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Morais A, Chung JY, Wu L, Ayata C, Simon B, Whalen MJ. Non-Invasive Vagal Nerve Stimulation Pre-Treatment Reduces Neurological Dysfunction After Closed Head Injury in Mice. Neurotrauma Rep 2024; 5:150-158. [PMID: 38435077 PMCID: PMC10908330 DOI: 10.1089/neur.2023.0058] [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] [Indexed: 03/05/2024] Open
Abstract
Non-invasive vagus nerve stimulation (nVNS) has recently been suggested as a potential therapy for traumatic brain injury (TBI). We previously demonstrated that nVNS inhibits cortical spreading depolarization, the electrophysiological event underlying migraine aura, and is relevant to TBI. Our past work also suggests a role for interleukin-1 beta (IL-1β) in cognitive deficits after closed head injury (CHI) in mice. We show that nVNS pre-treatment suppresses CHI-associated spatial learning and memory impairment and prevents IL-1β activation in injured neurons, but not endothelial cells. In contrast, nVNS administered 10 min after CHI was ineffective. These data suggest that nVNS prophylaxis might ameliorate neuronal dysfunction associated with CHI in populations at high risk for concussive TBI.
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Affiliation(s)
- Andreia Morais
- Neurovascular Research Unit, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts, USA
| | - Joon Yong Chung
- Department of Pediatrics, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts, USA
| | - Limin Wu
- Department of Pediatrics, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts, USA
| | - Cenk Ayata
- Neurovascular Research Unit, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts, USA
| | - Bruce Simon
- ElectroCore, Inc., Basking Ridge, New Jersey, USA
| | - Michael J. Whalen
- Department of Pediatrics, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts, USA
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Mota PC, Soares ML, Ferreira AC, Santos RF, Rufo JC, Vasconcelos D, Carvalho A, Guimarães S, Vasques-Nóvoa F, Cardoso C, Melo N, Alexandre AT, Coelho D, Novais-Bastos H, Morais A. Polymorphisms and haplotypes of TOLLIP and MUC5B are associated with susceptibility and survival in patients with fibrotic hypersensitivity pneumonitis. Pulmonology 2024:S2531-0437(24)00007-2. [PMID: 38309995 DOI: 10.1016/j.pulmoe.2024.01.002] [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: 11/15/2023] [Revised: 12/27/2023] [Accepted: 01/04/2024] [Indexed: 02/05/2024] Open
Abstract
INTRODUCTION AND OBJECTIVES Hypersensitivity pneumonitis (HP) is an interstitial lung disease with diverse clinical features that can present a fibrotic phenotype similar to idiopathic pulmonary fibrosis (IPF) in genetically predisposed individuals. While several single nucleotide polymorphisms (SNPs) have been associated with IPF, the genetic factors contributing to fibrotic HP (fHP) remain poorly understood. This study investigated the association of MUC5B and TOLLIP variants with susceptibility, clinical presentation and survival in Portuguese patients with fHP. MATERIAL AND METHODS A case-control study was undertaken with 97 fHP patients and 112 controls. Six SNPs residing in the MUC5B and TOLLIP genes and their haplotypes were analyzed. Associations with risk, survival, and clinical, radiographic, and pathological features of fHP were probed through comparisons among patients and controls. RESULTS MUC5B rs35705950 and three neighboring TOLLIP variants (rs3750920, rs111521887, and rs5743894) were associated with increased susceptibility to fHP. Minor allele frequencies were greater among fHP patients than in controls (40.7% vs 12.1%, P<0.0001; 52.6% vs 40.2%, P = 0.011; 22.7% vs 13.4%, P = 0.013; and 23.2% vs 12.9%, P = 0.006, respectively). Haplotypes formed by these variants were also linked to fHP susceptibility. Moreover, carriers of a specific haplotype (G-T-G-C) had a significant decrease in survival (adjusted hazard ratio 6.92, 95% CI 1.73-27.64, P = 0.006). Additional associations were found between TOLLIP rs111521887 and rs5743894 variants and decreased lung function at baseline, and the MUC5B SNP and radiographic features, further highlighting the influence of genetic factors in fHP. CONCLUSION These findings suggest that TOLLIP and MUC5B variants and haplotypes may serve as valuable tools for risk assessment and prognosis in fibrotic hypersensitivity pneumonitis, potentially contributing to its patient stratification, and offer insights into the genetic factors influencing the clinical course of the condition.
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Affiliation(s)
- P C Mota
- Departamento de Pneumologia, Centro Hospitalar Universitário de São João, EPE, Porto, Portugal; Faculdade de Medicina da Universidade do Porto, Porto, Portugal; Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| | - M L Soares
- Laboratório de Apoio à Investigação em Medicina Molecular (LAIMM), Departamento de Biomedicina, Faculdade de Medicina da Universidade do Porto, Portugal; LAIMM, Núcleo de Recursos Laboratoriais, Unidade de Gestão de Conhecimento, Departamento de Recursos Comuns, Faculdade de Medicina da Universidade do Porto, Portugal; Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal.
| | - A C Ferreira
- Laboratório de Apoio à Investigação em Medicina Molecular (LAIMM), Departamento de Biomedicina, Faculdade de Medicina da Universidade do Porto, Portugal; Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| | - R F Santos
- Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal; Escola Superior de Saúde - Instituto Politécnico do Porto, Portugal
| | - J C Rufo
- Indoor Air Quality and Respiratory Health Lab, Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal; EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Center for Translational Health and Medical Biotechnology Research (T.Bio), Escola Superior de Saúde, Instituto Politécnico do Porto, Porto, Portugal
| | - D Vasconcelos
- Laboratório de Apoio à Investigação em Medicina Molecular (LAIMM), Departamento de Biomedicina, Faculdade de Medicina da Universidade do Porto, Portugal; Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| | - A Carvalho
- Faculdade de Medicina da Universidade do Porto, Porto, Portugal; Departamento de Radiologia, Centro Hospitalar Universitário de São João, EPE, Porto, Portugal
| | - S Guimarães
- Faculdade de Medicina da Universidade do Porto, Porto, Portugal; Departamento de Anatomia Patológica, Centro Hospitalar Universitário de São João, EPE, Porto, Portugal
| | - F Vasques-Nóvoa
- Faculdade de Medicina da Universidade do Porto, Porto, Portugal; Departamento de Medicina Interna, Centro Hospitalar Universitário de São João, EPE, Porto, Portugal; UnIC@RISE, Department of Surgery and Physiology, Portugal
| | - C Cardoso
- Departamento de Pneumologia, Centro Hospitalar Universitário de São João, EPE, Porto, Portugal; Faculdade de Medicina da Universidade do Porto, Porto, Portugal; Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| | - N Melo
- Departamento de Pneumologia, Centro Hospitalar Universitário de São João, EPE, Porto, Portugal
| | - A T Alexandre
- Departamento de Pneumologia, Centro Hospitalar Universitário de São João, EPE, Porto, Portugal
| | - D Coelho
- Departamento de Pneumologia, Centro Hospitalar Universitário de São João, EPE, Porto, Portugal; Faculdade de Medicina da Universidade do Porto, Porto, Portugal; Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| | - H Novais-Bastos
- Departamento de Pneumologia, Centro Hospitalar Universitário de São João, EPE, Porto, Portugal; Faculdade de Medicina da Universidade do Porto, Porto, Portugal; Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| | - A Morais
- Departamento de Pneumologia, Centro Hospitalar Universitário de São João, EPE, Porto, Portugal; Faculdade de Medicina da Universidade do Porto, Porto, Portugal; Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
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Morais A, Duarte AC, Fernandes MO, Borba A, Ruano C, Marques ID, Calha J, Branco JC, Pereira JM, Salvador MJ, Bernardes M, Khmelinskii N, Pinto P, Pinto-Basto R, Freitas S, Campainha S, Alfaro T, Cordeiro A. Early detection of interstitial lung disease in rheumatic diseases: A joint statement from the Portuguese Pulmonology Society, the Portuguese Rheumatology Society, and the Portuguese Radiology and Nuclear Medicine Society. Pulmonology 2023:S2531-0437(23)00205-2. [PMID: 38148269 DOI: 10.1016/j.pulmoe.2023.11.007] [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: 06/29/2023] [Revised: 10/23/2023] [Accepted: 11/24/2023] [Indexed: 12/28/2023] Open
Abstract
INTRODUCTION Interstitial lung disease (ILD) contributes significantly to morbidity and mortality in connective tissue disease (CTD). Early detection and accurate diagnosis are essential for informing treatment decisions and prognosis in this setting. Clear guidance on CTD-ILD screening, however, is lacking. OBJECTIVE To establish recommendations for CTD-ILD screening based on the current evidence. METHOD Following an extensive literature research and evaluation of articles selected for their recency and relevance to the characterization, screening, and management of CTD-ILD, an expert panel formed by six pulmonologists from the Portuguese Society of Pulmonology, six rheumatologists from the Portuguese Society of Rheumatology, and six radiologists from the Portuguese Society of Radiology and Nuclear Medicine participated in a multidisciplinary discussion to produce a joint statement on screening recommendations for ILD in CTD. RESULTS The expert panel achieved consensus on when and how to screen for ILD in patients with systemic sclerosis, rheumatoid arthritis, mixed connective tissue disease, Sjögren syndrome, idiopathic inflammatory myopathies and systemic lupus erythematous. CONCLUSIONS Despite the lack of data on screening for CTD-ILD, an expert panel of pulmonologists, rheumatologists and radiologists agreed on a series of screening recommendations to support decision-making and enable early diagnosis of ILD to ultimately improve outcomes and prognosis in patients with CTD.
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Affiliation(s)
- A Morais
- Pulmonology Department, Hospital de São João, Centro Hospitalar Universitário São João, Porto, Portugal; Faculty of Medicine, University of Porto, Porto, Portugal; i3S - Instituto de Biologia Molecular e Celular/Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal; Portuguese Pulmonology Society (SPP).
| | - A C Duarte
- Rheumatology Department, Hospital Garcia de Orta, Almada, Portugal; Portuguese Rheumatology Society (SPR)
| | - M O Fernandes
- Imaging Department, Hospital de Santa Marta, Centro Hospitalar e Universitário de Lisboa Central, Lisboa, Portugal; Imaging Department, Hospital da Luz Lisboa, Lisboa, Portugal; Portuguese Rheumatology Society (SPR); Portuguese Radiology and Nuclear Medicine Society (SPRMN)
| | - A Borba
- Pulmonology Department, Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central, Lisboa, Portugal; Portuguese Pulmonology Society (SPP)
| | - C Ruano
- Imaging Department, Hospital de Santa Marta, Centro Hospitalar e Universitário de Lisboa Central, Lisboa, Portugal; Imaging Department, Hospital da Luz Lisboa, Lisboa, Portugal; Portuguese Radiology and Nuclear Medicine Society (SPRMN)
| | - I D Marques
- Imaging Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal; Portuguese Radiology and Nuclear Medicine Society (SPRMN)
| | - J Calha
- Imaging Department, Hospital Beatriz Ângelo, Loures, Portugal; Imaging Department, Hospital da Luz Lisboa, Lisboa, Portugal; Portuguese Radiology and Nuclear Medicine Society (SPRMN)
| | - J C Branco
- Imaging Department, Hospital Beatriz Ângelo, Loures, Portugal; Imaging Department, Hospital da Luz Lisboa, Lisboa, Portugal; Portuguese Radiology and Nuclear Medicine Society (SPRMN)
| | - J M Pereira
- Imaging Department, Hospital de São João, Centro Hospitalar Universitário São João, Porto, Portugal; Imaging Department, Unilabs Portugal, Porto, Portugal; Portuguese Radiology and Nuclear Medicine Society (SPRMN)
| | - M J Salvador
- Rheumatology Department Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Portuguese Rheumatology Society (SPR)
| | - M Bernardes
- Department of Medicine, Faculty of Medicine, University of Porto, Porto, Portugal; Rheumatology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - N Khmelinskii
- Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Portugal; Rheumatology Research Unit, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon Academic Medical Centre, Lisboa, Portugal; Portuguese Rheumatology Society (SPR)
| | - P Pinto
- Rheumatology Department, Centro Hospitalar Vila Nova de Gaia/ Espinho, Vila Nova de Gaia, Portugal; Faculty of Medicine, University of Porto, Porto, Portugal; Portuguese Rheumatology Society (SPR)
| | - R Pinto-Basto
- Pulmonology Department, Hospital Pulido Valente, Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal; Portuguese Pulmonology Society (SPP)
| | - S Freitas
- Pulmonology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Portuguese Pulmonology Society (SPP)
| | - S Campainha
- Pulmonology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal; Portuguese Pulmonology Society (SPP)
| | - T Alfaro
- Pulmonology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Portuguese Pulmonology Society (SPP)
| | - A Cordeiro
- Rheumatology Department, Hospital Garcia de Orta, Almada, Portugal; Portuguese Rheumatology Society (SPR)
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Froes F, Timóteo A, Almeida B, Raposo JF, Oliveira J, Carrageta M, Duque S, Morais A. Influenza vaccination in older adults and patients with chronic disorders: A position paper from the Portuguese Society of Pulmonology, the Portuguese Society of Diabetology, the Portuguese Society of Cardiology, the Portuguese Society of Geriatrics and Gerontology, the Study Group of Geriatrics of the Portuguese Society of Internal Medicine, and the Portuguese Society of Infectious Diseases and Clinical Microbiology. Pulmonology 2023:S2531-0437(23)00201-5. [PMID: 38129238 DOI: 10.1016/j.pulmoe.2023.11.003] [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: 10/10/2023] [Revised: 11/14/2023] [Accepted: 11/14/2023] [Indexed: 12/23/2023] Open
Abstract
Influenza affects millions of people worldwide each year and can lead to severe complications, hospitalizations, and even death, especially among vulnerable populations such as older adults and those with chronic medical conditions. Annual vaccination is considered the most effective measure for preventing influenza and its complications. Despite the widespread availability of influenza vaccines, however, vaccination coverage rates remain suboptimal in several countries. Based on the latest scientific evidence and expert opinions on influenza vaccination in older people and patients with chronic disease, the Portuguese Society of Pulmonology (SPP), the Portuguese Society of Diabetology (SPD), the Portuguese Society of Cardiology (SPC), the Portuguese Society of Geriatrics and Gerontology (SPGG), the Study Group of Geriatrics of the Portuguese Society of Internal Medicine (NEGERMI-SPMI), and the Portuguese Society of Infectious Diseases and Clinical Microbiology (SPDIMC) discussed best practices for promoting vaccination uptake and coverage and drew up several recommendations to mitigate the impact of influenza. These recommendations focus on the efficacy and safety of available vaccines; the impact of influenza vaccination on older adults; patients with chronic medical conditions, namely cardiac and respiratory conditions, diabetes, and immunosuppressive diseases; and health care professionals, optimal vaccination timing, and strategies to increase vaccination uptake and coverage. The resulting position paper highlights the critical role that vaccinations play in promoting public health, raising awareness, and encouraging more people to get vaccinated.
