1
|
Mirnezami AH, Drami I, Glyn T, Sutton PA, Tiernan J, Behrenbruch C, Guerra G, Waters PS, Woodward N, Applin S, Charles SJ, Rose SA, Denys A, Pape E, van Ramshorst GH, Baker D, Bignall E, Blair I, Davis P, Edwards T, Jackson K, Leendertse PG, Love-Mott E, MacKenzie L, Martens F, Meredith D, Nettleton SE, Trotman MP, van Hecke JJM, Weemaes AMJ, Abecasis N, Angenete E, Aziz O, Bacalbasa N, Barton D, Baseckas G, Beggs A, Brown K, Buchwald P, Burling D, Burns E, Caycedo-Marulanda A, Chang GJ, Coyne PE, Croner RS, Daniels IR, Denost QD, Drozdov E, Eglinton T, Espín-Basany E, Evans MD, Flatmark K, Folkesson J, Frizelle FA, Gallego MA, Gil-Moreno A, Goffredo P, Griffiths B, Gwenaël F, Harris DA, Iversen LH, Kandaswamy GV, Kazi M, Kelly ME, Kokelaar R, Kusters M, Langheinrich MC, Larach T, Lydrup ML, Lyons A, Mann C, McDermott FD, Monson JRT, Neeff H, Negoi I, Ng JL, Nicolaou M, Palmer G, Parnaby C, Pellino G, Peterson AC, Quyn A, Rogers A, Rothbarth J, Abu Saadeh F, Saklani A, Sammour T, Sayyed R, Smart NJ, Smith T, Sorrentino L, Steele SR, Stitzenberg K, Taylor C, Teras J, Thanapal MR, Thorgersen E, Vasquez-Jimenez W, Waller J, Weber K, Wolthuis A, Winter DC, Brangan G, Vimalachandran D, Aalbers AGJ, Abdul Aziz N, Abraham-Nordling M, Akiyoshi T, Alahmadi R, Alberda W, Albert M, Andric M, Angeles M, Antoniou A, Armitage J, Auer R, Austin KK, Aytac E, Baker RP, Bali M, Baransi S, Bebington B, Bedford M, Bednarski BK, Beets GL, Berg PL, Bergzoll C, Biondo S, Boyle K, Bordeianou L, Brecelj E, Bremers AB, Brunner M, Bui A, Burgess A, Burger JWA, Campain N, Carvalhal S, Castro L, Ceelen W, Chan KKL, Chew MH, Chok AK, Chong P, Christensen HK, Clouston H, Collins D, Colquhoun AJ, Constantinides J, Corr A, Coscia M, Cosimelli M, Cotsoglou C, Damjanovic L, Davies M, Davies RJ, Delaney CP, de Wilt JHW, Deutsch C, Dietz D, Domingo S, Dozois EJ, Duff M, Egger E, Enrique-Navascues JM, Espín-Basany E, Eyjólfsdóttir B, Fahy M, Fearnhead NS, Fichtner-Feigl S, Fleming F, Flor B, Foskett K, Funder J, García-Granero E, García-Sabrido JL, Gargiulo M, Gava VG, Gentilini L, George ML, George V, Georgiou P, Ghosh A, Ghouti L, Giner F, Ginther N, Glover T, Golda T, Gomez CM, Harris C, Hagemans JAW, Hanchanale V, Harji DP, Helbren C, Helewa RM, Hellawell G, Heriot AG, Hochman D, Hohenberger W, Holm T, Holmström A, Hompes R, Hornung B, Hurton S, Hyun E, Ito M, Jenkins JT, Jourand K, Kaffenberger S, Kapur S, Kanemitsu Y, Kaufman M, Kelley SR, Keller DS, Kersting S, Ketelaers SHJ, Khan MS, Khaw J, Kim H, Kim HJ, Kiran R, Koh CE, Kok NFM, Kontovounisios C, Kose F, Koutra M, Kraft M, Kristensen HØ, Kumar S, Lago V, Lakkis Z, Lampe B, Larsen SG, Larson DW, Law WL, Laurberg S, Lee PJ, Limbert M, Loria A, Lynch AC, Mackintosh M, Mantyh C, Mathis KL, Margues CFS, Martinez A, Martling A, Meijerink WJHJ, Merchea A, Merkel S, Mehta AM, McArthur DR, McCormick JJ, McGrath JS, McPhee A, Maciel J, Malde S, Manfredelli S, Mikalauskas S, Modest D, Morton JR, Mullaney TG, Navarro AS, Neto JWM, Nguyen B, Nielsen MB, Nieuwenhuijzen GAP, Nilsson PJ, Nordkamp S, O’Dwyer ST, Paarnio K, Pappou E, Park J, Patsouras D, Peacock O, Pfeffer F, Piqeur F, Pinson J, Poggioli G, Proud D, Quinn M, Oliver A, Radwan RW, Rajendran N, Rao C, Rasheed S, Rasmussen PC, Rausa E, Regenbogen SE, Reims HM, Renehan A, Rintala J, Rocha R, Rochester M, Rohila J, Rottoli M, Roxburgh C, Rutten HJT, Safar B, Sagar PM, Sahai A, Schizas AMP, Schwarzkopf E, Scripcariu D, Scripcariu V, Seifert G, Selvasekar C, Shaban M, Shaikh I, Shida D, Simpson A, Skeie-Jensen T, Smart P, Smith JJ, Solbakken AM, Solomon MJ, Sørensen MM, Spasojevic M, Steffens D, Stocchi L, Stylianides NA, Swartling T, Sumrien H, Swartking T, Takala H, Tan EJ, Taylor D, Tejedor P, Tekin A, Tekkis PP, Thaysen HV, Thurairaja R, Toh EL, Tsarkov P, Tolenaar J, Tsukada Y, Tsukamoto S, Tuech JJ, Turner G, Turner WH, Tuynman JB, Valente M, van Rees J, van Zoggel D, Vásquez-Jiménez W, Verhoef C, Vierimaa M, Vizzielli G, Voogt ELK, Uehara K, Wakeman C, Warrier S, Wasmuth HH, Weiser MR, Westney OL, Wheeler JMD, Wild J, Wilson M, Yano H, Yip B, Yip J, Yoo RN, Zappa MA. The empty pelvis syndrome: a core data set from the PelvEx collaborative. Br J Surg 2024; 111:znae042. [PMID: 38456677 PMCID: PMC10921833 DOI: 10.1093/bjs/znae042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 01/15/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND Empty pelvis syndrome (EPS) is a significant source of morbidity following pelvic exenteration (PE), but is undefined. EPS outcome reporting and descriptors of radicality of PE are inconsistent; therefore, the best approaches for prevention are unknown. To facilitate future research into EPS, the aim of this study is to define a measurable core outcome set, core descriptor set and written definition for EPS. Consensus on strategies to mitigate EPS was also explored. METHOD Three-stage consensus methodology was used: longlisting with systematic review, healthcare professional event, patient engagement, and Delphi-piloting; shortlisting with two rounds of modified Delphi; and a confirmatory stage using a modified nominal group technique. This included a selection of measurement instruments, and iterative generation of a written EPS definition. RESULTS One hundred and three and 119 participants took part in the modified Delphi and consensus meetings, respectively. This encompassed international patient and healthcare professional representation with multidisciplinary input. Seventy statements were longlisted, seven core outcomes (bowel obstruction, enteroperineal fistula, chronic perineal sinus, infected pelvic collection, bowel obstruction, morbidity from reconstruction, re-intervention, and quality of life), and four core descriptors (magnitude of surgery, radiotherapy-induced damage, methods of reconstruction, and changes in volume of pelvic dead space) reached consensus-where applicable, measurement of these outcomes and descriptors was defined. A written definition for EPS was agreed. CONCLUSIONS EPS is an area of unmet research and clinical need. This study provides an agreed definition and core data set for EPS to facilitate further research.
Collapse
|
2
|
Pacheco M, Sá P, Santos G, Boa-Sorte N, Domingues K, Assis L, Silva M, Oliveira A, Santos D, Ferreira J, Fernandes R, Fortes F, Rocha R, Santana G. Impact of an intervention program on drug adherence in patients with ulcerative colitis: Randomized clinical trial. PLoS One 2023; 18:e0295832. [PMID: 38150452 PMCID: PMC10752503 DOI: 10.1371/journal.pone.0295832] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 11/20/2023] [Indexed: 12/29/2023] Open
Abstract
AIMS Evaluate the impact of an intervention program in non-adherent patients with ulcerative colitis. METHODS Parallel controlled randomized clinical trial (1:1), approved by the ethics committee (No. 3.068.511/2018) and registered at The Brazilian Clinical Trials Registry (No. RBR-79dn4k). Non-adherent ulcerative colitis patients according to the Morisky-Green-Levine-test were included. Recruitment began in August 2019 until August 2020, with 6-month follow-up. All participants received standard usual care, and additionally the intervention group received educational (video, educational leaflet, verbal guidance) and behavioral interventions (therapeutic scheme, motivational and reminder type short message services). Researchers were blinded for allocation prior to data collection at Visits 1 and 2 (0 and 6 months). Primary outcome: 180-day adherence rate, with relative risk 95%CI. Secondary outcome: 180-day quality of life according to SF-36 domains, using Student's t test. Variables with p<0.20 were selected for regression. Analysis included data from August/2019 to May/2021. RESULTS Forty-six and 49 participants were allocated in control and intervention groups, respectively. Two were excluded due to intervention refusal, and 4 and 6 were lost to follow-up in control and intervention groups. There was no post-intervention adherence rate difference, even after adjustment for type of non-adherence (unintentional/both/intentional) as confounder, or if considered as adherent the intervention group participants lost in follow-up. Interventions promoted better quality of life scores even after multivariate analysis for "Pain", when adjusted for ulcerative colitis severity, sex, and marital status (β = 18.352, p = 0.004), "Vitality", when adjusted for ulcerative colitis severity (β = 10.568, p = 0.015) and "Emotional Aspects", when adjusted for disease severity, income, and education (β = 24.907, p = 0.041). CONCLUSIONS The intervention program was not able to produce a significant medication adherence rate difference between comparative groups, however, there was a significant improvement in quality of life. Study limitations may include: sample size calculated to identify differences of 30%, leading to a possible insufficient power; non blinded participants, exposing the results to the risk of performance bias; outcomes based on self-reported data.
Collapse
Affiliation(s)
- Mila Pacheco
- Departamento de Ciências da Vida, Universidade do Estado da Bahia (UNEB), Salvador, Bahia, Brazil
| | - Pedro Sá
- Departamento de Ciências da Vida, Universidade do Estado da Bahia (UNEB), Salvador, Bahia, Brazil
| | - Gláucia Santos
- Departamento de Ciências da Vida, Universidade do Estado da Bahia (UNEB), Salvador, Bahia, Brazil
| | - Ney Boa-Sorte
- Departamento de Ciências da Vida, Universidade do Estado da Bahia (UNEB), Salvador, Bahia, Brazil
| | - Kilma Domingues
- Departamento de Ciências da Vida, Universidade do Estado da Bahia (UNEB), Salvador, Bahia, Brazil
| | - Larissa Assis
- Departamento de Ciências da Vida, Universidade do Estado da Bahia (UNEB), Salvador, Bahia, Brazil
| | - Marina Silva
- Departamento de Ciências da Vida, Universidade do Estado da Bahia (UNEB), Salvador, Bahia, Brazil
| | - Ana Oliveira
- Departamento de Ciências da Vida, Universidade do Estado da Bahia (UNEB), Salvador, Bahia, Brazil
| | - Daniel Santos
- Departamento de Ciências da Vida, Universidade do Estado da Bahia (UNEB), Salvador, Bahia, Brazil
| | - Jamile Ferreira
- Departamento de Ciências da Vida, Universidade do Estado da Bahia (UNEB), Salvador, Bahia, Brazil
| | - Rosemeire Fernandes
- Centro de Infusões e Medicamentos Especializados da Bahia (CIMEB), Salvador, Bahia, Brazil
| | - Flora Fortes
- Departamento de Ciências da Vida, Universidade do Estado da Bahia (UNEB), Salvador, Bahia, Brazil
| | - Raquel Rocha
- Universidade Federal da Bahia (UFBA), Canela, Salvador, BA–Brazil
| | - Genoile Santana
- Departamento de Ciências da Vida, Universidade do Estado da Bahia (UNEB), Salvador, Bahia, Brazil
| |
Collapse
|
3
|
Almeida NS, Rocha R, de Souza CA, Daltro C, de Farias Costa PR, de Oliveira TM, de Oliveira Leite L, Cotrim HP. Energy and nutrient intake by people with and without sarcopenia diagnosed by the European Working Group on Sarcopenia in Older People: a systematic review and meta-analysis. Nutr Rev 2023:nuad154. [PMID: 38114090 DOI: 10.1093/nutrit/nuad154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023] Open
Abstract
CONTEXT There is growing evidence that insufficient dietary intake is associated with sarcopenia. OBJECTIVE In this systematic review and meta-analysis, the energy and nutrient intakes by people with and without sarcopenia were compared using only the European Working Group on Sarcopenia in Older People 2010 (EWGSOP1) and 2019 (EWGSOP2) consensus diagnostic criteria. DATA SOURCES Only observational studies that compared energy and nutrient intake from food alone by individuals with and without sarcopenia were included. Studies were searched in the following databases: Embase, PubMed, Scopus, Web of Science, Lilacs, Ovid, and Scopus. The review followed the PRISMA checklist and submitted the protocol to PROSPERO. DATA EXTRACTION Data were extracted by 2 authors independently. The methodological quality of the studies was assessed using the Newcastle-Ottawa scale. DATA ANALYSIS A total of 8648 articles were identified and 12 were selected. Among individuals with sarcopenia, lower intakes of energy and some nutrients, mainly with antioxidant properties, were observed compared with those without sarcopenia. Meta-analyses showed that individuals with sarcopenia consume fewer calories/day than individuals without sarcopenia (n = 10 studies; standardized mean difference (SMD) -0.15; 95% confidence interval: -0.29, -0.01) diagnosed by EWGSOP1 and EWGSOP2. Individuals with sarcopenia consume less omega-3, folate, magnesium, phosphorus, selenium, zinc, and vitamins C, D, and E when compared with those without sarcopenia. CONCLUSION The results of the present study suggest that insufficient intake of energy and nutrients with antioxidant potential may be associated with sarcopenia. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD 42020195698.
