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Ribeiro T, Lopes S, Moutinho-Ribeiro P, Macedo G, Vilas-Boas F. Performance of Intracystic Glucose Measurement for the Characterization of Pancreatic Cystic Lesions. J Gastrointestin Liver Dis 2024; 33:74-78. [PMID: 38554431 DOI: 10.15403/jgld-5330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 01/17/2024] [Indexed: 04/01/2024]
Abstract
BACKGROUND AND AIMS Endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA) is essential for the classification of pancreatic cystic lesions (PCLs). Recently, intracystic glucose has been suggested as an alternative to carcinoembryonic antigen (CEA) level as a predictor of mucinous cystic lesions (M-PCLs). This study aims to evaluate the diagnostic performance of intra-cystic glucose in distinguishing between M-PCLs and non M-PCLs (NM-PCLs) and to analyze the possibility of on-site glucose measurement with a standard glucometer. METHODS Patients with PCLs submitted to EUS-FNA with simultaneous intracystic glucose measurement between 2017 and 2022 were included. The diagnostic performance of glucose versus CEA for the differentiation between M-PCLs and NM-PCLs was compared to a final diagnosis based on the analysis of surgical specimen, intracystic biopsy or, if this data was unavailable, multidisciplinary evaluation. A cut-off of <50 mg/dL was used for the diagnosis of MCLs. Additionally, the agreement between on-site glucose determination with a standard glucometer and laboratory glucose measurement was assessed. RESULTS Mucinous lesions accounted for 56% of all PCLs. The median values of glucose and CEA for M-PCLs were 18 mg/dL and 286 ng/mL, respectively. Intracystic glucose had a sensitivity and specificity of 93.2% and 76.5%, respectively, for the diagnosis of MCLs (versus 55.6% and 87.5%, respectively, for CEA). The area under the curve was 0.870 for on-site glucose (versus 0.806 for CEA). An excellent correlation was observed between on-site and laboratory glucose measurement (ρ=0.919). CONCLUSIONS The measurement of intracystic glucose showed superior performance compared with CEA in distinguishing between M-PCLs and NM-PCLs, with excellent correlation between on-site and conventional lab glucose measurement. Thus, on-site intracystic glucose appears to be an excellent biomarker for the characterization of PCLs due to its low cost, high availability, and the need for a minimal cyst fluid volume for its determination.
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Affiliation(s)
- Tiago Ribeiro
- Department of Gastroenterology Centro Hospitalar e Universitário de São João Alameda Professor Hernani Monteiro 4200-319 Porto, Portugal.
| | - Susana Lopes
- Department of Gastroenterology Centro Hospitalar e Universitário de São João Alameda Professor Hernani Monteiro 4200-319 Porto, Portugal.
| | - Pedro Moutinho-Ribeiro
- Department of Gastroenterology Centro Hospitalar e Universitário de São João Alameda Professor Hernani Monteiro 4200-319 Porto, Portugal.
| | - Guilherme Macedo
- Department of Gastroenterology Centro Hospitalar e Universitário de São João Alameda Professor Hernani Monteiro 4200-319 Porto, Portugal.
| | - Filipe Vilas-Boas
- Department of Gastroenterology Centro Hospitalar e Universitário de São João Alameda Professor Hernani Monteiro 4200-319 Porto, Portugal.
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Freitas I, Velo-Antón G, Lopes S, Muñoz-Merida A, Martínez-Freiría F. Isolation and characterization of polymorphic microsatellite loci for the three Iberian vipers, Vipera aspis, V. Latastei and V. seoanei by Illumina MiSeq sequencing. Mol Biol Rep 2024; 51:294. [PMID: 38334910 PMCID: PMC10857953 DOI: 10.1007/s11033-024-09263-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 01/17/2024] [Indexed: 02/10/2024]
Abstract
BACKGROUND European vipers (genus Vipera) are a well-studied taxonomic group, but the low resolution of nuclear sanger-sequenced regions has precluded thorough studies at systematic, ecological, evolutionary and conservation levels. In this study, we developed novel microsatellite markers for the three Iberian vipers, Vipera aspis, V. latastei and V. seoanei, and assessed their polymorphism in north-central Iberian populations. METHODS AND RESULTS Genomic libraries were developed for each species using an Illumina Miseq sequencing approach. From the 70 primer pairs initially tested, 48 amplified reliably and were polymorphic within species. Cross-species transferability was achieved for 31 microsatellites loci in the three target species and four additional loci that were transferable to one species only. The 48 loci amplified in average seven alleles, and detected average expected and observed heterozygosities of 0.7 and 0.55, in the three genotyped populations/species (26 V. aspis, 20 V. latastei and 10 V. seoanei). CONCLUSIONS Our study provides a selection of 48 polymorphic microsatellite markers that will contribute significantly to current knowledge on genetic diversity, gene flow, population structure, demographic dynamics, systematics, reproduction and heritability in these species, and potentially in other congeneric taxa.
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Affiliation(s)
- Inês Freitas
- Centro de Investigação em Biodiversidade e Recursos Genéticos, CIBIO, InBIO Laboratório Associado, Universidade do Porto, Campus de Vairão, Vairão, 4485-661, Portugal.
- BIOPOLIS Program in Genomics, Biodiversity and Land Planning, CIBIO, Campus de Vairão, Vairão, 4485-661, Portugal.
- Departamento de Biologia, Faculdade de Ciências, Universidade do Porto, Porto, 4099-002, Portugal.
| | - Guillermo Velo-Antón
- Centro de Investigação em Biodiversidade e Recursos Genéticos, CIBIO, InBIO Laboratório Associado, Universidade do Porto, Campus de Vairão, Vairão, 4485-661, Portugal
- Facultad de Biología, Edificio de Ciencias Experimentales, Universidad de Vigo, Bloque B, Planta 2, Laboratorio 39 (Grupo GEA), Vigo, E-36310, Spain
| | - Susana Lopes
- Centro de Investigação em Biodiversidade e Recursos Genéticos, CIBIO, InBIO Laboratório Associado, Universidade do Porto, Campus de Vairão, Vairão, 4485-661, Portugal
- BIOPOLIS Program in Genomics, Biodiversity and Land Planning, CIBIO, Campus de Vairão, Vairão, 4485-661, Portugal
| | - Antonio Muñoz-Merida
- Centro de Investigação em Biodiversidade e Recursos Genéticos, CIBIO, InBIO Laboratório Associado, Universidade do Porto, Campus de Vairão, Vairão, 4485-661, Portugal
- BIOPOLIS Program in Genomics, Biodiversity and Land Planning, CIBIO, Campus de Vairão, Vairão, 4485-661, Portugal
| | - Fernando Martínez-Freiría
- Centro de Investigação em Biodiversidade e Recursos Genéticos, CIBIO, InBIO Laboratório Associado, Universidade do Porto, Campus de Vairão, Vairão, 4485-661, Portugal
- BIOPOLIS Program in Genomics, Biodiversity and Land Planning, CIBIO, Campus de Vairão, Vairão, 4485-661, Portugal
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Sousa B, Magalhães P, Pinto A, Trindade E, Presa Ramos J, Freitas S, Lopes S, Antunes H. Correction: Wilson's Disease: A Prevalence Study in a Portuguese Population. Cureus 2023; 15:c142. [PMID: 37929274 PMCID: PMC10622119 DOI: 10.7759/cureus.c142] [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: 11/07/2023] Open
Abstract
[This corrects the article DOI: 10.7759/cureus.43718.].
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Affiliation(s)
- Bebiana Sousa
- School of Medicine, University of Minho, Braga, PRT
- Paediatrics Department, Centro Materno-Infantil do Norte do Centro Hospitalar Universitário de Santo António, Porto, PRT
| | - Pedro Magalhães
- Internal Medicine Department, Centro Hospitalar de Vila Nova de Gaia / Espinho, Vila Nova de Gaia, PRT
| | - Alfredo Pinto
- Internal Medicine Department, Unidade Local de Saude do Alto Minho, Viana do Castelo, PRT
| | - Eunice Trindade
- Paediatric Gastroenterology Department, Centro Hospitalar Universitário de São João, Porto, PRT
| | - José Presa Ramos
- Hepatology Unit of Internal Medicine Department, Centro Hospitalar de Tras-os-Montes e Alto Douro, Vila Real, PRT
| | - Sara Freitas
- Internal Medicine Department, Hospital Senhora da Oliveira Guimarães, Guimarães, PRT
| | - Susana Lopes
- Gastroenterology Department, Centro Hospitalar Universitário de São João, Porto, PRT
| | - Henedina Antunes
- Life and Health Sciences Research Institute - ICVS/3B's Associated Laboratory and School of Medicine, University of Minho, Braga, PRT
- Paediatric Gastroenterology, Hepatology and Nutrition Unit, Hospital de Braga, Braga, PRT
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Lopes S, Nikitin T, Fausto R. Phenylpropiolic acid isolated in cryogenic nitrogen and xenon matrices: NIR and UV-induced study. J Chem Phys 2023; 159:164311. [PMID: 37888763 DOI: 10.1063/5.0167128] [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] [Received: 07/10/2023] [Accepted: 10/05/2023] [Indexed: 10/28/2023] Open
Abstract
Phenylpropiolic acid (C6H5C≡CCOOH, PPA) isolated in nitrogen and xenon cryogenic matrices was studied by infrared spectroscopy. The experimental studies were complemented by a series of quantum chemical calculations carried out at the density functional theory (B3LYP) and MP2 levels of theory (with different basis sets). The calculations predicted the existence of two planar PPA conformers, differing in the arrangement of the carboxylic group. The higher-energy trans-PPA conformer has a negligible population in the gas phase at room temperature and was prepared in situ in the N2 cryomatrix through vibrationally-induced rotamerization of the lower-energy cis-PPA conformer, achieved using selective narrowband infrared excitation of the OH stretching coordinate of the latter species. Broadband UV (λ > 235 nm) irradiation of matrix-isolated cis-PPA was also undertaken, leading to the observation of cis-PPA → trans-PPA isomerization. No other UV-induced photoreactions were observed. The in situ generated trans-PPA conformer was found to decay back to cis-PPA in the dark by tunneling, and its lifetimes under different experimental conditions were determined. The assignment of the infrared spectra of both conformers is presented, considerably extending the vibrational information available on this molecule.
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Affiliation(s)
- S Lopes
- CQC-IMS, Department of Chemistry, University of Coimbra, 3004-535 Coimbra, Portugal
| | - T Nikitin
- CQC-IMS, Department of Chemistry, University of Coimbra, 3004-535 Coimbra, Portugal
| | - R Fausto
- CQC-IMS, Department of Chemistry, University of Coimbra, 3004-535 Coimbra, Portugal
- Faculty of Sciences and Letters, Department of Physics, Istanbul Kultur University, Ataköy Campus, Bakirköy, 34156 Istanbul, Türkiye
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Silva JF, Lopes S, Macedo G. An unexpected cause of common bile duct obstruction diagnosed by endoscopic ultrasound-guided fine-needle biopsy. Rev Esp Enferm Dig 2023; 115:533. [PMID: 36633171 DOI: 10.17235/reed.2023.9393/2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
A 43-years-old woman with previous cholecystectomy presented as an outpatient with abnormal liver tests. A diagnosis of well-differentiated neuroendocrine tumor (NET) was made and a 68Ga-DOTA-somatostatin analogue positron emission tomography revealed no apparent metastatic disease.
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Affiliation(s)
| | - Susana Lopes
- Gastroenterology , Centro Hospitalar Universitário de São João
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Sousa B, Magalhães P, Pinto A, Trindade E, Silva E, Presa Ramos J, Freitas S, Lopes S, Antunes H. Wilson's Disease: A Prevalence Study in a Portuguese Population. Cureus 2023; 15:e43718. [PMID: 37724235 PMCID: PMC10505497 DOI: 10.7759/cureus.43718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2023] [Indexed: 09/20/2023] Open
Abstract
Introduction Wilson's disease (WD) is a rare and underdiagnosed genetic disorder caused by anomalous tissue copper deposition, and for which epidemiological studies, specifically in Portugal, are scarce. Objectives This study aimed to evaluate the prevalence and incidence of WD and provide a description of its main clinical and laboratory features. Methods A retrospective study was carried out, with a search between 1995 and 2015, of all patients with a minimum follow-up of three months and birth confirmed in the northern region of Portugal, with an estimated population of 3,689,682 inhabitants. Database collection was based on the Portuguese National Health Service's clinical coding system, relying on clinical data from 13 northern Portuguese hospitals, liver biopsy histology results, and hospital prescription records. Clinical and biochemical correlations were statistically assessed using chi-square, Mann-Whitney U, Friedman, and Wilcoxon tests. Results Over the 20-year period, a prevalence of 1:37.000 and an incidence of one per million person-year was found. A total of 94 patients were analyzed, with a slight male predominance (53%), the majority with the onset of clinical manifestations in pediatric age (56%), with a median age at diagnosis of 16.6 years (interquartile range of 12.3-20,.8 years). Most patients presented with predominant liver disease (54.8%), with more than a third with cirrhosis; mixed hepatic and neurological manifestations in 17.9%; and mainly neurological symptoms in 10.7% of the patients. Neurological impairment was strongly associated with delayed development of the manifestations of the disease (p = 0.001) and also a higher detection of Kayser-Fleischer rings (p < 0.001), present in 27.0% of the patients. Regarding therapy, penicillamine has been the most widely used, with adverse reactions reported in 24.8%. At six and 12 months after initiation of therapy, a significant decrease in liver enzymes was found (ALT: p = 0.002; AST: p = 0.002, respectively), but no significant reduction was observed in urinary copper excretion. Conclusion This was one of the first studies regarding WD prevalence in a Portuguese population, contributing to a better understanding of the epidemiology, diagnosis, and management of WD in the northern region of Portugal. WD should be considered in any individual with unexplained hepatic or neurological manifestations, and initial symptoms may manifest at an early age, even in children less than five years old. A high percentage of patients were identified in the early stages of the disease by asymptomatic elevation of transaminases. Following copper chelation therapy, cytolysis markers appear to be more sensitive indicators of treatment response.
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Affiliation(s)
- Bebiana Sousa
- School of Medicine, University of Minho, Braga, PRT
- Paediatrics Department, Centro Materno-Infantil do Norte do Centro Hospitalar Universitário de Santo António, Porto, PRT
| | - Pedro Magalhães
- Internal Medicine Department, Centro Hospitalar de Vila Nova de Gaia / Espinho, Vila Nova de Gaia, PRT
| | - Alfredo Pinto
- Internal Medicine Department, Unidade Local de Saude do Alto Minho, Viana do Castelo, PRT
| | - Eunice Trindade
- Paediatric Gastroenterology Department, Centro Hospitalar Universitário de São João, Porto, PRT
| | - Ermelinda Silva
- Paediatric Gastroenterology Department, Centro Materno-Infantil do Norte do Centro Hospitalar Universitario de Santo Antonio, Porto, PRT
| | - José Presa Ramos
- Hepatology Unit of Internal Medicine Department, Centro Hospitalar de Tras-os-Montes e Alto Douro, Vila Real, PRT
| | - Sara Freitas
- Internal Medicine Department, Hospital Senhora da Oliveira Guimarães, Guimarães, PRT
| | - Susana Lopes
- Gastroenterology Department, Centro Hospitalar Universitário de São João, Porto, PRT
| | - Henedina Antunes
- Life and Health Sciences Research Institute - ICVS/3B's Associated Laboratory and School of Medicine, University of Minho, Braga, PRT
- Paediatric Gastroenterology, Hepatology and Nutrition Unit, Hospital de Braga, Braga, PRT
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Bouhali A, Homrani A, Ferrand N, Lopes S, Emam AM. Assessment of genetic diversity among native Algerian rabbit populations using microsatellite markers. Arch Anim Breed 2023; 66:207-215. [PMID: 37560355 PMCID: PMC10407306 DOI: 10.5194/aab-66-207-2023] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 06/26/2023] [Indexed: 08/11/2023] Open
Abstract
Having higher adaptability against abiotic stress, which is characterized in rural areas in developing countries, local farm animal genetic resources (FAGRs) are increasingly precarious for random and unsystematic crossing with exotic breeds. In this study, 85 microsatellite loci were utilized to assess genetic diversity among native Algerian rabbits (NARs) sampled from an area of 753 km (from north to south) and 919 km (from east to west). Those distances covered 25 significant geographical points in seven rural areas (El Taref, Mostaganem, Sidi Bel Abbès, M'Sila, Dar Chioukh, Faidh El Botma, and Laghouat). A total of 558 alleles were observed in this study. The highest genetic diversity was registered in the southern direction among NAR populations. The mean number of alleles per locus (MNa) and the inbreeding coefficient (F IS ) were highest in Laghouat (4.482 and 0.232), while they were lowest in El Taref (4.000 and 0.149). In the current study, the number of private alleles (Pa) ranged from 9 to 23. In addition, the average of observed heterozygosity (0.427) was lower than the expected value (0.524) due to high levels of inbreeding. The discriminant analysis of principal components (DAPC), the neighbor-joining tree (NJ), and the analysis of STRUCTURE software confirmed the classification of populations according to geographical zones into four main groups (east, west, south, and middle). The results of the current study are useful for breeding improvement and conservation plan research in relation to local animal genetic resources in Algeria.
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Affiliation(s)
- Abdelbaki Bouhali
- Laboratory of Sciences and Technics for Animal Production (LSTAP),
Department of Agronomic Sciences, Faculty of Nature Sciences and Life,
Abdelhamid Ibn Badis Mostaganem University, Mostaganem, Algeria
- École Normale Supérieur Taleb abderrahmane Laghouat, Laghouat,
4033, Algeria
| | - Abdelkader Homrani
- Laboratory of Sciences and Technics for Animal Production (LSTAP),
Department of Agronomic Sciences, Faculty of Nature Sciences and Life,
Abdelhamid Ibn Badis Mostaganem University, Mostaganem, Algeria
| | - Nuno Ferrand
- CIBIO/InBIO, Centro de Investigacao em Biodiversidade e Recursos
Geneticos, Campus Agrario de Vairao, Universidade do Porto, 4485-661,
Vairão, Portugal
- Departamento de Biologia, Faculdade de Ciencias, Universidade do
Porto, Rua do Campo Alegre s/n, 4169-007, Porto, Portugal
| | - Susana Lopes
- CIBIO/InBIO, Centro de Investigacao em Biodiversidade e Recursos
Geneticos, Campus Agrario de Vairao, Universidade do Porto, 4485-661,
Vairão, Portugal
| | - Ahmed Mostafa Emam
- Animal Production Research Institute, Agricultural Research Centre,
Ministry of Agriculture, Nadi El Saiid street, 12618, Dokkii, Giza, Egypt
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Lopes S, Diniz F, Mesquita Bastos J, Oliveira J, Polónia J, Alves AJ, Ribeiro F, Figueiredo D. "What do we think?": a qualitative exploratory study of acceptability and experiences of individuals with resistant hypertension after completing a physical exercise program (the EnRICH trial). Disabil Rehabil 2023:1-8. [PMID: 37424233 DOI: 10.1080/09638288.2023.2229237] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
Purpose: Aerobic exercise training programs decrease blood pressure in individuals with resistant hypertension. However, participants' experiences regarding exercise training participation are unknown and often undervalued. Therefore, participant's experiences and program acceptability of the exercise arm of the EnRicH trial, a randomized clinical trial investigating the effect of a 12-week aerobic exercise training program in individuals with resistant hypertension were analysed.Methods: An exploratory qualitative study was conducted with twenty individuals with resistant hypertension (11 males, mean age 58.9 ± 8.9 years), after the exercise program. Four focus group interviews were performed to explore participants' perspectives. The interviews were digitally audio-recorded, transcribed verbatim, and subjected to thematic analysis.Results: Five themes emerged from the data analyses: 1) main impacts of participating in the exercise program; 2) facilitators of adherence; 3) perceived barriers; 4) perception of the program structure; and 5) global satisfaction with the program. Positive physical and emotional changes were reported, associated with reduced perceived stress and irritability, and decreased blood pressure. Adherence to the exercise program was facilitated by personalized supervision and feedback, the personal commitment to attend the training sessions, and different schedule options. Lack of motivation, peer support, physical health limitations, and difficulty in conciliating schedules were identified as barriers to the maintenance of exercise training after the program.Conclusion: The qualitative analysis demonstrates the acceptability of the program. Peer and health professional's support, commitment to health professionals, and boosting individual-perceived advantages are key-points to promote participants adherence.Implications for RehabilitationExercising in small groups seems to provide peer support, facilitating maintenance of exercise trainingProviding feedback on the health gains achieved by participants is important to increase adherence to exerciseEstablishing good and empathic communication between health professionals and participants facilitates adherence to exercise trainingProviding personal nutritional counselling may improve patient satisfactionIndividually tailored exercise programs may facilitate exercising for participants with physical limitationsProviding different training schedules may increase adherence and maintenance of exercise training.
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Affiliation(s)
- Susana Lopes
- School of Health Sciences and Institute of Biomedicine - iBiMED, University of Aveiro, Aveiro, Portugal
- Physiotherapy Department, Polytechnic of Coimbra, ESTeSC Coimbra Health School, Coimbra, Portugal
- Saúde Positiva, Clínica de Saúde Física e Mental, Aveiro, Portugal
| | - Filipa Diniz
- Saúde Positiva, Clínica de Saúde Física e Mental, Aveiro, Portugal
- Education and Psychology Department, University of Aveiro, Aveiro, Portugal
| | - José Mesquita Bastos
- School of Health Sciences and Institute of Biomedicine - iBiMED, University of Aveiro, Aveiro, Portugal
- Cardiology Department, Hospital Infante D. Pedro, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal
| | - José Oliveira
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
| | - Jorge Polónia
- Faculty of Medicine, University of Porto, Porto, Portugal
- Hypertension and Cardiovascular Risk Unit, Unidade Local de Saúde Matosinhos, Matosinhos, Portugal
| | - Alberto Jorge Alves
- Research Center in Sports Sciences, Health and Human Development, CIDESD, University of Maia, Maia, Portugal
- OncoMove, Associação de Investigação de Cuidados de Suporte em Oncologia (AICSO), Vila Nova de Gaia, Portugal
| | - Fernando Ribeiro
- School of Health Sciences and Institute of Biomedicine - iBiMED, University of Aveiro, Aveiro, Portugal
| | - Daniela Figueiredo
- Centre for Health Technology and Services Research (CINTESIS.UA), School of Health Sciences, University of Aveiro, Aveiro, Portugal
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Mesquita Bastos J, Ferraz L, Pereira FG, Lopes S. Systolic Blood Pressure and Pulse Pressure Are Predictors of Future Cardiovascular Events in Patients with True Resistant Hypertension. Diagnostics (Basel) 2023; 13:diagnostics13101817. [PMID: 37238300 DOI: 10.3390/diagnostics13101817] [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: 02/21/2023] [Revised: 05/13/2023] [Accepted: 05/15/2023] [Indexed: 05/28/2023] Open
Abstract
Given the increased risk of cardiovascular events associated with resistant hypertension, predictive cardiovascular prognosis is extremely important. Ambulatory blood pressure monitoring (ABPM) is mandatory for resistant hypertension diagnosis, but its use for prognosis is scarce. This observational longitudinal study included 258 patients (mean age of 60.4 ± 11.2 years; 61.2% male), who underwent 24 h ABPM in a hypertension unit from 1999 to 2019. The outcomes were global cardiovascular events (cerebrovascular, coronary, and other cardiovascular events). The mean follow-up period was 6.0 ± 5.0 years. Sixty-eight cardiovascular events (61 nonfatal) were recorded. Patients who experienced cardiovascular events were generally older, with higher rates of chronic kidney disease and prior cardiovascular events. The 24 h systolic blood pressure (hazard ratio 1.44; 95% CI 1.10-1.88), night systolic blood pressure (1.35; 95% CI 1.01-1.80), and 24 h pulse pressure (2.07; 95% CI 1.17-3.67) were independent predictors of global cardiovascular events. Multivariate Cox analysis revealed a higher risk of future cardiovascular events, particularly in patients with a 24 h daytime and nighttime pulse pressure > 60 mm Hg with respective hazard ratios of 1.95; 95% CI 1.01-3.45; 2.15; 95% CI 1.21-3.83 and 2.07; 95% CI 1.17-3.67. In conclusion, APBM is a fundamental tool not only for the diagnosis of resistant hypertension, but also for predicting future cardiovascular events.