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Affiliation(s)
- F Froes
- Torax Department, Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal; Portuguese Society of Pulmonology (SPP), Portugal
| | - A Timóteo
- Cardiology Department, Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central, Lisboa, Portugal; NOVA Medical School, Lisboa, Portugal; Portuguese Society of Cardiology (SPC), Portugal
| | - B Almeida
- APDP Diabetes, Lisbon, Portugal; Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal
| | - J F Raposo
- NOVA Medical School, Lisboa, Portugal; APDP Diabetes, Lisbon, Portugal; Portuguese Society of Diabetology (SPD), Portugal
| | - J Oliveira
- Infection Control and Prevention and Antimicrobial Resistance Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Portuguese Society of Infectious Diseases and Clinical Microbiology (SPDIMC), Portugal
| | - M Carrageta
- Institute of Preventive Cardiology, Almada, Portugal; Portuguese Society of Geriatrics and Gerontology (SPGG), Portugal
| | - S Duque
- Hospital CUF Descobertas, Lisboa, Portugal; Institute of Preventive Medicine and Public Health, Faculty of Medicine, University of Lisbon, Lisboa, Portugal; Study Group of Geriatrics of the Portuguese Society of Internal Medicine (NEGERMI-SPMI), Portugal
| | - A Morais
- Portuguese Society of Pulmonology (SPP), Portugal; Nova Medical School, Lisbon Faculty of Health Sciences, Universidade Nova de Lisboa, Lisboa, Portugal; Pulmonology Department, Hospital de São João, Centro Hospitalar Universitário São João, Porto, Portugal; Faculty of Medicine, University of Porto, Porto, Portugal; i3S - Instituto de Biologia Molecular e Celular, Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal.
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Freitas C, Lima B, Melo N, Mota P, Novais-Bastos H, Alves H, Sokhatska O, Delgado L, Morais A. Distinct TNF-alpha and HLA polymorphisms associate with fibrotic and non-fibrotic subtypes of hypersensitivity pneumonitis. Pulmonology 2023; 29 Suppl 4:S63-S69. [PMID: 34629327 DOI: 10.1016/j.pulmoe.2021.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 08/01/2021] [Accepted: 08/02/2021] [Indexed: 10/20/2022] Open
Abstract
INTRODUCTION Since Hypersensitivity Pneumonitis (HP) categorization in fibrotic and nonfibrotic/inflammatory types seems to be more consistent with the distinctive clinical course and outcomes, recent international guidelines recommended the use of this classification. Moreover, fibrotic subtype may share immunogenetic and pathophysiological mechanisms with other fibrotic lung diseases. AIM To investigate HLA -A, -B, -DRB1 and TNF-α -308 gene polymorphisms among fibrotic and nonfibrotic HP patients due to avian exposure, also in comparison with asymptomatic exposed controls. METHODS We prospectively enrolled 40 HP patients, classified as fibrotic or nonfibrotic/inflammatory, and 70 exposed controls. HLA and TNF-α polymorphisms were determined by polymerase chain reaction-sequence specific primer amplification. RESULTS While HLA alleles were not associated to HP susceptibility, fibrotic HP patients showed increased frequencies of HLA A*02 (46.7% vs 25.7%; OR=2.53, p = 0.02) and HLA DRB1*14 (10.0% vs 0.7%; OR=15.44, p=0.02) alleles when compared with exposed controls, although not statistically significant after correction for multiple comparisons. TNF-α G/G genotype (associated with low TNF-α production) frequencies were significantly increased among the non-fibrotic/inflammatory HP patients comparatively to fibrotic presentations (88% vs 60%; RR=0.44; p=0.04) and controls (88% vs 63%, OR 4.33, p=0.037). Also, these patients had a significantly increased frequency of the G allele (94.0% vs 73.3%, RR=0.44, p=0.01), while fibrotic HP patients predominantly presented the A allele (26.7% vs 6.0%, RR=2.28, p=0.01). CONCLUSIONS Our results support the hypothesis that fibrotic and non-fibrotic HP subtypes exhibit a distinct profile of TNF-α and HLA polymorphisms, which may be relevant to predict disease course and better define treatment strategies.
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Affiliation(s)
- C Freitas
- Pulmonology Department, Centro Hospitalar e Universitário de São João, Porto, Portugal; Department of Medicine, Faculty of Medicine, University of Porto, Portugal.
| | - B Lima
- Oficina de Bioestatística, Ermesinde, Portugal
| | - N Melo
- Pulmonology Department, Centro Hospitalar e Universitário de São João, Porto, Portugal
| | - P Mota
- Pulmonology Department, Centro Hospitalar e Universitário de São João, Porto, Portugal; Department of Medicine, Faculty of Medicine, University of Porto, Portugal
| | - H Novais-Bastos
- Pulmonology Department, Centro Hospitalar e Universitário de São João, Porto, Portugal; Department of Medicine, Faculty of Medicine, University of Porto, Portugal; Institute for Research and Innovation in Health (I3S), University of Porto, Portugal
| | - H Alves
- National Health Institute Doutor Ricardo Jorge, Porto, Portugal
| | - O Sokhatska
- Basic and Clinical Immunology, Department of Pathology, and Center for Health Technology and Services Research (CINTESIS@RISE), Faculty of Medicine, University of Porto, Portugal
| | - L Delgado
- Basic and Clinical Immunology, Department of Pathology, and Center for Health Technology and Services Research (CINTESIS@RISE), Faculty of Medicine, University of Porto, Portugal
| | - A Morais
- Pulmonology Department, Centro Hospitalar e Universitário de São João, Porto, Portugal; Department of Medicine, Faculty of Medicine, University of Porto, Portugal
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Morais A, Qin T, Ayata C, Harriott AM. Inhibition of persistent sodium current reduces spreading depression-evoked allodynia in a mouse model of migraine with aura. Pain 2023; 164:2564-2571. [PMID: 37318029 DOI: 10.1097/j.pain.0000000000002962] [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: 12/15/2022] [Accepted: 04/18/2023] [Indexed: 06/16/2023]
Abstract
ABSTRACT We investigated the efficacy of inhibiting persistent Na + currents (I NaP ) in acute rodent models of migraine with aura. Cortical spreading depression (SD) is a slow wave of neuronal and glial depolarization that underlies the migraine aura. Minimally invasive optogenetic SD (opto-SD) causes periorbital mechanical allodynia in mice, suggesting SD activates trigeminal nociceptors. Persistent Na + currents contribute to neuronal intrinsic excitability and have been implicated in peripheral and cortical excitation. We examined a preferential inhibitor of I NaP, GS-458967, on SD-induced periorbital allodynia, SD susceptibility, and formalin-induced peripheral pain. Periorbital mechanical allodynia was tested in male and female Thy1-ChR2-YFP mice after a single opto-SD event using manual von Frey monofilaments. GS-458967 (1 mg/kg, s.c.) or vehicle was dosed immediately after opto-SD induction, and allodynia was tested 1 hour later. The electrical SD threshold and KCl-induced SD frequency were examined in the cortex in male Sprague-Dawley rats after 1 hour pretreatment with GS-458967 (3 mg/kg, s.c.) or vehicle. Effects of GS-458967 (0.5-5 mg/kg, p.o.) on spontaneous formalin hind paw behavior and locomotion were also examined in male CD-1 mice. GS-458967 suppressed opto-SD-induced periorbital allodynia and decreased susceptibility to SD. GS-458967 also diminished early and late phase formalin-induced paw-licking behavior with early phase paw licking responding to lower doses. GS-458967 up to 3 mg/kg had no impact on locomotor activity. These data provide evidence that I NaP inhibition can reduce opto-SD-induced trigeminal pain behavior and support I NaP inhibition as an antinociceptive strategy for both abortive and preventive treatment of migraine.
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Affiliation(s)
- Andreia Morais
- Neurovascular Research Unit, Department of Radiology, Massachusetts General Hospital, Boston, MA, United States
| | - Tao Qin
- Neurovascular Research Unit, Department of Radiology, Massachusetts General Hospital, Boston, MA, United States
| | - Cenk Ayata
- Neurovascular Research Unit, Department of Radiology, Massachusetts General Hospital, Boston, MA, United States
- Department of Neurology, Massachusetts General Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| | - Andrea M Harriott
- Neurovascular Research Unit, Department of Radiology, Massachusetts General Hospital, Boston, MA, United States
- Department of Neurology, Massachusetts General Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
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Fischer P, Tamim I, Sugimoto K, Morais A, Imai T, Takizawa T, Qin T, Schlunk F, Endres M, Yaseen MA, Chung DY, Sakadzic S, Ayata C. Spreading Depolarizations Suppress Hematoma Growth in Hyperacute Intracerebral Hemorrhage in Mice. Stroke 2023; 54:2640-2651. [PMID: 37610105 PMCID: PMC10530404 DOI: 10.1161/strokeaha.123.042632] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 08/02/2023] [Indexed: 08/24/2023]
Abstract
BACKGROUND Spreading depolarizations (SDs) occur in all types of brain injury and may be associated with detrimental effects in ischemic stroke and subarachnoid hemorrhage. While rapid hematoma growth during intracerebral hemorrhage triggers SDs, their role in intracerebral hemorrhage is unknown. METHODS We used intrinsic optical signal and laser speckle imaging, combined with electrocorticography, to investigate the effects of SD on hematoma growth during the hyperacute phase (0-4 hours) after intracortical collagenase injection in mice. Hematoma expansion, SDs, and cerebral blood flow were simultaneously monitored under normotensive and hypertensive conditions. RESULTS Spontaneous SDs erupted from the vicinity of the hematoma during rapid hematoma growth. We found that hematoma growth slowed down by >60% immediately after an SD. This effect was even stronger in hypertensive animals with faster hematoma growth. To establish causation, we exogenously induced SDs (every 30 minutes) at a remote site by topical potassium chloride application and found reduced hematoma growth rate and final hemorrhage volume (18.2±5.8 versus 10.7±4.1 mm3). Analysis of cerebral blood flow using laser speckle flowmetry revealed that suppression of hematoma growth by spontaneous or induced SDs coincided and correlated with the characteristic oligemia in the wake of SD, implicating the vasoconstrictive effect of SD as one potential mechanism of action. CONCLUSIONS Our findings reveal that SDs limit hematoma growth during the early hours of intracerebral hemorrhage and decrease final hematoma volume.
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Affiliation(s)
- Paul Fischer
- Neurovascular Research Unit, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, 02129 Massachusetts, USA
- Klinik und Hochschulambulanz für Neurologie, Charité Universitätsmedizin Berlin, NeuroCure Excellence Cluster and Center for Stroke Research, 10117 Berlin, Germany
| | - Isra Tamim
- Neurovascular Research Unit, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, 02129 Massachusetts, USA
- Klinik und Hochschulambulanz für Neurologie, Charité Universitätsmedizin Berlin, NeuroCure Excellence Cluster and Center for Stroke Research, 10117 Berlin, Germany
| | - Kazutaka Sugimoto
- Neurovascular Research Unit, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, 02129 Massachusetts, USA
| | - Andreia Morais
- Neurovascular Research Unit, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, 02129 Massachusetts, USA
| | - Takahiko Imai
- Neurovascular Research Unit, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, 02129 Massachusetts, USA
| | - Tsubasa Takizawa
- Neurovascular Research Unit, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, 02129 Massachusetts, USA
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
| | - Tao Qin
- Neurovascular Research Unit, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, 02129 Massachusetts, USA
| | - Frieder Schlunk
- Department of Neuroradiology, Charité Universitätsmedizin Berlin, 10117 Berlin, Germany
| | - Matthias Endres
- Klinik und Hochschulambulanz für Neurologie, Charité Universitätsmedizin Berlin, NeuroCure Excellence Cluster and Center for Stroke Research, 10117 Berlin, Germany
- German Center for Neurodegenerative Diseases (DZNE), partner site 10117 Berlin, Germany
- German Centre for Cardiovascular Research (DZHK), partner site 10117 Berlin, Germany
| | - Mohammad A. Yaseen
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, 02129 Massachusetts, USA
| | - David Y. Chung
- Neurovascular Research Unit, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, 02129 Massachusetts, USA
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, 02114 Massachusetts, USA
| | - Sava Sakadzic
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, 02129 Massachusetts, USA
| | - Cenk Ayata
- Neurovascular Research Unit, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, 02129 Massachusetts, USA
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, 02114 Massachusetts, USA
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8
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Lyden PD, Diniz MA, Bosetti F, Lamb J, Nagarkatti KA, Rogatko A, Kim S, Cabeen RP, Koenig JI, Akhter K, Arbab AS, Avery BD, Beatty HE, Bibic A, Cao S, Simoes Braga Boisserand L, Chamorro A, Chauhan A, Diaz-Perez S, Dhandapani K, Dhanesha N, Goh A, Herman AL, Hyder F, Imai T, Johnson CW, Khan MB, Kamat P, Karuppagounder SS, Kumskova M, Mihailovic JM, Mandeville JB, Morais A, Patel RB, Sanganahalli BG, Smith C, Shi Y, Sutariya B, Thedens D, Qin T, Velazquez SE, Aronowski J, Ayata C, Chauhan AK, Leira EC, Hess DC, Koehler RC, McCullough LD, Sansing LH. A multi-laboratory preclinical trial in rodents to assess treatment candidates for acute ischemic stroke. Sci Transl Med 2023; 15:eadg8656. [PMID: 37729432 DOI: 10.1126/scitranslmed.adg8656] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 08/31/2023] [Indexed: 09/22/2023]
Abstract
Human diseases may be modeled in animals to allow preclinical assessment of putative new clinical interventions. Recent, highly publicized failures of large clinical trials called into question the rigor, design, and value of preclinical assessment. We established the Stroke Preclinical Assessment Network (SPAN) to design and implement a randomized, controlled, blinded, multi-laboratory trial for the rigorous assessment of candidate stroke treatments combined with intravascular thrombectomy. Efficacy and futility boundaries in a multi-arm multi-stage statistical design aimed to exclude from further study highly effective or futile interventions after each of four sequential stages. Six independent research laboratories performed a standard focal cerebral ischemic insult in five animal models that included equal numbers of males and females: young mice, young rats, aging mice, mice with diet-induced obesity, and spontaneously hypertensive rats. The laboratories adhered to a common protocol and efficiently enrolled 2615 animals with full data completion and comprehensive animal tracking. SPAN successfully implemented treatment masking, randomization, prerandomization inclusion and exclusion criteria, and blinded assessment of outcomes. The SPAN design and infrastructure provide an effective approach that could be used in similar preclinical, multi-laboratory studies in other disease areas and should help improve reproducibility in translational science.