Collapse
Affiliation(s)
- Naiade Silveira Almeida
- Programa de Pós-Graduação em Medicina e Saúde, Universidade Federal da Bahia, Salvador, Brazil
| | - Raquel Rocha
- Departamento de Ciências da Nutrição, Universidade Federal da Bahia, Escola de Nutrição, Salvador, Brazil
| | | | - Carla Daltro
- Programa de Pós-Graduação em Medicina e Saúde, Universidade Federal da Bahia, Salvador, Brazil
| | | | - Tatiane Melo de Oliveira
- Programa de Pós-Graduação em Gerontologia, Faculdade de Ciências Médicas da Universidade Estadual de Campinas, Campinas, Brazil
| | - Luana de Oliveira Leite
- Departamento de Ciências da Nutrição, Universidade Federal da Bahia, Escola de Nutrição, Salvador, Brazil
| | - Helma P Cotrim
- Programa de Pós-Graduação em Medicina e Saúde, Universidade Federal da Bahia, Salvador, Brazil
| |
Collapse
|
4
|
West CT, West MA, Mirnezami AH, Drami I, Denys A, Glyn T, Sutton PA, Tiernan J, Behrenbruch C, Guerra G, Waters PS, Woodward N, Applin S, Charles SJ, Rose SA, Pape E, van Ramshorst GH, Aalbers AGJ, Abdul AN, Abecasis N, Abraham-Nordling M, Akiyoshi T, Alahmadi R, Alberda W, Albert M, Andric M, Angeles M, Angenete E, Antoniou A, Armitage J, Auer R, Austin KK, Aytac E, Aziz O, Bacalbasa N, Baker RP, Bali M, Baransi S, Baseckas G, Bebington B, Bedford M, Bednarski BK, Beets GL, Berg PL, Bergzoll C, Biondo S, Boyle K, Bordeianou L, Brecelj E, Bremers AB, Brown K, Brunner M, Buchwald P, Bui A, Burgess A, Burger JWA, Burling D, Burns E, Campain N, Carvalhal S, Castro L, Caycedo-Marulanda A, Ceelen W, Chan KKL, Chang GJ, Chew MH, Chok AK, Chong P, Christensen HK, Clouston H, Collins D, Colquhoun AJ, Constantinides J, Corr A, Coscia M, Cosimelli M, Cotsoglou C, Coyne PE, Croner RS, Damjanovic L, Daniels IR, Davies M, Davies RJ, Delaney CP, de Wilt JHW, Denost QD, Deutsch C, Dietz D, Domingo S, Dozois EJ, Drozdov E, Duff M, Egger E, Eglinton T, Enrique-Navascues JM, Espín-Basany E, Evans MD, Eyjólfsdóttir B, Fahy M, Fearnhead NS, Fichtner-Feigl S, Flatmark K, Fleming F, Flor B, Folkesson J, Foskett K, Frizelle FA, Funder J, Gallego MA, García-Granero E, García-Sabrido JL, Gargiulo M, Gava VG, Gentilini L, George ML, George V, Georgiou P, Ghosh A, Ghouti L, Gil-Moreno A, Giner F, Ginther N, Glover T, Goffredo P, Golda T, Gomez CM, Griffiths B, Gwenaël F, Harris C, Harris DA, Hagemans JAW, Hanchanale V, Harji DP, Helbren C, Helewa RM, Hellawell G, Heriot AG, Hochman D, Hohenberger W, Holm T, Holmström A, Hompes R, Hornung B, Hurton S, Hyun E, Ito M, Iversen LH, Jenkins JT, Jourand K, Kaffenberger S, Kandaswamy GV, Kapur S, Kanemitsu Y, Kaufman M, Kazi M, Kelley SR, Keller DS, Kelly ME, Kersting S, Ketelaers SHJ, Khan MS, Khaw J, Kim H, Kim HJ, Kiran R, Koh CE, Kok NFM, Kokelaar R, Kontovounisios C, Kose F, Koutra M, Kraft M, Kristensen HØ, Kumar S, Kusters M, Lago V, Lakkis Z, Lampe B, Langheinrich MC, Larach T, Larsen SG, Larson DW, Law WL, Laurberg S, Lee PJ, Limbert M, Loria A, Lydrup ML, Lyons A, Lynch AC, Mackintosh M, Mann C, Mantyh C, Mathis KL, Margues CFS, Martinez A, Martling A, Meijerink WJHJ, Merchea A, Merkel S, Mehta AM, McArthur DR, McCormick JJ, McDermott FD, McGrath JS, McPhee A, Maciel J, Malde S, Manfredelli S, Mikalauskas S, Modest D, Monson JRT, Morton JR, Mullaney TG, Navarro AS, Neeff H, Negoi I, Neto JWM, Nguyen B, Nielsen MB, Nieuwenhuijzen GAP, Nilsson PJ, Nordkamp S, O’Dwyer ST, Paarnio K, Palmer G, Pappou E, Park J, Patsouras D, Peacock A, Pellino G, Peterson AC, Pfeffer F, Piqeur F, Pinson J, Poggioli G, Proud D, Quinn M, Oliver A, Quyn A, Radwan RW, Rajendran N, Rao C, Rasheed S, Rasmussen PC, Rausa E, Regenbogen SE, Reims HM, Renehan A, Rintala J, Rocha R, Rochester M, Rohila J, Rothbarth J, Rottoli M, Roxburgh C, Rutten HJT, Safar B, Sagar PM, Sahai A, Saklani A, Sammour T, Sayyed R, Schizas AMP, Schwarzkopf E, Scripcariu D, Scripcariu V, Seifert G, Selvasekar C, Shaban M, Shaikh I, Shida D, Simpson A, Skeie-Jensen T, Smart NJ, Smart P, Smith JJ, Smith T, Solbakken AM, Solomon MJ, Sørensen MM, Spasojevic M, Steele SR, Steffens D, Stitzenberg K, Stocchi L, Stylianides NA, Swartling T, Sumrien H, Swartking T, Takala H, Tan EJ, Taylor C, Taylor D, Tejedor P, Tekin A, Tekkis PP, Teras J, Thanapal MR, Thaysen HV, Thorgersen E, Thurairaja R, Toh EL, Tsarkov P, Tolenaar J, Tsukada Y, Tsukamoto S, Tuech JJ, Turner G, Turner WH, Tuynman JB, Valente M, van Rees J, van Zoggel D, Vásquez-Jiménez W, Verhoef C, Vierimaa M, Vizzielli G, Voogt ELK, Uehara K, Wakeman C, Warrier S, Wasmuth HH, Weber K, Weiser MR, Westney OL, Wheeler JMD, Wild J, Wilson M, Wolthuis A, Yano H, Yip B, Yip J, Yoo RN, Zappa MA, Winter DC. Empty pelvis syndrome: PelvEx Collaborative guideline proposal. Br J Surg 2023; 110:1730-1731. [PMID: 37757457 PMCID: PMC10805575 DOI: 10.1093/bjs/znad301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/22/2023] [Accepted: 08/28/2023] [Indexed: 09/29/2023]
|
5
|
Borges V, Duque MP, Martins JV, Vasconcelos P, Ferreira R, Sobral D, Pelerito A, de Carvalho IL, Núncio MS, Borrego MJ, Roemer C, Neher RA, O'Driscoll M, Rocha R, Lopo S, Neves R, Palminha P, Coelho L, Nunes A, Isidro J, Pinto M, Santos JD, Mixão V, Santos D, Duarte S, Vieira L, Martins F, Machado J, Veríssimo VC, Grau B, Peralta-Santos A, Neves J, Caldeira M, Pestana M, Fernandes C, Caria J, Pinto R, Póvoas D, Maltez F, Sá AI, Salvador MB, Teófilo E, Rocha M, Moneti V, Duque LM, E Silva FF, Baptista T, Vasconcelos J, Casanova S, Mansinho K, Alves JV, Alves J, Silva A, Alpalhão M, Brazão C, Sousa D, Filipe P, Pacheco P, Peruzzu F, de Jesus RP, Ferreira L, Mendez J, Jordão S, Duarte F, Gonçalves MJ, Pena E, Silva CN, Guimarães AR, Tavares M, Freitas G, Cordeiro R, Gomes JP. Viral genetic clustering and transmission dynamics of the 2022 mpox outbreak in Portugal. Nat Med 2023; 29:2509-2517. [PMID: 37696933 PMCID: PMC10579057 DOI: 10.1038/s41591-023-02542-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 08/08/2023] [Indexed: 09/13/2023]
Abstract
Pathogen genome sequencing during epidemics enhances our ability to identify and understand suspected clusters and investigate their relationships. Here, we combine genomic and epidemiological data of the 2022 mpox outbreak to better understand early viral spread, diversification and transmission dynamics. By sequencing 52% of the confirmed cases in Portugal, we identified the mpox virus sublineages with the highest impact on case numbers and fitted them into a global context, finding evidence that several international sublineages probably emerged or spread early in Portugal. We estimated a 62% infection reporting rate and that 1.3% of the population of men who have sex with men in Portugal were infected. We infer the critical role played by sexual networks and superspreader gatherings, such as sauna attendance, in the dissemination of mpox virus. Overall, our findings highlight genomic epidemiology as a tool for the real-time monitoring and control of mpox epidemics, and can guide future vaccine policy in a highly susceptible population.
Collapse
Affiliation(s)
- Vítor Borges
- Genomics and Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Mariana Perez Duque
- Epidemiology and Statistics Division, Directorate-General of Health, Lisbon, Portugal
- Pathogen Dynamics Group, Department of Genetics, University of Cambridge, Cambridge, United Kingdom
| | - João Vieira Martins
- Epidemiology and Statistics Division, Directorate-General of Health, Lisbon, Portugal
| | - Paula Vasconcelos
- Public Health Emergency Centre, Directorate-General of Health, Lisbon, Portugal
| | - Rita Ferreira
- Genomics and Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Daniel Sobral
- Genomics and Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Ana Pelerito
- Emergency Response and Biopreparedness Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Isabel Lopes de Carvalho
- Emergency Response and Biopreparedness Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Maria Sofia Núncio
- Emergency Response and Biopreparedness Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Maria José Borrego
- National Reference Laboratory for Sexually Transmitted Infections, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Cornelius Roemer
- Biozentrum, University of Basel, Basel, Switzerland
- Swiss Institute of Bioinformatics, Basel, Switzerland
| | - Richard A Neher
- Biozentrum, University of Basel, Basel, Switzerland
- Swiss Institute of Bioinformatics, Basel, Switzerland
| | - Megan O'Driscoll
- Pathogen Dynamics Group, Department of Genetics, University of Cambridge, Cambridge, United Kingdom
| | - Raquel Rocha
- National Reference Laboratory for Sexually Transmitted Infections, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Sílvia Lopo
- National Reference Laboratory for Sexually Transmitted Infections, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Raquel Neves
- National Reference Laboratory for Sexually Transmitted Infections, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Paula Palminha
- National Reference Laboratory for Sexually Transmitted Infections, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Luís Coelho
- Genomics and Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Alexandra Nunes
- Genomics and Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
- Veterinary and Animal Research Centre (CECAV), Faculty of Veterinary Medicine, Lusófona University, Lisbon, Portugal
| | - Joana Isidro
- Genomics and Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Miguel Pinto
- Genomics and Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - João Dourado Santos
- Genomics and Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Verónica Mixão
- Genomics and Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Daniela Santos
- Technology and Innovation Unit, Department of Human Genetics, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Silvia Duarte
- Technology and Innovation Unit, Department of Human Genetics, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Luís Vieira
- Technology and Innovation Unit, Department of Human Genetics, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Fátima Martins
- Technical Board, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Jorge Machado
- Department Coordination, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Vítor Cabral Veríssimo
- Epidemiology and Statistics Division, Directorate-General of Health, Lisbon, Portugal
- Public Health Unit, ACES Cascais, ARSLVT, Cascais, Portugal
| | - Berta Grau
- Epidemiology and Statistics Division, Directorate-General of Health, Lisbon, Portugal
- Public Health Emergency Centre, Directorate-General of Health, Lisbon, Portugal
- ECDC Fellowship Programme, Field Epidemiology path (EPIET), European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
- Directorate of Information and Analysis, Directorate-General of Health, Lisbon, Portugal
| | - André Peralta-Santos
- Directorate of Information and Analysis, Directorate-General of Health, Lisbon, Portugal
- Comprehensive Health Research Centre (CHRC), Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - José Neves
- Serviço de Dermatovenereologia, Consulta de DST, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal
| | - Margarida Caldeira
- Serviço de Dermatovenereologia, Consulta de DST, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal
| | - Mafalda Pestana
- Serviço de Dermatovenereologia, Consulta de DST, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal
| | - Cândida Fernandes
- Serviço de Dermatovenereologia, Consulta de DST, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal
| | - João Caria
- Serviço de Doenças Infeciosas, Hospital de Curry Cabral, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal
| | - Raquel Pinto
- Serviço de Doenças Infeciosas, Hospital de Curry Cabral, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal
| | - Diana Póvoas
- Serviço de Doenças Infeciosas, Hospital de Curry Cabral, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal
- Instituto Gulbenkian de Ciência, Oeiras, Portugal
| | - Fernando Maltez
- Serviço de Doenças Infeciosas, Hospital de Curry Cabral, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal
| | - Ana Isabel Sá
- Unidade de Doenças Sexualmente Transmissíveis da Lapa, Lisbon, Portugal
| | | | - Eugénio Teófilo
- GAT - Grupo de Ativistas em Tratamentos, Av. Paris, Lisbon, Portugal
| | - Miguel Rocha
- GAT - Grupo de Ativistas em Tratamentos, Av. Paris, Lisbon, Portugal
| | - Virginia Moneti
- GAT - Grupo de Ativistas em Tratamentos, Av. Paris, Lisbon, Portugal
| | - Luis Miguel Duque
- GAT - Grupo de Ativistas em Tratamentos, Av. Paris, Lisbon, Portugal
| | | | - Teresa Baptista
- GAT - Grupo de Ativistas em Tratamentos, Intendente, Lisbon, Portugal
| | - Joana Vasconcelos
- Serviço de Doenças Infeciosas e Medicina Tropical, Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
| | - Sara Casanova
- Serviço de Doenças Infeciosas e Medicina Tropical, Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
| | - Kamal Mansinho
- Serviço de Doenças Infeciosas e Medicina Tropical, Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
| | - João Vaz Alves
- Serviço de Doenças Infeciosas e Medicina Tropical, Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
| | - João Alves
- Serviço de Dermatovenereologia, Hospital Garcia de Orta, Almada, Portugal
| | - António Silva
- Serviço de Dermatovenereologia, Hospital Garcia de Orta, Almada, Portugal
| | - Miguel Alpalhão
- Dermatology Department, Centro Hospitalar Universitário Lisboa Norte EPE, Lisbon, Portugal
- Dermatology Research Unit (PFilipe Lab), Instituto de Medicina Molecular João Lobo Antunes, University of Lisbon, Lisbon, Portugal
- Dermatology University Clinic, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Cláudia Brazão
- Dermatology Department, Centro Hospitalar Universitário Lisboa Norte EPE, Lisbon, Portugal
| | - Diogo Sousa
- Dermatology Department, Centro Hospitalar Universitário Lisboa Norte EPE, Lisbon, Portugal
| | - Paulo Filipe
- Dermatology Department, Centro Hospitalar Universitário Lisboa Norte EPE, Lisbon, Portugal
- Dermatology Research Unit (PFilipe Lab), Instituto de Medicina Molecular João Lobo Antunes, University of Lisbon, Lisbon, Portugal
- Dermatology University Clinic, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Patrícia Pacheco
- Serviço de Infeciologia, Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal
| | - Francesca Peruzzu
- Serviço de Infeciologia, Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal
| | | | - Luís Ferreira
- Serviço Infeciologia do CHUP, Largo Professor Abel Salazar, Porto, Portugal
| | - Josefina Mendez
- Serviço Infeciologia do CHUP, Largo Professor Abel Salazar, Porto, Portugal
| | - Sofia Jordão
- Serviço de Doenças Infeciosas, Hospital Pedro Hispano - ULS Matosinhos, Matosinhos, Portugal
| | - Frederico Duarte
- Serviço de Doenças Infeciosas, Hospital Pedro Hispano - ULS Matosinhos, Matosinhos, Portugal
| | - Maria João Gonçalves
- Serviço de Doenças Infeciosas, Hospital Pedro Hispano - ULS Matosinhos, Matosinhos, Portugal
| | - Eduarda Pena
- Serviço de Doenças Infeciosas, Hospital Pedro Hispano - ULS Matosinhos, Matosinhos, Portugal
| | - Claúdio Nunes Silva
- Serviço de Doenças Infeciosas, Centro Hospitalar Universitário de São João, Porto, Portugal
| | | | - Margarida Tavares
- Serviço de Doenças Infeciosas, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Graça Freitas
- National Health Authority, Directorate-General of Health, Lisbon, Portugal
| | - Rita Cordeiro
- Emergency Response and Biopreparedness Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - João Paulo Gomes
- Genomics and Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal.
- Veterinary and Animal Research Centre (CECAV), Faculty of Veterinary Medicine, Lusófona University, Lisbon, Portugal.
| |
Collapse
|
6
|
Carvalho KD, Daltro C, Rocha R, Cotrim HP. Nonalcoholic fatty liver disease: A risk factor for chronic kidney disease. Ann Hepatol 2023; 28:101122. [PMID: 37271483 DOI: 10.1016/j.aohep.2023.101122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/15/2023] [Accepted: 05/18/2023] [Indexed: 06/06/2023]
Affiliation(s)
- Kellyane Dias Carvalho
- Post- graduate Program in Medicine and Health - Medicine School, Federal University of Bahia, Brazil
| | - Carla Daltro
- Post- graduate Program in Medicine and Health - Medicine School, Federal University of Bahia, Brazil
| | - Raquel Rocha
- Post- graduate Program in Medicine and Health - Medicine School, Federal University of Bahia, Brazil
| | - Helma P Cotrim
- Post- graduate Program in Medicine and Health - Medicine School, Federal University of Bahia, Brazil.
| |
Collapse
|
7
|
Kocillari L, Rocha R, Coletta L, Gozzi A, Panzeri S. FV 4 Mouse resting-state functional neuroimaging displays signatures of criticality. Clin Neurophysiol 2023. [DOI: 10.1016/j.clinph.2023.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
|
8
|
Passos RA, Costa PRF, da Maia Lima CF, Santana GMS, David V, de Jesus Santos G, Zaltman C, Soares-Mota M, Rocha R. Thiols as a marker of inflammatory bowel disease activity: a systematic review. BMC Gastroenterol 2023; 23:94. [PMID: 36977983 PMCID: PMC10052829 DOI: 10.1186/s12876-023-02711-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 03/03/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND Evidence indicates that inflammation in Inflammatory Bowel Disease (IBD) is associated with increased systemic levels of reactive oxygen species. Systemic oxidative stress has been associated with reduced levels of plasma thiols. Less invasive tests capable of reflecting and predicting IBD activity are increasingly sought after. We sought to systematically review the evidence inherent in serum thiol levels as a marker of Crohn's Disease and Ulcerative Colitis activity (PROSPERO: CRD42021255521). METHODS The highest quality documents for systematic reviews standards were used as reference. Articles were searched on Medline via PubMed, VHL, LILACS, WOS, EMBASE, SCOPUS, COCHRANE, CINAHL, OVID, CTGOV, WHO/ICTRP, OPENGREY, BDTD and CAPES, between August, 03 and September, 03 on 2021. Descriptors were defined according to the Medical Subject Heading. Of the 11 articles selected for full reading, 8 were included in the review. It was not possible to perform a pooled analysis of the studies, as there were no combinable studies between subjects with active IBD and controls/inactive disease. RESULTS Findings from the individual studies included in this review suggest an association between disease activity and systemic oxidation, as measured by serum thiol levels, however, there are limitations that preclude weighting the study results in a meta-analysis. CONCLUSIONS We recommend conducting better-designed and controlled studies, that include individuals of both phenotypes and at different stages of IBD, involving a larger number of participants, using the standardization of the technique for measuring serum thiols, to confirm whether thiols can be a good parameter for monitoring the clinical course of these intestinal diseases and the degree of clinical applicability.
Collapse
Affiliation(s)
- Rebeca Araujo Passos
- Postgraduate Program in Food, Nutrition and Health. School of Nutrition, Federal University of Bahia, Bahia, Brazil.
- Health Sciences Center, Federal University of Recôncavo da Bahia (UFRB), Bahia, Brazil.
| | - Priscila Ribas Farias Costa
- Postgraduate Program in Food, Nutrition and Health. School of Nutrition, Federal University of Bahia, Bahia, Brazil
| | | | | | - Victor David
- Federal University of Rio de Janeiro (UFRJ), Bahia, Brazil
| | - Geisa de Jesus Santos
- Postgraduate Program in Food, Nutrition and Health. School of Nutrition, Federal University of Bahia, Bahia, Brazil
| | - Cyrla Zaltman
- Federal University of Rio de Janeiro (UFRJ), Bahia, Brazil
| | | | - Raquel Rocha
- Postgraduate Program in Food, Nutrition and Health. School of Nutrition, Federal University of Bahia, Bahia, Brazil
| |
Collapse
|
9
|
Fortes FML, Rocha R, Santana GO. Thiopurines are an independent risk factor for active tuberculosis in inflammatory bowel disease patients. World J Gastroenterol 2023; 29:1536-1538. [PMID: 36998430 PMCID: PMC10044854 DOI: 10.3748/wjg.v29.i9.1536] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/05/2023] [Accepted: 02/22/2023] [Indexed: 03/07/2023] Open
Abstract
The use of thiopurines is an independent risk factor for active tuberculosis in patients with inflammatory bowel disease.
