- Immunology; Faculty of Medicine; University of Porto; Porto; Portugal
| | | | | | | | - R. Soares
- Biochemistry (U38-FCT); Faculty of Medicine; University of Porto; Porto; Portugal
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Albuquerque A, Ramalho R, Macedo G. Multiple esophagopleural and esophagobronchial fistulas in a patient with Crohn's disease. Endoscopy 2012; 44 Suppl 2 UCTN:E114-5. [PMID: 22477172 DOI: 10.1055/s-0031-1291671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- A Albuquerque
- Gastroenterology Department, Hospital de São João, Porto, Portugal.
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Ferreira F, Bastos P, Ribeiro A, Marques M, Azevedo F, Pereira P, Lopes S, Ramalho R, Macedo G. A comparative study between fluoroscopic and endoscopic guidance in palliative esophageal stent placement. Dis Esophagus 2011; 25:608-13. [PMID: 22151881 DOI: 10.1111/j.1442-2050.2011.01288.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Self-expanding metallic stents (SEMS) are the treatment of choice for incurable obstructive malignant esophageal strictures. Although the placement of SEMS is usually performed with fluoroscopic control (FC), recently several authors have shown the feasibility of placing SEMS under endoscopic control alone (EC). However, studies comparing the two techniques are lacking. The objective of this study was to compare the feasibility and safety of SEMS insertion under fluoroscopic control and endoscopic control. The study was performed through the retrospective analysis of patients who underwent SEMS insertion for malignant dysphagia between January 2005 and January 2010. Data concerning early and late complications and survival were retrieved. Early complications were defined as pain, vomiting, bleeding, malposition/migration, perforation, and/or dysphagia occurring until 30 days of SEMS insertion; and late complications as tumor ingrowth and overgrowth, migration, hemorrhage, fistulae, food impaction, and/or esophagitis occurring after 30 days. We placed 126 SEMS of which 87% for esophageal stricture, 8% for esophagus-respiratory fistula, and 5% for extrinsic compression. The mean age of the patients was 62 years, and 93 were male. SEMS insertion was performed with FC in 66 patients and EC in 60. Early complications occurred in 34 patients (52%) in the FC group and 28 (47%) in the EC group (P=0.71), including: pain in 22 patients of the FC group and 15 of the EC group (P=0.31); vomiting in 15 of the FC group and nine of the EC group (P=0.27); malposition/migration in three of the FC group and four of the EC group (P=0.60); hemorrhage in one of the FC group and two of the EC group (P=0.27); and dysphagia in two of the FC group and three of the EC group (P=0.57). Late complications occurred in 20 patients (30%) in the FC group and 22 (37%) in the EC group (P=0.44), including: tumor in/overgrowth in 13 patients of the FC group and 10 of the EC group (P=0.66); prostheses migration in five of the FC group and eight of the EC group (P=0.28); hemorrhage in two of the FC group and two of the EC group (P=0.54); appearance of esophageal fistulae in seven of the FC group and four of the EC group (P=0.43); food impaction in nine of the FC group and eight of the EC group (P=0.96); esophagitis in 12 of the FC group and 15 of the EC group (P=0.35). Median survival was 107 days (95% confidence interval [CI]=6-369 days) with no difference between the two groups. There were no statistical significant differences in the incidence of complications and in survival between patients undergoing SEMS placement under fluoroscopic control or endoscopic control.
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Affiliation(s)
- F Ferreira
- Gastroenterology Department, Hospital de São João, Porto, Portugal.