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Affiliation(s)
- J Mesquita Bastos
- School of Health Sciences and Institute of Biomedicine-iBiMED, University of Aveiro, 3810-193 Aveiro, Portugal
- Cardiology Department, Centro Hospitalar do Baixo Vouga, 3810-164 Aveiro, Portugal
| | - Lisa Ferraz
- Internal Medicine Department, Centro Hospitalar do Baixo Vouga, 3810-164 Aveiro, Portugal
| | - Flávio G Pereira
- Internal Medicine Department, Centro Hospitalar do Baixo Vouga, 3810-164 Aveiro, Portugal
| | - Susana Lopes
- School of Health Sciences and Institute of Biomedicine-iBiMED, University of Aveiro, 3810-193 Aveiro, Portugal
- Polytechnic of Coimbra, ESTeSCoimbra Health School, Physiotherapy Department, 3040-854 Coimbra, Portugal
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Garrido I, Lopes S, Dias CC, Macedo G. IBD-disk - a new tool for assessing disability in inflammatory bowel disease. Dig Liver Dis 2023; 55:824-827. [PMID: 37037765 DOI: 10.1016/j.dld.2023.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/13/2023] [Accepted: 03/22/2023] [Indexed: 04/12/2023]
Affiliation(s)
- Isabel Garrido
- Gastroenterology and Hepatology Department, Centro Hospitalar São João, Alameda Prof. Hernâni Monteiro, Porto 4200-319, Portugal; World Gastroenterology Organization (WGO) Porto Training Center, Porto, Portugal.
| | - Susana Lopes
- Gastroenterology and Hepatology Department, Centro Hospitalar São João, Alameda Prof. Hernâni Monteiro, Porto 4200-319, Portugal; World Gastroenterology Organization (WGO) Porto Training Center, Porto, Portugal
| | - Cláudia Camila Dias
- CINTESIS@RISE, MEDCIDS, Faculty of Medicine of Porto University, Porto, Portugal; Department of Community Medicine, Information and Decision in Health, Faculty of Medicine of Porto University, Porto, Portugal
| | - Guilherme Macedo
- Gastroenterology and Hepatology Department, Centro Hospitalar São João, Alameda Prof. Hernâni Monteiro, Porto 4200-319, Portugal; World Gastroenterology Organization (WGO) Porto Training Center, Porto, Portugal
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Macedo G, Lopes S. How Gastroenterology Leaders Performed while Navigating in Rough Seas: Lessons from the COVID-19 Pandemic. J Gastrointestin Liver Dis 2023; 32:7-9. [PMID: 37004217 DOI: 10.15403/jgld-4878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 02/27/2023] [Indexed: 04/03/2023]
Affiliation(s)
- Guilherme Macedo
- World Gastroenterology Organization Porto Training Center, Porto, Portugal.
| | - Susana Lopes
- World Gastroenterology Organization Porto Training Center, Porto, Portugal.
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Martins JRN, Lopes S, Hurtado HN, da Silva FN, Villard DR, Taboga SR, Souza KLA, Quesada I, Soriano S, Rafacho A. Acute and chronic effects of the organophosphate malathion on the pancreatic α and β cell viability, cell structure, and voltage-gated K + currents. Environ Toxicol Pharmacol 2023; 98:104046. [PMID: 36587778 DOI: 10.1016/j.etap.2022.104046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 12/09/2022] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
Studies indicate that the pesticide malathion may have a role in diabetes. Herein, we determined the effects of different concentrations of malathion on survival, ultrastructure, and electrophysiologic islet cell parameters. Acutely, high concentrations of malathion (0.5 or 1 mM) increased cell death in rat islet cells, while low concentrations (0.1 mM) caused signs of cell damage in pancreatic α and β cells. Exposure of RINm5F cells to malathion for 24 or 48 h confirmed the reduction in β-cell viability at lower concentrations (0.001-100 µM). Chronic exposure of mouse pancreatic α and β cells to 3 nM of malathion led to increased voltage-gated K+ (Kv) currents in α-cells. Our findings show a time and concentration dependency for the malathion effect on the reduction of islet cell viability and indicate that pancreatic α cells are more sensitive to malathion effects on Kv currents and cell death.
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Affiliation(s)
- J R N Martins
- Laboratory of Investigation in Chronic Diseases LIDoC, Department of Physiological Sciences, Center of Biological Sciences, Federal University of Santa Catarina UFSC, Florianópolis, Brazil; Graduate Program in Pharmacology, Center of Biological Sciences, Federal University of Santa Catarina UFSC, Florianópolis, Brazil
| | - S Lopes
- Central Laboratory of Electron Microscopy LCME, PROPESQ, Federal University of Santa Catarina UFSC, Florianópolis, Brazil
| | - H N Hurtado
- Department of Physiology, Genetics, and Microbiology, University of Alicante, Alicante, Spain
| | - F N da Silva
- Laboratory of Investigation in Chronic Diseases LIDoC, Department of Physiological Sciences, Center of Biological Sciences, Federal University of Santa Catarina UFSC, Florianópolis, Brazil; Graduate Program in Pharmacology, Center of Biological Sciences, Federal University of Santa Catarina UFSC, Florianópolis, Brazil
| | - D R Villard
- NUMPEX-BIO, Campus Duque de Caxias, Universidade Federal do Rio de Janeiro (UFRJ), Campus UFRJ Duque de Caxias Prof. Geraldo Cidade, Duque de Caxias 25245-390, Brazil
| | - S R Taboga
- Department of Biological Sciences, Laboratory of Microscopy and Microanalysis, Universidade Estadual Paulista-UNESP, São Paulo, Brazil
| | - K L A Souza
- NUMPEX-BIO, Campus Duque de Caxias, Universidade Federal do Rio de Janeiro (UFRJ), Campus UFRJ Duque de Caxias Prof. Geraldo Cidade, Duque de Caxias 25245-390, Brazil
| | - I Quesada
- Instituto de Investigación, Desarrollo e Innovación en Biotecnología Sanitaria de Elche (IDiBE), Universidad Miguel Hernández, Elche, Spain; Biomedical Research Center in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain
| | - S Soriano
- Department of Physiology, Genetics, and Microbiology, University of Alicante, Alicante, Spain; Instituto de Investigación, Desarrollo e Innovación en Biotecnología Sanitaria de Elche (IDiBE), Universidad Miguel Hernández, Elche, Spain
| | - A Rafacho
- Laboratory of Investigation in Chronic Diseases LIDoC, Department of Physiological Sciences, Center of Biological Sciences, Federal University of Santa Catarina UFSC, Florianópolis, Brazil; Graduate Program in Pharmacology, Center of Biological Sciences, Federal University of Santa Catarina UFSC, Florianópolis, Brazil.
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Garrido I, Lopes S, Fonseca E, Carneiro F, Macedo G. Autoimmune hepatitis and eosinophilia: A rare case report. World J Hepatol 2023; 15:311-317. [PMID: 36926232 PMCID: PMC10011904 DOI: 10.4254/wjh.v15.i2.311] [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: 11/01/2022] [Revised: 12/13/2022] [Accepted: 01/05/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Autoimmune hepatitis consists of a chronic liver disease whose etiology is unknown. It is comprised of relevant immunological aspects and of immune-mediated liver injury. Eosinophilia may be a considerable feature, particularly happening in male patients.
CASE SUMMARY We report here a Crohn´s disease patient presenting with de novo hypergammaglobulinemia, circulating autoantibodies and elevated transaminase levels. He also had significant peripheral eosinophilia and elevated immunoglobulin E levels at diagnosis. The pathology findings from liver biopsy were compatible with autoimmune hepatitis with eosinophilic infiltration.
CONCLUSION This is the first report of autoimmune hepatitis with exuberant eosinophilic infiltration in the liver and bone marrow, described in a patient with Crohn’s disease.
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Affiliation(s)
- Isabel Garrido
- Department of Gastroenterology and Hepatology, Centro Hospitalar Universitário de São João; World Gastroenterology Organization Porto Training Center; Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Susana Lopes
- Department of Gastroenterology and Hepatology, Centro Hospitalar Universitário de São João; World Gastroenterology Organization Porto Training Center; Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Elsa Fonseca
- Department of Pathology, Centro Hospitalar Universitário de São João; Instituto de Investigação e Inovação em Saúde (i3S) and Institute of Molecular Pathology and Immunology, University of Porto (Ipatimup); Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Fátima Carneiro
- Department of Pathology, Centro Hospitalar Universitário de São João; Instituto de Investigação e Inovação em Saúde (i3S) and Institute of Molecular Pathology and Immunology, University of Porto (Ipatimup); Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Guilherme Macedo
- Department of Gastroenterology and Hepatology, Centro Hospitalar Universitário de São João; World Gastroenterology Organization Porto Training Center; Faculty of Medicine of the University of Porto, Porto, Portugal
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Dias E, Marques M, Lopes S, Gullo I, Bastos J, Macedo G. Acute gastrointestinal graft-versus-host disease with cytomegalovirus and Epstein-Barr virus superinfection in a patient with COVID-19. Rev Esp Enferm Dig 2023; 115:92-93. [PMID: 35748474 DOI: 10.17235/reed.2022.9001/2022] [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: 11/20/2022]
Abstract
A 60-year-old female was diagnosed with acute myeloid leukemia. After initial remission with chemotherapy, she relapsed and underwent allogeneic hematopoietic stem cell transplantation (HSCT). Two months later, she presented to emergency department with watery diarrhea, abdominal pain and fever. She also tested positive for SARS-CoV2 on nasopharyngeal swab by polymerase chain reaction (PCR) and both cytomegalovirus (CMV) and Epstein-Barr virus (EBV) were detected in peripheral blood. Flexible sigmoidoscopy showed diffuse edema, erythema and loss of vascular pattern with interspersed segments of mucosal denudation and exudate and bBiopsies revealed epithelial cell apoptosis, diffuse crypt atrophy and dropout, with ulceration and both CMV and EBV were detected in colon mucosa, consistent with acute severe gastrointestinal graft-versus-host disease complicated by CMV and EBV superinfection. Despite starting therapy with methylprednisolone, ganciclovir and rituximab,she presented unfavorable evolution and died after 5 weeks.
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Affiliation(s)
- Emanuel Dias
- Gastrenterology , Centro Hospitalar Universitário de São João, Portugal
| | - Margarida Marques
- Gastrenterology, Centro Hospitalar Universitário de São João, Portugal
| | - Susana Lopes
- Gastroenterology, Centro Hospitalar Universitário de São João, Portugal
| | - Irene Gullo
- Pathology, Centro Hospitalar Universitário de São João
| | - Juliana Bastos
- Hemathology, Centro Hospitalar Universitário de São João
| | - Guilherme Macedo
- Gastroenterology , Centro Hospitalar Universitário de São João, Portugal
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15
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Dias E, Cardoso H, Marques M, Liberal R, Lopes S, Pereira P, Santos-Antunes J, Pinheiro J, Lopes J, Carneiro F, Macedo G. Hepatic amyloidosis: a prevalence study and clinical characterization of a rare and severe disease. Rev Esp Enferm Dig 2023; 115:16-21. [PMID: 35297258 DOI: 10.17235/reed.2022.8622/2022] [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: 02/01/2023]
Abstract
BACKGROUND AND AIM Amyloidosis is a systemic disease characterized by extracellular deposition of amyloid protein, most commonly in the heart and kidney. Hepatic amyloidosis is a rare form of presentation that ranges from mild hepatomegaly and altered liver biochemical tests to acute liver failure. The aims of this study were to evaluate the prevalence of amyloidosis in patients undergoing liver biopsy and describe its main clinical characteristics and prognostic impact. METHODS A retrospective analysis of all patients with a histological diagnosis of hepatic amyloidosis between January 2010 and December 2019 was performed. MAJOR RESULTS A total of 7 patients were identified from a total of 1773 liver biopsy procedures (0.4%), with a female predominance (6/7) and median age of diagnosis of 62 years. The most common clinical manifestations included hepatomegaly (4/7), jaundice (2/7) and peripheral edema (2/7), whereas 3/7 patients were asymptomatic. Every patient presented abnormalities in liver biochemical tests, more commonly cholestasis (6/7), but also cytolysis (4/7) or hyperbilirubinemia (2/7). Abnormal imaging findings included hepatomegaly, steatosis or parenchymal heterogeneity. In most patients (5/7), other organs were involved, most commonly with nephrotic syndrome (3/7) and infiltrative cardiomyopathy (3/7). The most common type was AA amyloidosis (3/7) followed by AL amyloidosis (2/7). The 1-year mortality rate was 43% and the median survival was 24 months. CONCLUSIONS We report a low prevalence (0.4%) of amyloidosis among patients undergoing liver biopsy. Although rare, hepatic amyloidosis is associated with a dismal prognosis and a high index of suspicion is crucial to achieve an early diagnosis. .
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Affiliation(s)
- Emanuel Dias
- Gastrenterology , Centro Hospitalar Universitário de São João, Portugal
| | - Hélder Cardoso
- Gastroenterology, Centro Hospitalar Universitário de São João
| | - Margarida Marques
- Gastrenterology, Centro Hospitalar Universitário de São João, Portugal
| | - Rodrigo Liberal
- Gastroenterology, Centro Hospitalar Universitário de São João
| | - Susana Lopes
- Gastroenterology, Centro Hospitalar Universitário de São João, Portugal
| | - Pedro Pereira
- Gastroenterology, Centro Hospitalar Universitário de São João, Portugal
| | | | | | - Joanne Lopes
- Pathology, Centro Hospitalar Universitário de São João
| | | | - Guilherme Macedo
- Gastroenterology, Centro Hospitalar Universitário de São João, Portugal
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16
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Dias E, Andrade P, Lopes S, Gonçalves R, Cardoso P, Gaspar R, Cardoso H, Lopes J, Carneiro F, Macedo G. Liver biopsy in inflammatory bowel disease patients with sustained abnormal liver function tests: a retrospective single-center study. Ann Gastroenterol 2023; 36:54-60. [PMID: 36593810 PMCID: PMC9756023 DOI: 10.20524/aog.2023.0761] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 10/21/2022] [Indexed: 01/04/2023] Open
Abstract
Background Inflammatory bowel disease (IBD) may be associated with a wide range of hepatobiliary manifestations. This study aimed to characterize the spectrum of hepatobiliary disorders in patients with IBD who underwent liver biopsy for sustained abnormal liver function tests (LFT). Method A retrospective study was performed of all patients with IBD who underwent liver biopsy between January 2010 and December 2020 for sustained abnormal LFT (at least 6-month duration). Results A total of 101 patients were included, mostly male (62.4%), with a mean age of 44.4±13.3 years. The most common IBD type was Crohn's disease (61.4%). Median time interval between abnormal LFT and biopsy was 14 (7-36) months. Abnormal LFT was predominantly hepatocellular in 40 patients (39.6%), cholestatic in 26 (25.7%) and mixed in 35 (34.7%). The most frequent diseases were nonalcoholic fatty liver disease (NAFLD) in 33 patients (32.7%), drug-induced liver disease (DILI) in 30 (29.7%), autoimmune hepatitis (AIH) in 13 (12.9%) and primary sclerosing cholangitis (PSC) in 13 (12.9%). Three patients had primary biliary cholangitis. Remarkably, 70 patients (69.3%) already had fibrosis by the time of liver biopsy and in 6 (5.9%) liver disease was already detected in the stage of cirrhosis. Conclusions Abnormal LFT in IBD patients had a wide range of etiologies and histology was often essential for reaching a correct diagnosis. NAFLD, DILI, AIH and PSC were the most common diagnoses and patients often presented in cirrhotic stage. Therefore, liver biopsy must be considered early in IBD patients with unexplained sustained abnormal LFT.
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Affiliation(s)
- Emanuel Dias
- Gastroenterology Department (Emanuel Dias, Patrícia Andrade, Susana Lopes, Raquel Gonçalves, Pedro Cardoso, Rui Gaspar, Hélder Cardoso, Guilherme Macedo)
| | - Patrícia Andrade
- Gastroenterology Department (Emanuel Dias, Patrícia Andrade, Susana Lopes, Raquel Gonçalves, Pedro Cardoso, Rui Gaspar, Hélder Cardoso, Guilherme Macedo)
| | - Susana Lopes
- Gastroenterology Department (Emanuel Dias, Patrícia Andrade, Susana Lopes, Raquel Gonçalves, Pedro Cardoso, Rui Gaspar, Hélder Cardoso, Guilherme Macedo)
| | - Raquel Gonçalves
- Gastroenterology Department (Emanuel Dias, Patrícia Andrade, Susana Lopes, Raquel Gonçalves, Pedro Cardoso, Rui Gaspar, Hélder Cardoso, Guilherme Macedo)
| | - Pedro Cardoso
- Gastroenterology Department (Emanuel Dias, Patrícia Andrade, Susana Lopes, Raquel Gonçalves, Pedro Cardoso, Rui Gaspar, Hélder Cardoso, Guilherme Macedo)
| | - Rui Gaspar
- Gastroenterology Department (Emanuel Dias, Patrícia Andrade, Susana Lopes, Raquel Gonçalves, Pedro Cardoso, Rui Gaspar, Hélder Cardoso, Guilherme Macedo)
| | - Hélder Cardoso
- Gastroenterology Department (Emanuel Dias, Patrícia Andrade, Susana Lopes, Raquel Gonçalves, Pedro Cardoso, Rui Gaspar, Hélder Cardoso, Guilherme Macedo)
| | - Joanne Lopes
- Pathology Department (Joanne Lopes, Fátima Carneiro), Centro Hospitalar de São João, Porto, Portugal
| | - Fátima Carneiro
- Pathology Department (Joanne Lopes, Fátima Carneiro), Centro Hospitalar de São João, Porto, Portugal
| | - Guilherme Macedo
- Gastroenterology Department (Emanuel Dias, Patrícia Andrade, Susana Lopes, Raquel Gonçalves, Pedro Cardoso, Rui Gaspar, Hélder Cardoso, Guilherme Macedo)
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Ribeiro T, Mascarenhas M, Afonso J, Cardoso H, Andrade P, Lopes S, Ferreira J, Mascarenhas Saraiva M, Macedo G. Artificial intelligence and colon capsule endoscopy: Automatic detection of ulcers and erosions using a convolutional neural network. J Gastroenterol Hepatol 2022; 37:2282-2288. [PMID: 36181257 DOI: 10.1111/jgh.16011] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 07/22/2022] [Revised: 09/12/2022] [Accepted: 09/25/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIM Colon capsule endoscopy (CCE) has become a minimally invasive alternative for conventional colonoscopy. Nevertheless, each CCE exam produces between 50 000 and 100 000 frames, making its analysis time-consuming and prone to errors. Convolutional neural networks (CNNs) are a type of artificial intelligence (AI) architecture with high performance in image analysis. This study aims to develop a CNN model for the identification of colonic ulcers and erosions in CCE images. METHODS A CNN model was designed using a database of CCE images. A total of 124 CCE exams performed between 2010 and 2020 in two centers were reviewed. For CNN development, a total of 37 319 images were extracted, 33 749 showing normal colonic mucosa and 3570 showing colonic ulcers and erosions. Datasets for CNN training, validation, and testing were created. The performance of the algorithm was evaluated regarding its sensitivity, specificity, positive and negative predictive values, accuracy, and area under the curve. RESULTS The network had a sensitivity of 96.9% and a specificity of 99.9% specific for the detection of colonic ulcers and erosions. The algorithm had an overall accuracy of 99.6%. The area under the curve was 1.00. The CNN had an image processing capacity of 90 frames per second. CONCLUSIONS The developed algorithm is the first CNN-based model to accurately detect ulcers and erosions in CCE images, also providing a good image processing performance. The development of these AI systems may contribute to improve both the diagnostic and time efficiency of CCE exams, facilitating CCE adoption to routine clinical practice.