Collapse
Affiliation(s)
- Flora Maria Lorenzo Fortes
- Ciências da Vida, Universidade do Estado da Bahia, Salvador 41150000, Brazil, and Programa de Pós-Graduação em Medicina e Saúde, Universidade Federal da Bahia, Salvador 40110060, Brazil
| | - Raquel Rocha
- Ciência da Nutrição, Universidade Federal da Bahia, Salvador 40110160, Brazil
| | - Genoile Oliveira Santana
- Ciências da Vida, Universidade do Estado da Bahia, Salvador 41150000, Brazil, and Programa de Pós-Graduação em Medicina e Saúde, Universidade Federal da Bahia, Salvador 40110060, Brazil
| |
Collapse
|
10
|
Rocha R, Hussey R, Pepi L, Azadi P, Mitchum M. Discovery of Novel Effector Protein Candidates Produced in the Dorsal Gland of Root-Knot Nematode Adult Females. Mol Plant Microbe Interact 2023. [PMID: 36847650 DOI: 10.1094/mpmi-11-22-0232-r] [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] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Root-knot nematodes (RKN; Meloidogyne spp.) represent one of the most damaging groups of plant-parasitic nematodes. They secrete effector proteins through a protrusible stylet to manipulate host cells for their benefit. Stylet-secreted effector proteins are produced within specialized secretory esophageal gland cells, one dorsal (DG) and two subventral (SvG), whose activity differ throughout the nematode life cycle. Previous gland transcriptomic profiling studies identified dozens of candidate RKN effectors, but were focused on the juvenile stages of the nematode when the SvGs are most active. We developed a new approach to enrich for the active DGs of RKN M. incognita adult females for RNA and protein extraction. Female heads were manually cut from the body, and a combination of sonication/vortexing was used to dislodge contents inside the heads. DG-enriched fractions were collected by filtering using cell strainers. Comparative transcriptome profiling of pre-parasitic second-stage juveniles, female heads, and DG-enriched samples was conducted using RNA sequencing. Application of an established effector mining pipeline led to the identification of 83 candidate effector genes upregulated in DG-enriched samples of adult females that code for proteins with a predicted signal peptide, but lack transmembrane domains or homology to proteins in the free-living nematode Caenorhabditis elegans. In situ hybridization resulted in the identification of 14 new DG-specific candidate effectors expressed in adult females. Taken together, we have identified novel candidate Meloidogyne effector genes that may have essential roles during later stages of parasitism.
Collapse
Affiliation(s)
- Raquel Rocha
- University of Georgia, 1355, Plant Pathology, 111 Riverbend Road, Athens, Georgia, United States, 30602-0002;
| | - Richard Hussey
- Plant Pathology, University of Georgia, Athens, Georgia, United States, 30602-7274;
| | - Lauren Pepi
- University of Georgia, 1355, Athens, Georgia, United States;
| | - Parastoo Azadi
- University of Georgia Complex Carbohydrate Research Center, 123423, Athens, Georgia, United States;
| | - Melissa Mitchum
- University of Georgia, 1355, Plant Pathology, 111 Riverbend Rd, Athens, Georgia, United States, 30602-0002;
| |
Collapse
|
11
|
Fahy MR, Kelly ME, Aalbers AGJ, Abdul Aziz N, Abecasis N, Abraham-Nordling M, Akiyoshi T, Alberda W, Albert M, Andric M, Angeles MA, Angenete E, Antoniou A, Auer R, Austin KK, Aytac E, Aziz O, Bacalbasa N, Baker RP, Bali M, Baransi S, Baseckas G, Bebington B, Bedford M, Bednarski BK, Beets GL, Berg PL, Bergzoll C, Beynon J, Biondo S, Boyle K, Bordeianou L, Brecelj E, Bremers AB, Brunner M, Buchwald P, Bui A, Burgess A, Burger JWA, Burling D, Burns E, Campain N, Carvalhal S, Castro L, Caycedo-Marulanda A, Ceelan W, Chan KKL, Chang GJ, Chang M, Chew MH, Chok AY, Chong P, Clouston H, Codd M, Collins D, Colquhoun AJ, Constantinides J, Corr A, Coscia M, Cosimelli M, Cotsoglou C, Coyne PE, Croner RS, Damjanovich L, Daniels IR, Davies M, Delaney CP, de Wilt JHW, Denost Q, Deutsch C, Dietz D, Domingo S, Dozois EJ, Drozdov E, Duff M, Eglinton T, Enriquez-Navascues JM, Espín-Basany E, Evans MD, Eyjólfsdóttir B, Fearnhead NS, Ferron G, Flatmark K, Fleming FJ, Flor B, Folkesson J, Frizelle FA, Funder J, Gallego MA, Gargiulo M, García-Granero E, García-Sabrido JL, Gargiulo M, Gava VG, Gentilini L, George ML, George V, Georgiou P, Ghosh A, Ghouti L, Gil-Moreno A, Giner F, Ginther DN, Glyn T, Glynn R, Golda T, Griffiths B, Harris DA, Hagemans JAW, Hanchanale V, Harji DP, Helewa RM, Hellawell G, Heriot AG, Hochman D, Hohenberger W, Holm T, Hompes R, Hornung B, Hurton S, Hyun E, Ito M, Iversen LH, Jenkins JT, Jourand K, Kaffenberger S, Kandaswamy GV, Kapur S, Kanemitsu Y, Kazi M, Kelley SR, Keller DS, Ketelaers SHJ, Khan MS, Kiran RP, Kim H, Kim HJ, Koh CE, Kok NFM, Kokelaar R, Kontovounisios C, Kose F, Koutra M, Kristensen HØ, Kroon HM, Kumar S, Kusters M, Lago V, Lampe B, Lakkis Z, Larach JT, Larkin JO, Larsen SG, Larson DW, Law WL, Lee PJ, Limbert M, Loria A, Lydrup ML, Lyons A, Lynch AC, Maciel J, Manfredelli S, Mann C, Mantyh C, Mathis KL, Marques CFS, Martinez A, Martling A, Mehigan BJ, Meijerink WJHJ, Merchea A, Merkel S, Mehta AM, Mikalauskas S, McArthur DR, McCormick JJ, McCormick P, McDermott FD, McGrath JS, Malde S, Mirnezami A, Monson JRT, Navarro AS, Negoi I, Neto JWM, Ng JL, Nguyen B, Nielsen MB, Nieuwenhuijzen GAP, Nilsson PJ, Nordkamp S, Nugent T, Oliver A, O’Dwyer ST, O’Sullivan NJ, Paarnio K, Palmer G, Pappou E, Park J, Patsouras D, Peacock O, Pellino G, Peterson AC, Pinson J, Poggioli G, Proud D, Quinn M, Quyn A, Rajendran N, Radwan RW, Rajendran N, Rao C, Rasheed S, Rausa E, Regenbogen SE, Reims HM, Renehan A, Rintala J, Rocha R, Rochester M, Rohila J, Rothbarth J, Rottoli M, Roxburgh C, Rutten HJT, Safar B, Sagar PM, Sahai A, Saklani A, Sammour T, Sayyed R, Schizas AMP, Schwarzkopf E, Scripcariu D, Scripcariu V, Selvasekar C, Shaikh I, Simpson A, Skeie-Jensen T, Smart NJ, Smart P, Smith JJ, Solbakken AM, Solomon MJ, Sørensen MM, Sorrentino L, Steele SR, Steffens D, Stitzenberg K, Stocchi L, Stylianides NA, Swartling T, Spasojevic M, Sumrien H, Sutton PA, Swartking T, Takala H, Tan EJ, Taylor C, Tekin A, Tekkis PP, Teras J, Thaysen HV, Thurairaja R, Thorgersen EB, Toh EL, Tsarkov P, Tsukada Y, Tsukamoto S, Tuech JJ, Turner WH, Tuynman JB, Valente M, van Ramshorst GH, van Zoggel D, Vasquez-Jimenez W, Vather R, Verhoef C, Vierimaa M, Vizzielli G, Voogt ELK, Uehara K, Urrejola G, Wakeman C, Warrier SK, Wasmuth HH, Waters PS, Weber K, Weiser MR, Wheeler JMD, Wild J, Williams A, Wilson M, Wolthuis A, Yano H, Yip B, Yip J, Yoo RN, Zappa MA, Winter DC. Minimum standards of pelvic exenterative practice: PelvEx Collaborative guideline. Br J Surg 2022; 109:1251-1263. [PMID: 36170347 DOI: 10.1093/bjs/znac317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 07/18/2022] [Accepted: 08/18/2022] [Indexed: 12/31/2022]
Abstract
This document outlines the important aspects of caring for patients who have been diagnosed with advanced pelvic cancer. It is primarily aimed at those who are establishing a service that adequately caters to this patient group. The relevant literature has been summarized and an attempt made to simplify the approach to management of these complex cases.
Collapse
|
12
|
Baldeiras I, Silva-Spínola A, Lima M, Leitão MJ, Durães J, Vieira D, Tbuas-Pereira M, Cruz VT, Rocha R, Alves L, Machado Á, Milheiro M, Santiago B, Santana I. Alzheimer’s Disease Diagnosis Based on the Amyloid, Tau, and Neurodegeneration Scheme (ATN) in a Real-Life Multicenter Cohort of General Neurological Centers. J Alzheimers Dis 2022; 90:419-432. [DOI: 10.3233/jad-220587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: The ATN scheme was proposed as an unbiased biological characterization of the Alzheimer’s disease (AD) spectrum, grouping biomarkers into three categories: brain Amyloidosis-A, Tauopathy-T, Neurodegeneration-N. Although this scheme was mainly recommended for research, it is relevant for diagnosis. Objective: To evaluate the ATN scheme performance in real-life cohorts reflecting the inflow of patients with cognitive complaints and different underlying disorders in general neurological centers. Methods: We included patients (n = 1,128) from six centers with their core cerebrospinal fluid-AD biomarkers analyzed centrally. A was assessed through Aβ 42/Aβ 40, T through pTau-181, and N through tTau. Association between demographic features, clinical diagnosis at baseline/follow-up and ATN profiles was assessed. Results: The prevalence of ATN categories was: A-T-N-: 28.3% ; AD continuum (A + T-/+N-/+): 47.8% ; non-AD (A- plus T or/and N+): 23.9% . ATN profiles prevalence was strongly influenced by age, showing differences according to gender, APOE genotype, and cognitive status. At baseline, 74.6% of patients classified as AD fell in the AD continuum, decreasing to 47.4% in mild cognitive impairment and 42.3% in other neurodegenerative conditions. At follow-up, 41% of patients changed diagnosis, and 92% of patients that changed to AD were classified within the AD continuum. A + was the best individual marker for predicting a final AD diagnosis, and the combinations A + T+(irrespective of N) and A + T+N+had the highest overall accuracy (83%). Conclusion: The ATN scheme is useful to guide AD diagnosis real-life neurological centers settings. However, it shows a lack of accuracy for patients with other types of dementia. In such cases, the inclusion of other markers specific for non-AD proteinopathies could be an important aid to the differential diagnosis.
Collapse
Affiliation(s)
- Inês Baldeiras
- Neurology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
- Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal
- Center for Neuroscience and Cell Biology; Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal
| | - Anuschka Silva-Spínola
- Center for Neuroscience and Cell Biology; Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal
| | - Marisa Lima
- Neurology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
- Center for Neuroscience and Cell Biology; Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | - Maria João Leitão
- Center for Neuroscience and Cell Biology; Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal
| | - João Durães
- Neurology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
- Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal
- Center for Neuroscience and Cell Biology; Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal
| | - Daniela Vieira
- Neurology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Miguel Tbuas-Pereira
- Neurology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
- Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal
- Center for Neuroscience and Cell Biology; Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal
| | | | - Raquel Rocha
- ULSM Unidade Local de Sáude de Matosinhos, Matosinhos, Portugal
| | - Luisa Alves
- Hospital Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal
| | | | | | | | - Isabel Santana
- Neurology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
- Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal
- Center for Neuroscience and Cell Biology; Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal
| |
Collapse
|
13
|
Almeida NS, Rocha R, de Souza CA, da Cruz ACS, Ribeiro BDR, Vieira LV, Daltro C, Silva R, Sarno M, Cotrim HP. Prevalence of sarcopenia using different methods in patients with non-alcoholic fatty liver disease. World J Hepatol 2022; 14:1643-1651. [PMID: 36157861 PMCID: PMC9453470 DOI: 10.4254/wjh.v14.i8.1643] [Citation(s) in RCA: 2] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 05/11/2022] [Accepted: 07/26/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Sarcopenia is a clinical condition associated with several liver diseases and it includes non-alcoholic fatty liver disease (NAFLD) in its broad spectrum as steatosis, steatohepatitis and fibrosis. However, the criteria to define sarcopenia are diverse, and even those established in consensus have been discussed regarding their performance in making an accurate diagnosis.
AIM To evaluate the prevalence of sarcopenia, using different methods, in patients with NAFLD, and its association with clinical-anthropometric parameters.
METHODS This was an observational study of outpatients with NAFLD. Sarcopenia was defined by the European Working Group Consensus on Sarcopenia in Older People of 2010 (EWGSOP1) and 2018 (EWGSOP2). The skeletal muscle index was used to estimate muscle mass, handgrip strength was assessed using the dynamometer and physical performance by walking a distance of four meters at usual walking speed. The non-invasive fibrosis scores, fibrosis-4 (FIB-4) index and Aspartate aminotransferase to platelet ratio index (APRI), were used to assess the absence and presence of fibrosis.
RESULTS Fifty-seven individuals with NAFLD were evaluated, the mean age (SD) was 52.7 (11.3) years and 75.4% were female. Fibrosis assessed by FIB-4 and APRI was observed in 3.7% and 16.6% of patients with NAFLD, respectively. The diagnosis of sarcopenia was identified only by EWGSOP1 in 3.5% of NAFLD patients, and the prevalence of probable/pre-sarcopenia was higher using the EWGSOP2 consensus at 26.3%, when compared to 1.8% with EWGSOP1. Sarcopenia defined by EWGSOP1, was associated with grade I steatosis, but without overweight (P < 0.05). An association between sarcopenia and fibrosis was not observed (P > 0.05). EWGSOP2 showed a greater number of patients with probable sarcopenia, and who were overweight (12 (80.0%)), with a higher degree of steatosis [11 (73.3%) and presence of fibrosis (1 (6.7%), FIB-4 and 3 (20.0%), APRI] compared to EWGSOP1 [1 (100%), 0 (0.0%), 0 (0.0%), FIB-4 and 0 (0.0%), APRI, respectively].
CONCLUSION The present study showed that sarcopenia in NAFLD was not predominant in patients without fibrosis, by both diagnostic methods. In addition, the prevalence of probable sarcopenia also depends on the method applied.
Collapse
Affiliation(s)
- Naiade Silveira Almeida
- Programa de Pós-Graduação em Medicina e Saúde, Universidade Federal da Bahia, Salvador 40110-060, BA, Brazil
| | - Raquel Rocha
- Departamento de Ciência da Nutrição, Escola de Nutrição, Universidade Federal da Bahia, Salvador 40110-060, Brazil
| | - Claudineia Almeida de Souza
- Programa de Pós-Graduação em Medicina e Saúde, Universidade Federal da Bahia, Salvador 40110-060, BA, Brazil
| | - Ana Carolina Sirelli da Cruz
- Departamento de Ciência da Nutrição, Escola de Nutrição, Universidade Federal da Bahia, Salvador 40110-060, Brazil
| | - Bruna dos Reis Ribeiro
- Departamento de Ciência da Nutrição, Escola de Nutrição, Universidade Federal da Bahia, Salvador 40110-060, Brazil
| | - Luiza Valois Vieira
- Departamento de Ciência da Nutrição, Escola de Nutrição, Universidade Federal da Bahia, Salvador 40110-060, Brazil
| | - Carla Daltro
- Programa de Pós-Graduação em Medicina e Saúde, Universidade Federal da Bahia, Salvador 40110-060, BA, Brazil
- Departamento de Ciência da Nutrição, Escola de Nutrição, Universidade Federal da Bahia, Salvador 40110-060, Brazil
| | - Rafael Silva
- Programa de Pós-Graduação em Medicina e Saúde, Universidade Federal da Bahia, Salvador 40110-060, BA, Brazil
- Caliper Clínica e Escola de Imagem, Salvador 41810-012, Brazil
| | - Manoel Sarno
- Programa de Pós-Graduação em Medicina e Saúde, Universidade Federal da Bahia, Salvador 40110-060, BA, Brazil
- Caliper Clínica e Escola de Imagem, Salvador 41810-012, Brazil
| | - Helma Pinchemel Cotrim
- Programa de Pós-Graduação em Medicina e Saúde, Universidade Federal da Bahia, Salvador 40110-060, BA, Brazil
| |
Collapse
|
14
|
Lopes MB, Lyra AC, Rocha R, Coqueiro FG, Lima CA, de Oliveira CC, Santana GO. Overweight and abdominal fat are associated with normal bone mineral density in patients with ulcerative colitis. World J Gastrointest Pharmacol Ther 2022; 13:57-66. [PMID: 36051180 PMCID: PMC9297289 DOI: 10.4292/wjgpt.v13.i4.57] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 04/27/2022] [Accepted: 05/28/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Low bone mineral density (BMD) is common in patients with inflammatory bowel disease. However, nutritional risk factors for low BMD in the ulcerative colitis (UC) population are still poorly understood.
AIM To investigate the association of anthropometric indicators and body composition with BMD in patients with UC.
METHODS This is a cross-sectional study on adult UC patients of both genders who were followed on an outpatient basis. A control group consisting of healthy volunteers, family members, and close people was also included. The nutritional indicators evaluated were body mass index (BMI), total body mass (TBM), waist circumference (WC), body fat in kg (BFkg), body fat in percentage (BF%), trunk BF (TBF), and also lean mass. Body composition and BMD assessments were performed by dual-energy X-ray absorptiometry.
