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Vieira RJ, Pereira AM, Taborda‐Barata L, Regateiro FS, Marques‐Cruz M, Robalo Cordeiro C, Loureiro CC, Dávila IJ, Bousquet J, Fonseca JA, Sousa‐Pinto B. Regional, sex, and age inequities in asthma hospital admissions in Spain and Portugal. Clin Transl Allergy 2024; 14:e12349. [PMID: 38554237 PMCID: PMC10981468 DOI: 10.1002/clt2.12349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Asthma presents a significant health challenge, imposing a considerable burden on healthcare services. Discrepancies in asthma-related hospitalisations may reflect underlying health disparities. We aimed to analyse inequities in asthma hospital admissions in mainland Portugal and Spain, from a regional perspective and considering sex and age. METHODS We conducted a retrospective study using data from the Spanish and Portuguese national hospitalisations databases. We calculated crude national and regional yearly hospitalisation rates according per Nomenclature of Territorial Units for Statistics region. Additionally, we calculated hospitalisation rates adjusted for asthma prevalence and the female-to-male ratio in asthma hospital admissions per age group, considering the female-to-male ratio in the overall population. RESULTS Between 2012 and 2016, there were 92,084 asthma hospital admissions in mainland Spain and 7717 in mainland Portugal. There was a trend for a higher-than-average rate of asthma-related hospitalisations in the Northern regions of both countries. Women had a hospitalisation rate that was 3.2 times higher than men. Age was associated with higher risk for asthma hospitalisation, with individuals aged 65 and older displaying a hospitalisation rate 4.5 times higher than those under 65. Additionally, while hospitalisations in women aged <65 years were 2.3 times more likely than in men of the same age, hospitalisations in women aged ≥65 years were 3.5 times higher than in men aged ≥65 years. CONCLUSION This study suggests that marked regional inequities in asthma hospital admissions exist in Spain and Portugal. Additionally, women are particularly at risk of hospitalisation due to asthma, and such risk increases with age.
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Affiliation(s)
- Rafael José Vieira
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS)Faculty of MedicineUniversity of PortoPortoPortugal
- Centre for Health Technology and Services ResearchHealth Research Network (CINTESIS@RISE)Faculty of Medicine of the University of PortoPortoPortugal
| | - Ana Margarida Pereira
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS)Faculty of MedicineUniversity of PortoPortoPortugal
- Allergy UnitCUF Porto Hospital & InstitutePortoPortugal
- PaCeIT – Patient Centered Innovation and TechnologiesCenter for Health Technology and Services Research (CINTESIS)Faculty of MedicineUniversity of PortoPortoPortugal
| | - Luís Taborda‐Barata
- UBIAir ‐ Clinical & Experimental Lung Centre and CICS‐UBI Health Sciences Research CentreUniversity of Beira InteriorCovilhãPortugal
- CICS – Health Sciences Research CentreUniversity of Beira InteriorCovilhãPortugal
- Department of ImmunoallergologyCova da Beira University Hospital CentreCovilhãPortugal
| | - Frederico S. Regateiro
- UBIAir ‐ Clinical & Experimental Lung Centre and CICS‐UBI Health Sciences Research CentreUniversity of Beira InteriorCovilhãPortugal
- Allergy and Clinical Immunology UnitCentro Hospitalar Universitário de CoimbraCoimbraPortugal
- Institute of ImmunologyFaculty of MedicineUniversity of CoimbraCoimbraPortugal
- Center for Innovative Biomedicine and Biotechnology (CIBB)Faculty of MedicineUniversity of CoimbraCoimbraPortugal
| | - Manuel Marques‐Cruz
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS)Faculty of MedicineUniversity of PortoPortoPortugal
| | - Carlos Robalo Cordeiro
- Department of PulmonologyUniversity Hospital of CoimbraCoimbraPortugal