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Affiliation(s)
- Tiago Ribeiro
- Department of Gastroenterology, São João University Hospital, Porto, Portugal.,World Gastroenterology Organisation Gastroenterology and Hepatology Training Center, Porto, Portugal
| | - Miguel Mascarenhas
- Department of Gastroenterology, São João University Hospital, Porto, Portugal.,World Gastroenterology Organisation Gastroenterology and Hepatology Training Center, Porto, Portugal.,Faculty of Medicine of the University of Porto, Porto, Portugal
| | - João Afonso
- Department of Gastroenterology, São João University Hospital, Porto, Portugal.,World Gastroenterology Organisation Gastroenterology and Hepatology Training Center, Porto, Portugal
| | - Hélder Cardoso
- Department of Gastroenterology, São João University Hospital, Porto, Portugal.,World Gastroenterology Organisation Gastroenterology and Hepatology Training Center, Porto, Portugal.,Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Patrícia Andrade
- Department of Gastroenterology, São João University Hospital, Porto, Portugal.,World Gastroenterology Organisation Gastroenterology and Hepatology Training Center, Porto, Portugal.,Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Susana Lopes
- Department of Gastroenterology, São João University Hospital, Porto, Portugal.,World Gastroenterology Organisation Gastroenterology and Hepatology Training Center, Porto, Portugal.,Faculty of Medicine of the University of Porto, Porto, Portugal
| | - João Ferreira
- Faculty of Engineering of the University of Porto, Porto, Portugal.,INEGI-Institute of Science and Innovation in Mechanical and Industrial Engineering, Porto, Portugal
| | | | - Guilherme Macedo
- Department of Gastroenterology, São João University Hospital, Porto, Portugal.,World Gastroenterology Organisation Gastroenterology and Hepatology Training Center, Porto, Portugal.,Faculty of Medicine of the University of Porto, Porto, Portugal
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Martins M, Ribeiro MH, Miranda A, Lopes S, Franco R, Paiva J, Almeida CMM. New foods with history: nutritional and toxic profile of prickly pear. Food Measure 2022. [DOI: 10.1007/s11694-022-01680-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Ribeiro C, Castro I, Lopes S, Paupério G. Unintended intrapleural insertion of an epidural catheter in thoracic surgery: regional analgesia game over, or is there another way out? Rev Esp Anestesiol Reanim (Engl Ed) 2022; 69:597-601. [PMID: 36220733 DOI: 10.1016/j.redare.2021.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 05/28/2021] [Indexed: 06/16/2023]
Abstract
In thoracic surgery, optimized pain control is crucial to prevent dysfunction in cardiorespiratory mechanics. Epidural anesthesia (EA) and paravertebral block (PVB) are the most popular techniques for analgesia. Unintended intrapleural insertion of an epidural catheter is a rare complication. Our report presents a case of a patient submitted to pulmonary tumor resection by video-assisted thoracoscopic surgery (VATS). There was difficulty in epidural insertion related to patient's obesity, but after general anesthesia induction, no additional intravenous analgesia was needed after epidural injection. Surgery required conversion to thoracotomy, with intrapleural identification of epidural catheter. At the end of surgery, surgeons reoriented catheter to paravertebral space, with leak absence confirmation after local anesthetic injection through the catheter. In postoperative period, pain control was efficient, with no complications. It was a successful case that shows that when we find unexpected complications, we can look for alternative solutions to give our patient the best treatment.
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Affiliation(s)
- C Ribeiro
- Department of Anesthesiology, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal.
| | - I Castro
- Department of Anesthesiology, Instituto Português de Oncologia do Porto Francisco Gentil, Porto, Portugal
| | - S Lopes
- Thoracic Surgery, Instituto Português de Oncologia do Porto Francisco Gentil, Porto, Portugal
| | - G Paupério
- Thoracic Surgery, Instituto Português de Oncologia do Porto Francisco Gentil, Porto, Portugal
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Lopes M, Lopes S, Monteiro M, Rodrigues M, Fertuzinhos A, Coelho ADS, Matos P, Borges A, Leite T, Sampaio C, Costa R, Alvarelhão J. Exploring the efficacy of a set of smart devices for postural awareness for workers in an industrial context – A protocol for a single-subject experimental design (Preprint). JMIR Res Protoc 2022; 12:e43637. [PMID: 37140979 DOI: 10.2196/43637] [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] [Received: 10/19/2022] [Revised: 01/20/2023] [Accepted: 01/25/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND In manufacturing industries, tasks requiring poor posture, high repetition, and long duration commonly induce fatigue and lead to an increased risk of work-related musculoskeletal disorders. Smart devices assessing biomechanics and providing feedback to the worker for correction may be a successful way to increase postural awareness, reducing fatigue, and work-related musculoskeletal disorders. However, evidence in industrial settings is lacking. OBJECTIVE This study protocol aims to explore the efficacy of a set of smart devices to detect malposture and increase postural awareness, reducing fatigue, and musculoskeletal disorders. METHODS A longitudinal single-subject experimental design following the ABAB sequence will be developed in a manufacturing industry real context with 5 workers. A repetitive task of screw tightening of 5 screws in a standing position into a piece placed horizontally was selected. Workers will be assessed in 4 moments per shift (10 minutes after the beginning of the shift, 10 minutes before and after the break, and 10 minutes before the end of the shift) in 5 nonconsecutive days. The primary outcomes are fatigue, assessed by electromyography, and musculoskeletal symptoms assessed by the Nordic Musculoskeletal Questionnaire. Secondary outcomes include perceived effort (Borg perceived exertion scale); range of motion of the main joints in the upper body, speed, acceleration, and deceleration assessed by motion analysis; risk stratification of range of motion; and cycle duration in minutes. Structured visual analysis techniques will be conducted to observe the effects of the intervention. Results for each variable of interest will be compared among the different time points of the work shift and longitudinally considering each assessment day as a time point. RESULTS Enrollment for the study will start in April 2023. Results are expected to be available still in the first semester of 2023. It is expected that the use of the smart system will reduce malposture, fatigue, and consequently, work-related musculoskeletal pain and disorders. CONCLUSIONS This proposed study will explore a strategy to increase postural awareness in industrial manufacturing workers who do repetitive tasks, using smart wearables that provide real-time feedback about biomechanics. Results would showcase a novel approach for improving self-awareness of risk for work-related musculoskeletal disorders for these workers providing an evidence base support for the use of such devices. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/43637.
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Affiliation(s)
- Mário Lopes
- School of Health Sciences and Institute of Biomedicine, University of Aveiro, Aveiro, Portugal
| | - Susana Lopes
- School of Health Sciences and Institute of Biomedicine, University of Aveiro, Aveiro, Portugal
| | - Mariana Monteiro
- School of Health Sciences, University of Aveiro, Aveiro, Portugal
| | - Mário Rodrigues
- School of Health Sciences, University of Aveiro, Aveiro, Portugal
| | | | - Augusto de Sousa Coelho
- Research Institute for Design, Media and Culture [ID+], School of Design, Management and Production Technologies Northern Aveiro, University of Aveiro, Aveiro, Portugal
| | - Paulo Matos
- ATENA Automação Industrial, Lda, Aveiro, Portugal
| | | | - Teófilo Leite
- ICC - Indústrias e Comércio de Calçado, SA, Guimarães, Portugal
| | - Cátia Sampaio
- ICC - Indústrias e Comércio de Calçado, SA, Guimarães, Portugal
| | - Rui Costa
- School of Health Sciences, University of Aveiro, Aveiro, Portugal
| | - José Alvarelhão
- School of Health Sciences, University of Aveiro, Aveiro, Portugal
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21
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Vilas-Boas F, Ribeiro T, Afonso J, Cardoso H, Lopes S, Moutinho-Ribeiro P, Ferreira J, Mascarenhas-Saraiva M, Macedo G. Deep Learning for Automatic Differentiation of Mucinous versus Non-Mucinous Pancreatic Cystic Lesions: A Pilot Study. Diagnostics (Basel) 2022; 12:diagnostics12092041. [PMID: 36140443 PMCID: PMC9498252 DOI: 10.3390/diagnostics12092041] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 08/20/2022] [Accepted: 08/22/2022] [Indexed: 12/12/2022] Open
Abstract
Endoscopic ultrasound (EUS) morphology can aid in the discrimination between mucinous and non-mucinous pancreatic cystic lesions (PCLs) but has several limitations that can be overcome by artificial intelligence. We developed a convolutional neural network (CNN) algorithm for the automatic diagnosis of mucinous PCLs. Images retrieved from videos of EUS examinations for PCL characterization were used for the development, training, and validation of a CNN for mucinous cyst diagnosis. The performance of the CNN was measured calculating the area under the receiving operator characteristic curve (AUC), sensitivity, specificity, and positive and negative predictive values. A total of 5505 images from 28 pancreatic cysts were used (3725 from mucinous lesions and 1780 from non-mucinous cysts). The model had an overall accuracy of 98.5%, sensitivity of 98.3%, specificity of 98.9% and AUC of 1. The image processing speed of the CNN was 7.2 ms per frame. We developed a deep learning algorithm that differentiated mucinous and non-mucinous cysts with high accuracy. The present CNN may constitute an important tool to help risk stratify PCLs.
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Affiliation(s)
- Filipe Vilas-Boas
- Department of Gastroenterology, São João University Hospital, Alameda Professor Hernâni Monteiro, 4200-427 Porto, Portugal
- World Gastroenterology Organisation Gastroenterology and Hepatology Training Center, 4200-427 Porto, Portugal
- Faculty of Medicine of the University of Porto, Alameda Professor Hernâni Monteiro, 4200-427 Porto, Portugal
| | - Tiago Ribeiro
- Department of Gastroenterology, São João University Hospital, Alameda Professor Hernâni Monteiro, 4200-427 Porto, Portugal
- World Gastroenterology Organisation Gastroenterology and Hepatology Training Center, 4200-427 Porto, Portugal
| | - João Afonso
- Department of Gastroenterology, São João University Hospital, Alameda Professor Hernâni Monteiro, 4200-427 Porto, Portugal
- World Gastroenterology Organisation Gastroenterology and Hepatology Training Center, 4200-427 Porto, Portugal
| | - Hélder Cardoso
- Department of Gastroenterology, São João University Hospital, Alameda Professor Hernâni Monteiro, 4200-427 Porto, Portugal
- World Gastroenterology Organisation Gastroenterology and Hepatology Training Center, 4200-427 Porto, Portugal
- Faculty of Medicine of the University of Porto, Alameda Professor Hernâni Monteiro, 4200-427 Porto, Portugal
| | - Susana Lopes
- Department of Gastroenterology, São João University Hospital, Alameda Professor Hernâni Monteiro, 4200-427 Porto, Portugal
- World Gastroenterology Organisation Gastroenterology and Hepatology Training Center, 4200-427 Porto, Portugal
- Faculty of Medicine of the University of Porto, Alameda Professor Hernâni Monteiro, 4200-427 Porto, Portugal
| | - Pedro Moutinho-Ribeiro
- Department of Gastroenterology, São João University Hospital, Alameda Professor Hernâni Monteiro, 4200-427 Porto, Portugal
- World Gastroenterology Organisation Gastroenterology and Hepatology Training Center, 4200-427 Porto, Portugal
- Faculty of Medicine of the University of Porto, Alameda Professor Hernâni Monteiro, 4200-427 Porto, Portugal
| | - João Ferreira
- Department of Mechanical Engineering, Faculty of Engineering of the University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal
- INEGI—Institute of Science and Innovation in Mechanical and Industrial Engineering, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal
| | - Miguel Mascarenhas-Saraiva
- Department of Gastroenterology, São João University Hospital, Alameda Professor Hernâni Monteiro, 4200-427 Porto, Portugal
- World Gastroenterology Organisation Gastroenterology and Hepatology Training Center, 4200-427 Porto, Portugal
- Faculty of Medicine of the University of Porto, Alameda Professor Hernâni Monteiro, 4200-427 Porto, Portugal
- Correspondence:
| | - Guilherme Macedo
- Department of Gastroenterology, São João University Hospital, Alameda Professor Hernâni Monteiro, 4200-427 Porto, Portugal
- World Gastroenterology Organisation Gastroenterology and Hepatology Training Center, 4200-427 Porto, Portugal
- Faculty of Medicine of the University of Porto, Alameda Professor Hernâni Monteiro, 4200-427 Porto, Portugal
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22
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Moutinho-Ribeiro P, Batista IA, Quintas ST, Adem B, Silva M, Morais R, Peixoto A, Coelho R, Costa-Moreira P, Medas R, Lopes S, Vilas-Boas F, Baptista M, Dias-Silva D, Esteves AL, Martins F, Lopes J, Barroca H, Carneiro F, Macedo G, Melo SA. Exosomal glypican-1 is elevated in pancreatic cancer precursors and can signal genetic predisposition in the absence of endoscopic ultrasound abnormalities. World J Gastroenterol 2022; 28:4310-4327. [PMID: 36159010 PMCID: PMC9453765 DOI: 10.3748/wjg.v28.i31.4310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 04/30/2022] [Accepted: 06/26/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Individuals within specific risk groups for pancreatic ductal adenocarcinoma (PDAC) [mucinous cystic lesions (MCLs), hereditary risk (HR), and new-late onset diabetes mellitus (NLOD)] represent an opportunity for early cancer detection. Endoscopic ultrasound (EUS) is a premium image modality for PDAC screening and precursor lesion characterization. While no specific biomarker is currently clinically available for this purpose, glypican-1 (GPC1) is overexpressed in the circulating exosomes (crExos) of patients with PDAC compared with healthy subjects or those harboring benign pancreatic diseases.
AIM To evaluate the capacity of GPC1+ crExos to identify individuals at higher risk within these specific groups, all characterized by EUS.
METHODS This cross-sectional study with a prospective unicentric cohort included 88 subjects: 40 patients with MCL, 20 individuals with HR, and 20 patients with NLOD. A control group (CG) was submitted to EUS for other reasons than pancreatic pathology, with normal pancreas and absence of hereditary risk factors (n = 8). The inclusion period was between October 2016 and January 2019, and the study was approved by the Ethics Committee of Centro Hospitalar Universitário de São João, Porto, Portugal. All patients provided written informed consent. EUS and blood tests for quantification of GPC1+ crExos by flow cytometry and carbohydrate antigen 19-9 (CA 19-9) levels by ELISA were performed in all subjects. EUS-guided tissue acquisition was done whenever necessary. For statistical analysis, SPSS® 27.0 (IBM Corp., Armonk, NY, United States) version was used. All graphs were created using GraphPad Prism 7.00 (GraphPad Software, San Diego, CA, United States).
RESULTS Half of MCLs harbored worrisome features (WF) or high-risk stigmata (HRS). Pancreatic abnormalities were detected by EUS in 10.0% and 35.0% in HR and NLOD individuals, respectively, all considered non-malignant and “harmless.” Median levels of GPC1+ crExos were statistically different: MCL [99.4%, interquartile range (IQR): 94.9%-99.8%], HR (82.0%, IQR: 28.9%-98.2%), NLOD (12.6%, IQR: 5.2%-63.4%), and CG (16.2%, IQR: 6.6%-20.1%) (P < 0.0001). Median levels of CA 19-9 were within the normal range in all groups (standard clinical cut-off of 37 U/mL). Within HR, individuals with a positive history of cancer had higher median levels of GPC1+ crExos (97.9%; IQR: 61.7%-99.5%), compared to those without (59.7%; IQR: 26.3%-96.4%), despite no statistical significance (P = 0.21). Pancreatic cysts with WF/HRS were statistically associated with higher median levels of GPC1+ crExos (99.6%; IQR: 97.6%-99.8%) compared to those without (96.5%; IQR: 81.3%-99.5%) (P = 0.011), presenting an area under the receiver operating characteristic curve value of 0.723 (sensitivity 75.0% and specificity 67.7%, using a cut-off of 98.5%; P = 0.012).
CONCLUSION GPC1+ crExos may act as biomarker to support the diagnosis and stratification of PDAC precursor lesions, and in signaling individuals with genetic predisposition in the absence of EUS abnormalities.
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Affiliation(s)
- Pedro Moutinho-Ribeiro
- Serviço de Gastrenterologia, Centro Hospitalar Universitário de São João, Porto 4200, Portugal
- Faculty of Medicine, University of Porto, Porto 4200, Portugal
| | - Ines A Batista
- Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Porto 4200, Portugal
- IPATIMUP–Institute of Molecular Pathology and Immunology, University of Porto, Porto 4200, Portugal
- Instituto de Ciências Biomédicas Abel Salazar (ICBAS), University of Porto, Porto 4050, Portugal
| | - Sofia T Quintas
- Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Porto 4200, Portugal
- IPATIMUP–Institute of Molecular Pathology and Immunology, University of Porto, Porto 4200, Portugal
| | - Bárbara Adem
- Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Porto 4200, Portugal
- Instituto de Ciências Biomédicas Abel Salazar (ICBAS), University of Porto, Porto 4050, Portugal
| | - Marco Silva
- Serviço de Gastrenterologia, Centro Hospitalar Universitário de São João, Porto 4200, Portugal
- Faculty of Medicine, University of Porto, Porto 4200, Portugal
| | - Rui Morais
- Serviço de Gastrenterologia, Centro Hospitalar Universitário de São João, Porto 4200, Portugal
- Faculty of Medicine, University of Porto, Porto 4200, Portugal
| | - Armando Peixoto
- Serviço de Gastrenterologia, Centro Hospitalar Universitário de São João, Porto 4200, Portugal
- Faculty of Medicine, University of Porto, Porto 4200, Portugal
| | - Rosa Coelho
- Serviço de Gastrenterologia, Centro Hospitalar Universitário de São João, Porto 4200, Portugal
- Faculty of Medicine, University of Porto, Porto 4200, Portugal
| | - Pedro Costa-Moreira
- Serviço de Gastrenterologia, Centro Hospitalar Universitário de São João, Porto 4200, Portugal
- Faculty of Medicine, University of Porto, Porto 4200, Portugal
| | - Renato Medas
- Serviço de Gastrenterologia, Centro Hospitalar Universitário de São João, Porto 4200, Portugal
- Faculty of Medicine, University of Porto, Porto 4200, Portugal
| | - Susana Lopes
- Serviço de Gastrenterologia, Centro Hospitalar Universitário de São João, Porto 4200, Portugal
- Faculty of Medicine, University of Porto, Porto 4200, Portugal
| | - Filipe Vilas-Boas
- Serviço de Gastrenterologia, Centro Hospitalar Universitário de São João, Porto 4200, Portugal
- Faculty of Medicine, University of Porto, Porto 4200, Portugal
| | - Manuela Baptista
- Serviço de Cirurgia Geral, Centro Hospitalar Universitário de São João, Porto 4200, Portugal
| | - Diogo Dias-Silva
- Unidade de Saúde Familiar Serpa Pinto, ACeS Porto Ocidental, Porto 4250, Portugal
| | - Ana L Esteves
- Unidade de Saúde Familiar Serpa Pinto, ACeS Porto Ocidental, Porto 4250, Portugal
| | - Filipa Martins
- Unidade de Saúde Familiar Serpa Pinto, ACeS Porto Ocidental, Porto 4250, Portugal
| | - Joanne Lopes
- Serviço de Anatomia Patológica, Centro Hospitalar Universitário de São João, Porto 4200, Portugal
| | - Helena Barroca
- Serviço de Anatomia Patológica, Centro Hospitalar Universitário de São João, Porto 4200, Portugal
| | - Fátima Carneiro
- Faculty of Medicine, University of Porto, Porto 4200, Portugal
- Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Porto 4200, Portugal
- IPATIMUP–Institute of Molecular Pathology and Immunology, University of Porto, Porto 4200, Portugal
- Serviço de Anatomia Patológica, Centro Hospitalar Universitário de São João, Porto 4200, Portugal
| | - Guilherme Macedo
- Serviço de Gastrenterologia, Centro Hospitalar Universitário de São João, Porto 4200, Portugal
- Faculty of Medicine, University of Porto, Porto 4200, Portugal
| | - Sonia A Melo
- Faculty of Medicine, University of Porto, Porto 4200, Portugal
- Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Porto 4200, Portugal
- IPATIMUP–Institute of Molecular Pathology and Immunology, University of Porto, Porto 4200, Portugal
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Abstract
ABSTRACT Hypertension is the leading risk factor for cardiovascular disease and an independent predictor of mortality. The prevalence of hypertension has doubled in the last two decades and evidence suggests that almost half the individuals are unaware of their condition. The antihypertensive effects of exercise are now undisputable, and exercise training is recommended by the major professional and scientific societies, including the American College of Sports Medicine (ACSM), as first-line treatment to prevent, treat, and control hypertension. This review aims to overview the evidence supporting the current ACSM Frequency, Intensity, Time, and Type exercise recommendations for hypertension, discuss new and emerging evidence on exercise in the treatment of hypertension from our laboratories; and propose future directions of research integrating this new and emerging evidence.
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Affiliation(s)
- Alberto J Alves
- Research Center in Sports Sciences, Health and Human Development (CIDESD), University of Maia, Maia, Porto, PORTUGAL
| | - Yin Wu
- Department of Kinesiology, University of Connecticut, Storrs, CT
| | - Susana Lopes
- Institute of Biomedicine, (iBiMED), School of Health Sciences, University of Aveiro, Aveiro, Porto, PORTUGAL
| | - Fernando Ribeiro
- Institute of Biomedicine, (iBiMED), School of Health Sciences, University of Aveiro, Aveiro, Porto, PORTUGAL
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24
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Moutinho-Ribeiro P, Adem B, Batista I, Silva M, Silva S, Ruivo CF, Morais R, Peixoto A, Coelho R, Costa-Moreira P, Lopes S, Vilas-Boas F, Durães C, Lopes J, Barroca H, Carneiro F, Melo SA, Macedo G. Exosomal glypican-1 discriminates pancreatic ductal adenocarcinoma from chronic pancreatitis. Dig Liver Dis 2022; 54:871-877. [PMID: 34840127 DOI: 10.1016/j.dld.2021.10.012] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 10/19/2021] [Accepted: 10/27/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS Pancreatic ductal adenocarcinoma (PDAC) diagnosis can be difficult in a chronic pancreatitis (CP) background, especially in its mass forming presentation. We aimed to assess the accuracy of glypican-1-positive circulating exosomes (GPC1+crExos) to distinguish PDAC from CP versus the state-of-the-art CA 19-9 biomarker. METHODS This was a unicentric prospective cohort. Endoscopic ultrasound with fine-needle aspiration or biopsy and blood tests (GPC1+crExos and serum CA 19-9) were performed. RESULTS The cohort comprised 60 PDAC and 29 CP (7 of which mass forming - MF) patients. Median levels of GPC1+crExos were significantly higher in PDAC (99.7%) versus CP (28.4%; p<0.0001) with an AUROC of 0.96 with 98.3% sensitivity and 86.2% specificity for a cut-off of 45.0% (p<0.0001); this outperforms CA 19-9 AUROC of 0.82 with 78.3% sensitivity and 65.5% specificity at a cut-off of 37 U/mL (p<0.0001). The superiority of% GPC1+crExos over CA 19-99 in differentiating PDAC from CP was observed in both early (stage I) and advanced tumors (stages II-IV). CONCLUSION Levels of GPC1+crExos coupled to beads enable differential diagnosis between PDAC and CP including its mass-forming presentation.