RESULTS The sociodemographic characteristics of patients with UC (n = 68) were similar to those of healthy volunteers (n = 66) (P > 0.05). Most patients (97.0%) were in remission of the disease, 58.8% were eutrophic, 33.8% were overweight, 39.0% had high WC, and 67.6% had excess BF%. However, mean BMI, WC, BFkg, and TBF of UC patients were lower when compared to those of the control group (P < 0.05). Reduced BMD was present in 41.2% of patients with UC (38.2% with osteopenia and 2.9% with osteoporosis) and 3.0% in the control group (P < 0.001). UC patients with low BMD had lower BMI, TBM, and BFkg values than those with normal BMD (P < 0.05). Male patients were more likely to have low BMD (prevalence ratio [PR] = 1.86; 95% confidence interval [CI]: 1.07-3.26). Those with excess weight (PR = 0.43; 95%CI: 0.19-0.97) and high WC (PR = 0.44; 95%CI: 0.21-0.94) were less likely to have low BMD.
CONCLUSION Patients with UC in remission have a high prevalence of metabolic bone diseases. Body fat appears to protect against the development of low BMD in these patients.
Collapse
Affiliation(s)
- Mirella Brasil Lopes
- Programa de Pós-graduação em Medicina e Saúde, Universidade Federal da Bahia, Salvador 40110-060, Brazil
| | - Andre Castro Lyra
- Programa de Pós-graduação em Medicina e Saúde, Universidade Federal da Bahia, Salvador 40110-060, Brazil
| | - Raquel Rocha
- Departamento Ciências da Nutrição, Universidade Federal da Bahia, Salvador 40110-060, Brazil
| | - Fernanda Gomes Coqueiro
- Departamento Ciências da Nutrição, Universidade Federal da Bahia, Salvador 40110-060, Brazil
| | - Carla Andrade Lima
- Programa de Pós-graduação em Medicina e Saúde, Universidade Federal da Bahia, Salvador 40110-060, Brazil
| | | | - Genoile Oliveira Santana
- Programa de Pós-graduação em Medicina e Saúde, Universidade Federal da Bahia, Salvador 40110-060, Brazil
- Departamento Ciências da Vida, Universidade do Estado da Bahia, Salvador 41.150-000, Brazil
| |
Collapse
|
15
|
Ferrari G, Giannichi B, Resende B, Paiva L, Rocha R, Falbel F, Rache B, Adami F, Rezende L. The economic burden of overweight and obesity in Brazil: perspectives for the Brazilian Unified Health System. Public Health 2022; 207:82-87. [DOI: 10.1016/j.puhe.2022.03.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 03/21/2022] [Accepted: 03/22/2022] [Indexed: 02/06/2023]
|
16
|
Abstract
The intestinal microbiota and its role in health and disease processes have been the subject of several studies. It is known that changes in the intestinal microbiota occur due to several factors, such as the use of medication, age, lifestyle and diseases, which can modify intestinal homeostasis and lead to excessive growth of bacteria in the small intestine, triggering a clinical condition called small bowel bacterial overgrowth (SIBO). Individuals with SIBO may present gastrointestinal symptoms ranging from nausea, diarrhea and/or constipation, and flatulence to distension and abdominal pain, resulting from poor absorption of nutrients or changes in intestinal permeability. The gold-standard treatment is based on the use of antibiotics to eradicate bacterial overgrowth. Some studies have evaluated diets in the treatment of SIBO; however, the studies are of low methodological quality, making extrapolation of the results to clinical practice unfeasible. Thus, there is still not enough scientific evidence to support a specific type of diet for the treatment of SIBO.
Collapse
Affiliation(s)
- Claudineia Souza
- Programa de Pós graduação em Medicina e Saúde, Universidade Federal da Bahia, Salvador 40110-060, BA, Brazil
| | - Raquel Rocha
- Sciences of Nutrition, Federal University of Bahia, Salvador 40110-060, BA, Brazil
| | - Helma Pinchemel Cotrim
- Programa de Pós graduação em Medicina e Saúde, Universidade Federal da Bahia, Salvador 40110-060, BA, Brazil
| |
Collapse
|
17
|
Rodrigues R, Vieira J, Vasconcelos G, Marinho L, Neto J, Siqueira R, Rocha R, Almeida G. Association of ANK2 Mutation and Massive Myocardial Calcification: A Case Report. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
18
|
Rocha R, Matos M, Pinto J, Sarmento A. Zoonotic foodborne diseases in a tertiary healthcare setting: diagnostics, resistance and underreporting of campylobacteriosis in Northern Portugal. Int J Infect Dis 2022. [DOI: 10.1016/j.ijid.2021.12.192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
|
19
|
Guedes ALV, Lorentz AL, Rios LFDAR, Freitas BC, Dias AGN, Uhlein ALE, Vieira Neto FO, Jesus JFS, Torres TDSN, Rocha R, Andrade VD, Santana GO. Hospitalizations and in-hospital mortality for inflammatory bowel disease in Brazil. World J Gastrointest Pharmacol Ther 2022; 13:1-10. [PMID: 35116179 PMCID: PMC8788161 DOI: 10.4292/wjgpt.v13.i1.1] [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] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 08/28/2021] [Accepted: 01/06/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Inflammatory bowel disease (IBD) is associated with complications, frequent hospitalizations, surgery and death. The introduction of biologic drugs into the therapeutic arsenal in the last two decades, combined with an expansion of immunosuppressant therapy, has changed IBD management and may have altered the profile of hospitalizations and in-hospital mortality (IHM) due to IBD.
AIM To describe hospitalizations from 2008 to 2018 and to analyze IHM from 1998 to 2017 for IBD in Brazil.
METHODS This observational, retrospective, ecological study used secondary data on hospitalizations for IBD in Brazil for 2008-2018 to describe hospitalizations and for 1998-2017 to analyze IHM. Hospitalization data were obtained from the Hospital Information System of the Brazilian Unified Health System and population data from demographic censuses. The following variables were analyzed: Number of deaths and hospitalizations, length of hospital stay, financial costs of hospitalization, sex, age, ethnicity and type of hospital admission.
RESULTS There was a reduction in the number of IBD hospitalizations, from 6975 admissions in 1998 to 4113 in 2017 (trend: y = -0.1682x + 342.8; R2 = 0.8197; P < 0.0001). The hospitalization rate also decreased, from 3.60/100000 in 2000 to 2.17 in 2010. IHM rates varied during the 20-year period, between 2.06 in 2017 and 3.64 in 2007, and did not follow a linear trend (y = -0.0005049x + 2.617; R2 = 0,00006; P = 0.9741). IHM rates also varied between regions, increasing in all but the southeast, which showed a decreasing trend (y = -0.1122x + 4.427; R2 = 0,728; P < 0.0001). The Southeast region accounted for 44.29% of all hospitalizations. The Northeast region had the highest IHM rate (2.86 deaths/100 admissions), with an increasing trend (y = 0.1105x + 1.110; R2 = 0.6265; P < 0.0001), but the lowest hospitalization rate (1.15). The Midwest and South regions had the highest hospitalization rates (3.27 and 3.17, respectively). A higher IHM rate was observed for nonelective admissions (2.88), which accounted for 81% of IBD hospitalizations. The total cost of IBD hospitalizations in 2017 exhibited an increase of 37.5% compared to 2008.
CONCLUSION There has been a notable reduction in the number of hospitalizations for IBD in Brazil over 20 years. IHM rates varied and did not follow a linear trend.
Collapse
Affiliation(s)
| | - Amanda Lopes Lorentz
- Life Sciences Department, State University of Bahia, Salvador 41150-000, Bahia, Brazil
| | | | | | | | | | | | | | | | - Raquel Rocha
- Sciences of Nutrition, Federal University of Bahia, Salvador 40110-060, Bahia, Brazil
| | - Vitor D Andrade
- Medicine Department, Universidade Salvador (UNIFACS), Salvador 41820-021, Bahia, Brazil
| | - Genoile Oliveira Santana
- Life Sciences Department, State University of Bahia, Salvador 41150-000, Bahia, Brazil
- Medicine and Health Postgraduate Program, Federal University of Bahia, Salvador 40110-060, Bahia, Brazil
| |
Collapse
|
20
|
Almeida NS, Rocha R, Daltro C, Souza CAD, Silva RLPD, Sarno MAC, Cotrim HP. Anthropometric clinical indicators of visceral adiposity as predictors of nonalcoholic fatty liver disease. Rev Assoc Med Bras (1992) 2021; 67:1544-1549. [PMID: 34909876 DOI: 10.1590/1806-9282.20210316] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 08/24/2021] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVE This study aims to evaluate the role of anthropometric clinical indicators of visceral adiposity as predictors of NAFLD, identifying the cutoff points based on gender. METHODS This was a cross-sectional study conducted in patients with or without NAFLD. Waist circumference (WC), body mass index (BMI), waist-to-height ratio (WHtR), Conicity Index (C Index), and lipid accumulation product (LAP) were evaluated. RESULTS A total of 107 individuals were evaluated, of which 46.7% were diagnosed with NAFLD. Individuals with NAFLD presented higher values of WC, BMI, C Index, LAP, and WHtR when compared with those without NAFLD (p<0.05). For the total sample, the indicators WC, BMI, WHtR, LAP, and C Index had an area under the receiver operator characteristic curve (AUC) above 0.87, with no difference in the prediction of NAFLD in both sexes. WHtR (AUC=0.934) was the indicator of visceral adiposity with the best discriminatory power for NAFLD, followed by LAP (0.919), WC (0.912), C Index (0.907), and BMI (0.877). CONCLUSIONS The anthropometric clinical indicators of visceral adiposity showed high performance, especially the WHtR indicator, as NAFLD predictors.
Collapse
Affiliation(s)
- Naiade Silveira Almeida
- Universidade Federal da Bahia, Escola de Nutrição, Departamento de Ciências da Nutrição - Salvador (BA), Brazil
| | - Raquel Rocha
- Universidade Federal da Bahia, Escola de Nutrição, Departamento de Ciências da Nutrição - Salvador (BA), Brazil
| | - Carla Daltro
- Universidade Federal da Bahia, Programa de Pós-Graduação em Medicina e Saúde -Salvador (BA), Brazil
| | | | | | | | | |
Collapse
|
21
|
Barreto IDS, Santos ROD, Rocha R, Souza CD, Almeida N, Vieira LV, Leiróz R, Sarno M, Daltro C, Cotrim HP. Muscle mass and cellular membrane integrity assessment in patients with nonalcoholic fatty liver disease. Rev Assoc Med Bras (1992) 2021; 67:1233-1239. [PMID: 34816913 DOI: 10.1590/1806-9282.20201016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 07/20/2021] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVE To evaluate the association between muscle mass depletion and compromising of the cell membrane integrity and clinical-anthropometric characteristics in patients with nonalcoholic fatty liver disease. METHODS This observational study evaluated waist circumference, body mass index, and waist-to-height ratio in patients with nonalcoholic fatty liver disease. Skeletal mass index corrected by weight and impairment of cell membrane integrity were assessed using bioelectrical impedance analysis. RESULTS In 56 patients, muscle mass depletion was observed in 62.5% and cell membrane impairment in 28.6%. The metabolic syndrome and elevated aspartate aminotransferase were the only clinical factors associated with mass depletion (p<0.05). The linear regression analysis showed association between skeletal mass index and waist-to-height ratio and waist circumference, after adjustments (p<0.05). The phase angle value was not different between those with and without mass depletion, and also it did not have correlation with skeletal mass index and clinical parameters (p>0.05). CONCLUSIONS The prevalence of mass depletion and cell membrane impairment was higher in patients with nonalcoholic fatty liver disease. The muscle mass depletion was associated with central obesity, aspartate aminotransferase elevated, and metabolic syndrome; however, the phase angle is not associated with clinical and anthropometric data.
Collapse
Affiliation(s)
| | | | - Raquel Rocha
- Universidade Federal da Bahia, Escola de Nutrição - Salvador (BA), Brazil
| | | | - Naiade Almeida
- Universidade Federal da Bahia, Escola de Nutrição - Salvador (BA), Brazil
| | | | - Rafael Leiróz
- Universidade Federal da Bahia, Faculdade de Medicina da Bahia - Salvador (BA), Brazil
| | - Manoel Sarno
- Universidade Federal da Bahia, Faculdade de Medicina da Bahia - Salvador (BA), Brazil
| | - Carla Daltro
- Universidade Federal da Bahia, Escola de Nutrição - Salvador (BA), Brazil
| | | |
Collapse
|
22
|
Carvalho V, Cunha C, Rocha R, Massano J, Correia F, Coelho P, França S, Cruz VT, Cruto C. Transthyretin amyloid-related transitory events (TARTEs): Descriptive analysis of clinical, imagiological, and neurophysiological features. J Neurol Sci 2021; 429:118068. [PMID: 34530288 DOI: 10.1016/j.jns.2021.118068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 09/01/2021] [Accepted: 09/02/2021] [Indexed: 10/20/2022]
Abstract
Transthyretin-related familial amyloid polyneuropathy (ATTR-FAP) is a multisystemic disorder inherited as an autosomal dominant trait. Transitory events in ATTR-FAP patients are a feature of this disorder and remain poorly depicted in the literature. We aimed to describe a case series of ATTR-FAP patients who presented to our department with transitory events and document the clinical, neuroimaging and neurophysiological characteristics of the events. We collected data from eight patients carrying the Val30Met ATTR-FAP variant. We registered a total of 23 events. Of the eight patients, seven had been submitted to hepatic transplant. The events were either TIA-like or seizures, often followed by prolonged language, motor or sensory impairment. In 9 (39%) of the events, the patients presented with fever, but an infection was only found in 5 (21%). Cerebrospinal fluid analysis was performed in 5 patients. EEG was abnormal in at least 1 event in 7 of the 8 patients. Brain MRI was performed in 3 patients during the acute stage and showed no acute lesions. Although the etiology of these events remains unclear, brain MRI performed in the acute phase of acute TIA-like events and the EEG abnormalities, argues in favor of regional brain dysfunction due to amyloid deposition. Focal neurological episodes should be considered in long-term duration Val30Met ATTR-FAP patients, who present with acute neurological deficits or seizures.
Collapse
Affiliation(s)
- Vanessa Carvalho
- Department of Neurology, Hospital Pedro Hispano/Matosinhos Local Unit, Matosinhos, Portugal.
| | - Carlota Cunha
- Medical Practitioner, Lismore GP Superclinic, Goonellabah, Australia
| | - Raquel Rocha
- Department of Neurology, Hospital Pedro Hispano/Matosinhos Local Unit, Matosinhos, Portugal
| | - João Massano
- Department of Neurology, Centro Hospitalar Universitário São João, Porto, Portugal; Department of Clinical Neurosciences and Mental Health, Faculty of Medicine University of Porto, Porto, Portugal
| | - Filipe Correia
- Department of Neurology, Hospital Pedro Hispano/Matosinhos Local Unit, Matosinhos, Portugal
| | - Paulo Coelho
- Department of Neurology, Hospital Pedro Hispano/Matosinhos Local Unit, Matosinhos, Portugal
| | - Sara França
- Department of Neurology, Hospital Pedro Hispano/Matosinhos Local Unit, Matosinhos, Portugal
| | - Vitor Tedim Cruz
- Department of Neurology, Hospital Pedro Hispano/Matosinhos Local Unit, Matosinhos, Portugal; Epidemiologic Research Unit, Public Health Institute, University of Porto, Porto, Portugal
| | - Catarina Cruto
- Department of Neurology, Hospital Pedro Hispano/Matosinhos Local Unit, Matosinhos, Portugal
| |
Collapse
|
23
|
Carvalho R, Rodrigues T, Rocha R, Ribeiro J, Silva G, Carpinteiro L, Cortez-Dias N, Sousa J. Real-world comparison of different periprocedural antithrombotic strategies for atrial fibrillation catheter ablation. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Atrial Fibrillation (AF) catheter ablation carries high bleeding and thromboembolic risks, requiring a detailed assessment of overall risk-benefit profile regarding antithrombotic strategy. Vitamin K Anticoagulant (VKA) and Non-Vitamin K Antagonist Oral Anticoagulant (NOAC) have been used in the latest years in this setting, and with different interruption protocols periprocedural. Our goal was to evaluate the rate of acute adverse events (AAE) and compare them according to antithrombotic strategy used periprocedural, in a real-world basis.
Methods
A single-center retrospective study, including adult patients admitted to first AF catheter ablation, from 2004 to 2020. Different antithrombotic strategies (anticoagulation with VKA uninterrupted, anticoagulation with NOAC uninterrupted, no therapy or antiaggregation/interrupted ACO) were compared concerning the rate of any clinically relevant AAE; the composite of major AAE (hemopericardium and stroke/transient ischemic attack [TIA]) and minor AAE associated with vascular access. Descriptive statistics and logistic regression were used to compare groups according to the antithrombotic strategy with an alpha level of 0.05.
Results
Among the 868 patients included (mean age 59±12 yo, 67,5% [n=586] men), pulmonary vein isolation was performed under uninterrupted anticoagulation in 640 (73,7%), of which 595 patients with NOAC (68,5%) and 45 with VKA (5,2%). AF was paroxysmal, persistent and long-standing persistent in 63,4% (n=550), 21,4% (n=185) and 15,4% (n=133) patients, respectively. Mean CHADS-VASc score was 1,86±1,48. Over time there was a shift in the distribution of the type of antithrombotic therapy used, consistent with changes in recommendations (Graph 1).
The composite outcome occurred in 6,8% (n=62), including hemopericardium in 1,8% (n=16), stroke/TIA in 0,7% (n=6) and events related to vascular access in 1,4% (n=13) [Table 1]. No anticoagulation therapy or antiaggregation/interrupted ACO was more associated to the outcome, driven by major AAE, although the difference did not meet statistical significance (p=0,06) [Table 1]. No difference was found between VKA and NOAC group. Additionally, there was no diference in the incidence of hemorrhagic AAE since the implementation of an uninterrupted anticoagulation strategy periprocedural.
Conclusion
In our population of patients submitted to AF catheter ablation, an uninterrupted anticoagulation strategy is associated with lower rate of AAE, either with VKA or NOAC. Our real-world results are reassuring of the benefit of an uninterrupted strategy, and consistent with recent controlled trials.