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Affiliation(s)
- Patrick D Lyden
- Department of Physiology and Neuroscience, Zilkha Neurogenetic Institute, Keck School of Medicine of USC, Los Angeles, CA 90033, USA
- Department of Neurology, Keck School of Medicine of USC, Los Angeles, CA 90033, USA
| | - Márcio A Diniz
- Biostatistics and Bioinformatics Research Center, Samuel Oschin Comprehensive Cancer Center, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Francesca Bosetti
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892, USA
| | - Jessica Lamb
- Department of Physiology and Neuroscience, Zilkha Neurogenetic Institute, Keck School of Medicine of USC, Los Angeles, CA 90033, USA
| | - Karisma A Nagarkatti
- Department of Physiology and Neuroscience, Zilkha Neurogenetic Institute, Keck School of Medicine of USC, Los Angeles, CA 90033, USA
| | - André Rogatko
- Biostatistics and Bioinformatics Research Center, Samuel Oschin Comprehensive Cancer Center, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Sungjin Kim
- Biostatistics and Bioinformatics Research Center, Samuel Oschin Comprehensive Cancer Center, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Ryan P Cabeen
- Laboratory of Neuro Imaging, USC Mark and Mary Stevens Imaging and Informatics Institute, Keck School of Medicine of USC, Los Angeles, CA 90033, USA
| | - James I Koenig
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892, USA
| | - Kazi Akhter
- Department of Radiology, Johns Hopkins University, Baltimore, MD 21218-2625, USA
| | - Ali S Arbab
- Biochemistry and Molecular Biology, Medical College of Georgia, Augusta University, Augusta, GA 30912-0004, USA
| | - Brooklyn D Avery
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, MD 21218-2625, USA
| | - Hannah E Beatty
- Department of Neurology, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Adnan Bibic
- Department of Radiology, Johns Hopkins University, Baltimore, MD 21218-2625, USA
| | - Suyi Cao
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, MD 21218-2625, USA
| | | | - Angel Chamorro
- Department of Neurology, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
- Department of Neurology, Hospital Clinic, University of Barcelona, Barcelona 08036, Spain
| | - Anjali Chauhan
- Department of Neurology, McGovern Medical School, University of Texas HSC, Houston, TX 77030, USA
| | - Sebastian Diaz-Perez
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Krishnan Dhandapani
- Department Neurosurgery, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - Nirav Dhanesha
- Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - Andrew Goh
- Department of Neurology, McGovern Medical School, University of Texas HSC, Houston, TX 77030, USA
| | - Alison L Herman
- Department of Neurology, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Fahmeed Hyder
- Department of Radiology and Biomedical Imaging, Yale University, New Haven, CT 06520, USA
- Department of Biomedical Engineering, Yale University, New Haven, CT 06520, USA
| | - Takahiko Imai
- Department of Radiology, Harvard Medical School, Massachusetts General Hospital, Charlestown, MA 02129, USA
| | - Conor W Johnson
- Department of Neurology, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Mohammad B Khan
- Department of Neurology, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - Pradip Kamat
- Department of Neurology, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | | | - Mariia Kumskova
- Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - Jelena M Mihailovic
- Department of Radiology and Biomedical Imaging, Yale University, New Haven, CT 06520, USA
| | - Joseph B Mandeville
- Department of Radiology, Harvard Medical School, Massachusetts General Hospital, Charlestown, MA 02129, USA
| | - Andreia Morais
- Department of Radiology, Harvard Medical School, Massachusetts General Hospital, Charlestown, MA 02129, USA
| | - Rakesh B Patel
- Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
| | | | - Cameron Smith
- Department of Neurology, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - Yanrong Shi
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, MD 21218-2625, USA
| | - Brijesh Sutariya
- Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - Daniel Thedens
- Department of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - Tao Qin
- Department of Radiology, Harvard Medical School, Massachusetts General Hospital, Charlestown, MA 02129, USA
| | - Sofia E Velazquez
- Department of Neurology, Yale University School of Medicine, New Haven, CT 06520, USA
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Jaroslaw Aronowski
- Department of Neurology, McGovern Medical School, University of Texas HSC, Houston, TX 77030, USA
| | - Cenk Ayata
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Anil K Chauhan
- Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - Enrique C Leira
- Department of Neurology, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
- Department of Neurosurgery, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA 52242, USA
| | - David C Hess
- Department of Neurology, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - Raymond C Koehler
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, MD 21218-2625, USA
| | - Louise D McCullough
- Department of Neurology, McGovern Medical School, University of Texas HSC, Houston, TX 77030, USA
| | - Lauren H Sansing
- Department of Neurology, Yale University School of Medicine, New Haven, CT 06520, USA
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT 06520, USA
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9
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Harriott AM, Waruinge A, Appiah-Danquah V, Berhanu L, Morais A, Ayata C. The effect of sex and estrus cycle stage on optogenetic spreading depression induced migraine-like pain phenotypes. J Headache Pain 2023; 24:85. [PMID: 37464297 PMCID: PMC10355061 DOI: 10.1186/s10194-023-01621-1] [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: 05/08/2023] [Accepted: 06/26/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Migraine is more prevalent in females, raising the possibility that sex and gonadal hormones modulate migraine. We recently demonstrated that minimally invasive optogenetic spreading depolarization (opto-SD) elicits robust periorbital allodynia. The objective of this study was to test the hypothesis that opto-SD induced migraine-like pain behavior is worse in females and varies during the estrus cycle. METHODS Single or repeated opto-SDs were induced in male and female adult Thy1-ChR2-YFP transgenic mice. Von Frey monofilaments were used to test periorbital mechanical allodynia. Mouse grimace was also examined under increasing light intensity to quantify spontaneous discomfort and light-aversive behavior. Vaginal smears were obtained for estrus cycle staging at the end of behavioral testing. RESULTS A multi-variable regression analysis was performed using a male and female cohort to test the effect of independent variables on periorbital allodynia. Opto-SD predicted lower periorbital thresholds as compared with sham stimulation (p < 0.0001). Additionally, female sex predicted lower periorbital thresholds compared with males (p = 0.011). There were significant interactions between opto-SD and time (interaction p = 0.030) as animals tended to recover from opto-SD allodynia over time, and between sex and time (p = 0.020) as females tended to take longer to recover. Proestrus, estrus (PE) and metestrus, diestrus (MD) stages were combined to represent high versus low circulating estradiol relative to progesterone, respectively. Multi-variable regression revealed an effect of estrus cycle (p = 0.015) on periorbital thresholds. In the sham group, PE had lower thresholds than MD. However, there was no interaction between opto-SD and the estrus cycle (p = 0.364). Grimace scores were also examined at incremental light intensities. There was an effect of opto-SD (p < 0.0001), light intensity (p = 0.001) and estrus cycle (p = 0.024) on grimace without interaction among them (three-way ANOVA). CONCLUSIONS Female sex and estrus stages with high circulating estradiol relative to progesterone lower trigeminal pain thresholds and augment photosensitivity. In females, opto-SD increased pain behavior and photosensitivity irrespective of the estrus stage.
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Affiliation(s)
- Andrea M Harriott
- Neurovascular Research Laboratory, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.
- Department of Neurology, Neurovascular Research Laboratory, Massachusetts General Hospital, Boston, MA, USA.
| | | | | | - Leah Berhanu
- Cambridge Rindge and Latin School, Boston, MA, USA
| | - Andreia Morais
- Neurovascular Research Laboratory, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Cenk Ayata
- Neurovascular Research Laboratory, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
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10
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Trindade A, Dias S, Morais A. A curious manifestation of mechanical tension theory in idiopathic pulmonary fibrosis. Pulmonology 2023; 29:170-172. [PMID: 35963830 DOI: 10.1016/j.pulmoe.2022.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/19/2022] [Accepted: 06/20/2022] [Indexed: 11/21/2022] Open
Affiliation(s)
- A Trindade
- Pulmonology Department, Hospital Professor Doutor Fernando Fonseca, Lisboa, Portugal.
| | - S Dias
- Pulmonology Department, Hospital Pedro Hispano, Porto, Portugal
| | - A Morais
- Pulmonology Department - Centro Hospitalar Universitário de São João, Porto, Portugal; Faculdade de Medicina da Universidade do Porto, Portugal; i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Portugal
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11
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Morais A, Locascio JJ, Sansing LH, Lamb J, Nagarkatti K, Imai T, van Leyen K, Aronowski J, Koenig JI, Bosetti F, Lyden P, Ayata C. Embracing Heterogeneity in The Multicenter Stroke Preclinical Assessment Network (SPAN) Trial. Stroke 2023; 54:620-631. [PMID: 36601951 PMCID: PMC9870939 DOI: 10.1161/strokeaha.122.040638] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [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] [Indexed: 01/06/2023]
Abstract
The Stroke Preclinical Assessment Network (SPAN) is a multicenter preclinical trial platform using rodent models of transient focal cerebral ischemia to address translational failure in experimental stroke. In addition to centralized randomization and blinding and large samples, SPAN aimed to introduce heterogeneity to simulate the heterogeneity embodied in clinical trials for robust conclusions. Here, we report the heterogeneity introduced by allowing the 6 SPAN laboratories to vary most of the biological and experimental model variables and the impact of this heterogeneity on middle cerebral artery occlusion (MCAo) performance. We included the modified intention-to-treat population of the control mouse cohort of the first SPAN trial (n=421) and examined the biological and procedural independent variables and their covariance. We then determined their impact on the dependent variables cerebral blood flow drop during MCAo, time to achieve MCAo, and total anesthesia duration using multivariable analyses. We found heterogeneity in biological and procedural independent variables introduced mainly by the site. Consequently, all dependent variables also showed heterogeneity among the sites. Multivariable analyses with the site as a random effect variable revealed filament choice as an independent predictor of cerebral blood flow drop after MCAo. Comorbidity, sex, use of laser Doppler flow to monitor cerebral blood flow, days after trial onset, and maintaining anesthesia throughout the MCAo emerged as independent predictors of time to MCAo. Total anesthesia duration was predicted by most independent variables. We present with high granularity the heterogeneity introduced by the biological and model selections by the testing sites in the first trial of cerebroprotection in rodent transient filament MCAo by SPAN. Rather than trying to homogenize all variables across all sites, we embraced the heterogeneity to better approximate clinical trials. Awareness of the heterogeneity, its sources, and how it impacts the study performance may further improve the study design and statistical modeling for future multicenter preclinical trials.
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Affiliation(s)
- Andreia Morais
- Department of Radiology, Harvard Medical School, Massachusetts General Hospital, Charlestown, MA, USA
| | - Joseph J. Locascio
- Department of Biostatistics, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
| | - Lauren H. Sansing
- Department of Neurology, Yale University School of Medicine, New Haven, CT USA
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT USA
| | - Jessica Lamb
- Department of Physiology and Neuroscience, Zilkha Neurogenetic Institute, Los Angeles, CA USA
| | - Karisma Nagarkatti
- Department of Physiology and Neuroscience, Zilkha Neurogenetic Institute, Los Angeles, CA USA
| | - Takahiko Imai
- Department of Radiology, Harvard Medical School, Massachusetts General Hospital, Charlestown, MA, USA
| | - Klaus van Leyen
- Department of Radiology, Harvard Medical School, Massachusetts General Hospital, Charlestown, MA, USA
| | - Jaroslaw Aronowski
- Department of Neurology, McGovern Medical School, University of Texas HSC, Houston, TX, USA
| | - James I. Koenig
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD USA
| | - Francesca Bosetti
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD USA
| | - Patrick Lyden
- Department of Physiology and Neuroscience, Zilkha Neurogenetic Institute, Los Angeles, CA USA
- Department of Neurology, Keck School of Medicine at USC, Los Angeles, CA USA
| | - Cenk Ayata
- Department of Radiology, Harvard Medical School, Massachusetts General Hospital, Charlestown, MA, USA
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
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12
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Moita J, Brito U, Rodrigues C, Ferreira L, Vieira JR, Catarino A, Morais A, Hespanhol V, Cordeiro CR. Chronic obstructive pulmonary disease exacerbations' management in Portuguese hospitals - EvaluateCOPDpt, a multicentre, observational, prospective study. Pulmonology 2022:S2531-0437(22)00155-6. [PMID: 36115826 DOI: 10.1016/j.pulmoe.2022.07.007] [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: 02/25/2022] [Revised: 07/15/2022] [Accepted: 07/16/2022] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION AND OBJECTIVES In order to improve the quality of chronic obstructive pulmonary disease (COPD) patients' care, better knowledge of clinical practice and the factors associated with patient outcomes are needed. This study aimed to evaluate the relation between clinical practice and the outcomes of patients admitted for COPD exacerbations in Portuguese hospitals. MATERIALS AND METHODS Observational, multicentre, prospective study with a 60-days follow-up period, in 11 hospitals, including patients aged ≥ 30 years, admitted to hospital for at least 24 hours due to an acute exacerbation of COPD. Demographic and clinical data were collected, including sex, age, smoking habits, hospitalisations, pulmonary function, comorbidities, COPD symptoms, and treatment. Sixty days after discharge, COPD exacerbations management, outcome measures, and readmission data were evaluated through a structured phone follow-up interview. RESULTS 196 patients were included (85.7% male, mean age 71.2 years), the majority admitted through the emergency service. Ex-smokers and current smokers accounted for 51% and 36%, respectively. On admission, 72.4% were on LAMA, 54.6% on LABA, and 45.5% were on LABA/LAMA. Inhaled corticosteroids (ICS) were used in 37.3% and systemic steroids (SCS) in 10.3%. 35.7 % had had at least one exacerbation, with hospitalisation, in the previous year. There was no spirometry data for 23.2%. On hospitalisation, 98.5% of patients were treated with oxygen and 38.3% with non-invasive ventilation. Additionally, 93.4% used SCS and 60.2% ICS. Antibiotics were administered to 85.2%. 95.4% of patients were discharged; 9 died, 5 of whom had a COPD-related death. The median length of stay was 12 days for discharged patients and 33 days for patients who died. At discharge, 79.1% were prescribed with LAMA, 63.6% SCS, 61.5% LABA and 55.6% LAMA+LABA. 26,2% were prescribed with ICS+LABA+LAMA. At follow-up, 44.4% had a scheduled medical appointment within the 60 days after being discharged, and 28.3% were later readmitted due to exacerbation, of whom 52.8% were hospitalised. CONCLUSIONS The severity of COPD, particularly in exacerbations, is directly related to impaired lung function and quality of life, mortality, and significant health system costs. Knowledge about COPD exacerbations' management in acute hospital admissions in Portugal may help stimulate a national discussion and review of existing data to engage clinicians, policymakers, managers, and patients, raising awareness and promoting action on COPD.
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Affiliation(s)
- J Moita
- Pulmonology Unit, Coimbra Hospital and University Centre, Coimbra, Portugal.
| | - U Brito
- Pulmonology Unit, Algarve Hospital and University Centre, Faro, Portugal
| | - C Rodrigues
- Pulmonology Unit, Coimbra Hospital and University Centre, Coimbra, Portugal
| | - L Ferreira
- Pulmonology Unit, Sousa Martins Hospital, Guarda, Portugal
| | - J R Vieira
- Pulmonology Unit, Garcia de Orta Hospital, Almada, Portugal
| | - A Catarino
- Pulmonology Unit, Coimbra Hospital and University Centre, Coimbra, Portugal
| | - A Morais
- Pulmonology Unit, São João Hospital and University Centre, Porto, Portugal
| | - V Hespanhol
- Pulmonology Unit, São João Hospital and University Centre, Porto, Portugal
| | - C R Cordeiro
- University Clinic of Pulmonology, Faculty of Medicine, University of Coimbra, Portugal; Clinical Academic Centre of Coimbra, Portugal
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13
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Aykan SA, Xie H, Zheng Y, Chung DY, Kura S, Han Lai J, Erdogan TD, Morais A, Tamim I, Yagmur D, Ishikawa H, Arai K, Abbas Yaseen M, Boas DA, Sakadzic S, Ayata C. Rho-Kinase Inhibition Improves the Outcome of Focal Subcortical White Matter Lesions. Stroke 2022; 53:2369-2376. [PMID: 35656825 DOI: 10.1161/strokeaha.121.037358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Subcortical white matter lesions are exceedingly common in cerebral small vessel disease and lead to significant cumulative disability without an available treatment. Here, we tested a rho-kinase inhibitor on functional recovery after focal white matter injury. METHODS A focal corpus callosum lesion was induced by stereotactic injection of N5-(1-iminoethyl)-L-ornithine in mice. Fasudil (10 mg/kg) or vehicle was administered daily for 2 weeks, starting one day after lesion induction. Resting-state functional connectivity and grid walk performance were studied longitudinally, and lesion volumes were determined at one month. RESULTS Resting-state interhemispheric functional connectivity significantly recovered between days 1 and 14 in the fasudil group (P<0.001), despite worse initial connectivity loss than vehicle before treatment onset. Grid walk test revealed an increased number of foot faults in the vehicle group compared with baseline, which persisted for at least 4 weeks. In contrast, the fasudil arm did not show an increase in foot faults and had smaller lesions at 4 weeks. Immunohistochemical examination of reactive astrocytosis, synaptic density, and mature oligodendrocytes did not reveal a significant difference between treatment arms. CONCLUSIONS These data show that delayed fasudil posttreatment improves functional outcomes after a focal subcortical white matter lesion in mice. Future work will aim to elucidate the mechanisms.