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Affiliation(s)
- P Moutinho-Ribeiro
- Serviço de Gastrenterologia, Centro Hospitalar Universitário de São João, Porto, Portugal; Medical Faculty of the University of Porto, Porto, Portugal
| | - B Adem
- Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Porto, Portugal; Instituto de Patologia e Imunologia Molecular da Universidade do Porto (IPATIMUP), Porto, Portugal; Instituto de Ciências Biomédicas Abel Salazar (ICBAS), University of Porto, Porto, Portugal
| | - I Batista
- Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Porto, Portugal; Instituto de Patologia e Imunologia Molecular da Universidade do Porto (IPATIMUP), Porto, Portugal
| | - M Silva
- Serviço de Gastrenterologia, Centro Hospitalar Universitário de São João, Porto, Portugal; Medical Faculty of the University of Porto, Porto, Portugal
| | - S Silva
- Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Porto, Portugal; Instituto de Patologia e Imunologia Molecular da Universidade do Porto (IPATIMUP), Porto, Portugal; iBiMED - Institute of Biomedicine, University of Aveiro
| | - C F Ruivo
- Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Porto, Portugal; Instituto de Patologia e Imunologia Molecular da Universidade do Porto (IPATIMUP), Porto, Portugal; Instituto de Ciências Biomédicas Abel Salazar (ICBAS), University of Porto, Porto, Portugal
| | - R Morais
- Serviço de Gastrenterologia, Centro Hospitalar Universitário de São João, Porto, Portugal; Medical Faculty of the University of Porto, Porto, Portugal
| | - A Peixoto
- Serviço de Gastrenterologia, Centro Hospitalar Universitário de São João, Porto, Portugal; Medical Faculty of the University of Porto, Porto, Portugal
| | - R Coelho
- Serviço de Gastrenterologia, Centro Hospitalar Universitário de São João, Porto, Portugal; Medical Faculty of the University of Porto, Porto, Portugal
| | - P Costa-Moreira
- Serviço de Gastrenterologia, Centro Hospitalar Universitário de São João, Porto, Portugal; Medical Faculty of the University of Porto, Porto, Portugal
| | - S Lopes
- Serviço de Gastrenterologia, Centro Hospitalar Universitário de São João, Porto, Portugal; Medical Faculty of the University of Porto, Porto, Portugal
| | - F Vilas-Boas
- Serviço de Gastrenterologia, Centro Hospitalar Universitário de São João, Porto, Portugal; Medical Faculty of the University of Porto, Porto, Portugal
| | - C Durães
- Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Porto, Portugal; Instituto de Patologia e Imunologia Molecular da Universidade do Porto (IPATIMUP), Porto, Portugal
| | - J Lopes
- Serviço de Anatomia Patológica, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - H Barroca
- Serviço de Anatomia Patológica, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - F Carneiro
- Medical Faculty of the University of Porto, Porto, Portugal; Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Porto, Portugal; Instituto de Patologia e Imunologia Molecular da Universidade do Porto (IPATIMUP), Porto, Portugal; Serviço de Anatomia Patológica, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - S A Melo
- Medical Faculty of the University of Porto, Porto, Portugal; Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Porto, Portugal; Instituto de Patologia e Imunologia Molecular da Universidade do Porto (IPATIMUP), Porto, Portugal
| | - G Macedo
- Serviço de Gastrenterologia, Centro Hospitalar Universitário de São João, Porto, Portugal; Medical Faculty of the University of Porto, Porto, Portugal.
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25
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Jiménez J, Godinho R, Pinto D, Lopes S, Castro D, Cubero D, Osorio MA, Piqué J, Moreno-Opo R, Quiros P, González-Nuevo D, Hernandez-Palacios O, Kéry M. The Cantabrian capercaillie: A population on the edge. Sci Total Environ 2022; 821:153523. [PMID: 35104529 DOI: 10.1016/j.scitotenv.2022.153523] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 01/11/2022] [Accepted: 01/25/2022] [Indexed: 06/14/2023]
Abstract
The capercaillie Tetrao urogallus - the world's largest grouse- is a circumboreal forest species, which only two remaining populations in Spain: one in the Cantabrian mountains in the west and the other in the Pyrenees further east. Both have shown severe declines, especially in the Cantabrian population, which has recently been classified as "Critically Endangered". To develop management plans, information on demographic parameters is necessary to understand and forecast population dynamics. We used spatial capture-recapture (SCR) modeling and non-invasive DNA samples to estimate the current population size in the whole Cantabrian mountain range. In addition, for the assessment of population status, we analyzed the population trajectory over the last 42 years (1978-2019) at 196 leks on the Southern slope of the range, using an integrated population model with a Dail-Madsen model at its core, combined with a multistate capture-recapture model for survival and a Poisson regression for productivity. For 2019, we estimate the size of the entire population at 191 individuals (95% BCI 165-222) for an estimated 60 (48-78) females and 131 (109-157) males. Since the 1970s, our study estimates a shrinkage of the population range by 83%. The population at the studied leks in 2019 was at about 10% of the size estimated for 1978. Apparent annual survival was estimated at 0.707 (0.677-0.735), and per-capita recruitment at 0.233 (0.207-0.262), and insufficient to maintain a stable population. We suggest work to improve the recruitment (and survival) and manage these mountain forests for capercaillie conservation. Also, in the future, management should assess the genetic viability of this population.
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Affiliation(s)
- José Jiménez
- Instituto de Investigación en Recursos Cinegéticos (IREC, CSIC-UCLM-JCCM), Ronda de Toledo 12, 13071 Ciudad Real, Spain.
| | - Raquel Godinho
- CIBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, InBIO Laboratório Associado, Universidade do Porto, Campus de Vairão, 4485-661 Vairão, Portugal; Departamento de Biologia, Faculdade de Ciências, Universidade do Porto, 4169-007 Porto, Portugal; BIOPOLIS Program in Genomics, Biodiversity and Land Planning, CIBIO, Campus de Vairão, 4485-661 Vairão, Portugal
| | - Daniel Pinto
- Fundación Patrimonio Natural de Castilla y León, Cañada Real 306, Edificio Prae, 47007 Valladolid, Spain
| | - Susana Lopes
- CIBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, InBIO Laboratório Associado, Universidade do Porto, Campus de Vairão, 4485-661 Vairão, Portugal; BIOPOLIS Program in Genomics, Biodiversity and Land Planning, CIBIO, Campus de Vairão, 4485-661 Vairão, Portugal
| | - Diana Castro
- CIBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, InBIO Laboratório Associado, Universidade do Porto, Campus de Vairão, 4485-661 Vairão, Portugal; BIOPOLIS Program in Genomics, Biodiversity and Land Planning, CIBIO, Campus de Vairão, 4485-661 Vairão, Portugal
| | - David Cubero
- Dirección General de Patrimonio Natural y Política Forestal, Junta de Castilla y León, c/Rigoberto Cortejoso 14, 47014 Valladolid, Spain
| | - M Angeles Osorio
- Servicio Territorial de Medio Ambiente de León, Avda. Peregrinos, s/n, 24071 León, Spain
| | - Josep Piqué
- Tragsatec, c/Julián Camarillo 6B, 28037 Madrid, Spain
| | - Rubén Moreno-Opo
- Subdirección General de Biodiversidad Terrestre y Marina, Ministerio para la Transición Ecológica y el Reto Demográfico, Pza. San Juan de la Cruz 10, 28071 Madrid, Spain
| | - Pablo Quiros
- Dirección General de Medio Natural, Principado de Asturias, c/Trece Rosas, 2, 33005 Oviedo, Spain
| | - Daniel González-Nuevo
- Dirección General de Medio Natural, Principado de Asturias, c/Trece Rosas, 2, 33005 Oviedo, Spain
| | | | - Marc Kéry
- Swiss Ornithological Institute, Sempach, Switzerland
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26
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Alves A, Confraria A, Lopes S, Costa B, Perdiguero P, Milhinhos A, Baena-González E, Correia S, Miguel CM. miR160 Interacts in vivo With Pinus pinaster AUXIN RESPONSE FACTOR 18 Target Site and Negatively Regulates Its Expression During Conifer Somatic Embryo Development. Front Plant Sci 2022; 13:857611. [PMID: 35371172 PMCID: PMC8965291 DOI: 10.3389/fpls.2022.857611] [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] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 02/21/2022] [Indexed: 06/14/2023]
Abstract
MicroRNAs (miRNAs) are key regulators of several plant developmental processes including embryogenesis. Most miRNA families are conserved across major groups of plant species, but their regulatory roles have been studied mainly in model species like Arabidopsis and other angiosperms. In gymnosperms, miRNA-dependent regulation has been less studied since functional approaches in these species are often difficult to establish. Given the fundamental roles of auxin signaling in somatic embryogenesis (SE) induction and embryo development, we investigated a previously predicted interaction between miR160 and a putative target encoding AUXIN RESPONSE FACTOR 18 in Pinus pinaster (PpARF18) embryonic tissues. Phylogenetic analysis of AUXIN RESPONSE FACTOR 18 (ARF18) from Pinus pinaster and Picea abies, used here as a model system of conifer embryogenesis, showed their close relatedness to AUXIN RESPONSE FACTOR (ARF) genes known to be targeted by miR160 in other species, including Arabidopsis ARF10 and ARF16. By using a luciferase (LUC) reporter system for miRNA activity in Arabidopsis protoplasts, we have confirmed that P. pinaster miR160 (ppi-miR160) interacts in vivo with PpARF18 target site. When the primary miR160 from P. pinaster was overexpressed in protoplasts under non-limiting levels of ARGONAUTE1, a significant increase of miR160 target cleavage activity was observed. In contrast, co-expression of the primary miRNA and the target mimic MIM160 led to a decrease of miR160 activity. Our results further support that this interaction is functional during consecutive stages of SE in the conifer model P. abies. Expression analyses conducted in five stages of development, from proembryogenic masses (PEMs) to the mature embryo, show that conifer ARF18 is negatively regulated by miR160 toward the fully developed mature embryo when miR160 reached its highest expression level. This study reports the first in vivo validation of a predicted target site of a conifer miRNA supporting the conservation of miR160 interaction with ARF targets in gymnosperms. The approach used here should be useful for future characterization of miRNA functions in conifer embryogenesis.
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Affiliation(s)
- Ana Alves
- Faculty of Sciences, BioISI—Biosystems and Integrative Sciences Institute, University of Lisbon, Lisbon, Portugal
| | - Ana Confraria
- Instituto Gulbenkian de Ciência, Oeiras, Portugal
- GREEN-IT Bioresources for Sustainability, ITQB NOVA, Oeiras, Portugal
| | - Susana Lopes
- Faculty of Sciences, BioISI—Biosystems and Integrative Sciences Institute, University of Lisbon, Lisbon, Portugal
- GREEN-IT Bioresources for Sustainability, ITQB NOVA, Oeiras, Portugal
| | - Bruno Costa
- Faculty of Sciences, BioISI—Biosystems and Integrative Sciences Institute, University of Lisbon, Lisbon, Portugal
- INESC-ID, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal
| | - Pedro Perdiguero
- Department of Genetics, Physiology and Microbiology, Faculty of Biological Sciences, Complutense University of Madrid (UCM), Madrid, Spain
| | - Ana Milhinhos
- Faculty of Sciences, BioISI—Biosystems and Integrative Sciences Institute, University of Lisbon, Lisbon, Portugal
- GREEN-IT Bioresources for Sustainability, ITQB NOVA, Oeiras, Portugal
| | - Elena Baena-González
- Instituto Gulbenkian de Ciência, Oeiras, Portugal
- GREEN-IT Bioresources for Sustainability, ITQB NOVA, Oeiras, Portugal
| | - Sandra Correia
- Department of Life Sciences, Centre for Functional Ecology, University of Coimbra, Coimbra, Portugal
| | - Célia M. Miguel
- Faculty of Sciences, BioISI—Biosystems and Integrative Sciences Institute, University of Lisbon, Lisbon, Portugal
- Instituto de Biologia Experimental e Tecnológica, Oeiras, Portugal
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27
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Garrido I, Marques M, Liberal R, Cardoso H, Lopes S, Macedo G. Wilson disease in Northern Portugal: a long-term follow-up study. Orphanet J Rare Dis 2022; 17:82. [PMID: 35197085 PMCID: PMC8867740 DOI: 10.1186/s13023-022-02245-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 02/13/2022] [Indexed: 12/02/2022] Open
Abstract
Introduction Wilson disease is an autosomal recessive disease of liver copper metabolism with predominant hepatic and neurological manifestations. Long-term data on the clinical follow-up and treatment efficacy are limited due to the low frequency of the disease. We evaluated a large cohort of Wilson disease patients from Northern Portugal during a 20-year follow-up period. Methods Twenty-four patients, diagnosed from 1975 to 2020 in a tertiary care center in Portugal, were retrospectively evaluated according to their clinical presentation, therapies and outcomes. Results Most of the patients were males (54%), with a median age at diagnosis of 19 years old (interquartile range 15–25). The main manifestations of Wilson disease were hepatic (71%) and neurological (25%). Family history was positive in 5 (21%) patients. Four patients (17%) presented with acute liver failure and fifteen (63%) individuals had cirrhosis at diagnosis. Penicillamine therapy was used by 11 (46%) patients, while trientine and zinc were given to 8 (33%) and 1 (4%) patient, respectively. Ten (42%) individuals underwent liver transplantation. The majority of patients (83%) had stable disease or improved outcomes during follow-up. Conclusion This is the largest cohort of adult patients with Wilson disease reported in Northern Portugal. We show that Wilson disease has favorable outcomes with long overall survival, assuming adherence to therapy and lack of other insults to their liver.
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Affiliation(s)
- Isabel Garrido
- Gastroenterology and Hepatology Department, Centro Hospitalar Universitário de São João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal. .,World Gastroenterology Organization (WGO) Porto Training Center, Porto, Portugal.
| | - Margarida Marques
- Gastroenterology and Hepatology Department, Centro Hospitalar Universitário de São João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.,World Gastroenterology Organization (WGO) Porto Training Center, Porto, Portugal
| | - Rodrigo Liberal
- Gastroenterology and Hepatology Department, Centro Hospitalar Universitário de São João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.,World Gastroenterology Organization (WGO) Porto Training Center, Porto, Portugal
| | - Hélder Cardoso
- Gastroenterology and Hepatology Department, Centro Hospitalar Universitário de São João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.,World Gastroenterology Organization (WGO) Porto Training Center, Porto, Portugal
| | - Susana Lopes
- Gastroenterology and Hepatology Department, Centro Hospitalar Universitário de São João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.,World Gastroenterology Organization (WGO) Porto Training Center, Porto, Portugal
| | - Guilherme Macedo
- Gastroenterology and Hepatology Department, Centro Hospitalar Universitário de São João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.,World Gastroenterology Organization (WGO) Porto Training Center, Porto, Portugal
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28
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Grilo C, Afonso BC, Afonso F, Alexandre M, Aliácar S, Almeida A, Alonso IP, Álvares F, Alves P, Alves PC, Alves P, Amado A, Amendoeira V, Amorim F, da Silva Aparício G, Araújo R, Ascensão F, Augusto M, Bandeira V, Barbosa AM, Barbosa S, Barbosa S, Barreiro S, Barros P, Barros T, Barros F, Basto M, Bernardino J, Bicho S, Biedma LE, Borges M, Braz L, Brito JC, Brito T, Cabral JA, Calzada J, Camarinha C, Carapuço M, Cardoso P, Carmo M, Carrapato C, da Silva Carrilho M, C S Carvalho DFT, Carvalho F, Carvalho J, Castro D, Castro G, Castro J, Castro LR, Catry FX, Cerveira AM, Cid A, Clarke R, Conde C, Conde J, Costa J, Costa M, Costa P, Costa C, do Couto AP, Craveiro J, Dias M, Dias S, Duarte B, Duro V, Encarnação C, Eufrázio S, Fael A, Falé JS, Faria S, Fernandes C, Fernandes M, da Costa GF, Ferreira C, Ferreira DF, Ferreira E, Ferreira JP, Ferreira J, Ferreira D, Fonseca C, Fontes I, Fragoso R, Franco C, Freitas T, Gabriel SI, Gibb R, Gil P, Jorge Gomes CP, Horta P, Gomes P, Gomes V, Grilo F, Guedes A, Guilherme F, Gutiérrez I, Harper H, Herrera JM, Hipólito D, Infante S, Jesus J, Jones KE, Laborde MI, de Oliveira LL, Leitão I, Lemos R, Lima C, Linck P, Lopes H, Lopes S, López-Baucells A, Loureiro A, Loureiro F, Lourenço R, Lourenço S, Lucas P, Magalhães A, Maldonado C, Marcolin F, Marques S, Marques JT, Marques C, Marques P, Marrecas PC, Martins F, Martins R, Mascarenhas M, Mata VA, Mateus AR, Matos M, Medinas D, Mendes T, Mendes G, Mestre F, Milhinhas C, Mira A, Monarca RI, Monteiro N, Monteiro B, Monterroso P, Nakamura M, Negrões N, Nóbrega EK, Nóvoa M, Nunes M, Nunes NJ, Oliveira F, Oliveira JM, Palmeirim JM, Pargana J, Paula A, Paupério J, Pedroso NM, Pereira G, Pereira PF, Pereira J, Ramos Pereira MJ, Petrucci-Fonseca F, Pimenta M, Pinto S, Pinto N, Pires R, Pita R, Pontes C, Quaresma M, Queirós J, Queirós L, Rainho A, da Graça Ramalhinho M, Ramalho P, Raposeira H, Rasteiro F, Rebelo H, Regala FT, Reto D, Ribeiro SB, Rio-Maior H, Rocha R, Rocha RG, Rodrigues L, Román J, Roque S, Rosalino LM, do Rosário IT, Rossa M, Russo D, Sá P, Sabino-Marques H, Salgueiro V, Santos H, Santos J, Santos JPV, Santos N, Santos S, Santos CP, Santos-Reis M, Serronha A, Sierra P, Silva B, Silva CSGM, Silva C, Silva D, da Silva LP, Silva R, Silva C, da Silva Júnior FMR, Sousa P, Sousa-Guedes D, Spadoni G, Tapisso JT, Teixeira D, Teixeira S, Teixeira N, Torres RT, Travassos P, Vale-Gonçalves H, Cidraes-Vieira N, von Merten S, da Luz Mathias M. MAMMALS IN PORTUGAL: A data set of terrestrial, volant, and marine mammal occurrences in Portugal. Ecology 2022; 103:e3654. [PMID: 35132618 DOI: 10.1002/ecy.3654] [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: 05/11/2021] [Revised: 07/16/2021] [Accepted: 08/20/2021] [Indexed: 11/08/2022]
Abstract
Mammals are threatened worldwide, with ca. 26% of all species being included in the IUCN threatened categories. This overall pattern is primarily associated to habitat loss or degradation, and human persecution for terrestrial mammals, and pollution, open net fishing, climate change and prey depletion for marine mammals. Mammals play a key role in maintaining ecosystems functionality and resilience, and therefore information on their distribution is crucial to delineate and support conservation actions. MAMMALS IN PORTUGAL is a publicly available data set compiling unpublished geo-referenced occurrence records of 92 terrestrial, volant, and marine mammals in mainland Portugal and archipelagos of Azores and Madeira that includes 107,852 data entries between 1873 and 2021 (72% of the data occurring in 2000 and 2021). The methods used to collect the data were: live observations/captures (42%), sign surveys (38%), camera trapping (16%), bioacoustics surveys (4%) and radio-tracking and inquiries that represent less than 1% of the records. The data set includes 13 types of records: 1) burrows | soil mounds | tunnel, 2) capture, 3) colony, 4) dead animal | hair | skulls | jaws, 5) genetic confirmation, 6) inquiries, 7) observation of live animal, 8), observation in shelters, 9) photo trapping | video, 10), predators diet | pellets | pine cones/nuts, 11) scat | track | ditch, 12) telemetry and 13) vocalization | echolocation. The spatial uncertainty of most records ranges between 0 and 100 m (76%). Rodentia (n = 34,754) has the highest number of records followed by Chiroptera (n = 18,858), Carnivora (n = 18,594), Lagomorpha (n = 17,679), Cetartiodactyla (n = 11,568) and Eulipotyphla (n = 6400). The data set includes records of species classified by the IUCN as threatened (e.g., Oryctolagus cuniculus (n = 12,407), Monachus monachus (n = 1512), and Lynx pardinus (n = 197)]. We believe that this data set may stimulate the publication of other European countries data sets which would certainly contribute to ecology and conservation-related research, and therefore assisting on the development of more accurate and tailored conservation management strategies for each species. There are no copyright restrictions; please cite this data paper when the data are used in publications.