Funding Acknowledgement
Type of funding sources: None. Antithrombotic therapies over timeClinically relevant acute adverse events
Collapse
Affiliation(s)
- R Carvalho
- Hospital Santo Andre, Cardiology, Leiria, Portugal
| | - T Rodrigues
- Centro Hospitalar Universitário Lisboa Norte, Cardiology, Lisbon, Portugal
| | - R Rocha
- Hospital Espirito Santo de Evora, Cardiology, Evora, Portugal
| | - J Ribeiro
- Centro Hospitalar Universitário Lisboa Norte, Cardiology, Lisbon, Portugal
| | - G.L Silva
- Centro Hospitalar Universitário Lisboa Norte, Cardiology, Lisbon, Portugal
| | - L Carpinteiro
- Centro Hospitalar Universitário Lisboa Norte, Cardiology, Lisbon, Portugal
| | - N Cortez-Dias
- Centro Hospitalar Universitário Lisboa Norte, Cardiology, Lisbon, Portugal
| | - J Sousa
- Centro Hospitalar Universitário Lisboa Norte, Cardiology, Lisbon, Portugal
| |
Collapse
|
24
|
Dias Claudio F, Rocha R, Carrington M, Pais J, Guerreiro R, Hyde-Congo K, Neves D, Santos AR, Picarra B. Characterization and quality of care indicators in patients with acute myocardial infarction without ST segment elevation. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
The definition of the quality of care in healthcare services is paramount to implement the resources necessary to grant the best quality of care according to the current guidelines. Recently, the European Society of Cardiology's guidelines for the management of acute coronary syndromes without ST segment elevation (NSTEMI) were published, and defined the quality indicators to be evaluated in such patients.
Purpose
To characterize the level of care given to the population of patients with NSTEMI included in the a national registry since 2011, according to the new guidelines directives.
Population and methods
We evaluated 12193 patients with NSTEMI. For each year the following variables were analyzed: age, gender, cardiovascular and non-cardiovascular comorbidities, clinical presentation (rhythm, blood pressure, Killip-Kimball Class), left ventricular ejection fraction (LVEF), treatment during admission and discharge, and time to invasive coronary angiography (ICA). Besides this, a comparing between years was made to analyze differences according to the quality indicators established in the guidelines.
Results
In 2019, 83.9% of patient with LVEF <40% were treated with IECA/ARA II and 80.6% were prescribed a betablocker at discharge. No statistically significant differences were found across the year with respect to IECA/ARA II at discharge (p=0.495), and beta-blocker at discharge (p=0.812). In terms of P2Y12 inhibitors during the hospital admission, there was a statistically significant increase in its use when comparing 2019 to 2014, 2015, 2016 and 2017 (p=0.019 for 2014 and p<0,001 the following years), with prescription in 90.4% of the patients in 2019. At discharge 88.3% of the patients were prescribed a P2Y12 inhibitor in 2019 and there was also a statistically significant increase in its prescription when compared to the previous years (from 2011 to 2017 with a p<0.001). When it comes to the prescription of statins at discharge there was a statistically significant difference between groups, driven mostly by an increase compared to the year 2012 (95.6% vs 90.8%, p=0.005). Only 16% of patients were subjected to ICA within 24h of admission during the year 2019. No statistically significant difference was found between other years (p>0.100 when comparing between years).
Discussion
The most striking feature that can be improved is the amount of patients subject to ICA within the first 24h after diagnosis. When it comes to the P2Y12 inhibitors it is also clear that there has been an increase in its prescription during the admission and at discharge. To sum up, it is clear that there is still some margin to improve care, of at least 10–20% in most parameters. This data portrays a picture of the measures and steps to take in order to provide the adequate care according to the latest guidelines.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
| | - R Rocha
- Hospital Espirito Santo de Evora, Evora, Portugal
| | - M Carrington
- Hospital Espirito Santo de Evora, Evora, Portugal
| | - J Pais
- Hospital Espirito Santo de Evora, Evora, Portugal
| | - R Guerreiro
- Hospital Espirito Santo de Evora, Evora, Portugal
| | - K Hyde-Congo
- Hospital Espirito Santo de Evora, Evora, Portugal
| | - D Neves
- Hospital Espirito Santo de Evora, Evora, Portugal
| | - A R Santos
- Hospital Espirito Santo de Evora, Evora, Portugal
| | - B Picarra
- Hospital Espirito Santo de Evora, Evora, Portugal
| | | |
Collapse
|
25
|
Dias Claudio F, Carias M, Rocha R, Picarra B, Neves D, Trinca M. Iron deficiency – a factor in left ventricular ejection fraction depression post-myocardial infarction. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Iron deficiency was shown to affect functional capacity and ejection fraction in patients with heart failure and reduced ejection fraction. Myocardial infarction is an important cause of reduced left ventricular ejection fraction (LVEF). Moreover, there is some evidence of the iron deficiency as a factor to predict cardiovascular and non-cardiovascular mortality.
Purpose
Evaluate the presence of iron deficiency in patients with acute coronary syndromes (ACS) admitted to the intensive cardiac care unit and its eventual association with LVEF and mortality.
Population and methods
We performed a prospective study in which ACS patients were divided into groups according to the presence or absence of iron deficiency. We collected demographic data, comorbidities, as well as determination of troponin I, haemoglobin and criteria for absolute and functional iron deficiency (ID) and other data related to the use of mechanical ventilation, need for aminergic support, LVEF and death.
Results
From 148 patients we included 78 patients who met the criteria for being analysed. 49 patients had iron deficiency (51% had absolute iron deficiency and 49% had relative iron deficiency). There were no differences between groups in terms of myocardial infarction with or without ST segment elevation (p=0.609 and p=0.329, respectively), hypertension (p=0.926), diabetes (p=0.882), obesity (p=0.343), dyslipidaemia (p=0.482), smoking (p=0.876), valvular heart disease (p=0.888), acute and chronic renal failure (p=0.800 and p=0.888, respectively) and LVEF (p=0.886). There were no differences in need for aminergic support (p=0.984), ventilation (p=0.315) and death (p=0.704).
We found that in the sub-population of patients without anaemia (Hb>12g/dL), the proportion of patients with depressed LVEF (inferior to 50%) and relative iron deficiency was significantly higher than those with preserved LVEF (48.1 vs 13.8%, p=0.005). Furthermore, we also found that in this sub-population, patients with myocardial infarction without ST segment elevation had higher proportion of absolute iron deficiency (45.0 vs 19.4%, p=0.043).
Conclusion
Our study showed that the prevalence of iron deficiency in ACS patients is 62.9% (n=49). Moreover, in patients without anaemia, this results seems to point out that the presence of iron deficiency may be related with LVEF, at least during the acute event. Further studies with a higher sample size are warranted to either establish or discard this association. Furthermore, a follow-up of this patients can further enlighten us as to the role of iron deficiency in long term LVEF and mortality.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
| | - M Carias
- Hospital Espirito Santo de Evora, Evora, Portugal
| | - R Rocha
- Hospital Espirito Santo de Evora, Evora, Portugal
| | - B Picarra
- Hospital Espirito Santo de Evora, Evora, Portugal
| | - D Neves
- Hospital Espirito Santo de Evora, Evora, Portugal
| | - M Trinca
- Hospital Espirito Santo de Evora, Evora, Portugal
| |
Collapse
|
26
|
Elbatarny M, Petrushko D, Rocha R, Hussein N, Mazine A, Van Arsdell G, Haller C. CARDIOPULMONARY BYPASS RE-INSTITUTION AND INTRAOPERATIVE REVISIONS ARE ASSOCIATED WITH INCREASED PERIOPERATIVE RISK IN CONGENITAL CARDIAC SURGERY. Can J Cardiol 2021. [DOI: 10.1016/j.cjca.2021.07.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
27
|
Rocha R, de J Santos G, Santana G. Influence of nutritional status in the postoperative period of patients with inflammatory bowel disease. World J Gastrointest Pharmacol Ther 2021; 12:90-99. [PMID: 34616585 PMCID: PMC8465395 DOI: 10.4292/wjgpt.v12.i5.90] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 05/21/2021] [Accepted: 08/30/2021] [Indexed: 02/06/2023] Open
Abstract
Inflammatory bowel diseases (IBDs) are a group of chronic inflammatory diseases that affect the gastrointestinal tract, including Crohn's disease (CD) and ulcerative colitis. Surgery is a treatment option, and more than half of the patients with CD will undergo surgical interventions over the course of the disease. Postoperative complications are common in IBD patients, the most frequent being intra-abdominal sepsis, infection of the surgical site, and adynamic ileum, and nutritional status is a factor that can influence postoperative outcome. Recent studies have shown that malnutrition, obesity, sarcopenia, and myosteatosis are predictors of surgical complications. However, most were retrospective studies with small patient samples and heterogeneity of clinical and nutritional assessment methods, which limit the extrapolation of data. Therefore, knowing the pathophysiological mechanisms of IBD and identifying the best parameters for assessing nutritional status are essential for prompt implementation of adequate nutritional interventions.
Collapse
Affiliation(s)
- Raquel Rocha
- Department of Sciences of Nutrition, School of Nutrition, Federal University of Bahia, Salvador 40110-150, Bahia, Brazil
| | - Geisa de J Santos
- Department of Sciences of Nutrition, School of Nutrition, Federal University of Bahia, Salvador 40110-150, Bahia, Brazil
| | - Genoile Santana
- Department of Life Sciences, State University of Bahia, Salvador 40110060, Bahia, Brazil
| |
Collapse
|
28
|
Castro S, Rocha R, João A, Richter E, Munoz R. Promising Applications of Additive-Manufactured (3D-printed) Electrochemical Sensors for Forensic Chemistry. Braz J Anal Chem 2021. [DOI: 10.30744/brjac.2179-3425.rv-50-2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Additive-manufacturing is one of the major pillars of the new industrial revolution and the three-dimensional (3D) printing technology has been highlighted in this scenario. Among the many areas benefited by 3D-printing, the development of electrochemical sensors has appeared in evidence in the last years. One potential application of 3D-printed electrochemical sensors is devoted to forensic chemistry, which demands for portable analytical methods that can provide on-site measurements and thus bring a relevant information in loco. In this context, this review highlights the recent contribution of 3D-printing technology on the development of electrochemical sensors with great promises for on-site analysis in “real-world” forensic scenarios. From the detection of trace explosives, gunshot residues, illicit drugs and chemical threats, to the measurement of adulterants in food and fuels, we show the wide range of applications that 3D-printed electrochemical sensors have been proposed and future demands that can be addressed by such a powerful, affordable, and accessible tool.
Collapse
|
29
|
Leonardi M, Rocha R, Tun-Ismail AN, Robledo KP, Armour M, Condous G. Assessing the knowledge of endometriosis diagnostic tools in a large, international lay population: an online survey. BJOG 2021; 128:2084-2090. [PMID: 34403184 DOI: 10.1111/1471-0528.16865] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2021] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To assess the general population's knowledge regarding the utility and availability of tools to diagnosis endometriosis, with a focus on ultrasound. DESIGN An international cross-sectional online survey study was performed between August and October 2019. SETTING AND POPULATION 5301 respondents, representing 73 countries. METHODS In all, 23 questions survey focused on knowledge of endometriosis diagnosis distributed globally via patient- and community-endometriosis groups using social media. MAIN OUTCOMES AND MEASURES Descriptive data of the knowledge of diagnostic tools for diagnosing endometriosis, including details about diagnosis using ultrasound. RESULTS In all, 84.0% of respondents had been previously diagnosed with endometriosis, 71.5% of whom had been diagnosed at the time of surgery. Ultrasound and MRI were the methods of diagnosis in 6.5% and 1.8%, respectively. A total of 91.8%, 28.8% and 16.6% of respondents believed surgery, ultrasound and MRI could diagnose endometriosis, respectively (more than one answer allowed). In those diagnosed by surgery, 21.7% knew about ultrasound as a diagnosis method, whereas in those diagnosed non-surgically, 51.5% knew (P < 0.001). In all, 14.7%, 31.1% and 18.2% stated superficial, ovarian and deep endometriosis could be diagnosed with ultrasound (32.9% stated they did not know which phenotypes of endometriosis could be diagnosed). Lastly, 58.4% of respondents do not believe they could access an advanced ultrasound in their region. CONCLUSIONS There is a limited appreciation for the role of non-surgical diagnostic tests for endometriosis among lay respondents to this survey. TWEETABLE ABSTRACT International survey shows limited awareness of lay respondents about non-surgical endometriosis diagnostic tools.
Collapse
Affiliation(s)
- M Leonardi
- Acute Gynaecology, Early Pregnancy, and Advanced Endosurgery Unit, Nepean Hospital, Kingswood, NSW, Australia.,The University of Sydney Nepean Clinical School, Sydney, NSW, Australia.,Department of Obstetrics and Gynecology, McMaster University, Hamilton, ON, Canada
| | - R Rocha
- Acute Gynaecology, Early Pregnancy, and Advanced Endosurgery Unit, Nepean Hospital, Kingswood, NSW, Australia.,The University of Sydney Nepean Clinical School, Sydney, NSW, Australia
| | - A N Tun-Ismail
- Acute Gynaecology, Early Pregnancy, and Advanced Endosurgery Unit, Nepean Hospital, Kingswood, NSW, Australia.,The University of Sydney Nepean Clinical School, Sydney, NSW, Australia
| | - K P Robledo
- NHMRC Clinical Trials Centre, University of Sydney, Sydney, NSW, Australia
| | - M Armour
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia.,Translational Health Research Institute (THRI), Western Sydney University, Penrith, NSW, Australia
| | - G Condous
- Acute Gynaecology, Early Pregnancy, and Advanced Endosurgery Unit, Nepean Hospital, Kingswood, NSW, Australia.,The University of Sydney Nepean Clinical School, Sydney, NSW, Australia.,OMNI Ultrasound & Gynaecological Care, St Leonards, NSW, Australia
| |
Collapse
|
30
|
Pimentel AM, de Freitas LAR, Cruz RDCR, Silva INDN, Andrade LD, Marques PN, Braga JC, Fortes FML, Brito KRM, Fontes JAM, Almeida NP, Surlo VC, Rocha R, Lyra AC, Santana GO. Endoscopic and Histopathological Findings of the Esophagus, Stomach, and Duodenum in Patients with Crohn's Disease from a Reference Center in Bahia, Brazil. Clin Pract 2021; 11:374-385. [PMID: 34203639 PMCID: PMC8293082 DOI: 10.3390/clinpract11020052] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/12/2021] [Accepted: 06/09/2021] [Indexed: 02/05/2023] Open
Abstract
(1) The aim of the present study was to describe the endoscopic and histopathological findings in the esophagus, stomach, and duodenum in patients with Crohn’s disease. (2) Methods: This was a cross-sectional study that included patients receiving treatment from the inflammatory bowel disease outpatient clinic. Esophagogastroduodenoscopies with biopsies of the stomach and proximal duodenum were performed. Presence of Helicobacter pylori bacteria was assessed by Giemsa staining. (3) Results: We included 58 patients. Erosive esophagitis was identified in 25 patients (43.1%), gastritis was diagnosed in 32 patients (55.2%) and erosive duodenitis was found in eight (13.8%). The most frequent histopathological finding in the H. pylori-positive group was increased inflammatory activity in the gastric body and antrum, with a predominance of mononuclear and polymorphonuclear cells. In turn, the most frequent finding in the H. pylori-negative group was chronic inflammation with predominance of mononuclear cells. Focally enhanced gastritis was identified in four patients (6.9%), all of whom were negative for H. pylori. Granulomas were not observed. H. pylori infection was present in 19 patients (32.8%). (4) Conclusions: Nonspecific endoscopic and histological findings were frequent in patients with Crohn’s disease. Focally enhanced gastritis was uncommon and observed only in H. pylori-negative patients. The time from the diagnosis, patient age, and therapy in use may have influenced the nondetection of epithelioid granuloma.
Collapse
Affiliation(s)
- Andrea Maia Pimentel
- Medicine and Health Science Postgraduate Program, Federal University of Bahia, Salvador 40026-010, Brazil; (A.M.P.); (A.C.L.)
| | | | - Rita de Cássia Reis Cruz
- Gastroenterology Unit, Hospital Geral Roberto Santos, Salvador 45675-000, Brazil; (R.d.C.R.C.); (F.M.L.F.); (K.R.M.B.); (J.A.M.F.); (N.P.A.); (V.C.S.)
| | - Isaac Neri de Novais Silva
- Department of Life Sciences, Universidade do Estado da Bahia, Salvador 41195-001, Brazil; (I.N.d.N.S.); (P.N.M.); (J.C.B.)
| | | | - Paola Nascimento Marques
- Department of Life Sciences, Universidade do Estado da Bahia, Salvador 41195-001, Brazil; (I.N.d.N.S.); (P.N.M.); (J.C.B.)
| | - Júlia Cordeiro Braga
- Department of Life Sciences, Universidade do Estado da Bahia, Salvador 41195-001, Brazil; (I.N.d.N.S.); (P.N.M.); (J.C.B.)
| | - Flora Maria Lorenzo Fortes
- Gastroenterology Unit, Hospital Geral Roberto Santos, Salvador 45675-000, Brazil; (R.d.C.R.C.); (F.M.L.F.); (K.R.M.B.); (J.A.M.F.); (N.P.A.); (V.C.S.)
| | - Katia Rejane Marques Brito
- Gastroenterology Unit, Hospital Geral Roberto Santos, Salvador 45675-000, Brazil; (R.d.C.R.C.); (F.M.L.F.); (K.R.M.B.); (J.A.M.F.); (N.P.A.); (V.C.S.)
| | - Jaciane Araújo Mota Fontes
- Gastroenterology Unit, Hospital Geral Roberto Santos, Salvador 45675-000, Brazil; (R.d.C.R.C.); (F.M.L.F.); (K.R.M.B.); (J.A.M.F.); (N.P.A.); (V.C.S.)
| | - Neogélia Pereira Almeida
- Gastroenterology Unit, Hospital Geral Roberto Santos, Salvador 45675-000, Brazil; (R.d.C.R.C.); (F.M.L.F.); (K.R.M.B.); (J.A.M.F.); (N.P.A.); (V.C.S.)
| | - Valdiana Cristina Surlo
- Gastroenterology Unit, Hospital Geral Roberto Santos, Salvador 45675-000, Brazil; (R.d.C.R.C.); (F.M.L.F.); (K.R.M.B.); (J.A.M.F.); (N.P.A.); (V.C.S.)
| | - Raquel Rocha
- Department of Sciences of Nutrition, School of Nutrition, Federal University of Bahia, Salvador 41195-00, Brazil;
| | - André Castro Lyra
- Medicine and Health Science Postgraduate Program, Federal University of Bahia, Salvador 40026-010, Brazil; (A.M.P.); (A.C.L.)
| | - Genoile Oliveira Santana
- Medicine and Health Science Postgraduate Program, Federal University of Bahia, Salvador 40026-010, Brazil; (A.M.P.); (A.C.L.)