- Faculty of MedicineUniversity of CoimbraCoimbraPortugal
| | - Cláudia Chaves Loureiro
- Department of PulmonologyUniversity Hospital of CoimbraCoimbraPortugal
- Faculty of MedicineUniversity of CoimbraCoimbraPortugal
| | - Ignacio J. Dávila
- Allergy ServiceUniversity HospitalSalamancaSpain
- School of MedicineUniversity of SalamancaSalamancaSpain
- Spanish Society of Allergology and Clinical ImmunologySalamancaSpain
| | - Jean Bousquet
- Institute for AllergologyCharité ‐ Universitätsmedizin BerlinCorporate, Member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
- Allergology and ImmunologyFraunhofer Institute for Translational Medicine and Pharmacology ITMPBerlinGermany
- ARIAMontpellierFrance
| | - João A. Fonseca
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS)Faculty of MedicineUniversity of PortoPortoPortugal
- Centre for Health Technology and Services ResearchHealth Research Network (CINTESIS@RISE)Faculty of Medicine of the University of PortoPortoPortugal
- Allergy UnitCUF Porto Hospital & InstitutePortoPortugal
| | - Bernardo Sousa‐Pinto
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS)Faculty of MedicineUniversity of PortoPortoPortugal
- Centre for Health Technology and Services ResearchHealth Research Network (CINTESIS@RISE)Faculty of Medicine of the University of PortoPortoPortugal
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2
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Bousquet J, Samolinski B, Kaidashev I, Maurer M, Roche N, Sousa-Pinto B, Kurchenko A, Stepanenko R, Tsaryk V, Klimek L, Ventura MT, Bedbrook A, Czarlewski W, Lysanets Y, Kupczyk M, Skolimowski Ł, Kulus M, Del Giacco S, Ollert M, Garcia-Aymerich J, Robalo Cordeiro C, Yorgancioglu A, Schlapbach C, Amaral R, Bonaglia C, Bossé I, Buquicchio R, Christou D, Fedoruk G, Fontanesi P, Gemicioglu B, Giuliano AFM, Lepore P, Nakonechna A, Neisinger S, Pereira AM, Ramanauskaite A, Raciborski F, Sitkauskiene B, Sokhatska O, Stepanenko V, Stevanovic K, Syzon O, Kvedariene V, de Vries G, van Eerd M, Valiulis A, Fonseca JA, Anto JM, Haahtela T, Schünemann H, Zuberbier T. UCRAID (Ukrainian Citizen and refugee electronic support in Respiratory diseases, Allergy, Immunology and Dermatology) action plan. Allergy 2023; 78:2581-2595. [PMID: 37641384 DOI: 10.1111/all.15855] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 07/26/2023] [Accepted: 08/08/2023] [Indexed: 08/31/2023]
Abstract
Eight million Ukrainians have taken refuge in the European Union. Many have asthma and/or allergic rhinitis and/or urticaria, and around 100,000 may have a severe disease. Cultural and language barriers are a major obstacle to appropriate management. Two widely available mHealth apps, MASK-air® (Mobile Airways Sentinel NetworK) for the management of rhinitis and asthma and CRUSE® (Chronic Urticaria Self Evaluation) for patients with chronic spontaneous urticaria, were updated to include Ukrainian versions that make the documented information available to treating physicians in their own language. The Ukrainian patients fill in the questionnaires and daily symptom-medication scores for asthma, rhinitis (MASK-air) or urticaria (CRUSE) in Ukrainian. Then, following the GDPR, patients grant their physician access to the app by scanning a QR code displayed on the physician's computer enabling the physician to read the app contents in his/her own language. This service is available freely. It takes less than a minute to show patient data to the physician in the physician's web browser. UCRAID-developed by ARIA (Allergic Rhinitis and its Impact on Asthma) and UCARE (Urticaria Centers of Reference and Excellence)-is under the auspices of the Ukraine Ministry of Health as well as European (European Academy of Allergy and Clinical immunology, EAACI, European Respiratory Society, ERS, European Society of Dermatologic Research, ESDR) and national societies.