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Affiliation(s)
- Sanem A Aykan
- Neurovascular Research Unit, Department of Radiology, Massachusetts General Hospital, Charlestown (S.A.A., H.X., Y.Z., D.Y.C., J.H.L., T.D.E., A.M., I.T., D.Y., C.A.)
| | - Hongyu Xie
- Neurovascular Research Unit, Department of Radiology, Massachusetts General Hospital, Charlestown (S.A.A., H.X., Y.Z., D.Y.C., J.H.L., T.D.E., A.M., I.T., D.Y., C.A.).,Department of Rehabilitation, Huashan Hospital, Fudan University, Shanghai, China (H.X.)
| | - Yi Zheng
- Neurovascular Research Unit, Department of Radiology, Massachusetts General Hospital, Charlestown (S.A.A., H.X., Y.Z., D.Y.C., J.H.L., T.D.E., A.M., I.T., D.Y., C.A.)
| | - David Y Chung
- Neurovascular Research Unit, Department of Radiology, Massachusetts General Hospital, Charlestown (S.A.A., H.X., Y.Z., D.Y.C., J.H.L., T.D.E., A.M., I.T., D.Y., C.A.).,Stroke Service, Department of Neurology, Massachusetts General Hospital, Charlestown, MA. (C.A., D.Y.C.)
| | - Sreekanth Kura
- Neurophotonics Center, Department of Biomedical Engineering, Boston University, MA (S.K., D.A.B.)
| | - James Han Lai
- Neurovascular Research Unit, Department of Radiology, Massachusetts General Hospital, Charlestown (S.A.A., H.X., Y.Z., D.Y.C., J.H.L., T.D.E., A.M., I.T., D.Y., C.A.)
| | - Taylan D Erdogan
- Neurovascular Research Unit, Department of Radiology, Massachusetts General Hospital, Charlestown (S.A.A., H.X., Y.Z., D.Y.C., J.H.L., T.D.E., A.M., I.T., D.Y., C.A.)
| | - Andreia Morais
- Neurovascular Research Unit, Department of Radiology, Massachusetts General Hospital, Charlestown (S.A.A., H.X., Y.Z., D.Y.C., J.H.L., T.D.E., A.M., I.T., D.Y., C.A.)
| | - Isra Tamim
- Neurovascular Research Unit, Department of Radiology, Massachusetts General Hospital, Charlestown (S.A.A., H.X., Y.Z., D.Y.C., J.H.L., T.D.E., A.M., I.T., D.Y., C.A.)
| | - Damla Yagmur
- Neurovascular Research Unit, Department of Radiology, Massachusetts General Hospital, Charlestown (S.A.A., H.X., Y.Z., D.Y.C., J.H.L., T.D.E., A.M., I.T., D.Y., C.A.)
| | - Hidehiro Ishikawa
- Neuroprotection Research Laboratory, Department of Radiology and Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown. (H.I., K.A.)
| | - Ken Arai
- Neuroprotection Research Laboratory, Department of Radiology and Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown. (H.I., K.A.)
| | - M Abbas Yaseen
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA. (D.A.B., M.A.Y., S.S.)
| | - David A Boas
- Neurophotonics Center, Department of Biomedical Engineering, Boston University, MA (S.K., D.A.B.).,Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA. (D.A.B., M.A.Y., S.S.)
| | - Sava Sakadzic
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA. (D.A.B., M.A.Y., S.S.)
| | - Cenk Ayata
- Neurovascular Research Unit, Department of Radiology, Massachusetts General Hospital, Charlestown (S.A.A., H.X., Y.Z., D.Y.C., J.H.L., T.D.E., A.M., I.T., D.Y., C.A.).,Stroke Service, Department of Neurology, Massachusetts General Hospital, Charlestown, MA. (C.A., D.Y.C.)
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14
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Cruz S, Cunha E Costa N, Morais A, Mendonça M, Trindade R, Xavier S. Paliperidone palmitate-induced enuresis: a case report. Eur Psychiatry 2022. [PMCID: PMC9567155 DOI: 10.1192/j.eurpsy.2022.2063] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Schizophrenia is a severe mental illness that requires long-term treatment with antipsychotics and the intramuscular (IM) long-acting injectable (LAI) formulations may enhance treatment adherence. Some antipsychotics have been associated with enuresis, including atypical antipsychotics such as risperidone(6.2%), quetiapine(6.7%), olanzapine (9.6% ) and clozapine (20.7%) [1]. Although oral paliperidone has been related to urinary incontinence, there is only 1 report of urinary incontinence linked to monthly paliperidone palmitate [2]. [1] Harrison-Woolrych, M., Skegg, K., Ashton, J., Herbison, P., Skegg, D.C., 2011. Nocturnal enuresis in patients taking clozapine, risperidone, olanzapine and quetiapine: comparative cohort study. British Journal of Psychiatry 199, 140–144. doi:10.1192/bjp.bp.110.087478 [2] Karslıoǧlu, E.H., Özalp, E., Çayköylü, A., 2016. Paliperidone Palmitate-induced Urinary Incontinence: A Case Report. Clinical Psychopharmacology and Neuroscience 14, 96–100. doi:10.9758/cpn.2016.14.1.96 Objectives To establish an association between paliperidone palmitate and enuresis. Methods Case report and a narrative review of the literature. Results The patient was a 25-year-old healthy man when he was diagnosed with schizophrenia. Doctors prescribed paliperidone palmitate (LAI) 200mg monthly and he started to complain of enuresis. He was clearly suffering with this unpleasant and embarrassing adverse effect so the LAI was reduced to 150mg. Enuresis remained, so it was prescribed oxybutynin 20 mg/day and the patient improved. Conclusions We reported a case in which enuresis is likely to be associated with high-dose paliperidone LAI (with no clinical evidence of an organic cause). To treat it, the most effective strategy was oxybutynin 20 mg/day. This case is also important to show the impact of this symptom, which is not actively investigated. Disclosure No significant relationships.
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Lyden PD, Bosetti F, Diniz MA, Rogatko A, Koenig JI, Lamb J, Nagarkatti KA, Cabeen RP, Hess DC, Kamat P, Khan MB, Wood K, Dhandapani K, Arbab AS, Leira EC, Chauhan AK, Dhanesha N, Patel RB, Kumskova M, Thedens D, Morais A, Imai T, Qin T, Ayata C, Boisserand LSB, Herman AL, Beatty HE, Velazquez SE, Diaz-Perez S, Sanganahalli BG, Mihailovic JM, Hyder F, Sansing LH, Koehler RC, Lannon S, Shi Y, Karuppagounder SS, Bibic A, Akhter K, Aronowski J, McCullough LD, Chauhan A, Goh A. The Stroke Preclinical Assessment Network: Rationale, Design, Feasibility, and Stage 1 Results. Stroke 2022; 53:1802-1812. [PMID: 35354299 PMCID: PMC9038686 DOI: 10.1161/strokeaha.121.038047] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [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: 11/23/2021] [Accepted: 01/26/2022] [Indexed: 12/12/2022]
Abstract
Cerebral ischemia and reperfusion initiate cellular events in brain that lead to neurological disability. Investigating these cellular events provides ample targets for developing new treatments. Despite considerable work, no such therapy has translated into successful stroke treatment. Among other issues-such as incomplete mechanistic knowledge and faulty clinical trial design-a key contributor to prior translational failures may be insufficient scientific rigor during preclinical assessment: nonblinded outcome assessment; missing randomization; inappropriate sample sizes; and preclinical assessments in young male animals that ignore relevant biological variables, such as age, sex, and relevant comorbid diseases. Promising results are rarely replicated in multiple laboratories. We sought to address some of these issues with rigorous assessment of candidate treatments across 6 independent research laboratories. The Stroke Preclinical Assessment Network (SPAN) implements state-of-the-art experimental design to test the hypothesis that rigorous preclinical assessment can successfully reduce or eliminate common sources of bias in choosing treatments for evaluation in clinical studies. SPAN is a randomized, placebo-controlled, blinded, multilaboratory trial using a multi-arm multi-stage protocol to select one or more putative stroke treatments with an implied high likelihood of success in human clinical stroke trials. The first stage of SPAN implemented procedural standardization and experimental rigor. All participating research laboratories performed middle cerebral artery occlusion surgery adhering to a common protocol and rapidly enrolled 913 mice in the first of 4 planned stages with excellent protocol adherence, remarkable data completion and low rates of subject loss. SPAN stage 1 successfully implemented treatment masking, randomization, prerandomization inclusion/exclusion criteria, and blinded assessment to exclude bias. Our data suggest that a large, multilaboratory, preclinical assessment effort to reduce known sources of bias is feasible and practical. Subsequent SPAN stages will evaluate candidate treatments for potential success in future stroke clinical trials using aged animals and animals with comorbid conditions.
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Affiliation(s)
- Patrick D. Lyden
- Department of Physiology and Neuroscience, Zilkha Neurogenetic Institute, Keck School of Medicine at USC; Los Angeles, CA USA
- Department of Neurology, Keck School of Medicine at USC; Los Angeles, CA USA
| | - Francesca Bosetti
- National Institute of Neurological Disorders and Stroke, National Institutes of Health; Bethesda, MD USA
| | - Márcio A. Diniz
- Biostatistics and Bioinformatics Research Center, Samuel Oschin Comprehensive Cancer Center, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - André Rogatko
- Biostatistics and Bioinformatics Research Center, Samuel Oschin Comprehensive Cancer Center, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - James I. Koenig
- National Institute of Neurological Disorders and Stroke, National Institutes of Health; Bethesda, MD USA
| | - Jessica Lamb
- Department of Physiology and Neuroscience, Zilkha Neurogenetic Institute, Keck School of Medicine at USC; Los Angeles, CA USA
| | - Karisma A. Nagarkatti
- Department of Physiology and Neuroscience, Zilkha Neurogenetic Institute, Keck School of Medicine at USC; Los Angeles, CA USA
| | - Ryan P. Cabeen
- Laboratory of Neuro Imaging, USC Mark and Mary Stevens Imaging and Informatics Institute, Keck School of Medicine of USC; Los Angeles, CA USA
| | - David C. Hess
- Department of Neurology, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Pradip Kamat
- Department of Neurology, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Mohammad B. Khan
- Department of Neurology, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Kristofer Wood
- Department of Neurology, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Krishnan Dhandapani
- Department of Neurosurgery, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Ali S. Arbab
- Department of Biochemistry and Molecular Biology, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Enrique C. Leira
- Department of Neurology, Carver College of Medicine, College of Public Health, University of Iowa
- Department of Neurosurgery, Carver College of Medicine, College of Public Health, University of Iowa
- Department of Epidemiology, Carver College of Medicine, College of Public Health, University of Iowa
| | - Anil K. Chauhan
- Department of Internal Medicine, Carver College of Medicine, College of Public Health, University of Iowa
| | - Nirav Dhanesha
- Department of Internal Medicine, Carver College of Medicine, College of Public Health, University of Iowa
| | - Rakesh B. Patel
- Department of Internal Medicine, Carver College of Medicine, College of Public Health, University of Iowa
| | - Mariia Kumskova
- Department of Internal Medicine, Carver College of Medicine, College of Public Health, University of Iowa
| | - Daniel Thedens
- Department of Radiology, Carver College of Medicine, College of Public Health, University of Iowa
| | - Andreia Morais
- Department of Radiology, Harvard Medical School, Massachusetts General Hospital, Charlestown, MA, USA
| | - Takahiko Imai
- Department of Radiology, Harvard Medical School, Massachusetts General Hospital, Charlestown, MA, USA
| | - Tao Qin
- Department of Radiology, Harvard Medical School, Massachusetts General Hospital, Charlestown, MA, USA
| | - Cenk Ayata
- Department of Radiology, Harvard Medical School, Massachusetts General Hospital, Charlestown, MA, USA
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
| | | | - Alison L. Herman
- Department of Neurology, Yale University School of Medicine, New Haven, CT USA
| | - Hannah E. Beatty
- Department of Neurology, Yale University School of Medicine, New Haven, CT USA
| | - Sofia E. Velazquez
- Department of Neurology, Yale University School of Medicine, New Haven, CT USA
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT USA
| | - Sebastian Diaz-Perez
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT USA
| | | | - Jelena M. Mihailovic
- Departments of Radiology and Biomedical Imaging, Yale University, New Haven, CT USA
| | - Fahmeed Hyder
- Departments of Radiology and Biomedical Imaging, Yale University, New Haven, CT USA
- Departments of Biomedical Engineering, Yale University, New Haven, CT USA
| | - Lauren H. Sansing
- Department of Neurology, Yale University School of Medicine, New Haven, CT USA
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT USA
| | - Raymond C. Koehler
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University; Baltimore, MD USA
| | - Steven Lannon
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University; Baltimore, MD USA
| | - Yanrong Shi
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University; Baltimore, MD USA
| | | | - Adnan Bibic
- Department of Radiology, Johns Hopkins University; Baltimore, MD USA
| | - Kazi Akhter
- Department of Radiology, Johns Hopkins University; Baltimore, MD USA
| | - Jaroslaw Aronowski
- Department of Neurology, McGovern Medical School, University of Texas HSC, Houston, TX, USA
| | - Louise D. McCullough
- Department of Neurology, McGovern Medical School, University of Texas HSC, Houston, TX, USA
| | - Anjali Chauhan
- Department of Neurology, McGovern Medical School, University of Texas HSC, Houston, TX, USA
| | - Andrew Goh
- Department of Neurology, McGovern Medical School, University of Texas HSC, Houston, TX, USA
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Froes F, Morais A, Hespanhol V, Nogueira R, Carlos J, Jacinto N, Martins M, Gomes C, Cordeiro C. The Vacinómetro® initiative: an eleven-year monitorization of influenza vaccination coverage rates among risk groups in Portugal. Pulmonology 2022; 28:427-430. [DOI: 10.1016/j.pulmoe.2022.03.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 03/08/2022] [Accepted: 03/08/2022] [Indexed: 11/27/2022] Open
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Liu TT, Morais A, Takizawa T, Mulder I, Simon BJ, Chen SP, Wang SJ, Ayata C, Yen JC. Efficacy profile of noninvasive vagus nerve stimulation on cortical spreading depression susceptibility and the tissue response in a rat model. J Headache Pain 2022; 23:12. [PMID: 35062860 PMCID: PMC8903561 DOI: 10.1186/s10194-022-01384-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 12/29/2021] [Indexed: 11/23/2022] Open
Abstract
Background Noninvasive vagus nerve stimulation (nVNS) has recently emerged as a promising therapy for migraine. We previously demonstrated that vagus nerve stimulation inhibits cortical spreading depression (CSD), the electrophysiological event underlying migraine aura and triggering headache; however, the optimal nVNS paradigm has not been defined. Methods Various intensities and doses of nVNS were tested to improve efficacy on KCl-evoked CSD frequency and electrical threshold of CSD in a validated rat model. Chronic efficacy was evaluated by daily nVNS delivery for four weeks. We also examined the effects of nVNS on neuroinflammation and trigeminovascular activation by western blot and immunohistochemistry. Results nVNS suppressed susceptibility to CSD in an intensity-dependent manner. Two 2-minute nVNS 5 min apart afforded the highest efficacy on electrical CSD threshold and frequency of KCl-evoked CSD. Daily nVNS for four weeks did not further enhance efficacy over a single nVNS 20 min prior to CSD. The optimal nVNS also attenuated CSD-induced upregulation of cortical cyclooxygenase-2, calcitonin gene-related peptide in trigeminal ganglia, and c-Fos expression in trigeminal nucleus caudalis. Conclusions Our study provides insight on optimal nVNS parameters to suppress CSD and suggests its benefit on CSD-induced neuroinflammation and trigeminovascular activation in migraine treatment. Supplementary Information The online version contains supplementary material available at 10.1186/s10194-022-01384-1.