- Department of Life Sciences, Universidade do Estado da Bahia, Salvador 41195-001, Brazil; (I.N.d.N.S.); (P.N.M.); (J.C.B.)
- Correspondence: ; Tel.: +55-71-999572121
| |
Collapse
|
31
|
Appel G, López‐Baucells A, Rocha R, Meyer CFJ, Bobrowiec PED. Habitat disturbance trumps moonlight effects on the activity of tropical insectivorous bats. Anim Conserv 2021. [DOI: 10.1111/acv.12706] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- G. Appel
- Programa de Pós‐graduação em Ecologia Instituto Nacional de Pesquisas da Amazônia Manaus Brazil
- Biological Dynamics of Forest Fragments Project Instituto Nacional de Pesquisas da Amazônia Manaus Brazil
| | - A. López‐Baucells
- Biological Dynamics of Forest Fragments Project Instituto Nacional de Pesquisas da Amazônia Manaus Brazil
- BiBio (Biodiversity and Bioindicators Research Group) Natural Sciences Museum of Granollers Granollers Spain
- Centre for Ecology, Evolution and Environmental Changes University of Lisbon Lisbon Portugal
| | - R. Rocha
- Biological Dynamics of Forest Fragments Project Instituto Nacional de Pesquisas da Amazônia Manaus Brazil
- Centre for Ecology, Evolution and Environmental Changes University of Lisbon Lisbon Portugal
- CIBIO‐InBIO, Research Center in Biodiversity and Genetic Resources University of Porto Vairão Portugal
- CIBIO‐InBIO, Research Center in Biodiversity and Genetic Resources Institute of Agronomy, University of Lisbon Lisbon Portugal
| | - C. F. J. Meyer
- Biological Dynamics of Forest Fragments Project Instituto Nacional de Pesquisas da Amazônia Manaus Brazil
- School of Science, Engineering and Environment University of Salford Salford UK
| | - P. E. D. Bobrowiec
- Programa de Pós‐graduação em Ecologia Instituto Nacional de Pesquisas da Amazônia Manaus Brazil
- Biological Dynamics of Forest Fragments Project Instituto Nacional de Pesquisas da Amazônia Manaus Brazil
| |
Collapse
|
32
|
Poças IM, Grilo A, Lino P, Cabrita A, Carvalho A, Ruivo C, Rocha R, Cairrão S. Visual function and psychological variables in alcohol dependency syndrome. Strabismus 2021; 29:130-137. [PMID: 33890536 DOI: 10.1080/09273972.2021.1914685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Alcohol Dependence Syndrome (ADS) is defined as excessive alcohol consumption accompanied by psychological, physical, social, and economic disorders. Alcohol consumption affects motor and proprioceptive functions, decreasing motor and cognitive functions and causing attention deficits. We aim to evaluate visual function and attention, and psychological profiles in consumer and abstainer ADS patients. METHODS This quantitative, descriptive, cross-sectional and correlational study evaluates visual function in a sample of ADS patients. The Portuguese version of the Brief Symptom Inventory was used to assess patients' psychological status. The orthoptic examination protocol for visual function consisted of 11 standardized tests: VA for distance and near, ocular movements, near convergence and accommodation point, cover and prismatic cover tests, fusional vergence for distance and near, near stereoacuity, chromatic vision, contrast sensitivity and visual attention. RESULTS The sample included 176 patients. 121 were consumers and 55 were abstainers, aged between 31 and 72. The most affected parameters of visual function were visual acuity (80.39%), contrast sensitivity (67.50%), convergence at distance (66.44%) and near stereopsis (62.75%). Visual function was impacted in both groups. Regarding psychological status, consumers had higher averages for the Depression subscale, followed by Paranoid Ideation and Obsession. Abstainers had the highest averages in the Obsession subscale, followed by Paranoid Ideation and Depression. Statistically significant differences existed between the groups in the subscales for depression (p=.046) and paranoid ideation (p =.042). CONCLUSION Changes in visual function and attention, as well as psychopathological function, should be considered in the rehabilitation of ADS patients.
Collapse
Affiliation(s)
- Ilda Maria Poças
- Specialist Orthoptist, MSc in Rehabilitation specialty in Visual Impairment, ESTeSL- Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa, Portugal.,Centro de Estudos de Interdisciplinares em Educação e Desenvolvimento, Universidade Lusófona de Humanidades e Tecnologias, Lisboa, Portugal
| | - Ana Grilo
- Psychologist, PhD in Psychology, speciality in Health Psychology, H&TRC-Health & Technology Research Center, ESTeSL - Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Portugal.,CICPsi - Research Center for Psychological Science, Faculty of Psychology, University of Lisbon, Portugal
| | - Pedro Lino
- Orthoptist, HBO in Orthoptic, Hospital Professor Doutor Fernando-Fonseca, EPE, Lisboa, Portugal
| | - Ana Cabrita
- Orthoptist, HBO in Orthoptic, ESTeSL - Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Portugal
| | - Ana Carvalho
- Orthoptist, HBO in Orthoptic, ESTeSL - Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Portugal
| | - Claudia Ruivo
- Orthoptist, HBO in Orthoptic, ESTeSL - Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Portugal
| | - Raquel Rocha
- Orthoptist, HBO in Orthoptic, ESTeSL - Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Portugal
| | - Sara Cairrão
- Orthoptist, HBO in Orthoptic, ESTeSL - Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Portugal
| |
Collapse
|
33
|
Rocha R, Ribeiro L, Correia F. SMART syndrome: a late-onset and not always reversible complication of radiotherapy. BMJ Case Rep 2021; 14:14/4/e241748. [PMID: 33858903 PMCID: PMC8055132 DOI: 10.1136/bcr-2021-241748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Stroke-like migraine attacks after radiation (SMART) syndrome is a rare and late complication of cerebral radiotherapy of unknown pathophysiology. It is characterised by hemicranial headache associated with persistent unilateral focal neurological signs and, occasionally, epileptic seizures. An increase in the frequency of SMART syndrome can be attributed to an increase in the survival rate of patients undergoing radiation therapy This study details the case of a 60-year-old woman with a history of small-cell lung carcinoma, who, in her late forties, was treated with prophylactic cranial irradiation. She presented at the emergency room with acute onset of global aphasia, lethargy and headache that started a few days before.
Collapse
Affiliation(s)
- Raquel Rocha
- Harvard Medical School, Boston, Massachusetts, USA .,Neurology Department, Hospital Pedro Hispano, Matosinhos, Portugal
| | - Luís Ribeiro
- Neurology Department, Hospital Pedro Hispano, Matosinhos, Portugal
| | - Filipe Correia
- Neurology Department, Hospital Pedro Hispano, Matosinhos, Portugal
| |
Collapse
|
34
|
Gandomkar S, Rocha R, Sorgenfrei FA, Montero LM, Fuchs M, Kroutil W. PQQ-dependent Dehydrogenase Enables One-pot Bi-enzymatic Enantio-convergent Biocatalytic Amination of Racemic sec-Allylic Alcohols. ChemCatChem 2021; 13:1290-1293. [PMID: 33777250 PMCID: PMC7986696 DOI: 10.1002/cctc.202001707] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/20/2020] [Indexed: 12/28/2022]
Abstract
The asymmetric amination of secondary racemic allylic alcohols bears several challenges like the reactivity of the bi-functional substrate/product as well as of the α,β-unsaturated ketone intermediate in an oxidation-reductive amination sequence. Heading for a biocatalytic amination cascade with a minimal number of enzymes, an oxidation step was implemented relying on a single PQQ-dependent dehydrogenase with low enantioselectivity. This enzyme allowed the oxidation of both enantiomers at the expense of iron(III) as oxidant. The stereoselective amination of the α,β-unsaturated ketone intermediate was achieved with transaminases using 1-phenylethylamine as formal reducing agent as well as nitrogen source. Choosing an appropriate transaminase, either the (R)- or (S)-enantiomer was obtained in optically pure form (>98 % ee). The enantio-convergent amination of the racemic allylic alcohols to one single allylic amine enantiomer was achieved in one pot in a sequential cascade.
Collapse
Affiliation(s)
| | - Raquel Rocha
- Institute of ChemistryUniversity of Graz, NAWI Graz8010GrazAustria
| | - Frieda A. Sorgenfrei
- Institute of ChemistryUniversity of Graz, NAWI Graz8010GrazAustria
- Austrian Centre of Industrial Biotechnology c/oUniversity of Graz8010GrazAustria
| | | | - Michael Fuchs
- Institute of ChemistryUniversity of Graz, NAWI Graz8010GrazAustria
| | - Wolfgang Kroutil
- Institute of ChemistryUniversity of Graz, NAWI Graz8010GrazAustria
- Field of Excellence BioHealthUniversity of Graz8010GrazAustria
- BioTechMed Graz8010GrazAustria
| |
Collapse
|
35
|
Rocha R, Ribeiro L, Correia F, Santos A, Martins J. Enfermedad de motoneurona asociada a procesos neoplásicos: una revisión de casos. Gal Clin 2021. [DOI: 10.22546/61/2196] [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: 11/22/2022] Open
|
36
|
Fortes FML, Sorte NB, Mariano VD, Andrade LD, Oliveira FA, Santos MCA, Santos CIND, Passos CA, Pacheco MP, Surlo VC, Almeida NPD, Fontes JAM, Pimentel AM, Rocha R, Santana GO. Active tuberculosis in inflammatory bowel disease patients under treatment from an endemic area in Latin America. World J Gastroenterol 2020; 26:6993-7004. [PMID: 33311945 PMCID: PMC7701941 DOI: 10.3748/wjg.v26.i44.6993] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 11/05/2020] [Accepted: 11/14/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND There has been an increase in cases of inflammatory bowel disease (IBD) in recent years. There is also greater access and availability of immunosuppressive and biological agents, which increase the risk of opportunistic infection despite improving the quality of life and promoting mucosal healing. Tuberculosis (TB) remains a public health problem, and it has a high incidence in several countries. Therefore, knowledge of the risk of developing TB in patients with IBD is important.
AIM To evaluate the risk of active TB in patients with IBD under treatment from an endemic area in Latin America.
METHODS A standard questionnaire included demographic variables, clinical aspects of IBD disease, history of active TB during treatment, active TB characteristics and evolution, initial screening and results and time from the start of anti-tumor necrosis factor alpha (TNFα) to TB development.
RESULTS Azathioprine, anti-TNFα and the combination of these two drugs were associated with a higher risk of active TB incidence. The TNFα blockers increased the relative risk of developing active TB compared to other treatments. All four multivariable models showed that the use of TNFα blockers alone or in combination with azathioprine was an important risk factor for the incidence of active TB. After adjustment for sex, age, type of IBD and latent TB, anti-TNFα with azathioprine increased the relative risk to 17.8 times more than conventional treatment. Late TB, which was diagnosed 3 mo after the start of anti-TNFα, was the most frequent.
CONCLUSION Treatment with anti-TNFα increased the risk of active TB in IBD patients from an endemic area in Latin America. This risk was increased when anti-TNFα was combined with azathioprine. The time from the beginning of the treatment to the active TB diagnosis suggests a new TB infection.
Collapse
Affiliation(s)
- Flora Maria Lorenzo Fortes
- Pharmaceutical Sciences Pos-graduation Program, State University of Bahia, Salvador, BA 40460-120, Brazil
- Outpatient Gastroenterology Unit, General Hospital Roberto Santos, Salvador, BA 40286-901, Brazil
| | - Ney Boa Sorte
- Pharmaceutical Sciences Pos-graduation Program, State University of Bahia, Salvador, BA 40460-120, Brazil
- Life Sciences Department, State University of Bahia, Salvador, BA 41150-000, Brazil
| | - Victor D Mariano
- Life Sciences Department, State University of Bahia, Salvador, BA 41150-000, Brazil
| | - Laíla D Andrade
- Department of Medicine, FTC University, Salvador, BA 41741-590, Brazil
| | - Fernanda A Oliveira
- Life Sciences Department, State University of Bahia, Salvador, BA 41150-000, Brazil
| | - Monique CA Santos
- Life Sciences Department, State University of Bahia, Salvador, BA 41150-000, Brazil
| | | | - Catharina A Passos
- Life Sciences Department, State University of Bahia, Salvador, BA 41150-000, Brazil
| | - Mila P Pacheco
- Pharmaceutical Sciences Pos-graduation Program, State University of Bahia, Salvador, BA 40460-120, Brazil
| | - Valdiana C Surlo
- Outpatient Gastroenterology Unit, General Hospital Roberto Santos, Salvador, BA 40286-901, Brazil
| | - Neogélia P de Almeida
- Outpatient Gastroenterology Unit, General Hospital Roberto Santos, Salvador, BA 40286-901, Brazil
| | - Jaciane AM Fontes
- Outpatient Gastroenterology Unit, General Hospital Roberto Santos, Salvador, BA 40286-901, Brazil
| | - Andréa M Pimentel
- Outpatient Gastroenterology Unit, General Hospital Roberto Santos, Salvador, BA 40286-901, Brazil
| | - Raquel Rocha
- Department of Sciences of Nutrition, School of Nutrition, Federal University of Bahia, Salvador, BA 41701-035, Brazil
| | - Genoile Oliveira Santana
- Pharmaceutical Sciences Pos-graduation Program, State University of Bahia, Salvador, BA 40460-120, Brazil
| |
Collapse
|
37
|
Bessa MC, Haas S, Ramos RC, Rocha R, Voss-Rech D, Rebelatto R, Duarte SC, Coldebella A, Vaz CSL. Survey of Campylobacter in foods implicated in foodborne diseases in Southern Brazil. Rev Inst Med Trop Sao Paulo 2020; 62:e90. [PMID: 33206864 PMCID: PMC7669274 DOI: 10.1590/s1678-9946202062090] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 10/28/2020] [Indexed: 11/21/2022] Open
Abstract
Campylobacter is not routinely tested in foodborne disease investigations in Brazil. Here, we studied the occurrence of Campylobacter among other food-related bacteria commonly found in foodborne disease outbreaks reported in Rio Grande do Sul State, Southern Brazil. Seventy-two food samples were analyzed by using culture-based detection methods during the 18-month investigation of 36 foodborne disease outbreaks. The sampled foods from the foodborne disease outbreaks were all negative for Campylobacter . However, at least one of other routinely investigated foodborne-related bacteria was detected in 29.17% (21/72) of the samples. Taken together, these results suggest the need to monitor Campylobacter in foodborne diseases to detect sporadic cases caused by Campylobacter that might go unnoticed in Rio Grande do Sul.
Collapse
Affiliation(s)
- Marjo Cadó Bessa
- Pontifícia Universidade Católica do Rio Grande do Sul, Laboratório de Imunologia e Microbiologia, Porto Alegre, Rio Grande do Sul, Brazil
| | - Simone Haas
- Secretaria Estadual de Saúde, Centro Estadual de Vigilância em Saúde, Laboratório Central de Saúde Pública, Porto Alegre, Rio Grande do Sul, Brazil
| | - Rosane Campanher Ramos
- Secretaria Estadual de Saúde, Centro Estadual de Vigilância em Saúde, Laboratório Central de Saúde Pública, Porto Alegre, Rio Grande do Sul, Brazil
| | - Raquel Rocha
- Secretaria Estadual de Saúde, Centro Estadual de Vigilância em Saúde, Laboratório Central de Saúde Pública, Porto Alegre, Rio Grande do Sul, Brazil
| | | | | | | | | | | |
Collapse
|
38
|
Tam D, Dharma C, Rocha R, Farkouh M, Abdel-Qadir H, Sun L, Gaudino M, Wijeysundera H, Austin P, Udell J, Fremes S, Lee D. Improved long-term survival with coronary artery bypass graft surgery compared to percutaneous coronary intervention in diabetics with multivessel disease. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
While randomized clinical trials have demonstrated the superiority of coronary artery bypass grafting (CABG) over percutaneous coronary intervention (PCI) in patients with diabetes and multivessel coronary artery disease (CAD), there remains a paucity of observational evidence comparing these two modalities.
Methods
Clinical and administrative databases for Canada's most populous province, Ontario, were linked to obtain records of all patients with angiographic evidence of multivessel CAD (defined as: 2-vessel and 3-vessel disease) treated with either isolated CABG or PCI from October 2008 to March 2017. Left main disease was excluded in the primary analysis. Baseline characteristics of patients undergoing CABG and PCI were compared and 1:1 propensity score matching was performed to account for baseline differences. 30-day mortality was compared in the matched groups. Late mortality and the composite of major cardiovascular and cerebrovascular events (MACCE, consisting of stroke, myocardial infarction (MI), repeat revascularization, and death) were compared between the matched groups using a stratified log rank test and Cox-proportional hazards model. The individual non-fatal components of MACCE were compared using the Fine-Gray model that accounted for death as a competing risk. A secondary analysis that included patients with left main disease was also performed for the outcome of late mortality. A sensitivity analysis that excluded patients with acute coronary syndrome was also conducted for late mortality.
Results
A total of 9,395 and 4,016 patients underwent CABG and PCI respectively. Prior to matching, CABG patients were younger (65.7 vs 68.5 years, p<0.001), more likely male (78% vs 73%, p<0.001) and with more severe CAD. Propensity score matching based on 24 baseline covariates yielded 3,782 well-balanced pairs. There was no difference in early mortality between CABG and PCI (2.3% vs 2.5%, p=0.65). The rate of all-cause mortality over 8-years was significantly higher with PCI compared to CABG (Figure- HR: 1.35, 95% CI: 1.23–1.50). The cumulative incidence of MI (HR 1.91, 95% CI: 1.66–2.20) and need for repeat revascularization (HR: 4.06, 95% CI: 3.54–4.66) were significantly higher with PCI over 8 years. There was no difference in late stroke between PCI and CABG (stroke (HR: 0.85, 95% CI: 0.68–1.07). Overall MACCE was higher in PCI compared to CABG (HR: 1.94, 95% CI: 1.80–2.09). In our secondary analysis that included patients with left main disease, findings were robust and late mortality remained higher with PCI compared to CABG (HR: 1.42, 95% CI: 1.30–1.54). In a sensitivity analysis where patients with acute coronary syndrome at the time of presentation were excluded, late mortality remained higher with PCI (HR: 1.30, 95% CI: 1.12–1.49) in 2,028 matched pairs.