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Affiliation(s)
- Clara Grilo
- CESAM - Centro de Estudos do Ambiente e do Mar, Departamento de Biologia Animal, Faculdade de Ciências, Universidade de Lisboa, Lisbon, Portugal.,Setor Ecologia/Departamento de Biologia Universidade Federal de Lavras 37200 000 Minas Gerais, Brazil
| | - Beatriz C Afonso
- cE3c - Centre for Ecology, Evolution and Environmental Changes and Departamento de Biologia Animal. Faculdade de Ciências da Universidade de Lisboa, Ed. C2, Campo Grande, Lisbon, Portugal.,Departamento de Biologia Universidade de Évora Pólo da Mitra Apartado 94 7002-554 Évora, Portugal
| | - Filipe Afonso
- Faculdade de Ciências de Lisboa, Universidade de Lisboa, Lisbon, Portugal
| | - Marta Alexandre
- CESAM - Centro de Estudos do Ambiente e do Mar, Departamento de Biologia Animal, Faculdade de Ciências, Universidade de Lisboa, Lisbon, Portugal
| | | | - Ana Almeida
- Departmento de Biologia, Universidade de Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
| | | | - Francisco Álvares
- CIBIO/InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, Universidade do Porto, Campus de Vairão, 4485-661, Vairão, Portugal
| | - Paulo Alves
- Quercus - Associação Nacional de Conservação da Natureza, Portugal
| | - Paulo Célio Alves
- CIBIO/InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, Universidade do Porto, Campus de Vairão, 4485-661, Vairão, Portugal.,Departamento de Biologia, Faculdade de Ciências, Universidade do Porto, Rua do Campo Alegre s/n, Porto, Portugal
| | - Pedro Alves
- GPS - Grupo Protecção Sicó, Portugal.,Plecotus, Lda, Portugal
| | | | | | - Francisco Amorim
- CIBIO/InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, Universidade do Porto, Campus de Vairão, 4485-661, Vairão, Portugal.,CIBIO/InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos- Instituto Superior de Agronomia, Universidade de Lisboa Tapada da Ajuda, Lisbon, Portugal
| | - Guilherme da Silva Aparício
- CESAM - Centro de Estudos do Ambiente e do Mar, Departamento de Biologia Animal, Faculdade de Ciências, Universidade de Lisboa, Lisbon, Portugal
| | | | - Fernando Ascensão
- cE3c - Centre for Ecology, Evolution and Environmental Changes and Departamento de Biologia Animal. Faculdade de Ciências da Universidade de Lisboa, Ed. C2, Campo Grande, Lisbon, Portugal
| | - Margarida Augusto
- Bioinsight - Ambiente & Biodiversidade, Lda. Rua Antero de Quental, Odivelas, Portugal.,CEAE-LPN - Centro de Estudos e Actividades Especiais da Liga para a Protecção da Natureza, Portugal
| | - Victor Bandeira
- CESAM - Centro de Estudos do Ambiente e do Mar, Departamento de Biologia, Universidade de Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
| | - A Márcia Barbosa
- CICGE - Centre for Research in Geo-Spatial Sciences, Faculdade de Ciências da Universidade do Porto, Alameda do Monte da Virgem, Vila Nova de Gaia, Portugal
| | - Soraia Barbosa
- CIBIO/InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, Universidade do Porto, Campus de Vairão, 4485-661, Vairão, Portugal.,Department of Fish and Wildlife Sciences, College of Natural Resources, University of Idaho, 875 Perimeter Drive, , Moscow, Idaho, United States
| | - Sérgio Barbosa
- CEAE-LPN - Centro de Estudos e Actividades Especiais da Liga para a Protecção da Natureza, Portugal
| | - Silvia Barreiro
- MED - Mediterranean Institute for Agriculture, Environment and Development, Universidade de Évora, Évora, Portugal
| | - Paulo Barros
- Centre for the Research and Technology of Agro-Environment and Biological Sciences (CITAB), University of Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal.,Laboratory of Applied Ecology, University of Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal
| | - Tânia Barros
- CESAM - Centro de Estudos do Ambiente e do Mar, Departamento de Biologia, Universidade de Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
| | - Filomena Barros
- CRASM-Centro de Recuperação de Animais Selvagens do Montejunto Morada:Rua 1° de Maio, n°10, 2550-076 Tojeira, Cadaval, Portugal
| | - Mafalda Basto
- cE3c - Centre for Ecology, Evolution and Environmental Changes and Departamento de Biologia Animal. Faculdade de Ciências da Universidade de Lisboa, Ed. C2, Campo Grande, Lisbon, Portugal
| | - Joana Bernardino
- CIBIO/InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, Universidade do Porto, Campus de Vairão, 4485-661, Vairão, Portugal
| | | | - Luis Eduardo Biedma
- Department of Integrated Sciences, Faculty of Experimental Sciences, University of Huelva, Avenida de las Fuerzas Armadas, S/N, 21007, Huelva, Spain
| | - Marta Borges
- GEM - Grupo de Espeleologia e Montanhismo, Portugal
| | - Luis Braz
- Centre for the Research and Technology of Agro-Environment and Biological Sciences (CITAB), University of Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal.,Laboratory of Applied Ecology, University of Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal
| | - José Carlos Brito
- CIBIO/InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, Universidade do Porto, Campus de Vairão, 4485-661, Vairão, Portugal
| | | | - João Alexandre Cabral
- Centre for the Research and Technology of Agro-Environment and Biological Sciences (CITAB), University of Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal.,Laboratory of Applied Ecology, University of Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal
| | - Javier Calzada
- Department of Integrated Sciences, Faculty of Experimental Sciences, University of Huelva, Avenida de las Fuerzas Armadas, S/N, 21007, Huelva, Spain
| | - Cláudia Camarinha
- cE3c - Centre for Ecology, Evolution and Environmental Changes and Departamento de Biologia Animal. Faculdade de Ciências da Universidade de Lisboa, Ed. C2, Campo Grande, Lisbon, Portugal
| | | | - Paulo Cardoso
- Bioinsight - Ambiente & Biodiversidade, Lda. Rua Antero de Quental, Odivelas, Portugal
| | - Mário Carmo
- Mário Carmo - Your Biodiversity and Ecosystem Consultant, Portugal
| | - Carlos Carrapato
- Instituto da Conservação da Natureza e das Florestas-ICNF, Portugal
| | - Maílis da Silva Carrilho
- CESAM - Centro de Estudos do Ambiente e do Mar, Departamento de Biologia Animal, Faculdade de Ciências, Universidade de Lisboa, Lisbon, Portugal
| | - Diogo Filipe T C S Carvalho
- Centre for the Research and Technology of Agro-Environment and Biological Sciences (CITAB), University of Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal.,Laboratory of Applied Ecology, University of Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal
| | - Filipe Carvalho
- CIBIO/InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, Universidade do Porto, Campus de Vairão, 4485-661, Vairão, Portugal.,Department of Zoology and Entomology, School of Biological and Environmental Sciences, University of Fort Hare, Private Bag X1314, Alice, South Africa
| | - João Carvalho
- CESAM - Centro de Estudos do Ambiente e do Mar, Departamento de Biologia, Universidade de Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
| | - Diana Castro
- CIBIO/InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, Universidade do Porto, Campus de Vairão, 4485-661, Vairão, Portugal
| | - Guilherme Castro
- CESAM - Centro de Estudos do Ambiente e do Mar, Departamento de Biologia, Universidade de Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
| | - Joana Castro
- AIMM - Associação para a Investigação do Meio Marinho, Portugal.,MARE - Marine and Environmental Sciences Centre, Faculty of Sciences, University of Lisbon, Campo Grande, Lisbon, Portugal
| | - Luis Roma Castro
- Instituto da Conservação da Natureza e das Florestas-ICNF, Portugal
| | - Filipe Xavier Catry
- Centre for Applied Ecology/Research Network in Biodiversity and Evolutionary Biology (CEABN/InBIO), School of Agriculture, University of Lisbon (ISA, UL), Lisbon, Portugal
| | - Ana M Cerveira
- CESAM - Centro de Estudos do Ambiente e do Mar, Departamento de Biologia Animal, Faculdade de Ciências, Universidade de Lisboa, Lisbon, Portugal.,Departmento de Biologia, Universidade de Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
| | - André Cid
- AIMM - Associação para a Investigação do Meio Marinho, Portugal
| | | | - Conceição Conde
- Instituto da Conservação da Natureza e das Florestas-ICNF, Portugal
| | - José Conde
- Município de Seia, Centro de Interpretação da Serra da Estrela, Portugal
| | | | - Mafalda Costa
- OnE - Organisms and Environment Division, School of Biosciences, Cardiff University, Wales, UK
| | | | - Cristina Costa
- Instituto da Conservação da Natureza e das Florestas-ICNF, Portugal
| | | | - João Craveiro
- MED - Mediterranean Institute for Agriculture, Environment and Development, Departamento de Biologia, Escola de Ciências e Tecnologia, Universidade de Évora
| | - Marta Dias
- cE3c - Centre for Ecology, Evolution and Environmental Changes and Departamento de Biologia Animal. Faculdade de Ciências da Universidade de Lisboa, Ed. C2, Campo Grande, Lisbon, Portugal
| | | | - Beatriz Duarte
- Departmento de Biologia, Universidade de Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
| | - Virginia Duro
- Laboratory of Applied Ecology, University of Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal
| | - Cláudia Encarnação
- Almargem - Associação de Defesa do Património Cultural e Ambiental do Algarve, Portugal.,Departamento de Biologia, Unidade de Biologia da Conservação, Escola de Ciências e Tecnologia, Universidade de Évora, Núcleo da Mitra, Ap. 94, 7006-554, Évora, Portugal
| | - Sofia Eufrázio
- MED - Mediterranean Institute for Agriculture, Environment and Development, Instituto de Investigação e Formação Avançada, Universidade de Évora, Pólo da Mitra, Ap. 94, 7006-554, Évora, Portugal
| | - António Fael
- Bioinsight - Ambiente & Biodiversidade, Lda. Rua Antero de Quental, Odivelas, Portugal.,Núcleo de Espeleologia de Leiria, Portugal
| | - João Salvador Falé
- CRASM-Centro de Recuperação de Animais Selvagens do Montejunto Morada:Rua 1° de Maio, n°10, 2550-076 Tojeira, Cadaval, Portugal
| | - Sandra Faria
- Laboratory of Applied Ecology, University of Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal
| | - Carlos Fernandes
- cE3c - Centre for Ecology, Evolution and Environmental Changes and Departamento de Biologia Animal. Faculdade de Ciências da Universidade de Lisboa, Ed. C2, Campo Grande, Lisbon, Portugal.,Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, Lisbon, Portugal
| | | | - Gonçalo Ferrão da Costa
- Bioinsight - Ambiente & Biodiversidade, Lda. Rua Antero de Quental, Odivelas, Portugal.,CESAM - Centro de Estudos do Ambiente e do Mar, Departamento de Biologia, Universidade de Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
| | - Clara Ferreira
- CIBIO/InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, Universidade do Porto, Campus de Vairão, 4485-661, Vairão, Portugal.,Animal Ecology, Institute for Biochemistry and Biology, University of Potsdam, Potsdam, Germany
| | - Diogo F Ferreira
- CIBIO/InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, Universidade do Porto, Campus de Vairão, 4485-661, Vairão, Portugal.,Department of Genetics, Evolution and Environment, Centre for Biodiversity and Environment Research, University College London, London, UK.,Madeira Interactive Technologies Institute, Polo Científico e Tecnológico da Madeira, Caminho da Penteada, Funchal, Portugal
| | - Eduardo Ferreira
- CESAM - Centro de Estudos do Ambiente e do Mar, Departamento de Biologia, Universidade de Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
| | - Joaquim Pedro Ferreira
- CESAM - Centro de Estudos do Ambiente e do Mar, Departamento de Biologia, Universidade de Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
| | | | - Diana Ferreira
- Departmento de Biologia, Universidade de Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
| | - Carlos Fonseca
- CESAM - Centro de Estudos do Ambiente e do Mar, Departamento de Biologia, Universidade de Aveiro, Campus Universitário de Santiago, Aveiro, Portugal.,ForestWISE - Collaborative Laboratory for Integrated Forest & Fire Management, Quinta de Prados, Vila Real, Portugal
| | - Inês Fontes
- Departamento de Biologia Universidade de Évora Pólo da Mitra Apartado 94 7002-554 Évora, Portugal
| | - Ricardo Fragoso
- Instituto da Conservação da Natureza e das Florestas-ICNF, Portugal
| | | | - Tamira Freitas
- Universidade da Madeira, Faculdade de Ciências da Vida, Portugal
| | - Sofia I Gabriel
- CESAM - Centro de Estudos do Ambiente e do Mar, Departamento de Biologia Animal, Faculdade de Ciências, Universidade de Lisboa, Lisbon, Portugal.,CESAM - Centro de Estudos do Ambiente e do Mar, Departamento de Biologia, Universidade de Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
| | - Rory Gibb
- Department of Genetics, Evolution and Environment, Centre for Biodiversity and Environment Research, University College London, London, UK
| | - Patricia Gil
- CIBIO/InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, Universidade do Porto, Campus de Vairão, 4485-661, Vairão, Portugal
| | - Carla Patricia Jorge Gomes
- Centre for the Research and Technology of Agro-Environment and Biological Sciences (CITAB), University of Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal.,Laboratory of Applied Ecology, University of Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal
| | - Pedro Horta
- CIBIO/InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, Universidade do Porto, Campus de Vairão, 4485-661, Vairão, Portugal.,Departamento de Biologia, Faculdade de Ciências, Universidade do Porto, Rua do Campo Alegre s/n, Porto, Portugal.,CIBIO/InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos- Instituto Superior de Agronomia, Universidade de Lisboa Tapada da Ajuda, Lisbon, Portugal.,OII - Observatório Inovação Investigação, Seia, Portugal
| | - Pedro Gomes
- CESAM - Centro de Estudos do Ambiente e do Mar, Departamento de Biologia, Universidade de Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
| | - Verónica Gomes
- CIBIO/InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, Universidade do Porto, Campus de Vairão, 4485-661, Vairão, Portugal
| | - Filipa Grilo
- cE3c - Centre for Ecology, Evolution and Environmental Changes and Departamento de Biologia Animal. Faculdade de Ciências da Universidade de Lisboa, Ed. C2, Campo Grande, Lisbon, Portugal
| | - Américo Guedes
- Palombar - Conservação da Natureza e do Património Rural, Antiga Escola Primária, Uva, Vimioso, Portugal
| | - Filipa Guilherme
- CIBIO/InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, Universidade do Porto, Campus de Vairão, 4485-661, Vairão, Portugal
| | - Iván Gutiérrez
- Palombar - Conservação da Natureza e do Património Rural, Antiga Escola Primária, Uva, Vimioso, Portugal
| | - Henry Harper
- AIMM - Associação para a Investigação do Meio Marinho, Portugal
| | - José M Herrera
- MED - Mediterranean Institute for Agriculture, Environment and Development, Universidade de Évora, Évora, Portugal
| | - Dário Hipólito
- CESAM - Centro de Estudos do Ambiente e do Mar, Departamento de Biologia, Universidade de Aveiro, Campus Universitário de Santiago, Aveiro, Portugal.,Department of Biology, Faculty of Veterinary Medicine, University of Zagreb, Heinzelova, Zagreb, Croatia
| | - Samuel Infante
- Quercus - Associação Nacional de Conservação da Natureza, Portugal
| | - José Jesus
- Universidade da Madeira, Faculdade de Ciências da Vida, Portugal
| | - Kate E Jones
- Department of Genetics, Evolution and Environment, Centre for Biodiversity and Environment Research, University College London, London, UK
| | - Marina I Laborde
- AIMM - Associação para a Investigação do Meio Marinho, Portugal.,MARE - Marine and Environmental Sciences Centre, Faculty of Sciences, University of Lisbon, Campo Grande, Lisbon, Portugal
| | - Luís Lamas de Oliveira
- Laboratory of Applied Ecology, University of Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal
| | - Inês Leitão
- Faculdade de Ciências de Lisboa, Universidade de Lisboa, Lisbon, Portugal
| | | | - Cátia Lima
- CESAM - Centro de Estudos do Ambiente e do Mar, Departamento de Biologia, Universidade de Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
| | - Paloma Linck
- CESAM - Centro de Estudos do Ambiente e do Mar, Departamento de Biologia, Universidade de Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
| | - Hugo Lopes
- CRASM-Centro de Recuperação de Animais Selvagens do Montejunto Morada:Rua 1° de Maio, n°10, 2550-076 Tojeira, Cadaval, Portugal
| | - Susana Lopes
- CIBIO/InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, Universidade do Porto, Campus de Vairão, 4485-661, Vairão, Portugal
| | - Adrià López-Baucells
- Natural Sciences Museum of Granollers, Palaudàries 102, Jardins Antoni Jonch Cuspinera, Granollers, Catalonia, Spain
| | - Armando Loureiro
- Instituto da Conservação da Natureza e das Florestas-ICNF, Portugal
| | - Filipa Loureiro
- cE3c - Centre for Ecology, Evolution and Environmental Changes and Departamento de Biologia Animal. Faculdade de Ciências da Universidade de Lisboa, Ed. C2, Campo Grande, Lisbon, Portugal
| | - Rui Lourenço
- MED - Mediterranean Institute for Agriculture, Environment and Development, LabOr Laboratório de Ornitologia, IIFA, Universidade de Évora, Pólo da Mitra, Apartado 94, Évora, Portugal
| | | | - Paula Lucas
- CRASM-Centro de Recuperação de Animais Selvagens do Montejunto Morada:Rua 1° de Maio, n°10, 2550-076 Tojeira, Cadaval, Portugal
| | - Ana Magalhães
- CESAM - Centro de Estudos do Ambiente e do Mar, Departamento de Biologia, Universidade de Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
| | - Cristina Maldonado
- Faculdade de Ciências de Lisboa, Universidade de Lisboa, Lisbon, Portugal
| | - Fabio Marcolin
- Centro de Estudos Florestais, Instituto Superior de Agronomia, Universidade de Lisboa, Portugal
| | - Sara Marques
- CESAM - Centro de Estudos do Ambiente e do Mar, Departamento de Biologia, Universidade de Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
| | - J Tiago Marques
- MED - Mediterranean Institute for Agriculture, Environment and Development, Departamento de Biologia, Escola de Ciências e Tecnologia, Universidade de Évora
| | - Carina Marques
- SPVS - Sociedade Portuguesa de Vida Selvagem, Portugal.,ARCM - Alto Relevo Clube de Montanhismo, Portugal
| | - Paulo Marques
- EDIA - Empresa de Desenvolvimento e Infraestruturas do Alqueva S.A., Portugal
| | | | - Frederico Martins
- MED - Mediterranean Institute for Agriculture, Environment and Development, Departamento de Biologia, Escola de Ciências e Tecnologia, Universidade de Évora
| | - Raquel Martins
- CESAM - Centro de Estudos do Ambiente e do Mar, Departamento de Biologia, Universidade de Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
| | - Miguel Mascarenhas
- Bioinsight - Ambiente & Biodiversidade, Lda. Rua Antero de Quental, Odivelas, Portugal
| | - Vanessa A Mata
- CIBIO/InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, Universidade do Porto, Campus de Vairão, 4485-661, Vairão, Portugal
| | - Ana Rita Mateus
- Faculdade de Ciências de Lisboa, Universidade de Lisboa, Lisbon, Portugal
| | - Milene Matos
- Associação BioLiving, Rua do Outeiro, Frossos 3850-635 Albergaria-a-Velha, Portugal.,Município de Lousada Pr. Dr. Francisco Sá Carneiro 4620-695 Lousada, Portugal
| | - Denis Medinas
- CIBIO/InBIO-UE, Research Centre in Biodiversity and Genetic Resources, University of Évora, Rua Dr. Joaquim Henrique da Fonseca, 2nd, Évora, Portugal
| | - Tiago Mendes
- MED - Mediterranean Institute for Agriculture, Environment and Development, Departamento de Biologia, Escola de Ciências e Tecnologia, Universidade de Évora
| | | | - Frederico Mestre
- MED - Mediterranean Institute for Agriculture, Environment and Development, Universidade de Évora, Évora, Portugal.,Cátedra "Rui Nabeiro" de Biodiversidade, Rua Dr. Joaquim Henrique da Fonseca 7000 - 890 Évora, Portugal
| | - Catarina Milhinhas
- MED - Mediterranean Institute for Agriculture, Environment and Development, Departamento de Biologia, Escola de Ciências e Tecnologia, Universidade de Évora
| | - António Mira
- MED - Mediterranean Institute for Agriculture, Environment and Development, Departamento de Biologia, Escola de Ciências e Tecnologia, Universidade de Évora
| | - Rita I Monarca
- CESAM - Centro de Estudos do Ambiente e do Mar, Departamento de Biologia Animal, Faculdade de Ciências, Universidade de Lisboa, Lisbon, Portugal
| | | | | | - Pedro Monterroso
- CIBIO/InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, Universidade do Porto, Campus de Vairão, 4485-661, Vairão, Portugal
| | - Mónia Nakamura
- CIBIO/InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, Universidade do Porto, Campus de Vairão, 4485-661, Vairão, Portugal.,Departamento de Biologia, Faculdade de Ciências, Universidade do Porto, Rua do Campo Alegre s/n, Porto, Portugal
| | - Nuno Negrões
- CESAM - Centro de Estudos do Ambiente e do Mar, Departamento de Biologia, Universidade de Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
| | - Eva K Nóbrega
- Universitat Autònoma de Barcelona, Campus de la UAB, Plaça Cívica, 08193 Bellaterra, , Barcelona, Spain
| | - Miguel Nóvoa
- Palombar - Conservação da Natureza e do Património Rural, Antiga Escola Primária, Uva, Vimioso, Portugal.,AEPGA - Associação para o Estudo e Proteção do Gado Asinino, Atenor, Miranda do Douro, Portugal
| | - Manuel Nunes
- Município de Lousada Pr. Dr. Francisco Sá Carneiro 4620-695 Lousada, Portugal
| | - Nuno Jardim Nunes
- Instituto Superior Técnico de Lisboa, University of Lisbon & ITI/LARSyS, Portugal
| | - Flávio Oliveira
- CESAM - Centro de Estudos do Ambiente e do Mar, Departamento de Biologia Animal, Faculdade de Ciências, Universidade de Lisboa, Lisbon, Portugal
| | | | - Jorge M Palmeirim
- cE3c - Centre for Ecology, Evolution and Environmental Changes and Departamento de Biologia Animal. Faculdade de Ciências da Universidade de Lisboa, Ed. C2, Campo Grande, Lisbon, Portugal
| | - João Pargana
- Instituto da Conservação da Natureza e das Florestas-ICNF, Portugal
| | - Anabela Paula
- Bioinsight - Ambiente & Biodiversidade, Lda. Rua Antero de Quental, Odivelas, Portugal
| | - Joana Paupério
- CIBIO/InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, Universidade do Porto, Campus de Vairão, 4485-661, Vairão, Portugal
| | - Nuno M Pedroso
- MED - Mediterranean Institute for Agriculture, Environment and Development, Instituto de Investigação e Formação Avançada, Universidade de Évora, Pólo da Mitra, Ap. 94, 7006-554, Évora, Portugal
| | - Guilherme Pereira
- cE3c - Centre for Ecology, Evolution and Environmental Changes and Departamento de Biologia Animal. Faculdade de Ciências da Universidade de Lisboa, Ed. C2, Campo Grande, Lisbon, Portugal
| | - Pedro F Pereira
- Bioinsight - Ambiente & Biodiversidade, Lda. Rua Antero de Quental, Odivelas, Portugal.,MED - Mediterranean Institute for Agriculture, Environment and Development, LabOr Laboratório de Ornitologia, IIFA, Universidade de Évora, Pólo da Mitra, Apartado 94, Évora, Portugal
| | - José Pereira
- Palombar - Conservação da Natureza e do Património Rural, Antiga Escola Primária, Uva, Vimioso, Portugal
| | - Maria João Ramos Pereira
- CESAM - Centro de Estudos do Ambiente e do Mar, Departamento de Biologia, Universidade de Aveiro, Campus Universitário de Santiago, Aveiro, Portugal.,Departamento de Zoologia, Instituto Biociencias, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Francisco Petrucci-Fonseca
- cE3c - Centre for Ecology, Evolution and Environmental Changes and Departamento de Biologia Animal. Faculdade de Ciências da Universidade de Lisboa, Ed. C2, Campo Grande, Lisbon, Portugal
| | - Miguel Pimenta
- Instituto da Conservação da Natureza e das Florestas-ICNF, Portugal
| | - Sara Pinto
- Palombar - Conservação da Natureza e do Património Rural, Antiga Escola Primária, Uva, Vimioso, Portugal.,AEPGA - Associação para o Estudo e Proteção do Gado Asinino, Atenor, Miranda do Douro, Portugal
| | - Nuno Pinto
- CESAM - Centro de Estudos do Ambiente e do Mar, Departamento de Biologia, Universidade de Aveiro, Campus Universitário de Santiago, Aveiro, Portugal.,Associação BioLiving, Rua do Outeiro, Frossos 3850-635 Albergaria-a-Velha, Portugal
| | - Rosa Pires
- Instituto das Florestas e Conservação da Natureza, IP-RAM
| | - Ricardo Pita
- MED - Mediterranean Institute for Agriculture, Environment and Development, Instituto de Investigação e Formação Avançada & Unidade de Biologia da Conservação, Departamento de Biologia, Universidade de Évora, Pólo da Mitra, Ap. 94, 7006-554, Évora, Portugal