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Gonçalves Correia J, Mendes G, Teixeira B, Braga I, Morais A, Silva-Ramos M. Predictors of residual disease in restaging transurethral resection for high-risk non-muscle invasive bladder cancer. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)03214-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Catarino R, Alves L, Pereira J, Pereira D, Costa G, Cardoso A, Braga I, Freitas R, Correia T, Cerqueira M, Carmo Reis F, Lobo F, Morais A, Silva V, Magalhães S, Prisco R. Neoadjuvant chemotherapy in patients with urothelial bladder cancer. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)03227-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Catarino R, Alves L, Costa G, Pereira D, Pereira J, Cardoso A, Braga I, Freitas R, Correia T, Cerqueira M, Carmo Reis F, Lobo F, Morais A, Prisco R. Neoadjuvant chemotherapy outcomes in muscle-invasive bladder cancer. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)01229-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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21
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Fischer P, Sugimoto K, Chung DY, Tamim I, Morais A, Takizawa T, Qin T, Gomez CA, Schlunk F, Endres M, Yaseen MA, Sakadzic S, Ayata C. Rapid hematoma growth triggers spreading depolarizations in experimental intracortical hemorrhage. J Cereb Blood Flow Metab 2021; 41:1264-1276. [PMID: 32936730 PMCID: PMC8142136 DOI: 10.1177/0271678x20951993] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Recurrent waves of spreading depolarization (SD) occur in brain injury and are thought to affect outcomes. What triggers SD in intracerebral hemorrhage is poorly understood. We employed intrinsic optical signaling, laser speckle flowmetry, and electrocorticography to elucidate the mechanisms triggering SD in a collagenase model of intracortical hemorrhage in mice. Hematoma growth, SD occurrence, and cortical blood flow changes were tracked. During early hemorrhage (0-4 h), 17 out of 38 mice developed SDs, which always originated from the hematoma. No SD was detected at late time points (8-52 h). Neither hematoma size, nor peri-hematoma perfusion were associated with SD occurrence. Further, arguing against ischemia as a trigger factor, normobaric hyperoxia did not inhibit SD occurrence. Instead, SDs always occurred during periods of rapid hematoma growth, which was two-fold faster immediately preceding an SD compared with the peak growth rates in animals that did not develop any SDs. Induced hypertension accelerated hematoma growth and resulted in a four-fold increase in SD occurrence compared with normotensive animals. Altogether, our data suggest that spontaneous SDs in this intracortical hemorrhage model are triggered by the mechanical distortion of tissue by rapidly growing hematomas.
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Affiliation(s)
- Paul Fischer
- Neurovascular Research Laboratory, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.,Klinik und Hochschulambulanz für Neurologie, Charité-Universitätsmedizin Berlin, NeuroCure Excellence Cluster and Center for Stroke Research, Berlin, Germany
| | - Kazutaka Sugimoto
- Neurovascular Research Laboratory, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - David Y Chung
- Neurovascular Research Laboratory, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Isra Tamim
- Neurovascular Research Laboratory, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.,Klinik und Hochschulambulanz für Neurologie, Charité-Universitätsmedizin Berlin, NeuroCure Excellence Cluster and Center for Stroke Research, Berlin, Germany
| | - Andreia Morais
- Neurovascular Research Laboratory, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Tsubasa Takizawa
- Neurovascular Research Laboratory, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Tao Qin
- Neurovascular Research Laboratory, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Carlos A Gomez
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Frieder Schlunk
- Department of Neuroradiology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Matthias Endres
- Klinik und Hochschulambulanz für Neurologie, Charité-Universitätsmedizin Berlin, NeuroCure Excellence Cluster and Center for Stroke Research, Berlin, Germany.,German Center for Neurodegenerative Diseases (DZNE), Partner Site Berlin, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Germany
| | - Mohammad A Yaseen
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Sava Sakadzic
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Cenk Ayata
- Neurovascular Research Laboratory, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.,Department of Neurology, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
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22
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Matos CP, Boléo-Tomé JP, Rosa P, Morais A. Tobacco and COVID-19: A position from Sociedade Portuguesa de Pneumologia. Authors' reply. Pulmonology 2021; 27:278-279. [PMID: 33781706 PMCID: PMC7980207 DOI: 10.1016/j.pulmoe.2021.01.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 01/22/2021] [Indexed: 11/30/2022] Open
Affiliation(s)
- C P Matos
- Lung Unit, The Champalimaud Center for the Unknown, Lisboa, Portugal; Pulmonology Department, Hospital Prof. Doutor Fernando Fonseca, Amadora, Portugal.
| | - J P Boléo-Tomé
- Pulmonology Department, Hospital Prof. Doutor Fernando Fonseca, Amadora, Portugal; Working Committee on Smoking, Portuguese Society of Pulmonology, Lisboa, Portugal
| | - P Rosa
- Pulmonology Department, Hospital Vila Franca de Xira, Vila Franca de Xira, Portugal; Working Committee on Smoking, Portuguese Society of Pulmonology, Lisboa, Portugal
| | - A Morais
- Pulmonology Department, Hospital de São João, Porto, Portugal; President of the Portuguese Society of Pulmonology, Lisboa, Portugal
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Boechat JL, Chora I, Morais A, Delgado L. The immune response to SARS-CoV-2 and COVID-19 immunopathology - Current perspectives. Pulmonology 2021; 27:423-437. [PMID: 33867315 PMCID: PMC8040543 DOI: 10.1016/j.pulmoe.2021.03.008] [Citation(s) in RCA: 87] [Impact Index Per Article: 29.0] [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] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 02/26/2021] [Accepted: 03/13/2021] [Indexed: 12/15/2022] Open
Abstract
SARS-CoV-2 is a new beta coronavirus, similar to SARS-CoV-1, that emerged at the end of 2019 in the Hubei province of China. It is responsible for coronavirus disease 2019 (COVID-19), which was declared a pandemic by the World Health Organization on March 11, 2020. The ability to gain quick control of the pandemic has been hampered by a lack of detailed knowledge about SARS-CoV-2-host interactions, mainly in relation to viral biology and host immune response. The rapid clinical course seen in COVID-19 indicates that infection control in asymptomatic patients or patients with mild disease is probably due to the innate immune response, as, considering that SARS-CoV-2 is new to humans, an effective adaptive response would not be expected to occur until approximately 2–3 weeks after contact with the virus. Antiviral innate immunity has humoral components (complement and coagulation-fibrinolysis systems, soluble proteins that recognize glycans on cell surface, interferons, chemokines, and naturally occurring antibodies) and cellular components (natural killer cells and other innate lymphocytes). Failure of this system would pave the way for uncontrolled viral replication in the airways and the mounting of an adaptive immune response, potentially amplified by an inflammatory cascade. Severe COVID-19 appears to be due not only to viral infection but also to a dysregulated immune and inflammatory response. In this paper, the authors review the most recent publications on the immunobiology of SARS-CoV-2, virus interactions with target cells, and host immune responses, and highlight possible associations between deficient innate and acquired immune responses and disease progression and mortality. Immunotherapeutic strategies targeting both the virus and dysfunctional immune responses are also addressed.
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Affiliation(s)
- J L Boechat
- Clinical Immunology Service, Internal Medicine Department, Faculty of Medicine, Universidade Federal Fluminense, Niterói, RJ, Brazil; Basic and Clinical Immunology Unit, Department of Pathology, Faculty of Medicine, University of Porto, Portugal; Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Portugal
| | - I Chora
- Internal Medicine Service, Department of Medicine, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Senhora da Hora, Portugal; Department of Medicine, Faculty of Medicine, University of Porto, Portugal
| | - A Morais
- Department of Medicine, Faculty of Medicine, University of Porto, Portugal; Pulmonology Department, Centro Hospitalar e Universitario de Sao Joao, Porto, Portugal
| | - L Delgado
- Basic and Clinical Immunology Unit, Department of Pathology, Faculty of Medicine, University of Porto, Portugal; Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Portugal
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Matos CP, Boléo-Tomé JP, Rosa P, Morais A. Tobacco and COVID-19: A position from Sociedade Portuguesa de Pneumologia. Pulmonology 2021; 27:91-93. [PMID: 33303350 PMCID: PMC7670923 DOI: 10.1016/j.pulmoe.2020.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 11/02/2020] [Accepted: 11/03/2020] [Indexed: 01/08/2023] Open
Affiliation(s)
- C P Matos
- Lung Unit, The Champalimaud Center for the Unknown, Lisboa, Portugal; Working Committee on Smoking, Portuguese Society of Pulmonology, Lisboa, Portugal.
| | - J P Boléo-Tomé
- Pulmonology Department, Hospital Prof. Doutor Fernando Fonseca, Amadora, Portugal; Working Committee on Smoking, Portuguese Society of Pulmonology, Lisboa, Portugal.
| | - P Rosa
- Pulmonology Department, Hospital Vila Franca de Xira, Vila Franca de Xira, Portugal; Working Committee on Smoking, Portuguese Society of Pulmonology, Lisboa, Portugal.
| | - A Morais
- Pulmonology Department, Hospital de São João, Porto, Portugal; President of the Portuguese Society of Pulmonology, Lisboa, Portugal.
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Harriott AM, Chung DY, Uner A, Bozdayi RO, Morais A, Takizawa T, Qin T, Ayata C. Optogenetic Spreading Depression Elicits Trigeminal Pain and Anxiety Behavior. Ann Neurol 2020; 89:99-110. [PMID: 33016466 DOI: 10.1002/ana.25926] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 10/01/2020] [Accepted: 10/02/2020] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Cortical spreading depression (SD) is an intense depolarization underlying migraine aura. Despite the weight of evidence linking SD to the pain phase of migraine, controversy remains over a causal role of SD in cephalgia because of the invasive nature of previous SD induction methods. To overcome this problem, we used a novel minimally invasive optogenetic SD induction method and examined the effect of SD on behavior. METHODS Optogenetic SD was induced as a single event or repeatedly every other day for 2 weeks. End points, including periorbital and hindpaw mechanical allodynia, mouse grimace, anxiety, and working memory, were examined in male and female mice. RESULTS A single SD produced bilateral periorbital mechanical allodynia that developed within 1 hour and resolved within 2 days. Sumatriptan prevented periorbital allodynia when administered immediately after SD. Repeated SDs also produced bilateral periorbital allodynia that lasted 4 days and resolved within 2 weeks after the last SD. In contrast, the hindpaw withdrawal thresholds did not change after repeated SDs suggesting that SD-induced allodynia was limited to the trigeminal region. Moreover, repeated SDs increased mouse grimace scores 2 days after the last SD, whereas a single SD did not. Repeated SDs also increased thigmotaxis scores as a measure of anxiety. In contrast, neither single nor repeated SDs affected visuospatial working memory. We did not detect sexual dimorphism in any end point. INTERPRETATION Altogether, these data show a clinically congruent causal relationship among SD, trigeminal pain, and anxiety behavior, possibly reflecting SD modulation of hypothalamic, thalamic, and limbic mechanisms. ANN NEUROL 2021;89:99-110.
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Affiliation(s)
- Andrea M Harriott
- Neurovascular Research Laboratory, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA.,Vascular Division, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.,Headache and Neuropathic Pain Division, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - David Y Chung
- Neurovascular Research Laboratory, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA.,Division of Neurocritical Care, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Aylin Uner
- Baskent University Medical School, Ankara, Turkey
| | | | - Andreia Morais
- Neurovascular Research Laboratory, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA
| | - Tsubasa Takizawa
- Neurovascular Research Laboratory, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA.,Department of Neurology, Keio University School of Medicine, Tokyo, Japan
| | - Tao Qin
- Neurovascular Research Laboratory, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA
| | - Cenk Ayata
- Neurovascular Research Laboratory, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA.,Vascular Division, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
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Sugimoto K, Morais A, Sadeghian H, Qin T, Chung DY, Ashina M, Hougaard A, Ayata C. Intravascular Endothelin-1 does not trigger or increase susceptibility to Spreading Depolarizations. J Headache Pain 2020; 21:127. [PMID: 33109086 PMCID: PMC7590662 DOI: 10.1186/s10194-020-01194-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Accepted: 10/19/2020] [Indexed: 11/22/2022] Open
Abstract
Objectives Spreading depolarizations (SD) likely manifest as aura in migraineurs. Triggers are unknown although vascular events have been implicated. Direct carotid puncture has been reported to trigger migraine with aura. The potent vasoconstrictor endothelin-1 (ET-1), which can be released from the endothelium under pathological conditions, may play a role. Here, we tested whether intracarotid ET-1 infusion triggers SD and whether systemic ET-1 infusion increases the susceptibility to SD. Methods Carotid infusions were performed in mice (C57BL/6, male) through a catheter placed at the carotid bifurcation via the external carotid artery. Intracarotid ET-1 (1.25 nmol/ml) was infused at various rates (2–16 μl/min) with or without heparin in the catheter and compared with vehicle infusion (PBS with 0.01% acetic acid) or sham-operated mice (n = 5). Systemic infusions ET-1 (1 nmol/kg, n = 7) or vehicle (n = 7) infusions were performed in rats (Sprague-Dawley, male) via the tail vein. Electrical SD threshold and KCl-induced SD frequency were measured after the infusion. Results Intracarotid infusion of saline (n = 19), vehicle (n = 7) or ET-1 (n = 12) all triggered SDs at various proportions (21%, 14% and 50%, respectively). These were often associated with severe hypoperfusion prior to SD onset. Heparinizing the infusion catheter completely prevented SD occurrence during the infusions (n = 8), implicating microembolization from carotid thrombi as the trigger. Sham-operated mice never developed SD. Systemic infusion of ET-1 did not affect the electrical SD threshold or KCl-induced SD frequency. Conclusion Intravascular ET-1 does not trigger or increase susceptibility to SD. Microembolization was the likely trigger for migraine auras in patients during carotid puncture.
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Affiliation(s)
- Kazutaka Sugimoto
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 149 13th Street, 6408, Charlestown, MA, 02129, USA.,Department of Neurosurgery, Yamaguchi University School of Medicine, Yamaguchi, Japan
| | - Andreia Morais
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 149 13th Street, 6408, Charlestown, MA, 02129, USA
| | - Homa Sadeghian
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 149 13th Street, 6408, Charlestown, MA, 02129, USA
| | - Tao Qin
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 149 13th Street, 6408, Charlestown, MA, 02129, USA
| | - David Y Chung
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 149 13th Street, 6408, Charlestown, MA, 02129, USA.,Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - Messoud Ashina
- Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, Glostrup, Denmark
| | - Anders Hougaard
- Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, Glostrup, Denmark
| | - Cenk Ayata
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 149 13th Street, 6408, Charlestown, MA, 02129, USA. .,Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
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Yanagisawa T, Zhang H, Suzuki T, Kamio Y, Takizawa T, Morais A, Chung DY, Qin T, Murayama Y, Faber JE, Patel AB, Ayata C. Sex and Genetic Background Effects on the Outcome of Experimental Intracranial Aneurysms. Stroke 2020; 51:3083-3094. [PMID: 32912097 DOI: 10.1161/strokeaha.120.029651] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND PURPOSE Intracranial aneurysm formation and rupture risk are, in part, determined by genetic factors and sex. To examine their role, we compared 3 mouse strains commonly used in cerebrovascular studies in a model of intracranial aneurysm formation and rupture. METHODS Intracranial aneurysms were induced in male CD1 (Crl:CD1[ICR]), male and female C57 (C57BL/6NCrl), and male 129Sv (129S2/SvPasCrl or 129S1/SvImJ) mice by stereotaxic injection of elastase at the skull base, combined with systemic deoxycorticosterone acetate-salt hypertension. Neurological deficits and mortality were recorded. Aneurysms and subarachnoid hemorrhage grades were quantified postmortem, either after spontaneous mortality or at 7 to 21 days if the animals survived. In separate cohorts, we examined proinflammatory mediators by quantitative reverse transcriptase-polymerase chain reaction, arterial blood pressure via the femoral artery, and the circle of Willis by intravascular latex casting. RESULTS We found striking differences in aneurysm formation, rupture, and postrupture survival rates among the groups. 129Sv mice showed the highest rates of aneurysm rupture (80%), followed by C57 female (36%), C57 male (27%), and CD1 (21%). The risk of aneurysm rupture and the presence of unruptured aneurysms significantly differed among all 3 strains, as well as between male and female C57. The same hierarchy was observed upon Kaplan-Meier analysis of both overall survival and deficit-free survival. Subarachnoid hemorrhage grades were also more severe in 129Sv. CD1 mice showed the highest resistance to aneurysm rupture and the mildest outcomes. Higher mean blood pressures and the major phenotypic difference in the circle of Willis anatomy in 129Sv provided an explanation for the higher incidence of and more severe aneurysm ruptures. TNFα (tumor necrosis factor-alpha), IL-1β (interleukin-1-beta), and CCL2 (chemokine C-C motif ligand 2) expressions did not differ among the groups. CONCLUSIONS The outcome of elastase-induced intracranial aneurysm formation and rupture in mice depends on genetic background and shows sexual dimorphism.