Conclusions
In patients with multivessel CAD and diabetes we observed improved long-term mortality and freedom from MACCE at 8-years with CABG compared to PCI.
Figure 1
Funding Acknowledgement
Type of funding source: Foundation. Main funding source(s): Canadian Institutes of Health Research
Collapse
Affiliation(s)
- D Tam
- Sunnybrook Health Sciences Centre, Toronto, Canada
| | - C Dharma
- Institute for Clinical Evaluative Sciences, Toronto, Canada
| | - R Rocha
- Toronto General Hospital, Toronto, Canada
| | - M Farkouh
- Toronto General Hospital, Toronto, Canada
| | | | - L.Y Sun
- Ottawa Heart Institute, Ottawa, Canada
| | - M Gaudino
- Weill Cornell Medicine, New York, United States of America
| | | | - P.C Austin
- Institute for Clinical Evaluative Sciences, Toronto, Canada
| | - J Udell
- Women's College Hospital, Toronto, Canada
| | - S Fremes
- Sunnybrook Health Sciences Centre, Toronto, Canada
| | - D.S Lee
- Institute for Clinical Evaluative Sciences, Toronto, Canada
| |
Collapse
|
39
|
Kelly ME, Aalbers AGJ, Abdul Aziz N, Abecasis N, Abraham‐Nordling M, Akiyoshi T, Alberda W, Albert M, Andric M, Angenete E, Antoniou A, Auer R, Austin KK, Aziz O, Baker RP, Bali M, Baseckas G, Bebington B, Bednarski BK, Beets GL, Berg PL, Beynon J, Biondo S, Boyle K, Bordeianou L, Bremers AB, Brunner M, Buchwald P, Bui A, Burgess A, Burger JWA, Burling D, Burns E, Campain N, Carvalhal S, Castro L, Caycedo‐Marulanda A, Chan KKL, Chang GJ, Chew MH, Chong PC, Christensen HK, Clouston H, Codd M, Collins D, Colquhoun A, Corr A, Coscia M, Coyne PE, Creavin B, Croner RS, Damjanovic L, Daniels IR, Davies M, Davies RJ, Delaney CP, Denost Q, Deutsch C, Dietz D, Domingo S, Dozois EJ, Duff M, Eglinton T, Enrique‐Navascues JM, Espin‐Basany E, Evans MD, Fearnhead NS, Flatmark K, Fleming F, Frizelle FA, Gallego MA, Garcia‐Granero E, Garcia‐Sabrido JL, Gentilini L, George ML, Ghouti L, Giner F, Ginther N, Glynn R, Golda T, Griffiths B, Harris DA, Hagemans JAW, Hanchanale V, Harji DP, Helewa RM, Heriot AG, Hochman D, Hohenberger W, Holm T, Hompes R, Jenkins JT, Kaffenberger S, Kandaswamy GV, Kapur S, Kanemitsu Y, Kelley SR, Keller DS, Khan MS, Kiran RP, Kim H, Kim HJ, Koh CE, Kok NFM, Kokelaar R, Kontovounisios C, Kristensen HØ, Kroon HM, Kusters M, Lago V, Larsen SG, Larson DW, Law WL, Laurberg S, Lee PJ, Limbert M, Lydrup ML, Lyons A, Lynch AC, Mantyh C, Mathis KL, Margues CFS, Martling A, Meijerink WJHJ, Merkel S, Mehta AM, McArthur DR, McDermott FD, McGrath JS, Malde S, Mirnezami A, Monson JRT, Morton JR, Mullaney TG, Negoi I, Neto JWM, Nguyen B, Nielsen MB, Nieuwenhuijzen GAP, Nilsson PJ, O’Connell PR, O’Dwyer ST, Palmer G, Pappou E, Park J, Patsouras D, Pellino G, Peterson AC, Poggioli G, Proud D, Quinn M, Quyn A, Radwan RW, van Ramshorst GH, Rasheed S, Rasmussen PC, Regenbogen SE, Renehan A, Rocha R, Rochester M, Rohila J, Rothbarth J, Rottoli M, Roxburgh C, Rutten HJT, Ryan ÉJ, Safar B, Sagar PM, Sahai A, Saklani A, Sammour T, Sayyed R, Schizas AMP, Schwarzkopf E, Scripcariu V, Selvasekar C, Shaikh I, Hellawell G, Shida D, Simpson A, Smart NJ, Smart P, Smith JJ, Solbakken AM, Solomon MJ, Sørensen MM, Steele SR, Steffens D, Stitzenberg K, Stocchi L, Stylianides NA, Sumrien H, Sutton PA, Swartking T, Taylor C, Tekkis PP, Teras J, Thurairaja R, Toh EL, Tsarkov P, Tsukada Y, Tsukamoto S, Tuech JJ, Turner WH, Tuynman JB, Vasquez‐Jimenez W, Verhoef C, Vizzielli G, Voogt ELK, Uehara K, Wakeman C, Warrier S, Wasmuth HH, Weber K, Weiser MR, Wheeler JMD, Wild J, Wilson M, de Wilt JHW, Wolthuis A, Yano H, Yip B, Yip J, Yoo RN, van Zoggel D, Winter DC. Simultaneous pelvic exenteration and liver resection for primary rectal cancer with synchronous liver metastases: results from the PelvEx Collaborative. Colorectal Dis 2020; 22:1258-1262. [PMID: 32294308 DOI: 10.1111/codi.15064] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 03/24/2020] [Indexed: 02/08/2023]
Abstract
AIM At presentation, 15-20% of patients with rectal cancer already have synchronous liver metastases. The aim of this study was to determine the surgical and survival outcomes in patients with advanced rectal cancer who underwent combined pelvic exenteration and liver (oligometastatic) resection. METHOD Data from 20 international institutions that performed simultaneous pelvic exenteration and liver resection between 2007 and 2017 were accumulated. Primarily, we examined perioperative outcomes, morbidity and mortality. We also assessed the impact that margin status had on survival. RESULTS Of 128 patients, 72 (56.2%) were men with a median age of 60 years [interquartile range (IQR) 15 years]. The median size of the liver oligometastatic deposits was 2 cm (IQR 1.8 cm). The median duration of surgery was 406 min (IQR 240 min), with a median blood loss of 1090 ml (IQR 2010 ml). A negative resection margin (R0 resection) was achieved in 73.5% of pelvic exenterations and 66.4% of liver resections. The 30-day mortality rate was 1.6%, and 32% of patients had a major postoperative complication. The 5-year overall survival for patients in whom an R0 resection of both primary and metastatic disease was achieved was 54.6% compared with 20% for those with an R1/R2 resection (P = 0.006). CONCLUSION Simultaneous pelvic exenteration and liver resection is feasible, with acceptable morbidity and mortality. Simultaneous resection should only be performed where an R0 resection of both pelvic and hepatic disease is anticipated.
Collapse
|
40
|
Almeida J, Rocha R, Signorelli M, Silva V, Prado S, Evans D. The House of the Brazilian Woman: impacts of a cross-sectoral public health policy for abused women. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.945] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Issue
Violence against women is a serious public health concern in Brazil; the country ranks 5th globally for femicide and has high rates of intimate partner violence. In response, a national policy created the House of the Brazilian Woman (HBW). HBWs aimed at caring for abused women, are staffed 24/7 with multi-disciplinary teams; cross-sectoral services include: psychosocial support; healthcare; specialized police; courts; public attorney's offices; temporary shelter; and access to financial support.
Description of the Problem
The purpose of this study was to characterize the preliminary impacts of the HBW of Curitiba. Based on mixed-methods participatory action-research, data were collected between 2018-2020. We present quantitative measures describing the individuals served and a thematic analysis of in-depth interviews with HBW staff.
Results
Since its opening, in 2016, the HBW of Curitiba has served around 50,000 users, including women and perpetrators. The most prevalent type of violence reported was psychological (67%, n = 14,343), followed by physical (25.8%, n = 5,531), economic (5.2%, n = 1,104) and sexual (2%, n = 428). Positive qualitative impacts perceived by staff were: 1) improved women's empowerment; 2) the importance of centralized resources; 3) acting as a support to ensure existing legal protections. The main challenges were: 1) high demand; 2) discontinuous care; 3) negative impacts on staff's health.
Lessons
The HBW of Curitiba is a key cross-sectoral service for abused women, part of a greater national policy to prevent violence and support women. Despite serving a large number of women in a short period of time challenges remain including integration with other parts of the network and considerations of staff burnout.
Key messages
Effective cross-sectoral policies for abused women are paramount for comprehensive women’s health. Having cross-sectoral services in just one place operating 24/7 has high impact for abused women.
Collapse
Affiliation(s)
- J Almeida
- Chamber of Public Health, Federal University of Parana, Matinhos, Brazil
| | - R Rocha
- Post Graduation in Public Health, Federal University of Parana, Curitiba, Brazil
| | - M Signorelli
- Chamber of Public Health, Federal University of Parana, Matinhos, Brazil
- Post Graduation in Public Health, Federal University of Parana, Curitiba, Brazil
| | - V Silva
- Chamber of Public Health, Federal University of Parana, Matinhos, Brazil
| | - S Prado
- House of the Brazilian Woman, Curitiba, Brazil
| | - D Evans
- Department of Public Health, Emory University, Atlanta, USA
| |
Collapse
|
41
|
Ribeiro L, Rocha R, Martins J, Monteiro A. Starch–iodine test: a diagnostic tool for Horner syndrome. BMJ Case Rep 2020; 13:13/9/e238541. [DOI: 10.1136/bcr-2020-238541] [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: 11/03/2022] Open
|
42
|
Rocha R, Aziz SA, Brook CE, Carvalho WD, Cooper‐Bohannon R, Frick WF, Huang JC, Kingston T, López‐Baucells A, Maas B, Mathews F, Medellin RA, Olival KJ, Peel AJ, Plowright RK, Razgour O, Rebelo H, Rodrigues L, Rossiter SJ, Russo D, Straka TM, Teeling EC, Treuer T, Voigt CC, Webala PW. Bat conservation and zoonotic disease risk: a research agenda to prevent misguided persecution in the aftermath of COVID‐19. Anim Conserv 2020. [DOI: 10.1111/acv.12636] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- R. Rocha
- CIBIO/InBIO‐UP Research Centre in Biodiversity and Genetic Resources University of Porto Vairão Portugal
- CEABN‐InBIO Centre for Applied Ecology “Prof. Baeta Neves” Institute of Agronomy University of Lisbon Tapada da Ajuda Lisbon Portugal
| | - S. A. Aziz
- Project Pteropus Rimba Kuala Lumpur Malaysia
| | - C. E. Brook
- Department of Integrative Biology University of California, Berkeley Berkeley CA USA
| | - W. D. Carvalho
- Programa de Pós‐Graduação em Biodiversidade Tropical Universidade Federal do Amapá Macapá‐AP Brazil
| | - R. Cooper‐Bohannon
- School of Biological and Environmental Sciences University of Stirling Stirling UK
- Bats without Borders Blantyre Malawi
| | - W. F. Frick
- Bat Conservation International Austin Texas USA
- Ecology and Evolutionary Biology University of California, Santa Cruz Santa Cruz California USA
| | - J. C.‐C. Huang
- Formosan Golden Bat’s Home Shuilin Township Yunlin County Taiwan
| | - T. Kingston
- Department of Biological Sciences Texas Tech University Lubbock Texas USA
| | | | - B. Maas
- Department of Botany and Biodiversity Research University of Vienna Vienna Austria
- Institute of Zoology University of Natural Resources and Life Sciences Vienna Austria
| | | | - R. A. Medellin
- Instituto de Ecología Universidad Nacional Autónoma de México México City México
| | | | - A. J. Peel
- Environmental Futures Research Institute Griffith University Nathan Queensland Australia
| | - R. K. Plowright
- Department of Microbiology and Immunology Montana State University Bozeman MT USA
| | - O. Razgour
- Biosciences University of Exeter Hatherly Laboratories Exeter UK
| | - H. Rebelo
- CIBIO/InBIO‐UP Research Centre in Biodiversity and Genetic Resources University of Porto Vairão Portugal
- CEABN‐InBIO Centre for Applied Ecology “Prof. Baeta Neves” Institute of Agronomy University of Lisbon Tapada da Ajuda Lisbon Portugal
| | - L. Rodrigues
- Instituto da Conservação da Natureza e das Florestas Lisboa Portugal
| | - S. J. Rossiter
- School of Biological and Chemical Sciences Queen Mary University of London London UK
| | - D. Russo
- Dipartimento di Agraria Università degli Studi di Napoli Federico II via Università 100 Portici (Napoli) Italy
| | - T. M. Straka
- Institute of Ecology Technische Universität Berlin Berlin Germany
| | - E. C. Teeling
- School of Biology and Environmental Science University College Dublin Dublin Ireland
| | - T. Treuer
- College of Engineering and Mathematical Sciences University of Vermont Burlington Vermont USA
| | - C. C. Voigt
- Leibniz Institute for Zoo and Wildlife Research Berlin Germany
| | - P. W. Webala
- Department of Forestry and Wildlife Management Maasai Mara University Narok Kenya
| |
Collapse
|
43
|
Rocha R, Correia F, Santos A, Martins J. Adjuvant rituximab improves sensory ataxia in CIDP-related Sjögren syndrome. BMJ Case Rep 2020; 13:13/8/e234681. [DOI: 10.1136/bcr-2020-234681] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an autoimmune neuropathy characterised by insidious onset, progressive course, proximal and distal symmetrical weakness, and sensory impairment. It may affect patients of any age with varying degrees of clinical involvement and response rates to existing treatments. Sjögren syndrome (SS) is a systemic autoimmune disorder that primarily affects the exocrine glands causing a sicca syndrome. It may affect the peripheral nervous system, usually causing painful small fibre or pure sensory axonal neuropathy, ganglioneuronopathy or a predominantly sensory CIDP. We report the case of a 71-year-old man diagnosed with a debilitating and difficult-to-treat CIDP who, 5 years later, developed SS with pulmonary involvement. Due to lack of response to treatments other than periodic intravenous immunoglobulin (IVIg) every 12 days, we started adjuvant treatment with rituximab which increased the time interval between IVIg therapies by 50%, providing better quality of life for the patient.
Collapse
|
44
|
Pires LB, Rocha R, Vargas D, Daltro C, Cotrim HP. Non-alcoholic fatty liver disease in patients infected with human immunodeficiency virus: a systematic review. ACTA ACUST UNITED AC 2020; 66:81-86. [PMID: 32130386 DOI: 10.1590/1806-9282.66.1.81] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 09/01/2019] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To evaluate the prevalence of nonalcoholic fatty liver disease (NAFLD) in patients with HIV/AIDS. METHODS The systematic review included articles indexed in MEDLINE (by PubMed), Web of Science, IBECS, and LILACS. Studies eligible included the year of publication, diagnose criteria of NAFLD and HIV, and were published in English, Portuguese, or Spanish from 2006 to 2018. The exclusion criteria were studies with HIV-infection patients and other liver diseases. Two reviewers were involved in the study and applied the same methodology, according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). RESULTS One hundred and sixteen papers were selected, including full articles, editorial letters, and reviews. Twenty-seven articles were excluded because they did meet the inclusion criteria. A total of 89 articles were read, and 13 were considered eligible for this review. Four case series used imaging methods to identify NAFLD, and nine included histology. The prevalence of NAFLD in HIV-patients ranged from 30%-100% and, in nonalcoholic steatohepatitis (NASH), from 20% to 89%. A positive association between dyslipidemia, insulin resistance, and body mass index was observed. There was no agreement between the studies that evaluated the relationship between antiretroviral drugs and NAFLD. CONCLUSION This systematic review showed a high prevalence of NAFLD in HIV-patients, which was associated with metabolic risk factors. The possible association between antiretroviral therapy and NAFLD needs further studies.
Collapse
Affiliation(s)
- Leonardo Bispo Pires
- . Faculdade de Medicina da Bahia - Universidade Federal da Bahia (UFBA), Salvador, BA, Brasil.,. NASH Study Group - Universidade Federal da Bahia (UFBA), Salvador, BA, Brasil
| | - Raquel Rocha
- . Escola de Nutrição - Universidade Federal da Bahia (UFBA), Salvador, BA, Brasil.,. NASH Study Group - Universidade Federal da Bahia (UFBA), Salvador, BA, Brasil
| | - Daniel Vargas
- . Faculdade de Medicina da Bahia - Universidade Federal da Bahia (UFBA), Salvador, BA, Brasil
| | - Carla Daltro
- . Faculdade de Medicina da Bahia - Universidade Federal da Bahia (UFBA), Salvador, BA, Brasil.,. Escola de Nutrição - Universidade Federal da Bahia (UFBA), Salvador, BA, Brasil.,. NASH Study Group - Universidade Federal da Bahia (UFBA), Salvador, BA, Brasil
| | - Helma P Cotrim
- . Faculdade de Medicina da Bahia - Universidade Federal da Bahia (UFBA), Salvador, BA, Brasil.,. NASH Study Group - Universidade Federal da Bahia (UFBA), Salvador, BA, Brasil
| |
Collapse
|
45
|
Rocha R, Fernandes R, Carvalho J, Pais J, Bras D, Guerreiro R, Aguiar J. P840 A surprising outcome. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
infective endocarditis(IE) is a high morbidity and mortality disease, and heart failure,central nervous system embolization and annular abscess account for common complications.Nevertheless,intracardiac fistula is rare and predicts higher mortality and urgency for surgery.