| | | | - Marisa Quaresma
- Instituto da Conservação da Natureza e das Florestas-ICNF, Portugal
| | - João Queirós
- CIBIO/InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, Universidade do Porto, Campus de Vairão, 4485-661, Vairão, Portugal
| | - Luís Queirós
- Palombar - Conservação da Natureza e do Património Rural, Antiga Escola Primária, Uva, Vimioso, Portugal
| | - Ana Rainho
- cE3c - Centre for Ecology, Evolution and Environmental Changes and Departamento de Biologia Animal. Faculdade de Ciências da Universidade de Lisboa, Ed. C2, Campo Grande, Lisbon, Portugal
| | - Maria da Graça Ramalhinho
- CESAM - Centro de Estudos do Ambiente e do Mar, Departamento de Biologia Animal, Faculdade de Ciências, Universidade de Lisboa, Lisbon, Portugal.,Museu Nacional de História Natural e da Ciência, Universidade de Lisboa, Lisbon, Portugal
| | - Patrícia Ramalho
- Almargem - Associação de Defesa do Património Cultural e Ambiental do Algarve, Portugal.,Câmara Municipal de Loulé, Portugal
| | - Helena Raposeira
- CIBIO/InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, Universidade do Porto, Campus de Vairão, 4485-661, Vairão, Portugal.,Departamento de Biologia, Faculdade de Ciências, Universidade do Porto, Rua do Campo Alegre s/n, Porto, Portugal.,CIBIO/InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos- Instituto Superior de Agronomia, Universidade de Lisboa Tapada da Ajuda, Lisbon, Portugal.,OII - Observatório Inovação Investigação, Seia, Portugal
| | | | - Hugo Rebelo
- CIBIO/InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, Universidade do Porto, Campus de Vairão, 4485-661, Vairão, Portugal.,CIBIO/InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos- Instituto Superior de Agronomia, Universidade de Lisboa Tapada da Ajuda, Lisbon, Portugal
| | | | - Dyana Reto
- Faculdade de Ciências de Lisboa, Universidade de Lisboa, Lisbon, Portugal
| | | | - Helena Rio-Maior
- CIBIO/InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, Universidade do Porto, Campus de Vairão, 4485-661, Vairão, Portugal
| | - Ricardo Rocha
- CIBIO/InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, Universidade do Porto, Campus de Vairão, 4485-661, Vairão, Portugal.,CIBIO/InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos- Instituto Superior de Agronomia, Universidade de Lisboa Tapada da Ajuda, Lisbon, Portugal
| | - Rita Gomes Rocha
- CIBIO/InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, Universidade do Porto, Campus de Vairão, 4485-661, Vairão, Portugal
| | - Luísa Rodrigues
- Instituto da Conservação da Natureza e das Florestas-ICNF, Portugal
| | - Jacinto Román
- Department of Conservation Biology, Doñana Biological Station, CSIC, C. Américo Vespucio 26, Sevilla, Spain
| | - Sara Roque
- Faculdade de Ciências de Lisboa, Universidade de Lisboa, Lisbon, Portugal
| | - Luís Miguel Rosalino
- cE3c - Centre for Ecology, Evolution and Environmental Changes and Departamento de Biologia Animal. Faculdade de Ciências da Universidade de Lisboa, Ed. C2, Campo Grande, Lisbon, Portugal
| | - Inês T do Rosário
- cE3c - Centre for Ecology, Evolution and Environmental Changes and Departamento de Biologia Animal. Faculdade de Ciências da Universidade de Lisboa, Ed. C2, Campo Grande, Lisbon, Portugal
| | - Mariana Rossa
- CESAM - Centro de Estudos do Ambiente e do Mar, Departamento de Biologia, Universidade de Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
| | - Danilo Russo
- Wildlife Research Unit, Dipartimento di Agraria, Università degli Studi di Napoli Federico II, Italy
| | - Pedro Sá
- Associação BioLiving, Rua do Outeiro, Frossos 3850-635 Albergaria-a-Velha, Portugal.,Município de Lousada Pr. Dr. Francisco Sá Carneiro 4620-695 Lousada, Portugal
| | - Helena Sabino-Marques
- Departamento de Biologia, Unidade de Biologia da Conservação, Escola de Ciências e Tecnologia, Universidade de Évora, Núcleo da Mitra, Ap. 94, 7006-554, Évora, Portugal
| | | | - Helena Santos
- CIBIO/InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, Universidade do Porto, Campus de Vairão, 4485-661, Vairão, Portugal.,CIBIO/InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos- Instituto Superior de Agronomia, Universidade de Lisboa Tapada da Ajuda, Lisbon, Portugal
| | - Joana Santos
- Bioinsight - Ambiente & Biodiversidade, Lda. Rua Antero de Quental, Odivelas, Portugal
| | - João P V Santos
- CESAM - Centro de Estudos do Ambiente e do Mar, Departamento de Biologia, Universidade de Aveiro, Campus Universitário de Santiago, Aveiro, Portugal.,Palombar - Conservação da Natureza e do Património Rural, Antiga Escola Primária, Uva, Vimioso, Portugal.,Sanidad y Biotecnología (SaBio), Instituto de Investigación en Recursos Cinegéticos (IREC, UCLM-CSIC-JCCM), Ciudad Real, Spain
| | - Nuno Santos
- CIBIO/InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, Universidade do Porto, Campus de Vairão, 4485-661, Vairão, Portugal
| | - Sara Santos
- MED - Mediterranean Institute for Agriculture, Environment and Development, Instituto de Investigação e Formação Avançada & Unidade de Biologia da Conservação, Departamento de Biologia, Universidade de Évora, Pólo da Mitra, Ap. 94, 7006-554, Évora, Portugal
| | | | - Margarida Santos-Reis
- cE3c - Centre for Ecology, Evolution and Environmental Changes and Departamento de Biologia Animal. Faculdade de Ciências da Universidade de Lisboa, Ed. C2, Campo Grande, Lisbon, Portugal
| | - Ana Serronha
- CIBIO/InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, Universidade do Porto, Campus de Vairão, 4485-661, Vairão, Portugal
| | | | - Bruno Silva
- MED - Mediterranean Institute for Agriculture, Environment and Development, Universidade de Évora, Évora, Portugal
| | - Carla S G M Silva
- Direção Regional do Ambiente e Alterações Climáticas, Secretaria Regional do Ambiente e Alterações Climáticas - Governo Regional dos Açores, Portugal
| | - Clara Silva
- Rua Professor Moisés Amzalak n.8, Lisbon, Portugal
| | - Diogo Silva
- CESAM - Centro de Estudos do Ambiente e do Mar, Departamento de Biologia, Universidade de Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
| | - Luís P da Silva
- CIBIO/InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, Universidade do Porto, Campus de Vairão, 4485-661, Vairão, Portugal
| | - Ricardo Silva
- CESAM - Centro de Estudos do Ambiente e do Mar, Departamento de Biologia Animal, Faculdade de Ciências, Universidade de Lisboa, Lisbon, Portugal
| | | | | | - Pedro Sousa
- CIBIO/InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, Universidade do Porto, Campus de Vairão, 4485-661, Vairão, Portugal
| | - Diana Sousa-Guedes
- CESAM - Centro de Estudos do Ambiente e do Mar, Departamento de Biologia, Universidade de Aveiro, Campus Universitário de Santiago, Aveiro, Portugal.,CICGE - Centre for Research in Geo-Spatial Sciences, Faculdade de Ciências da Universidade do Porto, Alameda do Monte da Virgem, Vila Nova de Gaia, Portugal
| | | | - Joaquim T Tapisso
- CESAM - Centro de Estudos do Ambiente e do Mar, Departamento de Biologia Animal, Faculdade de Ciências, Universidade de Lisboa, Lisbon, Portugal
| | - Daniela Teixeira
- CESAM - Centro de Estudos do Ambiente e do Mar, Departamento de Biologia, Universidade de Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
| | - Sérgio Teixeira
- Universidade da Madeira, Faculdade de Ciências da Vida, Portugal.,EUROBATS Madeira Focal Point (IFCN, IP-RAM), United States.,Madeira Fauna & Flora - Biologia e Conservação, Rua Ponta da Cruz, C. C. Centromar, Loja 9, Madeira, Portugal
| | - Nuno Teixeira
- Ecosativa, Rua do Moinho de Vento Lote 11 1° F, 7645-909 Vila Nova de Milfontes, Portugal
| | - Rita T Torres
- CESAM - Centro de Estudos do Ambiente e do Mar, Departamento de Biologia, Universidade de Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
| | - Paulo Travassos
- Centre for the Research and Technology of Agro-Environment and Biological Sciences (CITAB), University of Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal.,Laboratory of Applied Ecology, University of Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal
| | - Hélia Vale-Gonçalves
- Centre for the Research and Technology of Agro-Environment and Biological Sciences (CITAB), University of Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal.,Laboratory of Applied Ecology, University of Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal
| | | | - Sophie von Merten
- CESAM - Centro de Estudos do Ambiente e do Mar, Departamento de Biologia Animal, Faculdade de Ciências, Universidade de Lisboa, Lisbon, Portugal
| | - Maria da Luz Mathias
- CESAM - Centro de Estudos do Ambiente e do Mar, Departamento de Biologia Animal, Faculdade de Ciências, Universidade de Lisboa, Lisbon, Portugal
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Santos-Antunes J, Marques M, Morais R, Baldaque-Silva F, Vilas-Boas F, Moutinho-Ribeiro P, Lopes S, Carneiro F, Macedo G. Retrospective analysis of the outcomes of endoscopic submucosal dissection for the diagnosis and treatment of subepithelial lesions in a center with high expertise. Ann Gastroenterol 2022; 35:68-73. [PMID: 34987291 PMCID: PMC8713347 DOI: 10.20524/aog.2021.0675] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 08/26/2021] [Indexed: 11/11/2022] Open
Abstract
Background Use of endoscopic submucosal dissection (ESD) for the diagnosis and treatment of subepithelial lesions (SELs) is limited in the West, and the best approach for these lesions is still debated. In this study we describe our experience regarding the usefulness, safety and outcomes of ESD for SELs. Method We performed a retrospective analysis of ESD in the diagnosis and treatment of SELs between November 2010 and February 2021. Results A total of 634 ESDs were reviewed. Fifty-five (9%) were performed in SELs, 6 in the esophagus, 34 in the stomach, and 15 in the rectum. ESD was technically successful in 53 lesions (96%). Most of them (82%) had previous endoscopic ultrasound evaluation, but only 20% had a histological diagnosis previous to the ESD. Neuroendocrine tumors, gastrointestinal stromal tumors, and granular cell tumors accounted for 38% of the procedures, with a 100% rate of en bloc resection and 65% of R0 resection; the main criterion for non-curative resection was a deep positive margin, and none of the patients treated with complementary surgery had lesions on the gastrointestinal wall. Most of the procedures (62%) were performed in lesions with very low malignant potential, providing the definitive diagnosis of SELs where the previous diagnostic workup was inconclusive. We had a total of 2 delayed bleedings and 1 perforation, all treated endoscopically. Conclusion Our real-life experience showed that ESD can be an effective and safe diagnostic tool for undetermined SELs, as well as an effective treatment for neoplastic SELs with malignant potential.
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Affiliation(s)
- João Santos-Antunes
- Gastroenterology Department, Faculty of Medicine, Centro Hospitalar S. João, Porto, Portugal (João Santos-Antunes, Margarida Marques, Rui Morais, Filipe Vilas-Boas, Pedro Moutinho-Ribeiro, Susana Lopes, Guilherme Macedo).,Ipatimup/i3S (Instituto de Investigação e Inovação em Saúde da Universidade do Porto), Porto, Portugal (João Santos-Antunes)
| | - Margarida Marques
- Gastroenterology Department, Faculty of Medicine, Centro Hospitalar S. João, Porto, Portugal (João Santos-Antunes, Margarida Marques, Rui Morais, Filipe Vilas-Boas, Pedro Moutinho-Ribeiro, Susana Lopes, Guilherme Macedo)
| | - Rui Morais
- Gastroenterology Department, Faculty of Medicine, Centro Hospitalar S. João, Porto, Portugal (João Santos-Antunes, Margarida Marques, Rui Morais, Filipe Vilas-Boas, Pedro Moutinho-Ribeiro, Susana Lopes, Guilherme Macedo)
| | - Francisco Baldaque-Silva
- Division of Medicine, Department of Upper Gastrointestinal Diseases, Karolinska University Hospital and Karolinska Institute, Stockholm, Sweden (Francisco Baldaque-Silva)
| | - Filipe Vilas-Boas
- Gastroenterology Department, Faculty of Medicine, Centro Hospitalar S. João, Porto, Portugal (João Santos-Antunes, Margarida Marques, Rui Morais, Filipe Vilas-Boas, Pedro Moutinho-Ribeiro, Susana Lopes, Guilherme Macedo)
| | - Pedro Moutinho-Ribeiro
- Gastroenterology Department, Faculty of Medicine, Centro Hospitalar S. João, Porto, Portugal (João Santos-Antunes, Margarida Marques, Rui Morais, Filipe Vilas-Boas, Pedro Moutinho-Ribeiro, Susana Lopes, Guilherme Macedo)
| | - Susana Lopes
- Gastroenterology Department, Faculty of Medicine, Centro Hospitalar S. João, Porto, Portugal (João Santos-Antunes, Margarida Marques, Rui Morais, Filipe Vilas-Boas, Pedro Moutinho-Ribeiro, Susana Lopes, Guilherme Macedo)
| | - Fátima Carneiro
- Pathology Department, Faculty of Medicine, Centro Hospitalar S. João, Porto, Portugal (Fátima Carneiro)
| | - Guilherme Macedo
- Gastroenterology Department, Faculty of Medicine, Centro Hospitalar S. João, Porto, Portugal (João Santos-Antunes, Margarida Marques, Rui Morais, Filipe Vilas-Boas, Pedro Moutinho-Ribeiro, Susana Lopes, Guilherme Macedo)
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30
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Lopes S, Félix G, Mesquita-Bastos J, Figueiredo D, Oliveira J, Ribeiro F. Determinants of exercise adherence and maintenance among patients with hypertension: a narrative review. Rev Cardiovasc Med 2021; 22:1271-1278. [PMID: 34957769 DOI: 10.31083/j.rcm2204134] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 08/05/2021] [Revised: 09/22/2021] [Accepted: 10/08/2021] [Indexed: 11/06/2022] Open
Abstract
Treatment options for hypertension have been evolving over time. However, prevalence rates keep increasing and perpetuate hypertension as a major cardiovascular risk factor. Exercise training is effective in reducing blood pressure, cardiovascular disease risk factors and mortality, besides improving quality of life. However, participation rates for hypertensive patients remain shockingly low and adherence to exercise training tends to decline following exercise programs. These trends emphasize the need to deepen our knowledge of modifiable intrapersonal, interpersonal, and socioeconomic and environmental factors that help explain exercise adherence among people with hypertension. The present review focuses on the determinants of adherence and long-term maintenance of a physically active lifestyle in hypertensive individuals.
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Affiliation(s)
- Susana Lopes
- Institute of Biomedicine - iBiMED, School of Health Sciences, University of Aveiro, 3810-193 Aveiro, Portugal.,Physiotherapy Department, Polytechnic of Coimbra, ESTeSC Coimbra Health School, 3040-854 Coimbra, Portugal
| | - Gonçalo Félix
- School of Health Sciences, University of Aveiro, 3810-193 Aveiro, Portugal
| | - José Mesquita-Bastos
- School of Health Sciences, University of Aveiro, 3810-193 Aveiro, Portugal.,Cardiology Department, Hospital Infante D. Pedro, Centro Hospitalar do Baixo Vouga, 3810-164 Aveiro, Portugal
| | - Daniela Figueiredo
- Centre for Health Technology and Services Research (CINTESIS.UA), School of Health Sciences, University of Aveiro, 3810-193 Aveiro, Portugal
| | - José Oliveira
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, 4200-450 Porto, Portugal.,Laboratory for Integrative and Translational Research in Population Health (ITR), 4200-450 Porto, Portugal
| | - Fernando Ribeiro
- Institute of Biomedicine - iBiMED, School of Health Sciences, University of Aveiro, 3810-193 Aveiro, Portugal
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31
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Costa-Moreira P, Lopes S, Macedo G. A Rare Cause of Cholestasis Related to Polycystic Liver Disease. GE Port J Gastroenterol 2021; 28:443-445. [PMID: 34901456 DOI: 10.1159/000514008] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 12/04/2020] [Indexed: 11/19/2022]
Affiliation(s)
- Pedro Costa-Moreira
- Gastroenterology Department, Centro Hospitalar Universitário São João, Porto, Portugal.,Faculty of Medicine, University of Porto, Porto, Portugal
| | - Susana Lopes
- Gastroenterology Department, Centro Hospitalar Universitário São João, Porto, Portugal.,Faculty of Medicine, University of Porto, Porto, Portugal
| | - Guilherme Macedo
- Gastroenterology Department, Centro Hospitalar Universitário São João, Porto, Portugal.,Faculty of Medicine, University of Porto, Porto, Portugal
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32
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Magro F, Alves C, Lopes J, Lopes S, Tavares de Sousa H, Cotter J, Macedo da Silva V, Lago P, Vieira A, Brito M, Duarte MAM, Portela F, Silva JP, Ministro P, Arroja B, Carvalho L, Torres J, Santiago M, Estevinho MM, Danese S, Peyrin-Biroulet L, Dias CC, Borralho P, Feakins RM, Carneiro F. Histologic Features of Colon Biopsies (Geboes Score) Associated With Progression of Ulcerative Colitis for the First 36 Months After Biopsy. Clin Gastroenterol Hepatol 2021; 19:2567-2576.e9. [PMID: 32920215 DOI: 10.1016/j.cgh.2020.09.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 05/20/2020] [Revised: 09/03/2020] [Accepted: 09/04/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS In addition to findings from endoscopy, histologic features of colon biopsies have been associated with outcomes of patients with ulcerative colitis (UC). We investigated associations between Geboes scores (a system to quantify structural changes and inflammatory activity in colon biopsies) and UC progression, and the time period over which this association is valid. METHODS We analyzed data from 399 asymptomatic patients with UC enrolled in the ACERTIVE study, followed at 13 inflammatory bowel disease (IBD) centers in Portugal through 31 December 2019. Blood and stool samples were collected and analyzed, and all patients underwent sigmoidoscopy within 24 h of sample collection. We assessed baseline endoscopic status (Mayo endoscopic subscore), histologic features of 2 sigmoid and 2 rectal biopsies (Geboes score), and concentration of fecal calprotectin (FC). The primary outcome was UC progression (surgical, pharmacologic, and clinical events). We generated survival curves for 36 months or less and more than 36 months after biopsy according to Geboes score using the Kaplan-Meier method and compared findings with those from a log rank test. Cox regression was adjusted for Mayo endoscopic subscore, Geboes score, and level of FC; results were expressed as adjusted hazard ratios (HR) with 95% CIs. RESULTS Patients with Geboes scores >2B.0, Geboes scores >3.0, or Geboes scores >4.0 had a higher frequency of, and a shorter time to UC progression, than patients with Geboes scores ≤2B.0, Geboes scores ≤3.0, or Geboes score ≤4.0 (P < .001). Disease progression occurred earlier in patients with Geboes scores >2B.0, Geboes scores >3.0, or Geboes scores >4.0 compared with patients with Geboes scores ≤2B.0 (HR, 2.021; 95% CI, 1.158-3.526), Geboes scores ≤3.0 (HR, 2.007; 95% CI, 1.139-3.534), or Geboes scores ≤4.0 (HR, 2.349; 95% CI, 1.269-4.349), respectively, in the first 36 months after biopsy. Similar results were found for patients with concentrations of FC below 150 μg/g. CONCLUSIONS We found histologic features of colon biopsies (Geboes score) to be an independent risk factor for progression of UC in the first 36 months after biopsy.
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Affiliation(s)
- Fernando Magro
- Department of Gastroenterology, São João University Hospital Center (CHUSJ), Porto, Portugal; Department of Biomedicine, Unit of Pharmacology and Therapeutics, Faculty of Medicine, University of Porto, Porto, Portugal; Department of Clinical Pharmacology, São João University Hospital Center (CHUSJ), Porto, Portugal.
| | - Catarina Alves
- Faculty of Medicine, University of Porto, Porto, Portugal
| | - Joanne Lopes
- Department of Pathology, São João University Hospital Center (CHUSJ), Porto, Portugal
| | - Susana Lopes
- Department of Gastroenterology, São João University Hospital Center (CHUSJ), Porto, Portugal
| | - Helena Tavares de Sousa
- Department of Gastroenterology, Algarve Hospital University Center-Portimão Unit, Portimão, Portugal; ABC - Algarve Biomedical Center, University of Algarve, Faro, Portugal
| | - José Cotter
- Gastroenterology Department, Hospital da Senhora da Oliveira, Guimarães, Portugal; Life and Health Sciences Research Institute (ICVS), School of Medicine - University of Minho, Braga, Portugal; ICVS/3B's PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | | | - Paula Lago
- Department of Gastroenterology, Porto Hospital Center, Hospital de Santo António, Porto, Portugal
| | - Ana Vieira
- Department of Gastroenterology, Garcia de Orta Hospital, Almada, Portugal
| | - Mariana Brito
- Department of Gastroenterology, Garcia de Orta Hospital, Almada, Portugal
| | - Maria A M Duarte
- Department of Gastroenterology, Divino Espírito Santo Hospital, Ponta Delgada, Portugal
| | - Francisco Portela
- Gastroenterology Department, University Hospital Center of Coimbra, Coimbra, Portugal
| | - João P Silva
- Gastroenterology Department, Portuguese Institute of Oncology of Lisbon, Lisboa, Portugal
| | - Paula Ministro
- Department of Gastroenterology, Tondela-Viseu Hospital Center, Viseu, Portugal
| | - Bruno Arroja
- Department of Gastroenterology, Braga Hospital, Braga, Portugal
| | - Liliana Carvalho
- Department of Gastroenterology, Lisbon Ocidental Hospital Center, Lisboa, Portugal
| | - Joana Torres
- Department of Gastroenterology, Beatriz Ângelo Hospital, Loures, Portugal
| | - Mafalda Santiago
- Centre for Health Technology and Services Research (CINTESIS), Porto, Portugal
| | - Maria Manuela Estevinho
- Department of Biomedicine, Unit of Pharmacology and Therapeutics, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Silvio Danese
- Department of Biomedical Sciences, Humanitas University, Milan, Italy; Inflammatory Bowel Disease (IBD) Center, Department of Gastroenterology, Humanitas Clinical and Research Center (IRCCS), Milan, Italy
| | - Laurent Peyrin-Biroulet
- Department of Gastroenterology and Inserm NGERE U1256, University Hospital of Nancy, University of Lorraine, Vandoeuvre-lès-Nancy, France
| | - Cláudia Camila Dias
- Centre for Health Technology and Services Research (CINTESIS), Porto, Portugal; Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Paula Borralho
- Institute of Pathology, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Roger M Feakins
- Department of Histopathology, Royal Free Hospital, London, United Kingdom
| | - Fátima Carneiro
- Department of Pathology, São João University Hospital Center (CHUSJ), Porto, Portugal; Institute of Molecular Pathology and Immunology of the University of Porto (Ipatimup), University of Porto, Porto, Portugal
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Nunes A, Dinis A, Oliveira B, Lopes S, Freitas T, Sousa B. Adolescents eating habits: the perception of adolescents vs parents. Clin Nutr ESPEN 2021. [DOI: 10.1016/j.clnesp.2021.09.670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Garrido I, Lopes S, Simões MS, Liberal R, Lopes J, Carneiro F, Macedo G. Autoimmune hepatitis after COVID-19 vaccine - more than a coincidence. J Autoimmun 2021; 125:102741. [PMID: 34717185 PMCID: PMC8547941 DOI: 10.1016/j.jaut.2021.102741] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [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: 09/15/2021] [Revised: 10/13/2021] [Accepted: 10/19/2021] [Indexed: 01/04/2023]
Abstract
The COVID-19 pandemic is still raging across the world and vaccination is expected to lead us out of this pandemic. Although the efficacy of the vaccines is beyond doubt, safety still remains a concern. We report a case of a 65-year-old woman who experienced acute severe autoimmune hepatitis two weeks after receiving the first dose of Moderna-COVID-19 vaccine. Serum immunoglobulin G was elevated and antinuclear antibody was positive (1:100, speckled pattern). Liver histology showed a marked expansion of the portal tracts, severe interface hepatitis and multiple confluent foci of lobular necrosis. She started treatment with prednisolone, with a favorable clinical and analytical evolution. Some recent reports have been suggested that COVID-19 vaccination can lead to the development of autoimmune diseases. It is speculated that the vaccine can disturb self-tolerance and trigger autoimmune responses through cross-reactivity with host cells. Therefore, healthcare providers must remain vigilant during mass COVID-19 vaccination.