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Affiliation(s)
- Takeshi Yanagisawa
- Neurovascular Research Laboratory, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown (T.Y., T.S., T.T., D.Y.C., T.Q., A.M., C.A.).,Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston. (T.Y., A.B.P.).,Department of Neurosurgery, Jikei University School of Medicine, Tokyo, Japan (T.Y., Y.M.)
| | - Hua Zhang
- Department of Cell Biology and Physiology, University of North Carolina, Chapel Hill. (H.Z., J.E.F.)
| | - Tomoaki Suzuki
- Neurovascular Research Laboratory, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown (T.Y., T.S., T.T., D.Y.C., T.Q., A.M., C.A.)
| | - Yoshinobu Kamio
- Department of Neurosurgery, Hamamatsu University School of Medicine, Japan (Y.K.)
| | - Tsubasa Takizawa
- Neurovascular Research Laboratory, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown (T.Y., T.S., T.T., D.Y.C., T.Q., A.M., C.A.)
| | - Andreia Morais
- Neurovascular Research Laboratory, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown (T.Y., T.S., T.T., D.Y.C., T.Q., A.M., C.A.).,National Institute of Translational Neuroscience, Biomedical Science Institute, Federal University of Rio de Janeiro, Brazil (A.M.)
| | - David Y Chung
- Neurovascular Research Laboratory, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown (T.Y., T.S., T.T., D.Y.C., T.Q., A.M., C.A.).,Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston. (D.Y.C., C.A.)
| | - Tao Qin
- Neurovascular Research Laboratory, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown (T.Y., T.S., T.T., D.Y.C., T.Q., A.M., C.A.)
| | - Yuichi Murayama
- Department of Neurosurgery, Jikei University School of Medicine, Tokyo, Japan (T.Y., Y.M.)
| | - James E Faber
- Department of Cell Biology and Physiology, University of North Carolina, Chapel Hill. (H.Z., J.E.F.).,Department of Neurobiology Curriculum, McAllister Heart Institute, University of North Carolina, Chapel Hill. (J.E.F.)
| | - Aman B Patel
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston. (T.Y., A.B.P.)
| | - Cenk Ayata
- Neurovascular Research Laboratory, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown (T.Y., T.S., T.T., D.Y.C., T.Q., A.M., C.A.).,Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston. (D.Y.C., C.A.)
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Robalo-Cordeiro C, Morais A. Translating Idiopathic pulmonary fibrosis guidelines into clinical practice. Pulmonology 2020; 27:7-13. [PMID: 32561352 DOI: 10.1016/j.pulmoe.2020.05.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 05/28/2020] [Accepted: 05/28/2020] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION AND OBJECTIVES Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive fibrotic interstitial lung disease of unknown cause, which predominantly manifests in older males. IPF diagnosis is a complex, multi-step process and delay in diagnosis cause a negative impact on patient survival. Additionally, a multidisciplinary team of pulmonologists, radiologists and pathologists is necessary for an accurate IPF diagnosis. The present study aims to assess how diagnosis and treatment of IPF are followed in Portugal, as well as the knowledge and implementation of therapeutic guidelines adopted by the Portuguese Society of Pulmonology. MATERIALS AND METHODS Seventy-eight practicing pulmonologists were enrolled (May-August 2019) in a survey developed by IPF expert pulmonologists comprised of one round of 31 questions structured in three parts. The first part was related to participant professional profile, the second part assessed participant level of knowledge and practice agreement with national consensus and international guidelines for IPF as well as their access to radiology and pathology for IPF diagnosis, and the third part was a self-evaluation of the guidelines adherence for diagnosis and treatment in their daily practice. RESULTS Participants represented a wide spectrum of pulmonologists from 14 districts of Portugal and autonomous regions of Azores and Madeira. The majority were female (65%), with 5-19 years of experience (71%) and working in a public clinical center (83%). Importantly, the majority of pulmonologists follow their IPF patients (n=45) themselves, while 26% referred IPF patients to ILD experts in the same hospital and 22% to another center. Almost all pulmonologists (98%) agreed or absolutely agreed that multidisciplinary discussion is recommended to accurately diagnose IPF. No pulmonologists considered pulmonary biopsy as absolutely required to establish an IPF diagnosis. However, 87% agreed or absolutely agree with considering biopsy in a possible/probable UIP context. If a biopsy is necessary, 96% of pulmonologists absolutely agree or agree with considering criobiopsy as an option for IPF diagnosis. Regarding IPF treatment, 98% absolutely agreed or agreed that antifibrotic therapy should be started once the IPF diagnosis is established. Finally, 76% stated that 6 months is the recommended time for follow-up visit in IPF patients. CONCLUSIONS Portuguese pulmonologists understand and agree with national consensus and international guidelines for IPF treatment but their implementation in Portugal is heterogeneous.
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Affiliation(s)
- C Robalo-Cordeiro
- Pulmonology Department, Coimbra University Hospital, University of Coimbra, Portugal
| | - A Morais
- Pulmonology Department, São João Hospital Centre, Faculty of Medicine of Porto University, Oporto, Portugal
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Freitas C, Sousa C, Novais-Bastos H, Fernandes G, Morais A, Magalhães A. 16 YEARS INSIDE THE TRACHEA. Chest 2020. [DOI: 10.1016/j.chest.2020.05.263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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30
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Oliveira T, Melo N, Guimarães S, Morais A. Diagnostic challenges of hypersensitivity pneumonitis with autoimmune features: Dealing with more than a coincidence? Pulmonology 2020; 26:320-323. [PMID: 32229195 DOI: 10.1016/j.pulmoe.2020.02.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 02/23/2020] [Accepted: 02/28/2020] [Indexed: 11/30/2022] Open
Affiliation(s)
- T Oliveira
- Pulmonology Department, Centro Hospitalar Universitário do Porto - Hospital de Santo António, Largo do Prof. Abel Salazar, 4099-001 Porto, Portugal; Abel Salazar Institute of Biomedical Sciences - University of Porto, Rua de Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal.
| | - N Melo
- Pulmonology Department, Centro Hospitalar Universitário de São João - Hospital de São João, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - S Guimarães
- Anatomic Pathology Department, Centro Hospitalar Universitário de São João - Hospital de São João, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal; Faculty of Medicine - University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - A Morais
- Pulmonology Department, Centro Hospitalar Universitário de São João - Hospital de São João, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal; Faculty of Medicine - University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
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31
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Freitas C, Martins N, Novais-Bastos H, Morais A, Fernandes G, Magalhães A. The role of interventional bronchoscopy in the management of post-intubation tracheal stenosis: A 20-year experience. Pulmonology 2019; 27:296-304. [PMID: 31901372 DOI: 10.1016/j.pulmoe.2019.12.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 11/27/2019] [Accepted: 12/10/2019] [Indexed: 10/25/2022] Open
Abstract
PURPOSE Benign tracheal stenosis management is still controversial, and there is no international consensus on the best treatment option. Thus, we aimed to look into the history of PITS and the different strategies used in its treatment. The importance of bronchoscopic treatment was also defined, and its effectiveness and safety were assessed. METHODS Retrospective study of patients diagnosed with PITS, who were referred to the Bronchology Department between January 1996 and December 2016. RESULTS Of 115 patients enrolled (mean age 48.5±17.6 years, 53% males), 66.1% had complex stenosis. The most common causes of intubation were respiratory (29.9%), neurological (26.8%) and surgical (19.6%). Complex stenosis was caused by longer intubation, and was more frequent among previously tracheostomized patients. The most common location was the upper third of trachea (60.9%). Most cases were initially treated by interventional bronchoscopy, and although serial dilations were effective in some complex PITS, a higher proportion of simple stenosis was successfully managed with this treatment option. Long-term recurrence after serial dilation was observed in 25.0% of cases. Stent placement was required (19.1%) only for complex PITS. Stent-related complications were frequent (61.9%) and linked to the stenting time (p<0.001). Overall, there were no procedure-related complications. Surgical intervention was also performed (30.0%), always with complex PITS. Post-surgical recurrences were observed in 24.2% of cases. CONCLUSIONS Interventional bronchoscopy is an efficient and safe modality in PITS management. Further studies are needed for better classification and improved knowledge of PITS pathogenesis, and to achieve international consensus of definition to guide clinicians in their practice.
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Affiliation(s)
- C Freitas
- Department of Pulmonology, Centro Hospitalar e Universitário São João, Alameda Prof. Hernani Monteiro, 4200-319 Porto, Portugal; Faculty of Medicine, University of Porto, Alameda Prof. Hernani Monteiro, 4200-319 Porto, Portugal.
| | - N Martins
- Department of Pulmonology, Centro Hospitalar e Universitário São João, Alameda Prof. Hernani Monteiro, 4200-319 Porto, Portugal; Faculty of Medicine, University of Porto, Alameda Prof. Hernani Monteiro, 4200-319 Porto, Portugal; Institute for Research and Innovation in Health, University of Porto, Rua Alfredo Allen, 208, 4200-136 Porto, Portugal
| | - H Novais-Bastos
- Department of Pulmonology, Centro Hospitalar e Universitário São João, Alameda Prof. Hernani Monteiro, 4200-319 Porto, Portugal; Faculty of Medicine, University of Porto, Alameda Prof. Hernani Monteiro, 4200-319 Porto, Portugal; Institute for Research and Innovation in Health, University of Porto, Rua Alfredo Allen, 208, 4200-136 Porto, Portugal
| | - A Morais
- Department of Pulmonology, Centro Hospitalar e Universitário São João, Alameda Prof. Hernani Monteiro, 4200-319 Porto, Portugal; Faculty of Medicine, University of Porto, Alameda Prof. Hernani Monteiro, 4200-319 Porto, Portugal
| | - G Fernandes
- Department of Pulmonology, Centro Hospitalar e Universitário São João, Alameda Prof. Hernani Monteiro, 4200-319 Porto, Portugal; Faculty of Medicine, University of Porto, Alameda Prof. Hernani Monteiro, 4200-319 Porto, Portugal
| | - A Magalhães
- Department of Pulmonology, Centro Hospitalar e Universitário São João, Alameda Prof. Hernani Monteiro, 4200-319 Porto, Portugal
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Noites A, Vale AL, Pereira AS, Morais A, Vilarinho R, Carvalho P, Amorim M, Moreira T, Mendonça A. Effect of an aerobic exercise session combined with abdominal radiofrequency on lipolytic activity in women: Randomized control trial. J Cosmet Dermatol 2019; 19:638-645. [PMID: 31254455 DOI: 10.1111/jocd.13056] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 10/31/2018] [Revised: 05/02/2019] [Accepted: 06/05/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Abdominal adiposity is a cardiovascular risk factor; it is assumed that the combination of radiofrequency and physical exercise may decrease this excess of adipose tissue. PURPOSE To understand whether an aerobic physical exercise session associated with abdominal radiofrequency increases the level of lipolytic activity. METHODOLOGY The study analyzes the effect of a combined aerobic exercise session with radiofrequency. Participants were 30 healthy female volunteers, aged 18-28 years, randomly assigned to an experimental group and placebo group. They were characterized by a sociodemographic questionnaire, the International Physical Activity Questionnaire and the Food Frequency Questionnaire. The groups performed an abdominal radiofrequency session followed by moderate aerobic exercise, assessing glycerol concentration and lipid profile values before and after the intervention. In the experimental group, a percentage of potency was used that allowed to maintain the temperature between 40º C and 42º C to the epidermis. In the placebo group, the power of the radiofrequency was 0 Watt. To compare results, Student's t test was used for a significance level of 0.05. RESULTS There were no significant changes in glycerol concentrations between groups (P > 0.05). There were no changes in the lipid profile of both groups after the intervention (P > 0.05). CONCLUSION The association of exercise with radiofrequency did not present an increased effect on lipolytic activity when compared to the isolated exercise. The application of this technique is a safe intervention.
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Affiliation(s)
- Andreia Noites
- Department of Physiotherapy, School of Health, Polytechnic Institute of Porto, Portugal.,Center for Rehabilitation Research (CIR)- Human Movement System (Re) habilitation, Polytechnic Institute of Porto, Portugal
| | - Ana Luísa Vale
- Department of Physiotherapy, School of Health, Polytechnic Institute of Porto, Portugal
| | - Ana Sofia Pereira
- Department of Physiotherapy, School of Health, Polytechnic Institute of Porto, Portugal
| | - Andreia Morais
- Department of Physiotherapy, School of Health, Polytechnic Institute of Porto, Portugal
| | - Rui Vilarinho
- Department of Physiotherapy, School of Health, Polytechnic Institute of Porto, Portugal.,Center for Rehabilitation Research (CIR)- Human Movement System (Re) habilitation, Polytechnic Institute of Porto, Portugal
| | - Paulo Carvalho
- Department of Physiotherapy, School of Health, Polytechnic Institute of Porto, Portugal.,Center for Rehabilitation Research (CIR)- Human Movement System (Re) habilitation, Polytechnic Institute of Porto, Portugal
| | - Manuela Amorim
- Department of Clinical Analyzes and Public Health, School of Health, Polytechnic Institute of Porto, Portugal
| | - Teresa Moreira
- Department of Clinical Analyzes and Public Health, School of Health, Polytechnic Institute of Porto, Portugal
| | - Adriana Mendonça
- Department of Applied Physiotherapy, Health Sciences Institute, Federal University of Triângulo Mineiro, Uberaba, Brazil
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Affiliation(s)
- P Pamplona
- Hospital Pulido Valente, Lisboa, Portugal
| | - S Ravara
- University of Beira Interior. Faculty of Health Sciences,Preventive Medecine, Lisboa, Portugal
| | - J P Boléo-Tomé
- Hospital Prof. Dr. Fernando Fonseca EPE, Amadora, Portugal
| | - P Rosa
- Hospital de Vila Franca de Xira, Vila Franca de Xira, Portugal
| | - A Morais
- Centro Hospitalar Universitário São João, Faculdade de Medicina do Porto, Portugal.