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Garcia-Larsen V, Luczynska M, Kowalski ML, Voutilainen H, Ahlström M, Haahtela T, Toskala E, Bockelbrink A, Lee HH, Vassilopoulou E, Papadopoulos NG, Ramalho R, Moreira A, Delgado L, Castel-Branco MG, Calder PC, Childs CE, Bakolis I, Hooper R, Burney PG. Use of a common food frequency questionnaire (FFQ) to assess dietary patterns and their relation to allergy and asthma in Europe: pilot study of the GA2LEN FFQ. Eur J Clin Nutr 2011; 65:750-6. [PMID: 21427744 DOI: 10.1038/ejcn.2011.15] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND/OBJECTIVES Comparable international data on food and nutrient intake is often hindered by the lack of a common instrument to assess food intake. The objective of this study was within the Global Allergy and Asthma European Network of Excellence (GA(2)LEN), we developed and piloted a food frequency questionnaire (FFQ) to assess its validity in Europe. SUBJECTS/METHODS Five countries participating in GA(2)LEN took part in the pilot study. A total of 200 adults aged 31-75 years were invited to complete a FFQ in two occasions and to give a blood sample. The intra-class correlation coefficient (ICC) was used to assess repeatability of the FFQ. Plasma phospholipid fatty acids (FAs) were analysed by gas chromatography. Pearson correlation was used to analyse the correlation between estimated dietary FA intake and plasma phospholipid FA levels. RESULTS A total of 177 participants (89%) had complete data on FFQ(1) and plasma phospholipid FAs. In all, 152 participants (76%) completed both FFQs. ICCs between macronutrients ranged from 0.70 (saturated FAs) to 0.78 (proteins) and between 0.70 (retinol) and 0.81 (vitamin D) for micronutrients. Dietary n-3 FAs showed a good correlation with total plasma phospholipid n-3 FAs and with docosahexaenoic acid in the whole sample (0.40) and in individual countries. Poor correlations were observed for other FAs. CONCLUSIONS The GA(2)LEN FFQ is an appropriate tool to estimate dietary intake for a range of nutrients across Europe regardless of cultural and linguistic differences. The FFQ seems to be useful to estimate the intake of n-3 FAs but not other FAs.
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Affiliation(s)
- V Garcia-Larsen
- National Heart and Lung Institute, Imperial College London, UK.
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Ramalho R. A new approach to the history of psychiatry. Eur Psychiatry 2011. [DOI: 10.1016/s0924-9338(11)72763-8] [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: 10/18/2022] Open
Abstract
The concepts scientific progress or scientific advancement refer to a directionality of the evolution of the theoretical and practical core of a science. Beneath these concepts the notion of change is submerged in that directionality. The science of medicine framed its history in this notion of progress or advancement. By these means, it is easy to understand how the physician and the general population perceive the current medical model as the result of centuries and millennia of the mentioned progress. Psychiatry, a medical science, is no exception to this concept. This paper has the intention of introducing the history of medicine and psychiatry as a succession of changes, without a particular directionality by contextualizing the successive theories and practices as well as the transitions between models, up until the current medical science model. The objective being to demystify one of the concepts that could work for the inertia of change in the medical and the psychiatric science, in the case where doing so would be considered appropriate.
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Abstract
At this time the European Union regulations require that the heterotrophic plate counts (HPC) of mineral waters be assessed at two recovery temperatures: 22 degrees C for 72 h and 37 degrees C for 24 h. This procedure is time consuming and expensive. Development of new rapid methods for microbiological assessment of the microbial flora in the bottled water is an industry-driven need. The objectives of this work were to develop a method for the HPC that utilises only one recovery temperature and one incubation period and evaluate the use of, the LIVE/DEAD(R) BacLight Bacterial Viability Kit, 5-cyano-2,3-ditotyl tetrazolium chloride (CTC) and impedance methods to enumerate viable bacteria in bottled mineral water. Results showed that incubation at 30 degrees C could be used instead of incubation at 22 degrees C and 37 degrees C. Good correlation exists between counts at 30 degrees C and counts at 22 degrees C (r>0.90) and all the pathogens important in mineral water analyses grow similarly at 30 degrees C and 37 degrees C during 24 h. It was demonstrated that impedance methods might be useful to the mineral water industry as a rapid indicator of microbiological quality of the water. Results obtained with BacLight and CTC were similar to those obtained with plate counts.
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Affiliation(s)
- R Ramalho
- Escola Superior de Biotecnologia, R. Dr. António Bernardino de Almeida, 4200-072, Porto, Portugal
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