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Affiliation(s)
- Isabel Garrido
- Gastroenterology and Hepatology Department, Centro Hospitalar e Universitário de São João, Porto, Portugal,World Gastroenterology Organization (WGO) Porto Training Center, Porto, Portugal,Corresponding author. Gastroenterology and Hepatology Department, Centro Hospitalar e Universitário de São João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
| | - Susana Lopes
- Gastroenterology and Hepatology Department, Centro Hospitalar e Universitário de São João, Porto, Portugal,World Gastroenterology Organization (WGO) Porto Training Center, Porto, Portugal
| | - Manuel Sobrinho Simões
- Department of Clinical Hematology, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Rodrigo Liberal
- Gastroenterology and Hepatology Department, Centro Hospitalar e Universitário de São João, Porto, Portugal,World Gastroenterology Organization (WGO) Porto Training Center, Porto, Portugal
| | - Joanne Lopes
- Pathology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Fátima Carneiro
- Pathology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Guilherme Macedo
- Gastroenterology and Hepatology Department, Centro Hospitalar e Universitário de São João, Porto, Portugal,World Gastroenterology Organization (WGO) Porto Training Center, Porto, Portugal
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Abstract
Crohn disease (CD) and ulcerative colitis (UC) are considered chronic disorders of the gastrointestinal tract, lifelong medication often being necessary. Furthermore, they have significant implications on the quality of life. In the past few years, major advances have been achieved concerning the treatment of inflammatory bowel disease. These advances are expanding the possibilities for managing these patients. Janus kinase (JAK) inhibitors represent the most auspicious treatment to date because they consist of drugs that are orally administered, with a short half-life and low antigenicity. In addition, they seem to concurrently lessen various proinflammatory routes. In fact, tofacitinib has already been approved in patients with UC, both naïve and with prior exposure to tumor necrosis factor inhibitors. In CD, the results with tofacitinib have been less impressive. Several other JAK inhibitors are currently being investigated. However, given the wide spectrum of immunosuppressive effects, special attention has been given to the safety profile of these drugs, namely with regard to the occurrence of thromboembolic events, opportunistic infections, and malignancy. In this article, we review key evidence on the efficacy and safety of JAK inhibitors concerning both UC and CD.
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Affiliation(s)
- Isabel Garrido
- Gastroenterology and Hepatology Department, Centro Hospitalar Universitário de São João, Porto, Portugal.,World Gastroenterology Organization Porto Training Center, Porto, Portugal
| | - Susana Lopes
- Gastroenterology and Hepatology Department, Centro Hospitalar Universitário de São João, Porto, Portugal.,World Gastroenterology Organization Porto Training Center, Porto, Portugal
| | - Guilherme Macedo
- Gastroenterology and Hepatology Department, Centro Hospitalar Universitário de São João, Porto, Portugal.,World Gastroenterology Organization Porto Training Center, Porto, Portugal
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36
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Affiliation(s)
- Isabel Garrido
- Gastroenterology and Hepatology Department, Centro Hospitalar e Universitário de São João, Porto, Portugal
- World Gastroenterology Organization (WGO) Porto Training Center, Porto, Portugal
- Corresponding author: Isabel Garrido, MD, Gastroenterology and Hepatology Department, Centro Hospitalar e Universitário de São João, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal. Tel: +351 22 551 2100;
| | - Susana Lopes
- Gastroenterology and Hepatology Department, Centro Hospitalar e Universitário de São João, Porto, Portugal
- World Gastroenterology Organization (WGO) Porto Training Center, Porto, Portugal
| | - Guilherme Macedo
- Gastroenterology and Hepatology Department, Centro Hospitalar e Universitário de São João, Porto, Portugal
- World Gastroenterology Organization (WGO) Porto Training Center, Porto, Portugal
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Vales L, Soares P, Nunes C, Lopes S. Healthcare system delay and utilization in tuberculosis patients in Portuguese high-incidence region. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
In Portugal, the Tâmega e Sousa region (TeS) has a high incidence of tuberculosis (TB) [27.4 and 43.8 per 100.000 inhabitants in sub-regions Baixo Tâmega (BxT) and Vale do Sousa Sul (VSS), 2017]. Delay in TB diagnosis leads to increased transmission, which may lead to more people infected. This study aimed to describe healthcare system delay among TB patients and healthcare utilization from symptoms onset to diagnosis in TeS.
Methods
We analysed pulmonary TB cases notified in BxT and VSS in 2014-7 in the national surveillance system (SVIG-TB). Concomitantly, we analysed healthcare utilisation from patients in a retrospective study (URBAN-TB) about TB delays in 2019-20. We characterised demographics of patients from each data source and comorbidities from SVIG-TB. We calculated median overall delay until diagnosis (days); and healthcare delay overall and by patient characteristics, for each sub-region. Delay was calculated only when relevant dates were recorded. Healthcare utilisation from symptoms onset to diagnosis was described using the frequency of each first contact provider and the average number of visits until diagnosis.
Results
Included 139 patients from BxT and 206 from VSS (83% male, 53% aged 40-59y, and 17% with silicosis). Global delays were 48 and 75 days (n = 57/132; BxT and VSS). Healthcare delays were 7 and 8 days (n = 76/180; BxT and VSS). In both ACES, healthcare delays were longer for patients aged 60-79y, with COPD and aged 0-19y. Healthcare utilisation analysis included 38 patients (89% male; 55% aged 40-59y; n = 17/21). Primary care (n = 15; 39%) and emergency department (ED) (n = 9; 24%) were frequent points of first contact. The average number of visits until diagnosis was higher for patients from ED (3.9) and lower for patients from TB specialised units (1.3).
Conclusions
Our results suggest that in TeS it is important to avoid ED as a point of first contact of TB patients and to facilitate the diagnosis in young, older and COPD patients.
Key messages
Emergency department is a relevant point of first contact and may be included in efforts to reduce tuberculosis delay. Policies to reduce tuberculosis delay may target younger, older and COPD patients.
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Affiliation(s)
- L Vales
- NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - P Soares
- NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - C Nunes
- NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - S Lopes
- NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
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Lopes S, Soares P, Gama A, Pedro AR, Moniz M, Laires P, Goes AR, Nunes C, Dias S. Factors associated with avoidance of emergency department visits in Portugal during the pandemic. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Avoiding an emergency department (ED) visit risks irreversible negative consequences for patients' health. EDs are a frequent access point to the Portuguese health system. Previous studies have shown that patients may avoid visiting ED during the pandemic. This study aims to identify factors associated with avoidance of ED visits in Portugal during the COVID-19 pandemic.
Methods
We used data from a community-based survey, “COVID-19 Barometer: Social Opinion”, which includes healthcare utilisation, health status, and risk perception in Portugal from 11th April 2020 to 16th April 2021. We included respondents that reported having needed ED care. Data were collected on sociodemographics, health status (comorbidities, mental health), risk perception (COVID-19 and complications), level of trust in health services and self-assessment of the severity of the reason for ED visit. The outcome of interest was the decision to avoid ED care. We used logistic regression to identify factors associated with the decision to avoid ED.
Results
Preliminary data showed that 914 respondents reported needing ED care (74.8% female; mean age 43 years). From those, 224 (25%) decided to avoid ED care. ED visits avoidance was higher during lockdowns (28%). People reporting specific comorbidities (cardiac, autoimmune, respiratory) avoided ED more than those without them. Perception of no severe reason for ED visit, poor mental health, perception of higher risk of COVID-19 and complications, and low trust in health services response to the pandemic were associated with higher odds of ED visit avoidance.
Conclusions
People avoiding ED visits represented a considerable share. The decision to avoid ED visit was associated with clinical characteristics, but the perception of risk and assessment of the context and health system response also played a role in decision making.
Key messages
The effect of avoided ED visits on health should be a research and policy concern. People with certain comorbidities or perception of high risk of COVID-19 and complications may be closely monitored.
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Affiliation(s)
- S Lopes
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - P Soares
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - A Gama
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - AR Pedro
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - M Moniz
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - P Laires
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - AR Goes
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - C Nunes
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - S Dias
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
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Santos AL, Lopes S, Peixoto A, Garrido I, Medas R, Andrade P, Macedo G. The ACE (Albumin, CRP, and Endoscopy) Index in Acute Colitis: Simplify to a Better Prognostic Prediction. Inflamm Bowel Dis 2021; 27:e140. [PMID: 34331454 DOI: 10.1093/ibd/izab189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Affiliation(s)
- Ana Luísa Santos
- Gastroenterology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Susana Lopes
- Gastroenterology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Armando Peixoto
- Gastroenterology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Isabel Garrido
- Gastroenterology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Renato Medas
- Gastroenterology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Patrícia Andrade
- Gastroenterology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Guilherme Macedo
- Gastroenterology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
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Pereira FG, Lopes S, Pacheco A, Cavadas S, Mesquita Bastos J. Resistant hypertension must be defined by ambulatory blood pressure and pulse pressure is best predictor of new cardiovascular events. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2324] [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
Resistant Hypertension (RH) defined by Ambulatory blood pressure monitoring (ABPM) isn't so common. Prognostic CV by ABPM of RH is uncertain.
Objective
RH Population defined by ABPM, followed 5.9±5.0 years and prognostic value of ABPM for new CV events (CVe).
Design and method
ABPM-collected 1999–2019. Identified RH patients by ABPM. Obtained anthropometric, clinic, laboratorial data from the patient and clinical records. CVe defined by: stroke (ST) (Ischemic (STisq), haemorrhagic (SThs)), Coronary Event (CD), Other CV events (OCV) (acute heart failure (HF), peripheral arterial disease (PAD). Follow-up finished with event, last evaluation of the patient or death.
Results
258 patients, follow-up – 5.9±5.0 years,158 males, mean age – 60.4±11 years. Diabetes Mellitus (DM) 45.3%, Dyslipidaemia 74.4%, Obesity 45.3%, Chronic Kidney Disease 37.2%, previous CVe (PCVe) 34.5%. Observed 68 CVe: 26 ST (21 STisq, 5 SThs), 21 CD, 21 OCV (15 HF, 6 PAD). 18 death (8 unknown, 1 infection, 2 cancer, 1 sudden death, 2 STisq, 1 CD, 3 HF). When compared those with event vs no-event (fig. 1), in T student to independent samples, those with event had larger left atrium (42.6±5.7 vs 40.2±4.7, p<0.05), lower creatinine clearance (mL/min/1.73m2) (63.6±34 vs 74.5±33). PCVe was significantly more prevalent on those with event (c 9.8, p<0.01). In a multivariate Cox analysis for the risk of CVe (adjusted to age, gender, DM, PCVe, glycemia, creatinine, number of antihypertensive), Day Pulse Pressure with cut-off 60mmHg was statically significant (HR 2.46 (95% CI 1.26–4.83), p<0.01). In Kaplan-Meier survival curve free of events, the best CV predictor obtained was the cut-off 60mmHg of PP (24h, Day, night PP), mostly Day PP-60mmHg (log rank 9.27, p<0.01) (fig. 2A). When analyzed for those who had Stroke, in the multivariate Cox analysis 24h SBP (p<0.05, HR 1.04 (95% CI 1.00–1.07), and night SBP (p<0.05, HR 1.03 (95% CI 1.00–1.06) were statically significant on top of age, gender, DM, PCVe, glycemia, creatinine, number of antihypertensive. In Kaplan-Meier survival curve free of events, the best CV predictor obtained was the cut-off 60mmHg PP, mostly Day PP 60mmHg (log rank 8.5 p<0.01) (fig. 2B). For those who had CD in the multivariate Cox analysis, adjusted for other variables, 24h SBP (p<0.05, HR 1.04 (95% CI 1.00–1.07), and night SBP (p<0.05 HR1.03 (95% CI 1.00–1.06) were statically significant. In Kaplan-Meier survival curve free of events, night PP 60mmHg predicted CD events (log rank 4.42 p<0.05) (fig. 2C). For OCV the multivariate Cox analysis, adjusted for other variables, 24h PP (p<0.05, HR 1.04 (95% CI 1.00–1.07) and night SBP (p<0.05, HR 1.03 (95% CI 1.00–1.06) were statically significant for new OCV. In Kaplan-Meier survival curve free of events, best predictor was mostly night PP 60mmHg (log rank 19, p<0.001) (fig. 2D).
Conclusion
In our sample of RH the definition by ABPM is essential. PP is the key prognosis for future CVe, special if analysed by the cut of PP-60 mmHg.
Funding Acknowledgement
Type of funding sources: None. Kaplan-Meier survival curves
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Affiliation(s)
- F G Pereira
- Centro Hospitalar do Baixo Vouga, Internal Medicine, Aveiro, Portugal
| | - S Lopes
- iBiMED - Institute of Biomedicine, Aveiro, Portugal
| | - A Pacheco
- Centro Hospitalar do Baixo Vouga, Cardiology, Aveiro, Portugal
| | - S Cavadas
- Centro Hospitalar do Baixo Vouga, Internal Medicine, Aveiro, Portugal
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Lopes S, Mesquita-Bastos J, Teixeira M, Figueiredo D, Oliveira J, Polonia J, Alves AJ, Ribeiro F. Aerobic exercise training reduces blood pressure, angiotensin II and oxidative stress of patients with resistant hypertension: the EnRiCH trial. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2392] [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
Resistant hypertension is a major challenge of modern cardiovascular medicine, as it is a puzzling problem without a clear solution. Exercise training clearly reduces blood pressure (BP) and oxidative stress in patients with hypertension, however evidence is limited regarding resistant hypertension.
Purpose
To determine the effect of an aerobic exercise training program in BP, angiotensin II and oxidative stress in patients with resistant hypertension.
Methods
EnRicH is a prospective, two-center, single-blinded, randomized controlled trial with a parallel two-arm group. Sixty patients with resistant hypertension were randomly assigned in a 1:1 ratio to undergo a 12-week aerobic exercise training program (exercise) or usual care (control). The powered primary efficacy measure was 24-hour ambulatory systolic BP change from baseline. Secondary outcome measures included daytime and nighttime ambulatory BP, office BP, cardiorespiratory fitness, and oxidative stress and inflammatory biomarkers: Interferon-gamma (IFN-y), Angiotensin II, vascular endothelial growth factor (VEGF), and superoxide dismutase (SOD).
Results
Fifty-three patients (exercise n=26, control n=27) completed the study. Patients were mainly women (54.7%), with an office BP of 140.7±15.9/84.2±9.4 mm Hg and taking an average of 4.6 antihypertensive medications (median, 5; range, 3 to 7). At baseline, no differences were found between groups for the study outcomes and patient characteristics. Ambulatory systolic BP was reduced −7.1 mm Hg (95% CI, −12.8 to −1.4; P=0.015) in the exercise group (127.4±12.2 to 121.2±12.2, p=0.007) compared to control group (126.1±17.2 to 126.9±15.2, p=514) over 24-hour. In addition, 24-hour ambulatory diastolic BP (−5.1 mm Hg, −7.9 to −2.3, P=0.001), daytime ambulatory systolic (−8.4 mm Hg, −14.3 to −2.5, P=0.006), and diastolic BP (−5.7 mm Hg, −9.0 to −2.4, P=0.001) were also reduced in the exercise group compared to the control group. There were no differences in the change of nighttime ambulatory BP between groups. Cardiorespiratory fitness improved in the exercise group by 14% (4.7 ml.kg-1.min-1, P<0.001), while it remained unchanged in the control group (−0.37 ml.kg-1.min-1, P=0.442). A significant between-group difference in favor of exercise group was found for IFN-y (−4.3 pg/mL, 95% CI: −7.1 to −1.5; P=0.003), Angiotensin II (−157.0 pg/mL, 95% CI: −288.1 to −25.9; P=0.020), VEGF (10.53 pg/mL, 95% CI: 0.60 to 22.54; P=0.035), and SOD (0.35 pg/mL, 95% CI: 0.10 to 0.58; P=0.009).
Conclusions
A 12-week moderate intensity aerobic exercise program reduced ambulatory BP, angiotensin II and oxidative stress in patients with resistant hypertension. The antihypertensive effects of exercise in patients with resistant hypertension may be mediated by positive changes in oxidative stress and inflammatory biomarkers.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): European Union through European Regional Development Fund – Operational Competitiveness Factors Program (COMPETE)Portuguese Government through FCT - Foundation for Science and Technology
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Affiliation(s)
- S Lopes
- University of Aveiro, iBiMED - Institute of Biomedicine and School of Health Sciences, Aveiro, Portugal
| | - J Mesquita-Bastos
- Centro Hospitalar do Baixo Vouga, Cardiology Department, Hospital Infante D. Pedro, Aveiro, Portugal
| | - M Teixeira
- University of Aveiro, iBiMED - Institute of Biomedicine and School of Health Sciences, Aveiro, Portugal
| | - D Figueiredo
- University of Aveiro, School of Health Sciences and CINTESIS@UA, Aveiro, Portugal
| | - J Oliveira
- University of Porto, Research Centre in Physical Activity, Health and Leisure, Faculty of Sport,, Porto, Portugal
| | - J Polonia
- Faculty of Medicine University of Porto, Hypertension Unit, ULS Matosinhos, Porto, Portugal
| | - A J Alves
- University Institute of Maia, Research Center in Sports Sciences, Health and Human Development, CIDESD, Maia, Portugal
| | - F Ribeiro
- University of Aveiro, iBiMED - Institute of Biomedicine and School of Health Sciences, Aveiro, Portugal
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Vale F, Pinto F, Oliveira R, Martins C, Lopes S. Referenciação dos Cuidados de Saúde Primários ao Serviço de Urgência de Pediatria de um Hospital Nível II: Que Realidade? Gaz Med 2021. [DOI: 10.29315/gm.v1i1.425] [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: 11/14/2022] Open
Abstract
INTRODUÇÃO: O objetivo foi caracterizar os episódios referenciados pelos cuidados de saúde primários (CSP) ao serviço de urgência (SU) do Centro Hospitalar do Médio Ave, assim como classificar a adequabilidade da referenciação.MATERIAL E MÉTODOS: Foi realizado um estudo observacional retrospetivo, incluindo todos os utentes com idade inferior a 18 anos referenciados por parte dos CSP ao SU, durante o ano de 2017. A referenciação foi considerada adequada sempre que foram realizados exames complementares de diagnóstico ou terapêuticas não disponíveis nos CSP. Assim como, a observação por outra especialidade que não a pediatria, a necessidade de internamento e a transferência para outro hospital.RESULTADOS: Foram obtidos 406 episódios de urgência, dos quais 25,9% obtiveram como diagnóstico de saída a patologia gastrointestinal e 29,4% a patologia respiratória. Foram consideradas adequadas 65,3% das referenciações, sendo as mais frequentes a patologia gastrointestinal, respiratória e trauma. As patologias genitourinária e infecciológica foram as mais constantes quanto à referenciação inadequada (OR = 11,5 e OR = 3,49, respetivamente, ajustado à idade). Verificou-se concordância entre o motivo de referenciação e o diagnóstico de saída nas patologias gastrointestinal, otorrinolaringológica, trauma e oftalmológica (kappa > 0,7). A grande maioria (92,2%) das crianças teve alta clínica.CONCLUSÃO: A taxa de referenciação adequada aos serviços hospitalares no presente estudo foi semelhante à descrita na literatura. No entanto, a otimização da comunicação entre os CSP e o SU, a implementação de protocolos, bem como, a formação dos profissionais dos CSP permitirão melhorar a referenciação.
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Lopes S, Mesquita-Bastos J, Garcia C, Leitão C, Bertoquini S, Ribau V, Carvalho P, Oliveira J, Viana J, Figueiredo D, Guimarães GV, Polonia J, Alves AJ, Ribeiro F. Physical Activity is Associated With Lower Arterial Stiffness in Patients With Resistant Hypertension. Heart Lung Circ 2021; 30:1762-1768. [PMID: 34417116 DOI: 10.1016/j.hlc.2021.06.532] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 05/26/2021] [Accepted: 06/02/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Physical activity is associated with reduced arterial stiffness, although such a relationship has not been reported in those with resistant hypertension. Therefore, this study aimed to determine the association between daily physical activity and arterial stiffness in patients with resistant hypertension. METHODS Fifty-seven (57) patients with resistant hypertension (50.9% men), aged 58.8±9.4 years, were consecutively recruited. Arterial stiffness was evaluated using carotid-femoral pulse wave velocity (cf-PWV). Daily physical activity was objectively assessed with accelerometers during 7 consecutive days. RESULTS Patients had a body mass index of 29.0±4.0 kg/m2 (84.3% overweight/obese) and were taking an average 4.5 antihypertensive medications. Overall, the cf-PWV was 9.2±2.4 m/s and the majority of participants (n=41, 71.9%) presented a cf-PWV <10 m/s. The cf-PWV showed an inverse correlation with light-intensity physical activity (r = -0.290, p=0.029) and total daily physical activity (r = -0.287, p=0.030). The correlation between light physical activity and cf-PWV remained significant after adjustment for systolic and diastolic blood pressure, but lost significance when further adjusted for age. CONCLUSIONS Higher daily levels of light-intensity and total physical activity were associated with lower arterial stiffness. Nonetheless, this association is weak and attenuated or abolished when adjusted for blood pressure and age. These results suggest that physical activity may play an important role as a lifestyle intervention for patients with resistant hypertension. Future studies with larger samples sizes are necessary to confirm this preliminary data.