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34
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Vale AL, Pereira AS, Morais A, de Carvalho P, Vilarinho R, Mendonça A, Noites A. Effect of four sessions of aerobic exercise with abdominal radiofrequency in adipose tissue in healthy women: Randomized control trial. J Cosmet Dermatol 2019; 19:359-367. [PMID: 31157522 DOI: 10.1111/jocd.13036] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 05/07/2019] [Accepted: 05/12/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Abdominal adiposity is a cardiovascular risk factor; it is assumed that the combination of radiofrequency and physical exercise may decrease this excess of adipose tissue. PURPOSE To analyze the effect of four intervention sessions on abdominal adipose tissue. METHODOLOGY The study analyzes the effect of four sessions of aerobic exercise combined with radiofrequency. Participants were 28 healthy female volunteers, aged 18-28 years, randomly assigned to an experimental group and a placebo group. They were characterized by a sociodemographic questionnaire, the International Physical Activity Questionnaire and the Food Frequency Questionnaire. The groups performed four sessions of abdominal radiofrequency followed by moderate aerobic exercise, assessing body mass, body mass index, fat mass, waist circumference, waist/height ratio, subcutaneous adipose thickness, and horizontal abdominal adipose fold at the first and fourth sessions. In the experimental group, a percentage of potency was used that allowed to maintain the temperature between 40°C and 42°C to the epidermis. In the placebo group, the power of the radiofrequency was 0 W. To compare results, Student's t test was used for a significance level of 0.05. RESULTS There was a statistically significant decrease in waist circumference, abdominal subcutaneous adipose thickness, and horizontal abdominal fold in the experimental group compared to the placebo group (P < 0.05). CONCLUSION Combined exercise intervention with radiofrequency has been shown to be effective in reducing abdominal adiposity.
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Affiliation(s)
- Ana Luísa Vale
- Department of Physiotherapy, School of Health, Polytechnic Institute of Porto, Portugal
| | - Ana Sofia Pereira
- Department of Physiotherapy, School of Health, Polytechnic Institute of Porto, Portugal
| | - Andreia Morais
- Department of Physiotherapy, School of Health, Polytechnic Institute of Porto, Portugal
| | - Paulo de Carvalho
- Department of Physiotherapy, School of Health, Polytechnic Institute of Porto, Portugal
| | - Rui Vilarinho
- Department of Physiotherapy, School of Health, Polytechnic Institute of Porto, Portugal
| | - Adriana Mendonça
- Department of Applied Physiotherapy, Health Sciences Institute, Federal University of Triângulo Mineiro, Uberaba, Brazil
| | - Andreia Noites
- Department of Physiotherapy, School of Health, Polytechnic Institute of Porto, Portugal.,Center for Rehabilitation Research (CIR)- Human Movement System (Re)habilitation, Polytechnic Institute of Porto, Portugal
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Pereira N, Cardoso A, Mota P, Santos A, Melo N, Morais A, Drummond M. Predictive factors of obstructive sleep apnoea in patients with fibrotic lung diseases. Sleep Med 2019; 56:123-127. [DOI: 10.1016/j.sleep.2019.01.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 11/06/2018] [Accepted: 01/14/2019] [Indexed: 01/09/2023]
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36
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Sousa SR, Caetano Mota P, Melo N, Bastos HN, Padrão E, Pereira JM, Cunha R, Souto Moura C, Guimarães S, Morais A. Heterozygous TERT gene mutation associated with familial idiopathic pulmonary fibrosis. Respir Med Case Rep 2019; 26:118-122. [PMID: 30603600 PMCID: PMC6304384 DOI: 10.1016/j.rmcr.2018.12.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 12/06/2018] [Accepted: 12/07/2018] [Indexed: 11/16/2022] Open
Abstract
Idiopathic pulmonary fibrosis (IPF) is a chronic interstitial lung disease of unknown cause that occurs sporadically, but it can also occur in families and so named as Familial Pulmonary Fibrosis (FPF). Some forms of FPF overlaps IPF features, namely the radiological and histological pattern of usual interstitial pneumonia (UIP). Genetic and environmental factors commonly play an important role in the pathogenesis of FPF and the most commonly identified mutations involve the telomerase complex. Here, we report a rare case of FPF in a male at the age of 44, in whom genetic testing showed heterozygous variants for the telomerase reverse transcriptase gene (TERT). Our report highlights the importance of compiling a thorough family history in younger patients identified with UIP serving as a resource for identifying the current and future genetic links to disease. Families with UIP hold a great promise in defining UIP pathogenesis, potentially suggesting targets for the development of future therapies.
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Affiliation(s)
- S R Sousa
- Pulmonology Department, Coimbra University Hospital, Hospital Geral, Coimbra, Portugal
| | - P Caetano Mota
- Pulmonology Department, São João Hospital Centre, Faculty of Medicine of Porto University, Oporto, Portugal
| | - N Melo
- Pulmonology Department, São João Hospital Centre, Faculty of Medicine of Porto University, Oporto, Portugal
| | - H N Bastos
- Pulmonology Department, São João Hospital Centre, Faculty of Medicine of Porto University, Oporto, Portugal
| | - E Padrão
- Pulmonology Department, São João Hospital Centre, Faculty of Medicine of Porto University, Oporto, Portugal
| | - J M Pereira
- Radiology Department, São João Hospital Centre, Oporto, Portugal
| | - R Cunha
- Radiology Department, São João Hospital Centre, Oporto, Portugal
| | - C Souto Moura
- Pathology Department, São João Hospital Centre, Faculty of Medicine of Porto University, Oporto, Portugal
| | - S Guimarães
- Pathology Department, São João Hospital Centre, Faculty of Medicine of Porto University, Oporto, Portugal
| | - A Morais
- Pulmonology Department, São João Hospital Centre, Faculty of Medicine of Porto University, Oporto, Portugal
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Vale AL, Pereira AS, Morais A, Noites A, Mendonça AC, Martins Pinto J, Vilarinho R, Carvalho P. Effects of radiofrequency on adipose tissue: A systematic review with meta-analysis. J Cosmet Dermatol 2018; 17:703-711. [DOI: 10.1111/jocd.12776] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 07/27/2018] [Accepted: 08/02/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Ana Luísa Vale
- School of Allied Health Technologies; Polytechnic Institute of Porto; Porto Portugal
| | - Ana Sofia Pereira
- School of Allied Health Technologies; Polytechnic Institute of Porto; Porto Portugal
| | - Andreia Morais
- School of Allied Health Technologies; Polytechnic Institute of Porto; Porto Portugal
| | - Andreia Noites
- Department of Physiotherapy, Activity and Human Movement Study Centre, School of Allied Health Technologies; Polytechnic Institute of Porto; Porto Portugal
| | - Adriana Clemente Mendonça
- Department of Applied Physiotherapy, Health Sciences Institute; Federal University of Triângulo Mineiro; Uberaba Brazil
| | - Juliana Martins Pinto
- Department of Applied Physiotherapy, Health Sciences Institute; Federal University of Triângulo Mineiro; Uberaba Brazil
| | - Rui Vilarinho
- Department of Physiotherapy, Activity and Human Movement Study Centre, School of Allied Health Technologies; Polytechnic Institute of Porto; Porto Portugal
| | - Paulo Carvalho
- Department of Physiotherapy, Activity and Human Movement Study Centre, School of Allied Health Technologies; Polytechnic Institute of Porto; Porto Portugal
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Vieira A, Vale A, Melo N, Caetano Mota P, Jesus J, Cunha R, Guimarães S, Souto Moura C, Morais A. Organizing pneumonia revisited: insights and uncertainties from a series of 67 patients. Sarcoidosis Vasc Diffuse Lung Dis 2018; 35:129-138. [PMID: 32476892 PMCID: PMC7170093 DOI: 10.36141/svdld.v35i2.6860] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 01/08/2018] [Indexed: 12/23/2022]
Abstract
Background: Organizing pneumonia (OP) is classified as an acute/subacute pneumonia according to the American Thoracic Society/European Respiratory Society statement (2013 update). Although its clinical presentation, radiologic and histologic features are well established, data on the relevance of potential causes, corticosteroid doses and length, or management of relapses are based on heterogeneous series of patients. Objectives: The aims of this study were to describe clinical presentation, diagnosis and treatment of OP, explore potential causes, discuss strategies for managing relapses, and analyze prognostic factors. We also discuss our findings in relation to relevant data in the literature. Methods: We performed a cross-sectional study of all patients diagnosed with OP at a tertiary referral center in northern Portugal between 2008 and 2015. Results: Sixty-seven patients were diagnosed with OP over the 7-year study period. Dyspnea and cough were the most common presenting symptoms and approximately 30% of patients were hospitalized at the time of diagnosis. Approximately half of the patients were receiving drugs described as potential causes of OP. Microorganisms were isolated in approximately one-third of patients. Other potential causes identified were hematologic disorders, neoplasms, connective tissue diseases, myelodysplastic syndromes, immunodeficiencies, radiotherapy, and bird exposure. Cryptogenic OP was diagnosed in just 16 patients (23.8%). Corticosteroids were the most common treatment and 11 patients (16.4%) experienced relapse. Conclusions: The findings for this series of patients confirm the extreme variability of the contexts in which OP can occur and suggest that rather than a distinct, homogeneous clinicopathologic entity, OP is a non-specific reaction whose outcomes are dependent on the cause. (Sarcoidosis Vasc Diffuse Lung Dis 2018; 35: 129-138).
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Affiliation(s)
- A.L. Vieira
- Pulmonology Department, Hospital de Braga, Braga, Portugal
| | - A. Vale
- Pulmonology Department, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - N. Melo
- Pulmonology Department and Diffuse Lung Diseases Study Group, Centro Hospitalar de São João, Porto, Portugal
| | - P. Caetano Mota
- Pulmonology Department and Diffuse Lung Diseases Study Group, Centro Hospitalar de São João, Porto, Portugal
- Faculdade de Medicina do Porto, Universidade do Porto, Porto, Portugal
| | - J.M. Jesus
- Radiology Department, Centro Hospitalar de São João, Porto, Portugal
| | - R. Cunha
- Radiology Department, Centro Hospitalar de São João, Porto, Portugal
| | - S. Guimarães
- Pathology Department, Centro Hospitalar de São João, Porto, Portugal
| | - C. Souto Moura
- Pathology Department, Centro Hospitalar de São João, Porto, Portugal
| | - A. Morais
- Pulmonology Department and Diffuse Lung Diseases Study Group, Centro Hospitalar de São João, Porto, Portugal
- Pathology Department, Centro Hospitalar de São João, Porto, Portugal
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Almeida LM, Lima B, Mota PC, Melo N, Magalhães A, Pereira JM, Moura CS, Guimarães S, Morais A. Learning curve for transbronchial lung cryobiopsy in diffuse lung disease. Pulmonology 2017; 24:S2173-5115(17)30148-3. [PMID: 29174087 DOI: 10.1016/j.rppnen.2017.09.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [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: 05/27/2017] [Revised: 08/25/2017] [Accepted: 09/20/2017] [Indexed: 01/28/2023] Open
Abstract
INTRODUCTION Transbronchial lung cryobiopsy (TBLC) is increasingly used in the diagnosis of diffuse lung disease (DLD), but no data have yet been published on the learning curve associated with this technique. AIM To evaluate diagnostic yield, lung tissue sample length and area, and procedure-related complications in a cohort of TBLC procedures to define the learning curve and threshold for proficiency. METHODS Retrospective analysis of the first 100 TBLCs performed in different segments of the same lobe in patients with suspected DLD. We compared diagnostic yield, sample length and area, and complications between consecutive groups of patients. RESULTS The overall diagnostic yield for TBLC was 82%. Median sample length was 5.4mm (IQR, 5-6) and median area was 19.5mm2 (IQR, 13.3-25). Pneumothorax was the most common complication (18%). On comparing the two groups of 50 consecutive patients, a significant difference was found for diagnostic yield (74% vs 90%; p=0.04), sample length (5.0mm [2.5-16] vs 6.0mm [4-12;] p<0.01) and area (17.5mm2 [6-42] vs 21.5mm2 [10-49]; p<0.01). Logarithm regression was applied to median diagnostic yield and sample length and area for groups of 10 consecutive patients to define the learning curve, which plateaued after approximately 70 procedures. CONCLUSIONS Our findings suggest that proficiency in TBLC is achieved at approximately the 70th procedure; however they need to be validated in more series and cohorts.
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Affiliation(s)
- L M Almeida
- Pulmonology Department, Centro Hospitalar de São João, Porto, Portugal.
| | - B Lima
- Oficina de Bioestatística, Porto, Portugal
| | - P C Mota
- Pulmonology Department, Centro Hospitalar de São João, Porto, Portugal; Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - N Melo
- Pulmonology Department, Centro Hospitalar de São João, Porto, Portugal
| | - A Magalhães
- Pulmonology Department, Centro Hospitalar de São João, Porto, Portugal
| | - J M Pereira
- Radiology Department, Centro Hospitalar de São João, Porto, Portugal
| | - C S Moura
- Faculdade de Medicina da Universidade do Porto, Porto, Portugal; Pathology Department, Centro Hospitalar de São João, Porto, Portugal
| | - S Guimarães
- Faculdade de Medicina da Universidade do Porto, Porto, Portugal; Pathology Department, Centro Hospitalar de São João, Porto, Portugal
| | - A Morais
- Pulmonology Department, Centro Hospitalar de São João, Porto, Portugal; Faculdade de Medicina da Universidade do Porto, Porto, Portugal
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Morais A. Are we ready to get in the eye of the storm? Rev Port Pneumol (2006) 2017; 23:243-244. [PMID: 28918850 DOI: 10.1016/j.rppnen.2017.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Merinero B, Alcaide P, Martín-Hernández E, Morais A, García-Silva MT, Quijada-Fraile P, Pedrón-Giner C, Dulin E, Yahyaoui R, Egea JM, Belanger-Quintana A, Blasco-Alonso J, Fernandez Ruano ML, Besga B, Ferrer-López I, Leal F, Ugarte M, Ruiz-Sala P, Pérez B, Pérez-Cerdá C. Four Years' Experience in the Diagnosis of Very Long-Chain Acyl-CoA Dehydrogenase Deficiency in Infants Detected in Three Spanish Newborn Screening Centers. JIMD Rep 2017; 39:63-74. [PMID: 28755359 DOI: 10.1007/8904_2017_40] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [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: 03/13/2017] [Revised: 06/08/2017] [Accepted: 06/15/2017] [Indexed: 12/13/2022] Open
Abstract
Identification of very long-chain acyl-CoA dehydrogenase deficiency is possible in the expanded newborn screening (NBS) due to the increase in tetradecenoylcarnitine (C14:1) and in the C14:1/C2, C14:1/C16, C14:1/C12:1 ratios detected in dried blood spots. Nevertheless, different confirmatory tests must be performed to confirm the final diagnosis. We have revised the NBS results and the results of the confirmatory tests (plasma acylcarnitine profiles, molecular findings, and lymphocytes VLCAD activity) for 36 cases detected in three Spanish NBS centers during 4 years, correlating these with the clinical outcome and treatment. Our aim was to distinguish unambiguously true cases from disease carriers in order to obtain useful diagnostic information for clinicians that can be applied in the follow-up of neonates identified by NBS.Increases in C14:1 and of the different ratios, the presence of two pathogenic mutations, and deficient enzyme activity in lymphocytes (<12% of the intra-assay control) identified 12 true-positive cases. These cases were given nutritional therapy and all of them are asymptomatic, except one. Seventeen individuals were considered disease carriers based on the mild increase in plasma C14:1, in conjunction with the presence of only one mutation and/or intermediate residual activity (18-57%). In addition, seven cases were classified as false positives, with normal biochemical parameters and no mutations in the exonic region of ACADVL. All these carriers and the false positive cases remained asymptomatic. The combined evaluation of the acylcarnitine profiles, genetic results, and residual enzyme activities have proven useful to definitively classify individuals with suspected VLCAD deficiency into true-positive cases and carriers, and to decide which cases need treatment.