Case
84years old male patient,with an aortic bioprosthesis valve Perimount n23 since 2015,was admitted to internal medicine ward 3months before,due to Enterococcus faecalis bacteremia.at that time,transoesophageal echocardiography(TEE) revealed moderate to severe mitral valve(MV) regurgitation(vena contracta 0.7cm) and trivial tricuspid regurgitation,but did not showed any suggestive images of endocarditis.the patient was treated with 14days of amoxicillin-clavulanate.
On the current presentation,due to fadigue to mild physical activity and fever for 2weeks,he was admitted to cardiology ward for further investigation.blood cultures were positive for the previous agent,so antibiotherapy with ampicillin 12g/day and gentamicin 240mg id was started.TEE revealed thickening of aortic bioprosthesis’ leaflets with preserved systolic opening.aortic valve annulus thickening,mainly near the non-coronary cusp,was evident, without characteristic features of peri-annular abscess.on ventricular side of the prosthesis,there was a vegetation(10.7x10.8mm). a small nodule lesion,coherent with a second vegetation,was present on the MV’s posterior leaflet,without regurgitation’s worsening. a third one was observed on the septal leaflet of the tricuspid valve(7.3x6.5mm),which also caused an increasement in severity of the regurgitation,quantified as moderate.
On the sixth day,the patient presented with right arm paresis,so a brain CT was performed,showing an ischemic lesion on the left middle cerebral artery.Reevaluation,5days later,owing to new neurological changes,showed multiple acute vertebrobasilar embolic strokes.
As a result of poor medical response and embolic strokes,the patient was referred to surgical treatment. however, due to prohibitive surgical risk (euroscore 59%), the patient was refused.
After 6weeks of blood culture driven antibiotherapy,a reevaluation TEE revealed a periprosthetic pseudoaneurysm with small aorta-to-right atrium fistula.no vegetations were found.
Conclusion
rate complication of cardiac fistulae is high,60%of the patients develop heart failure and mortality rate is higher than 40%.although conservative treatment was addressed,after 8months discharge,the patient remains with few heart failure symptoms(NYHA classII).
Collapse
Affiliation(s)
- R Rocha
- Hospital Espirito Santo de Evora, Cardiology, Evora, Portugal
| | - R Fernandes
- Hospital Espirito Santo de Evora, Cardiology, Evora, Portugal
| | - J Carvalho
- Hospital Espirito Santo de Evora, Cardiology, Evora, Portugal
| | - J Pais
- Hospital Espirito Santo de Evora, Cardiology, Evora, Portugal
| | - D Bras
- Hospital Espirito Santo de Evora, Cardiology, Evora, Portugal
| | - R Guerreiro
- Hospital Espirito Santo de Evora, Cardiology, Evora, Portugal
| | - J Aguiar
- Hospital Espirito Santo de Evora, Cardiology, Evora, Portugal
| |
Collapse
|
46
|
Kroon HM, Dudi-Venkata N, Bedrikovetski S, Thomas M, Kelly M, Aalbers A, Abdul Aziz N, Abraham-Nordling M, Akiyoshi T, Alberda W, Andric M, Antoniou A, Austin K, Baker R, Bali M, Baseckas G, Bednarski B, Beets G, Berg P, Beynon J, Biondo S, Bordeianou L, Brunner M, Buchwald P, Burger J, Burling D, Campain N, Chan K, Chang G, Chew M, C Chong P, Christensen H, Codd M, Colquhoun A, Corr A, Coscia M, Coyne P, Creavin B, Damjanovic L, Daniels I, Davies M, Davies R, de Wilt J, Denost Q, Dietz D, Dozois E, Duff M, Eglinton T, Enriquez-Navascues J, Evans M, Fearnhead N, Frizelle F, Garcia-Granero E, Garcia-Sabrido J, Gentilini L, George M, Glynn R, Golda T, Griffiths B, Harris D, Evans M, Hagemans J, Harji D, Heriot A, Hohenberger W, Holm T, Jenkins J, Kapur S, Kanemitsu Y, Kelley S, Keller D, Kim H, Koh C, Kok N, Kokelaar R, Kontovounisios C, Kusters M, Larson D, Law W, Laurberg S, Lee P, Lydrup M, Lynch A, Mantyh C, Mathis K, Martling A, Meijerink W, Merkel S, Mehta A, McDermott F, McGrath J, Mirnezami A, Morton J, Mullaney T, Mesquita-Neto J, Nielsen M, Nieuwenhuijzen G, Nilsson P, O'Connell P, Palmer G, Patsouras D, Pellino G, Poggioli G, Quinn M, Quyn A, Radwan R, Rasheed S, Rasmussen P, Regenbogen S, Rocha R, Rothbarth J, Roxburgh C, Rutten H, Ryan É, Sagar P, Saklani A, Schizas A, Schwarzkopf E, Scripcariu V, Shaikh I, Shida D, Simpson A, Smart N, Smith J, Solomon M, Sørensen M, Steele S, Steffens D, Stocchi L, Stylianides N, Tekkis P, Taylor C, Tsarkov P, Tsukamoto S, Turner W, Tuynman J, van Ramshorst G, van Zoggel D, Vasquez-Jimenez W, Verhoef C, Verstegen M, Wakeman C, Warrier S, Wasmuth H, Weiser M, Wheeler J, Wild J, Yip J, Winter D, Sammour T. Palliative pelvic exenteration: A systematic review of patient-centered outcomes. Eur J Surg Oncol 2019; 45:1787-1795. [DOI: 10.1016/j.ejso.2019.06.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 06/02/2019] [Accepted: 06/07/2019] [Indexed: 12/13/2022] Open
|
47
|
Ambrosy A, Braunwald E, Morrow D, Devore A, McCague K, Duffy C, Rocha R, Velazquez E. 1135Angiotensin receptor-neprilysin inhibition in patients with de novo acute decompensated heart failure: a prespecified subgroup analysis of the PIONEER-HF trial. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The efficacy, safety, and tolerability of an angiotensin receptor-neprilysin inhibitor (ARNi) in patients presenting with de novo heart failure (HF) has not been previously well-defined.
Methods
The PIONEER-HF trial was a prospective, multicenter, double-blind, active-controlled, randomized clinical trial which enrolled 887 patients (pts) at 129 sites in the United States. Pts with or without a history of prior HF and an ejection fraction (EF) <40% and a NT-proBNP >1600 pg/mL or BNP >400 pg/mL were eligible for participation no earlier than 24 hours while still hospitalized for acute decompensated HF (ADHF). Pts were randomly assigned 1:1 to in-hospital initiation of sacubitril/valsartan (S/V) titrated to 97/103 mg vs. enalapril titrated to 10 mg both by mouth twice daily for 8 weeks. We performed a pre-specified analysis in pts with de novo HF (i.e., defined as pts without a history of HF prior to the qualifying ADHF event).
Results
At the time of enrollment, 34% (N=303) had de novo HF. These pts experienced a similar improvement in NT-proBNP with S/V vs. enalapril (Ratio of geometric means 0.65, 95% Confidence Interval [CI] 0.53–0.81; p-value = 0.0002) compared to pts with worsening chronic HF (ratio 0.72 (0.63–0.83, p-value <0.0001) (Figure). In addition, the incidence of worsening renal function, hyperkalemia, and hypotension was comparable with S/V vs. enalapril regardless of whether they were hospitalized for de novo or worsening chronic HF. Finally, there was no interaction (p-value = 0.350) between previous HF status and the effect of S/V on the composite of cardiovascular death or rehospitalization for HF (de novo HF: Hazard Ratio [HR] 0.34, 95% CI 0.11–1.05 vs. worsening chronic HF: HR 0.60, 95% CI 0.39–0.93).
Conclusion
Among patients admitted for ADHF, irrespective of prior HF history, in-hospital initiation of an ARNi led to a greater reduction in natriuretic peptide levels, a comparable safety profile, and a significant improvement in clinical outcomes.
Acknowledgement/Funding
Novartis
Collapse
Affiliation(s)
- A Ambrosy
- Kaiser Permanente Northern California, San Francisco, United States of America
| | - E Braunwald
- Brigham and Womens Hospital, Boston, United States of America
| | - D Morrow
- Brigham and Womens Hospital, Boston, United States of America
| | - A Devore
- Duke Clinical Research Institute, Durham, United States of America
| | - K McCague
- Novartis Pharmaceuticals Corporation, East Hanover, United States of America
| | - C Duffy
- Novartis Pharmaceuticals Corporation, East Hanover, United States of America
| | - R Rocha
- Novartis Pharmaceuticals Corporation, East Hanover, United States of America
| | - E Velazquez
- Yale New Haven Hospital, New Haven, United States of America
| |
Collapse
|
48
|
Carrington M, Santos R, Pais J, Picarra B, Rocha R, Bras D, Azevedo-Guerreiro R, Hyde-Congo K, Aguiar J. P603Cardiac Magnetic Resonance evaluation and risk stratification of patients with unexplained or suspected arrhythmias. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Introduction
The etiological diagnosis of cardiac arrhythmias is often difficult. Cardiac Magnetic Resonance (CMR) is the gold standard exam for anatomical and functional cardiac evaluation and it may be indicated in patients with ventricular arrhythmias when echocardiography does not provide an accurate assessment of left and right ventricles (LV, RV).
Purpose
The aim of this study was to determine the impact of CMR in the diagnosis and stratification of arrhythmic risk in patients with confirmed or suspected arrhythmias, as well as to describe the changes observed.
Methods
We performed a prospective registry over a 5-year period of all the patients with arrhythmias who underwent CMR for diagnostic and risk stratification purposes. We followed a protocol to evaluate both anatomically and functionally the ventricles and to look for the presence of late gadolinium enhancement (LGE).
Results
A total of 78 patients were included, of which 65% were male and a mean age of 46±17 years-old was observed. The indications for CMR evaluation of patients with confirmed or suspected arrhythmias were as follows: 33% (n=26) of the patients had very frequent premature ventricular complexes (PVC), 23% (n=18) had sustained ventricular tachycardia (VT), 17% (n=13) suspected structural heart disease with high arrhythmic potential, 12% (n=9) unexplained recurrent syncope, 6% (n=5) supraventricular tachycardia, 5% (n=4) non-sustained VT and 4% (n=3) aborted sudden cardiac death. Depressed ventricular ejection fraction (<50%) was present in 9% (n=7) for the LV and in 14% (n=11)for the RV. Dilation of the LV was found in 24% of the patients (n=19, mean LV volume: 115±4ml/m2) and RV dilation was present in only 1 patient who had right ventricle arrhythmogenic dysplasia (RVAD) (RV volume: 152ml/m2). Cardiac synchronization artifacts due to the presence of very frequent PVC compromised the calculation of v volumes in only 4% (n=3) of the patients. In total, 6% (n=5) had interventricular septum hypertrophy (mean 15±6g/m2), 10% (n=8) had a slight prolapse of the anterior leaflet of the mitral valve and 19% (n=15) had a dilated left auricle. LGE was present in 13% (n=10) and slight pericardium effusion was detected in 12% (n=9). CMR was considered normal in 65% (n=51), in 15% (n=12) we found nonspecific changes deserving follow-up and in 20% (n=15) it was possible to establish a diagnosis which was previously unknown: 5% (n=4) had hypertrophic cardiomyopathy, 4% (n=3) LV non-compaction, 4% (n=3) a myocarditis sequelae, 3% (n=2) RVAD, 3% (n=2) a myocardial infarction scar and 1 had non-ischemic dilated cardiomyopathy.
Conclusions
CMR is a technique with high spatial resolution, feasible and safe, which allowed an increase in diagnosis in 20% of the patients, thus contributing to the risk stratification of our study population with suspected high arrhythmic potential when the first-line complementary exams were inconclusive.
Collapse
Affiliation(s)
- M Carrington
- Hospital Espirito Santo de Evora, Cardiology, Evora, Portugal
| | - R Santos
- Hospital Espirito Santo de Evora, Cardiology, Evora, Portugal
| | - J Pais
- Hospital Espirito Santo de Evora, Cardiology, Evora, Portugal
| | - B Picarra
- Hospital Espirito Santo de Evora, Cardiology, Evora, Portugal
| | - R Rocha
- Hospital Espirito Santo de Evora, Cardiology, Evora, Portugal
| | - D Bras
- Hospital Espirito Santo de Evora, Cardiology, Evora, Portugal
| | | | - K Hyde-Congo
- Hospital Espirito Santo de Evora, Cardiology, Evora, Portugal
| | - J Aguiar
- Hospital Espirito Santo de Evora, Cardiology, Evora, Portugal
| |
Collapse
|
49
|
Quintana-Hayashi MP, Rocha R, Padra M, Thorell A, Jin C, Karlsson NG, Roxo-Rosa M, Oleastro M, Lindén SK. BabA-mediated adherence of pediatric ulcerogenic H. pylori strains to gastric mucins at neutral and acidic pH. Virulence 2019; 9:1699-1717. [PMID: 30298790 PMCID: PMC7000205 DOI: 10.1080/21505594.2018.1532243] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Helicobacter pylori infection can result in non-ulcer dyspepsia (NUD), peptic ulcer disease (PUD), adenocarcinoma, and gastric lymphoma. H. pylori reside within the gastric mucus layer, mainly composed of mucins carrying an array of glycan structures that can serve as bacterial adhesion epitopes. The aim of the present study was to characterize the binding ability, adhesion modes, and growth of H. pylori strains from pediatric patients with NUD and PUD to gastric mucins. Our results showed an increased adhesion capacity of pediatric PUD H. pylori strains to human and rhesus monkey gastric mucins compared to the NUD strains both at neutral and acidic pH, regardless if the mucins were positive for Lewis b (Leb), Sialyl-Lewis x (SLex) or LacdiNAc. In addition to babA positive strains being more common among PUD associated strains, H. pylori babA positive strains bound more avidly to gastric mucins than NUD babA positive strains at acidic pH. Binding to Leb was higher among babA positive PUD H. pylori strains compared to NUD strains at neutral, but not acidic, pH. PUD derived babA-knockout mutants had attenuated binding to mucins and Leb at acidic and neutral pH, and to SLex and DNA at acidic pH. The results highlight the role of BabA-mediated adherence of pediatric ulcerogenic H. pylori strains, and points to a role for BabA in adhesion to charged structures at acidic pH, separate from its specific blood group binding activity.
Collapse
Affiliation(s)
- Macarena P Quintana-Hayashi
- a Department of Biomedical Chemistry and Cell Biology, Institute of Biomedicine, Sahlgrenska Academy , University of Gothenburg , Gothenburg , Sweden
| | - Raquel Rocha
- b Department of Infectious Diseases , National Institute of Health Dr. Ricardo Jorge , Lisbon , Portugal
| | - Médea Padra
- a Department of Biomedical Chemistry and Cell Biology, Institute of Biomedicine, Sahlgrenska Academy , University of Gothenburg , Gothenburg , Sweden
| | - Anders Thorell
- c Department for Clinical Science and Department of Surgery, Ersta Hospital , Karolinska Institutet , Stockholm , Sweden
| | - Chunsheng Jin
- a Department of Biomedical Chemistry and Cell Biology, Institute of Biomedicine, Sahlgrenska Academy , University of Gothenburg , Gothenburg , Sweden
| | - Niclas G Karlsson
- a Department of Biomedical Chemistry and Cell Biology, Institute of Biomedicine, Sahlgrenska Academy , University of Gothenburg , Gothenburg , Sweden
| | - Mónica Roxo-Rosa
- b Department of Infectious Diseases , National Institute of Health Dr. Ricardo Jorge , Lisbon , Portugal
| | - Mónica Oleastro
- d Centro de Estudo de Doenças Crónicas, Nova Medical School/Faculdade de Ciências Médicas , Universidade Nova de Lisboa , Lisbon , Portugal
| | - Sara K Lindén
- a Department of Biomedical Chemistry and Cell Biology, Institute of Biomedicine, Sahlgrenska Academy , University of Gothenburg , Gothenburg , Sweden
| |
Collapse
|
50
|
Rocha R, Sousa UH, Reis TLM, Santana GO. Nutritional status as a predictor of hospitalization in inflammatory bowel disease: A review. World J Gastrointest Pharmacol Ther 2019; 10:50-56. [PMID: 30891328 PMCID: PMC6422851 DOI: 10.4292/wjgpt.v10.i2.50] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Revised: 12/12/2018] [Accepted: 01/10/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Inflammatory bowel disease (IBD) presents an inflammatory picture that in the long run can lead to complications and consequently more hospitalizations compared to other diseases.
AIM To evaluate the influence of nutritional status on the occurrence of IBD-related hospitalization.
METHODS This integrative review was conducted in the online databases PubMed and MEDLINE, using the terms “obesity” and “malnutrition” accompanied by “hospitalization”, each combined with “Crohn’s disease” or “ulcerative colitis”. Only studies conducted with humans, adults, and published in English or Spanish were selected, and those that were not directly associated with nutritional status and hospitalization were excluded from this review. The Preferred Reporting Items for Systematic Reviews and Meta-Analyzes guide was used as the basis for selection of studies.
RESULTS Of the 80 studies identified, only five met the proposal of this review. None evaluated the association of good nutritional status with the risk of hospitalization. Malnutrition had a strong correlation with the risk of hospitalization related to IBD, and there was disagreement among three studies regarding the association of obesity and hospitalization rates.
CONCLUSION Few studies have evaluated nutritional status as a predictor of IBD-related hospitalization. The presence of malnutrition appears to be associated with hospitalization in these patients, but further studies are needed to elucidate the issue.
Collapse
Affiliation(s)
- Raquel Rocha
- Escola de Nutrição, Universidade Federal da Bahia, Salvador 40110-150, Bahia, Brazil
| | - Uli H Sousa
- Escola de Nutrição, Universidade Federal da Bahia, Salvador 40110-150, Bahia, Brazil
| | - Thamiris L M Reis
- Escola de Nutrição, Universidade Federal da Bahia, Salvador 40110-150, Bahia, Brazil
| | - Genoile O Santana
- Pós graduação em Medicina e Saúde, Universidade Federal da Bahia, Salvador 40110-060, Bahia, Brazil
- Department of Life Sciences, Universidade do Estado da Bahia, Salvador 41150-000, Bahia, Brazil
| |
Collapse
|