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Affiliation(s)
- Susana Lopes
- Institute of Biomedicine - iBiMED, School of Health Sciences, University of Aveiro, Aveiro, Portugal
| | - José Mesquita-Bastos
- Institute of Biomedicine - iBiMED, School of Health Sciences, University of Aveiro, Aveiro, Portugal; Cardiology Department, Hospital Infante D. Pedro, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal
| | - Catarina Garcia
- Research Center in Sports Sciences, Health and Human Development - CIDESD, University Institute of Maia, Maia, Portugal
| | - Cátia Leitão
- I3N, Department of Physics, University of Aveiro, Aveiro, Portugal
| | - Susana Bertoquini
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, & Hypertension and Cardiovascular Risk Unit, ULS Matosinhos, Matosinhos, Portugal
| | - Verónica Ribau
- Cardiology Department, Hospital Infante D. Pedro, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal
| | - Pedro Carvalho
- Cardiology Department, Hospital Infante D. Pedro, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal
| | - José Oliveira
- Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal
| | - João Viana
- Research Center in Sports Sciences, Health and Human Development - CIDESD, University Institute of Maia, Maia, Portugal
| | - Daniela Figueiredo
- Center for Health Technology and Services Research (CINTESIS.UA), School of Health Sciences, University of Aveiro, Aveiro, Portugal
| | - Guilherme V Guimarães
- University of São Paulo (USP), School of Medicine, Heart Institute, São Paulo, Brazil
| | - Jorge Polonia
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, & Hypertension and Cardiovascular Risk Unit, ULS Matosinhos, Matosinhos, Portugal
| | - Alberto J Alves
- Research Center in Sports Sciences, Health and Human Development - CIDESD, University Institute of Maia, Maia, Portugal
| | - Fernando Ribeiro
- Institute of Biomedicine - iBiMED, School of Health Sciences, University of Aveiro, Aveiro, Portugal.
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Lopes S, Mesquita-Bastos J, Garcia C, Bertoquini S, Ribau V, Teixeira M, Ribeiro IP, Melo JB, Oliveira J, Figueiredo D, Guimarães GV, Pescatello LS, Polonia J, Alves AJ, Ribeiro F. Effect of Exercise Training on Ambulatory Blood Pressure Among Patients With Resistant Hypertension: A Randomized Clinical Trial. JAMA Cardiol 2021; 6:1317-1323. [PMID: 34347008 DOI: 10.1001/jamacardio.2021.2735] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Importance Limited evidence suggests exercise reduces blood pressure (BP) in individuals with resistant hypertension, a clinical population with low responsiveness to drug therapy. Objective To determine whether an aerobic exercise training intervention reduces ambulatory BP among patients with resistant hypertension. Design, Settings, and Participants The Exercise Training in the Treatment of Resistant Hypertension (EnRicH) trial is a prospective, 2-center, single-blinded randomized clinical trial performed at 2 hospital centers in Portugal from March 2017 to December 2019. A total of 60 patients with a diagnosis of resistant hypertension aged 40 to 75 years were prospectively enrolled and observed at the hospitals' hypertension outpatient clinic. Interventions Patients were randomly assigned in a 1:1 ratio to a 12-week moderate-intensity aerobic exercise training program (exercise group) or a usual care control group. The exercise group performed three 40-minute supervised sessions per week in addition to usual care. Main Outcomes and Measures The powered primary efficacy measure was 24-hour ambulatory systolic BP change from baseline. Secondary outcomes included daytime and nighttime ambulatory BP, office BP, and cardiorespiratory fitness. Results A total of 53 patients completed the study, including 26 in the exercise group and 27 in the control group. Of these, 24 (45%) were women, and the mean (SD) age was 60.1 (8.7) years. Compared with the control group, among those in the exercise group, 24-hour ambulatory systolic BP was reduced by 7.1 mm Hg (95% CI, -12.8 to -1.4; P = .02). Additionally, 24-hour ambulatory diastolic BP (-5.1 mm Hg; 95% CI, -7.9 to -2.3; P = .001), daytime systolic BP (-8.4 mm Hg; 95% CI, -14.3 to -2.5; P = .006), and daytime diastolic BP (-5.7 mm Hg; 95% CI, -9.0 to -2.4; P = .001) were reduced in the exercise group compared with the control group. Office systolic BP (-10.0 mm Hg; 95% CI, -17.6 to -2.5; P = .01) and cardiorespiratory fitness (5.05 mL/kg per minute of oxygen consumption; 95% CI, 3.5 to 6.6; P < .001) also improved in the exercise group compared with the control group. Conclusions and Relevance A 12-week aerobic exercise program reduced 24-hour and daytime ambulatory BP as well as office systolic BP in patients with resistant hypertension. These findings provide clinicians with evidence to embrace moderate-intensity aerobic exercise as a standard coadjutant therapy targeting this patient population. Trial Registration ClinicalTrials.gov Identifier: NCT03090529.
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Affiliation(s)
- Susana Lopes
- Institute of Biomedicine (iBiMED), School of Health Sciences, University of Aveiro, Aveiro, Portugal
| | - José Mesquita-Bastos
- Institute of Biomedicine (iBiMED), School of Health Sciences, University of Aveiro, Aveiro, Portugal.,Cardiology Department, Hospital Infante D. Pedro, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal
| | - Catarina Garcia
- Research Center in Sports Sciences, Health and Human Development (CIDESD), University Institute of Maia, Maia, Portugal
| | - Susana Bertoquini
- Centre for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, Portugal.,Hypertension and Cardiovascular Risk Unit, Unidade Local de Saúde Matosinhos, Matosinhos, Portugal
| | - Verónica Ribau
- Cardiology Department, Hospital Infante D. Pedro, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal
| | - Manuel Teixeira
- Institute of Biomedicine (iBiMED), School of Health Sciences, University of Aveiro, Aveiro, Portugal
| | - Ilda P Ribeiro
- University of Coimbra, Cytogenetics and Genomics Laboratory, Institute of Cellular and Molecular Biology, Coimbra, Portugal.,Coimbra Institute for Clinical and Biomedical Research (iCBR) and Center of Investigation on Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine and Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal
| | - Joana B Melo
- University of Coimbra, Cytogenetics and Genomics Laboratory, Institute of Cellular and Molecular Biology, Coimbra, Portugal.,Coimbra Institute for Clinical and Biomedical Research (iCBR) and Center of Investigation on Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine and Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal
| | - José Oliveira
- Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal
| | - Daniela Figueiredo
- Center for Health Technology and Services Research (CINTESIS.UA), School of Health Sciences, University of Aveiro, Aveiro, Portugal
| | | | | | - Jorge Polonia
- Centre for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, Portugal.,Hypertension and Cardiovascular Risk Unit, Unidade Local de Saúde Matosinhos, Matosinhos, Portugal
| | - Alberto J Alves
- Research Center in Sports Sciences, Health and Human Development (CIDESD), University Institute of Maia, Maia, Portugal.,OncoMove, Associação de Investigação de Cuidados de Suporte em Oncologia (AICSO), Vila Nova de Gaia, Portugal
| | - Fernando Ribeiro
- Institute of Biomedicine (iBiMED), School of Health Sciences, University of Aveiro, Aveiro, Portugal
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Solis J, Lopes S, Yazdanpanah Y, Zucman D, Majerholc C. Que pensent les médecins généralistes d’un suivi partagé ville–hôpital des personnes vivant avec le VIH ? Une étude qualitative. Infect Dis Now 2021. [DOI: 10.1016/j.idnow.2021.06.286] [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]
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46
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Lopes S, Mesquita-Bastos J, Garcia C, Figueiredo D, Carvalho P, Oliveira J, Polonia J, Alves AJ, Ribeiro F. May the brief physical activity assessment tool accurately measure physical activity in patients with resistant hypertension? Eur J Cardiovasc Nurs 2021. [DOI: 10.1093/eurjcn/zvab060.033] [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]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – EU funding. Main funding source(s): FEDER Funds through the Operational Competitiveness Factors Program—COMPETE National Funds through the Portuguese Foundation for Science and Technology (FCT) “PTDC/DTP-DES/1725/2014”. SL is a PhD fellow supported by the FCT (Grant Ref: SFRH/BD/129454/2017).
Introduction
Resistant hypertension is a major health problem due to the increased risk of cardiovascular events and mortality. Physical activity and exercise reduces blood pressure in resistant hypertension and is associated with lower cardiovascular risk and mortality. It is presently recommended that physical activity assessment should be a priority in all visits to health settings
Purpose
This study aims to determine if the Brief Physical Activity Assessment Tool (BPAAT), a 2-question tool to assess physical activity, is a valid instrument to detect inactive patients with resistant hypertension.
Methods
Sixty patients with a diagnosis of resistant hypertension were recruited. Outcome measures included clinical data, blood pressure and daily physical activity. Physical activity was objectively measured over a 7-day period with an accelerometer and subjectively assessed (self-assessment) by the BPAAT. The association between the BPAAT and accelerometry, according to the BPAAT scoring categories, was assessed bythe percentage of agreement, Cohen’s Kappa and sensitivity and specificity.
Results
Patients (33 were male) had a mean age of 59.4 ± 9.1years, were on average overweight (BMI 29.5 ± 4.5 kg/m2) and on an average of 4.5 ± 0.7 antihypertensive medications. Forty-two patients (70%) were classified as insufficiently active by the BPAAT compared to the 38 (63.3%) insufficiently active patients identified by the accelerometry data. Regarding the questionnaire’s specificity and sensitivity, the BPAAT correctly identified 32 [84.2 (73.1 – 95.3) %] of the 38 ‘insufficiently active’ patients and 12 [54.5 (34.3 – 74.7) %] of the 22 ‘sufficiently active’ patients identified by accelerometry. The agreement between BPAAT and accelerometry to identify sufficiently/insufficiently active patients, according to the BPAAT’s cut-off values was fair to moderate (Kappa = 0.403 (0.162 – 0.674), with a percentage of agreement of 73.3%.
Conclusion
The BPAAT, a 2-question tool to assess physical activity, seems to be a valid and fast solution to identify insufficiently active adults with resistant hypertension during routine clinical visits.
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Affiliation(s)
- S Lopes
- University of Aveiro, iBiMED - Institute of Biomedicine, School of Health Sciences, Aveiro, Portugal
| | - J Mesquita-Bastos
- Centro Hospitalar do Baixo Vouga, Cardiology Department, Hospital Infante D.Pedro, Aveiro, Portugal
| | - C Garcia
- University Institute of Maia, Research Center in Sports Sciences, Health and Human Development, CIDESD, Maia, Portugal
| | - D Figueiredo
- University of Aveiro, School of Health Sciences and CINTESIS@UA, Aveiro, Portugal
| | - P Carvalho
- Centro Hospitalar do Baixo Vouga, Cardiology Department, Hospital Infante D.Pedro, Aveiro, Portugal
| | - J Oliveira
- University of Porto, Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, , Porto, Portugal
| | - J Polonia
- Faculty of Medicine University of Porto, Hypertension Unit, ULS Matosinhos, Porto, Portugal
| | - AJ Alves
- University Institute of Maia, Research Center in Sports Sciences, Health and Human Development, CIDESD, Maia, Portugal
| | - F Ribeiro
- University of Aveiro, iBiMED - Institute of Biomedicine, School of Health Sciences, Aveiro, Portugal
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Lopes S, Mesquita-Bastos J, Garcia C, Leitao C, Bertoquini S, Ribau V, Carvalho P, Oliveira J, Viana J, Figueiredo D, Guimaraes GV, Polonia J, Alves AJ, Ribeiro F. Higher levels of physical activity is associated with lower arterial stiffness in patients with resistant hypertension. Eur J Cardiovasc Nurs 2021. [DOI: 10.1093/eurjcn/zvab060.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): Portuguese Foundation for Science and Technology (FCT) European Regional Development Fund – Operational Competitiveness Factors Program (COMPETE)
Background
Physical activity has been associated with reduced arterial stiffness in patients with hypertension. However, in resistant hypertension, a specific population with an increased risk for target organ damage, cardiovascular morbidity, and mortality, the evidence is sparse.
Purpose
The present study aimed to determine the association between daily physical activity and arterial stiffness in patients with resistant hypertension.
Methods
Fifty-seven patients with resistant hypertension were recruited. Physical activity was objectively assessed during 7 consecutive days with accelerometers. Arterial stiffness was evaluated using carotid-femoral pulse wave velocity (cf-PWV) .
Results
Participants (50.9% men), aged 58.8 ± 9.4 years, were mainly overweight and were taking in average 4.5 antihypertensive medications. The cf-PWV showed an inverse correlation with light-intensity physical activity (r = -0.290, p = 0.029) and total daily physical activity (r = -0.287, p = 0.030). Additionally, cf-PWV tended to be inversely associated with the number of steps per day (r = -0.242, p = 0.069). Patients with higher risk of cardiovascular events (cf-PWV ≥ 10 m/s) tended to spend less time in light-intensity physical activity (324.0 ± 129.4 vs. 380.5 ± 103.1 min/day, p = 0.090) and to perform less total daily physical activity (351.5 ± 141.7 vs. 411.7 ± 109.1 min/day, p = 0.091) than participants with cf-PWV below the risk threshold value.
Conclusions
Higher levels of total physical activity and daily levels of light-intensity were associated to lower arterial stiffness. These results emphasize the importance of physical activity as a nonpharmacological tool for patients with resistant hypertension.
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Affiliation(s)
- S Lopes
- University of Aveiro, Aveiro, Portugal
| | - J Mesquita-Bastos
- University of Aveiro, iBiMED - Institute of Biomedicine, School of Health Sciences, Aveiro, Portugal
| | - C Garcia
- University Institute of Maia, Research Center in Sports Sciences, Health and Human Development, CIDESD, Maia, Portugal
| | - C Leitao
- University of Aveiro, I3N, Department of Physics, Aveiro, Portugal
| | - S Bertoquini
- Faculty of Medicine University of Porto, Center for Health Technology and Services Research (CINTESIS), Porto, Portugal
| | - V Ribau
- Centro Hospitalar do Baixo Vouga, Cardiology Department, Hospital Infante D.Pedro, Aveiro, Portugal
| | - P Carvalho
- Centro Hospitalar do Baixo Vouga, Cardiology Department, Hospital Infante D.Pedro, Aveiro, Portugal
| | - J Oliveira
- University of Porto, Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, Porto, Portugal
| | - J Viana
- University Institute of Maia, Research Center in Sports Sciences, Health and Human Development, CIDESD, Maia, Portugal
| | - D Figueiredo
- University of Aveiro, Center for Health Technology and Services Research (CINTESIS.UA), School of Health Sciences, Aveiro, Portugal
| | - GV Guimaraes
- Heart Institute of the University of Sao Paulo (InCor), School of Medicine, Sao Paulo, Brazil
| | - J Polonia
- Faculty of Medicine University of Porto, Center for Health Technology and Services Research (CINTESIS) & Hypertension and Cardiovascular Risk, Porto, Portugal
| | - AJ Alves
- University Institute of Maia, Research Center in Sports Sciences, Health and Human Development, CIDESD, Maia, Portugal
| | - F Ribeiro
- University of Aveiro, iBiMED - Institute of Biomedicine, School of Health Sciences, Aveiro, Portugal
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48
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Lopes S, Mesquita-Bastos J, Garcia C, Figueiredo D, Carvalho P, Oliveira J, Polónia J, Alves AJ, Ribeiro F. Are subjective measures the answer to assess physical inactivity on a daily basis in patients with resistant hypertension? J Hum Hypertens 2021; 35:1180-1182. [PMID: 34282247 DOI: 10.1038/s41371-021-00579-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 06/23/2021] [Accepted: 07/07/2021] [Indexed: 11/09/2022]
Affiliation(s)
- Susana Lopes
- School of Health Sciences and Institute of Biomedicine-iBiMED, University of Aveiro, Aveiro, Portugal.
| | - José Mesquita-Bastos
- School of Health Sciences, University of Aveiro, Aveiro, Portugal.,Cardiology Department, Hospital Infante D.Pedro, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal
| | - Catarina Garcia
- Research Center in Sports Sciences, Health and Human Development, CIDESD, University Institute of Maia, Maia, Portugal
| | - Daniela Figueiredo
- Center for Health Technology and Services Research (CINTESIS.UA), School of Health Sciences, University of Aveiro, Aveiro, Portugal
| | - Pedro Carvalho
- Cardiology Department, Hospital Infante D.Pedro, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal
| | - José Oliveira
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal.,Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
| | - Jorge Polónia
- Faculty of Medicine, University of Porto, Porto, Portugal.,Hypertension Unit, ULS, Matosinhos, Portugal
| | - Alberto Jorge Alves
- Research Center in Sports Sciences, Health and Human Development, CIDESD, University Institute of Maia, Maia, Portugal.,OncoMove, Associação de Investigação de Cuidados de Suporte em Oncologia-AICSO, Vila Nova de Gaia, Portugal
| | - Fernando Ribeiro
- School of Health Sciences and Institute of Biomedicine-iBiMED, University of Aveiro, Aveiro, Portugal
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Marco A, Martins S, Martín-Rábano A, Lopes S, Clarke LJ, Abella E. Risk assessment of wildlife-watching tourism in an important endangered loggerhead turtle rookery. ENDANGER SPECIES RES 2021. [DOI: 10.3354/esr01130] [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] [Indexed: 11/23/2022] Open
Abstract
Wildlife-watching tourism is a non-exploitative activity that can contribute to sustainable economic development of coastal communities. However, it is important to assess the potential impact and implement best practices to mitigate any negative effects of such tourism. We studied this issue on Boa Vista (Cabo Verde), which supports around 60% of nesting activity of one of the most endangered loggerhead turtle rookeries globally. Between 2013 and 2016, authorized turtle watching involved 4942 tourists, generating a mean annual direct income of >USD 289000 and the direct creation of >250 jobs. On João Barrosa beach, which supports around 20% of nests and 48% of turtle-watching activity on the island, we tested the influence of turtle watching on nesting behavior, reproduction and nest-site fidelity. Nesting females observed by tourists spent significantly less time on nest-camouflaging behavior, although all other phases of nesting were unaffected. There were no statistically significant differences between the re-nesting frequency of females watched (n = 187) and non-watched (n = 972) by tourists. We found no evidence that the current turtle-watching intensity has an effect on turtle reproduction. Turtle poaching remains a severe threat on beaches with no turtle watching, although it has strongly decreased on beaches with tourist visits. We suggest tour guides follow best practice guidelines to minimize disturbance, specifically retreating from the immediate vicinity of a female during nest camouflaging to mitigate the observed impact.
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Affiliation(s)
- A Marco
- Estación Biológica de Doñana, CSIC, C/ Américo Vespucio s/n, Sevilla 41092, Spain
- BIOS.CV, C/ Sta Isabel s/n, Sal Rei, 5211 Boa Vista, Cabo Verde
| | - S Martins
- BIOS.CV, C/ Sta Isabel s/n, Sal Rei, 5211 Boa Vista, Cabo Verde
| | - A Martín-Rábano
- BIOS.CV, C/ Sta Isabel s/n, Sal Rei, 5211 Boa Vista, Cabo Verde
| | - S Lopes
- Direcção Geral do Ambiente, Cha d’ Areia s/n, Praia, 332A Santiago Island, Cabo Verde
| | - LJ Clarke
- School of Ocean Sciences, Bangor University, Menai Bridge LL59 5AB, UK
| | - E Abella
- Estación Biológica de Doñana, CSIC, C/ Américo Vespucio s/n, Sevilla 41092, Spain
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Santos A, Silva MA, Cardoso H, Marques M, Rodrigues-Pinto E, Peixoto A, Gaspar R, Lopes S, Macedo G. Lewis score: a useful tool for diagnosis and prognosis in Crohn's disease. Rev Esp Enferm Dig 2021; 112:121-126. [PMID: 31960694 DOI: 10.17235/reed.2020.6434/2019] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND videocapsule endoscopy (VCE) is currently the most sensitive diagnostic tool to detect early small bowel inflammation. A Lewis score (LS) of ≥ 135 as the cutoff value for the presence of significant inflammatory activity in patients undergoing VCE for suspected Crohn's disease (CD) has been suggested as a useful tool for the diagnosis of CD. The aim of this study was to evaluate the diagnostic and prognostic accuracy of the LS in patients with suspected CD undergoing VCE. METHODS a retrospective single-center study was performed that included patients who underwent VCE for suspected CD between January 2010 and December 2015. Inflammatory activity was assessed with the LS. Patients were grouped according to the criteria of the International Conference on Capsule Endoscopy (ICCE) for the definition of suspected CD; group 1: patients not fulfilling ICCE and group 2: patients with ≥ 2 ICCE criteria. RESULTS one hundred and ninety-one patients were included, 61% were female and the mean age was 39 ± 14 years. VCE detected significant inflammatory activity (LS ≥ 135) in 81 patients (42%); 24 patients from group 1 (32%) and 57 patients from group 2 (50%) (p = 0.014). During a mean follow-up period of 41 ± 21 months (12-79), a CD diagnosis was determined in 60 patients (31%); 55 patients with LS ≥ 135 (92%) and five patients with LS < 135 (5%) (p < 0.001). The LS showed a good diagnostic accuracy with an AUROC of 0.93 (p < 0.001). During the first year after diagnosis, there was a significant association between a higher LS and the need for immunomodulatory therapy, biological therapy, bowel resection surgery or hospital admission due to a CD flare-up. CONCLUSIONS the LS (cutoff ≥ 135) is very useful in the diagnosis of CD in patients undergoing VCE. Moreover, higher values of this score was associated with prognostic variables.
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Affiliation(s)
- Ana Santos
- Gastrenterologia, Centro Hospitalar de São João, Portugal
| | | | - Hélder Cardoso
- Gastrenterologia, Centro Hospitalar de São João, Portugal
| | | | | | | | - Rui Gaspar
- Gastrenterologia, Centro Hospitalar de São João, Portugal
| | - Susana Lopes
- Gastrenterologia, Centro Hospitalar de São João, Portugal
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