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Affiliation(s)
- B Merinero
- Centro de Diagnóstico de Enfermedades Moleculares, Centro de Biología Molecular-SO UAM-CSIC, Universidad Autónoma de Madrid, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), IdiPAZ, Madrid, Spain.
| | - P Alcaide
- Centro de Diagnóstico de Enfermedades Moleculares, Centro de Biología Molecular-SO UAM-CSIC, Universidad Autónoma de Madrid, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), IdiPAZ, Madrid, Spain
| | - E Martín-Hernández
- Departamento de Pediatría, Unidad de Enfermedades Mitocondriales-Metabólicas Hereditarias, Hospital Universitario Doce de Octubre, Universidad Complutense de Madrid, CIBERER, Madrid, Spain
| | - A Morais
- Unidad de Nutrición Infantil y Enfermedades Metabólicas, Hospital Universitario Infantil La Paz, Madrid, Spain
| | - M T García-Silva
- Departamento de Pediatría, Unidad de Enfermedades Mitocondriales-Metabólicas Hereditarias, Hospital Universitario Doce de Octubre, Universidad Complutense de Madrid, CIBERER, Madrid, Spain
| | - P Quijada-Fraile
- Departamento de Pediatría, Unidad de Enfermedades Mitocondriales-Metabólicas Hereditarias, Hospital Universitario Doce de Octubre, Universidad Complutense de Madrid, CIBERER, Madrid, Spain
| | - C Pedrón-Giner
- Sección de Gastroenterología y Nutrición, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - E Dulin
- Laboratorio de Cribado Neonatal, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - R Yahyaoui
- Laboratorio de Metabolopatías, Hospital Regional de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - J M Egea
- Centro de Bioquímica y Genética Clínica, Unidad de Metabolopatías, Hospital General Universitario Virgen de la Arrixaca, Murcia, Spain
| | - A Belanger-Quintana
- Unidad de Enfermedades Metabólicas, Servicio de Pediatría, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - J Blasco-Alonso
- Sección de Gastroenterología y Nutrición Pediátrica, Hospital Regional de Málaga, Málaga, Spain
| | - M L Fernandez Ruano
- Laboratorio de Cribado Neonatal, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - B Besga
- Laboratorio de Cribado Neonatal, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - I Ferrer-López
- Centro de Diagnóstico de Enfermedades Moleculares, Centro de Biología Molecular-SO UAM-CSIC, Universidad Autónoma de Madrid, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), IdiPAZ, Madrid, Spain
| | - F Leal
- Centro de Diagnóstico de Enfermedades Moleculares, Centro de Biología Molecular-SO UAM-CSIC, Universidad Autónoma de Madrid, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), IdiPAZ, Madrid, Spain
| | - M Ugarte
- Centro de Diagnóstico de Enfermedades Moleculares, Centro de Biología Molecular-SO UAM-CSIC, Universidad Autónoma de Madrid, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), IdiPAZ, Madrid, Spain
| | - P Ruiz-Sala
- Centro de Diagnóstico de Enfermedades Moleculares, Centro de Biología Molecular-SO UAM-CSIC, Universidad Autónoma de Madrid, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), IdiPAZ, Madrid, Spain
| | - B Pérez
- Centro de Diagnóstico de Enfermedades Moleculares, Centro de Biología Molecular-SO UAM-CSIC, Universidad Autónoma de Madrid, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), IdiPAZ, Madrid, Spain
| | - C Pérez-Cerdá
- Centro de Diagnóstico de Enfermedades Moleculares, Centro de Biología Molecular-SO UAM-CSIC, Universidad Autónoma de Madrid, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), IdiPAZ, Madrid, Spain
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Robalo-Cordeiro C, Campos P, Carvalho L, Borba A, Clemente S, Freitas S, Furtado S, Jesus JM, Leal C, Marques A, Melo N, Souto-Moura C, Neves S, Sousa V, Santos A, Morais A. Idiopathic pulmonary fibrosis in the era of antifibrotic therapy: Searching for new opportunities grounded in evidence. Rev Port Pneumol (2006) 2017; 23:287-293. [PMID: 28668400 DOI: 10.1016/j.rppnen.2017.05.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 05/29/2017] [Indexed: 11/16/2022] Open
Abstract
Idiopathic pulmonary fibrosis (IPF) is a progressive and fatal lung disease that up to now has been associated with a poor prognosis. However, the results of the INPULSIS and ASCEND trials and the approval of nintedanib and pirfenidone have marked the beginning of a new era for IPF patients. Questions remain, however. Should these drugs be used earlier? What effect will they have on more severe disease? Will their effects last beyond the trial period? This manuscript is the outcome of a multidisciplinary meeting between pulmonology, radiology, and pathology clinicians on the use of antifibrotic agents in IPF. In our opinion, the existing data show that pirfenidone and nintedanib slow functional decline in early stages of disease. These drugs also appear to result in therapeutic benefits when administered to patients with advanced disease at diagnosis and maintain effective over time. The data also suggest that continuing antifibrotic therapy after disease progression may confer benefits, but more evidence is needed. Early diagnosis and treatment are crucial for reducing functional decline, slowing disease progression, and improving quality of life.
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Affiliation(s)
- C Robalo-Cordeiro
- Pulmonology Department, Coimbra University Hospital, Faculty of Medicine of Coimbra, Coimbra, Portugal.
| | - P Campos
- Imagiology Department, Santa Maria Hospital, Northern Lisbon Hospital Centre, Lisbon, Portugal
| | - L Carvalho
- Pathology Department, Faculty of Medicine of the University of Coimbra, Coimbra, Portugal
| | - A Borba
- Pulmonology Department, Santa Marta Hospital, Central Lisbon Hospital Centre, Lisbon, Portugal
| | - S Clemente
- Pulmonology Department, Beatriz Ângelo Hospital, Loures, Portugal
| | - S Freitas
- Pulmonology Department, Coimbra University Hospital Centre, Coimbra, Portugal
| | - S Furtado
- Pulmonology Department, Beatriz Ângelo Hospital, Loures, Portugal
| | - J M Jesus
- Radiology Department, São João Hospital Centre, Oporto, Portugal
| | - C Leal
- Radiology Department, Santa Marta Hospital, Central Lisbon Hospital Centre, Lisbon, Portugal
| | - A Marques
- Pulmonology Department, São João Hospital Centre, Oporto, Portugal
| | - N Melo
- Pulmonology Department, São João Hospital Centre, Oporto, Portugal
| | - C Souto-Moura
- Pathology Department, São João Hospital Centre, Faculty of Medicine of Porto University, Oporto, Portugal
| | - S Neves
- Pulmonology Department, Vila Nova de Gaia/Espinho Hospital Centre, Vila Nova de Gaia, Portugal
| | - V Sousa
- Pathology Department, Faculty of Medicine of the University of Coimbra, Coimbra, Portugal
| | | | - A Morais
- Pulmonology Department, São João Hospital Centre, Oporto, Portugal
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Cardoso AV, Mota PC, Melo N, Guimarães S, Souto Moura C, Jesus JM, Cunha R, Morais A. Analysis of sarcoidosis in the Oporto region (Portugal). Rev Port Pneumol (2006) 2017. [PMID: 28625882 DOI: 10.1016/j.rppnen.2017.05.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND Sarcoidosis is a systemic granulomatous disease of unknown etiology. Epidemiological studies of different populations are essential because clinical presentation, organ involvement, disease severity, and prognosis vary significantly according to region and population. The aim of this study was to assess epidemiological and clinical characteristics, staging factors, and clinical course in patients with sarcoidosis from a tertiary hospital in Oporto, Portugal. METHODS A retrospective analysis of patients with sarcoidosis and at least 2 years of follow-up evaluated at the Centro Hospitalar de São João between 2000 and 2014. RESULTS We identified 409 patients with sarcoidosis (females, 58.9%; mean age at diagnosis, 38.9±13.4 years; smokers, 14.4%]. All the patients were diagnosed according to the ERS/ATS/WASOG consensus statement and 64.1% had evidence of noncaseating epithelioid cell granulomas in biopsy specimens. Bronchoalveolar lavage was performed as part of the diagnostic work-up in 289 patients and 90.2% had lymphocytosis (CD4/CD8 ratio ≥3.5 in 60.9% of cases). Exertion dyspnea, cough, and constitutional symptoms were the most common presenting symptoms; 10.1% of patients were asymptomatic, 22.8% had Löfgren syndrome, and 50.5% had extrathoracic involvement. Radiographic stages of disease according to the Scadding criteria were as follows: stage 0 (5.2%), stage I (33.7%), stage II (47.0%), stage III (8.4%), and stage IV (5.7%). Impaired respiratory function was observed in 45.6% patients and was mostly mild. Systemic treatment was administered in 58.6% of cases. Overall, 45.3% of patients experienced disease resolution. CONCLUSION The epidemiological and clinical characteristics of this cohort of patients with sarcoidosis from the Oporto region in northern Portugal revealed epidemiological and clinical characteristics that were generally similar to those described in other Western Europe populations and in the US ACCESS study. However, we found a higher proportion of patients who progressed to chronic forms.
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Affiliation(s)
- A V Cardoso
- Pneumology Department, Centro Hospitalar de São João, Porto, Portugal.
| | - P C Mota
- Pneumology Department and Diffuse Lung Disease Study Group, Centro Hospitalar de São João, Porto, Portugal; Faculty of Medicine of Porto University, Porto, Portugal
| | - N Melo
- Pneumology Department and Diffuse Lung Disease Study Group, Centro Hospitalar de São João, Porto, Portugal
| | - S Guimarães
- Pathology Department, Centro Hospitalar de São João, Porto, Portugal
| | - C Souto Moura
- Pathology Department, Centro Hospitalar de São João, Porto, Portugal
| | - J M Jesus
- Radiology Department, Centro Hospitalar de São João, Porto, Portugal
| | - R Cunha
- Radiology Department, Centro Hospitalar de São João, Porto, Portugal
| | - A Morais
- Pneumology Department and Diffuse Lung Disease Study Group, Centro Hospitalar de São João, Porto, Portugal; Faculty of Medicine of Porto University, Porto, Portugal
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Morais A. IMPACT FACTOR 1,35Once again; what should and could we do about it? Rev Port Pneumol (2006) 2016; 22:305-307. [PMID: 27955804 DOI: 10.1016/j.rppnen.2016.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Indexed: 06/06/2023] Open
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Morais A. Wisdom and tenacity: Our inseparable companions on this long and hard road. Rev Port Pneumol (2006) 2016; 22:185-6. [PMID: 27370107 DOI: 10.1016/j.rppnen.2016.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Indexed: 11/18/2022] Open
Affiliation(s)
- A Morais
- Serviço de Pneumologia, Hospital São João, Porto, Portugal.
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Dias C, Mota P, Neves I, Guimarães S, Souto Moura C, Morais A. Transbronchial cryobiopsy in the diagnosis of desquamative interstitial pneumonia. Rev Port Pneumol (2006) 2016; 22:288-90. [PMID: 27134124 DOI: 10.1016/j.rppnen.2016.03.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 02/26/2016] [Accepted: 03/22/2016] [Indexed: 10/21/2022] Open
Affiliation(s)
- C Dias
- Centro Hospitalar de São João, Porto, Portugal.
| | - P Mota
- Serviço de Pneumologia, Centro Hospitalar de São João, Porto, Portugal
| | - I Neves
- Serviço de Pneumologia, ULSM - Hospital Pedro Hispano, Matosinhos, Portugal
| | - S Guimarães
- Serviço de Anatomia Patológica, Centro Hospitalar de São João, Porto, Portugal
| | - C Souto Moura
- Serviço de Anatomia Patológica, Centro Hospitalar de São João, Porto, Portugal, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - A Morais
- Serviço de Pneumologia - Centro Hospitalar de São João, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
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Morais A, Longo C, Araujo JR, Barroso M, Durrant JR, Nogueira AF. Nanocrystalline anatase TiO2/reduced graphene oxide composite films as photoanodes for photoelectrochemical water splitting studies: the role of reduced graphene oxide. Phys Chem Chem Phys 2016; 18:2608-16. [DOI: 10.1039/c5cp06707c] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Schematic of a photoelectrochemical cell using TiO2/RGO film as the photoanode.
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Affiliation(s)
- Andreia Morais
- Chemistry Institute
- University of Campinas (UNICAMP)
- São Paulo
- Brazil
| | - Claudia Longo
- Chemistry Institute
- University of Campinas (UNICAMP)
- São Paulo
- Brazil
| | - Joyce R. Araujo
- National Institute of Metrology
- Quality and Technology
- Rio de Janeiro
- Brazil
| | - Monica Barroso
- Debye Institute for Nanomaterials Science
- Utrecht University
- 3584 CJ Utrecht
- Netherlands
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Silva R, Morais A, Melo J, Macedo P, Costa L, Batista‐de‐Oliveira Hornsby M. Neonatal Exercise Prevents Anxiety‐Related Behavior and Improves Episodic Memory in Adult but not in Aged Rats. FASEB J 2015. [DOI: 10.1096/fasebj.29.1_supplement.840.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Rosangela Silva
- NutritionFederal University of PernambucoRecifePernambucoBrazil
| | - Andreia Morais
- NutritionFederal University of PernambucoRecifePernambucoBrazil
| | - Janatar Melo
- NutritionFederal University of PernambucoRecifePernambucoBrazil
| | - Patricia Macedo
- NutritionFederal University of PernambucoRecifePernambucoBrazil
| | - Lais Costa
- NutritionFederal University of PernambucoRecifePernambucoBrazil
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Redondo MT, Melo N, Mota PC, Jesus JM, Moura CS, Guimarães S, Morais A. Idiopathic pleuroparenchymal fibroelastosis: a rare but increasingly recognized entity. Rev Port Pneumol (2006) 2015; 21:41-4. [PMID: 25854135 DOI: 10.1016/j.rppnen.2014.04.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 12/03/2013] [Accepted: 04/29/2014] [Indexed: 11/15/2022] Open
Abstract
Idiopathic pleuroparenchymal fibroelastosis (IPPFE) is a recently described rare entity, characterized by pleural and subpleural parenchymal fibrosis and elastosis mainly in the upper lobes. The etiology and pathophysiology are unknown. The prognosis is poor, with no effective therapies other than lung transplantation. IPPFE should be properly identified so that it can be approached correctly. This report describes two clinical cases with clinical imaging and histological features compatible with IPPFE.
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Affiliation(s)
- M T Redondo
- Department of Pneumology, Centro Hospitalar de São João, Portugal.
| | - N Melo
- Department of Pneumology, Centro Hospitalar de São João, Portugal
| | - P C Mota
- Department of Pneumology, Centro Hospitalar de São João, Portugal; Faculty of Medicine of University of Porto, Portugal
| | - J M Jesus
- Department of Radiology, Centro Hospitalar de São João, Portugal
| | - C S Moura
- Faculty of Medicine of University of Porto, Portugal; Department of Pathology, Centro Hospitalar de São João, Portugal
| | - S Guimarães
- Department of Pathology, Centro Hospitalar de São João, Portugal
| | - A Morais
- Department of Pneumology, Centro Hospitalar de São João, Portugal; Faculty of Medicine of University of Porto, Portugal
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Benedetti JE, Bernardo DR, Morais A, Bettini J, Nogueira AF. Synthesis and characterization of a quaternary nanocomposite based on TiO2/CdS/rGO/Pt and its application in the photoreduction of CO2 to methane under visible light. RSC Adv 2015. [DOI: 10.1039/c4ra15605f] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
”Together we are stronger”: For the first time, TiO2/CdS/rGO/Pt nanocomposite was used as a catalyst for the photocatalytic reduction of CO2 to CH4.
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Affiliation(s)
- J. E. Benedetti
- Chemistry Institute
- University of Campinas – UNICAMP
- Campinas, Brazil
| | - D. R. Bernardo
- Chemistry Institute
- University of Campinas – UNICAMP
- Campinas, Brazil
| | - A. Morais
- Chemistry Institute
- University of Campinas – UNICAMP
- Campinas, Brazil
| | - Jefferson Bettini
- National Nanotechnology Laboratory
- National Center for Energy and Materials Research
- CNPEM
- Campinas, Brazil
| | - A. F. Nogueira
- Chemistry Institute
- University of Campinas – UNICAMP
- Campinas, Brazil
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