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Affiliation(s)
- Jean Bousquet
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
- MASK-air, Montpellier, France
| | - Boleslaw Samolinski
- Department of Prevention of Environmental Hazards, Allergology and Immunology, Medical University of Warsaw, Warsaw, Poland
| | | | - Marcus Maurer
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
| | - Nicolas Roche
- Pneumologie, AP-HP Centre Université de Paris Cité, Hôpital Cochin, Paris, France
- UMR 1016, Institut Cochin, Paris, France
| | - Bernardo Sousa-Pinto
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS@RISE- Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Andrii Kurchenko
- Department of Clinical Immunology and Allergology with section of Medical Genetic, Bogomolets National Medical University, Kiev, Ukraine
| | - Roman Stepanenko
- Department of Dermatology and Venereology with Cosmetology Course, Bogomolets National Medical University, Kiev, Ukraine
| | - Vladyslav Tsaryk
- Department of Clinical Immunology and Allergology with section of Medical Genetic, Bogomolets National Medical University, Kiev, Ukraine
| | - Ludger Klimek
- Department of Otolaryngology, Head and Neck Surgery, Universitätsmedizin Mainz, Mainz, Germany
- Center for Rhinology and Allergology, Wiesbaden, Germany
| | - Maria Teresa Ventura
- Allergy and Clinical Immunology, University of Bari Medical School, Bari, Italy
- Institute of Sciences of Food Production, National Research Council (ISPA-CNR), Bari, Italy
| | - Anna Bedbrook
- MASK-air, Montpellier, France
- ARIA, Montpellier, France
| | | | | | - Maciej Kupczyk
- Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | | | - Marek Kulus
- Department of Pediatric Respiratory Diseases and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - Stefano Del Giacco
- Department of Medical Sciences and Public Health and Unit of Allergy and Clinical Immunology, University Hospital 'Duilio Casula', University of Cagliari, Cagliari, Italy
| | - Markus Ollert
- Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark
- Odense Research Center for Anaphylaxis (ORCA), Odense, Denmark
| | - Judith Garcia-Aymerich
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Carlos Robalo Cordeiro
- Department of Pneumology, Coimbra University Hospital, Faculty of Medicine, Coimbra, Portugal
| | - Arzu Yorgancioglu
- Department of Pulmonary Diseases, Celal Bayar University, Faculty of Medicine, Manisa, Turkey
| | | | - Rita Amaral
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS@RISE- Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Cristina Bonaglia
- Institute 'Bona Sforza', University for Linguistic Mediators, Bari, Italy
| | | | | | - Demetrios Christou
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
| | - Galyna Fedoruk
- Department of Clinical Immunology and Allergology with section of Medical Genetic, Bogomolets National Medical University, Kiev, Ukraine
| | - Pietro Fontanesi
- Institute 'Bona Sforza', University for Linguistic Mediators, Bari, Italy
| | - Bilun Gemicioglu
- Department of Pulmonary Diseases, Istanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Istanbul, Turkey
| | - Antonio F M Giuliano
- Allergy and Clinical Immunology, University of Bari Medical School, Bari, Italy
- Department of Internal Medicine 'A. Murri', University of Bari Medical School, Bari, Italy
| | - Paolo Lepore
- Rotary Club Bari Mediterranean RY23/24, Bari, Italy
| | - Alla Nakonechna
- Clinical Immunology and Allergy Unit, Sheffield Teaching Hospitals, Sheffield, UK
- University of Liverpool, Liverpool, UK
| | - Sophia Neisinger
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
| | - Ana M Pereira
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS@RISE- Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Aiste Ramanauskaite
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
| | - Filip Raciborski
- Department of Prevention of Environmental Hazards, Allergology and Immunology, Medical University of Warsaw, Warsaw, Poland
| | - Brigita Sitkauskiene
- Department of Immunology and Allergology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Oksana Sokhatska
- Basic & Clinical Immunology Unit, Department of Pathology, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Viktor Stepanenko
- Department of Dermatology and Venereology with Cosmetology Course, Bogomolets National Medical University, Kiev, Ukraine
| | - Katarina Stevanovic
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
| | - Orysya Syzon
- Department of Dermatology, Venereology, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
| | - Violeta Kvedariene
- Institute of Clinical Medicine, Clinic of Chest Diseases and Allergology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
- Department of Pathology, Faculty of Medicine, Institute of Biomedical Sciences, Vilnius University, Vilnius, Lithuania
| | | | | | - Arunas Valiulis
- Interdisciplinary Research Group of Human Ecology, Institute of Clinical Medicine and Institute of Health Sciences, Medical Faculty of Vilnius University, Vilnius, Lithuania
- European Academy of Paediatrics (EAP/UEMS-SP), Brussels, Belgium
| | - Joao A Fonseca
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS@RISE- Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Josep M Anto
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Tari Haahtela
- Skin and Allergy Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Holger Schünemann
- Department of Health Research Methods, Evidence, and Impact & Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Torsten Zuberbier
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
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3
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Figueira JR, Oliveira HM, Serro AP, Colaço R, Froes F, Robalo Cordeiro C, Diniz A, Guimarães M. A multiple criteria approach for building a pandemic impact assessment composite indicator: The case of COVID-19 in Portugal. Eur J Oper Res 2023; 309:795-818. [PMID: 36688141 PMCID: PMC9847371 DOI: 10.1016/j.ejor.2023.01.025] [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] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 01/14/2023] [Indexed: 06/17/2023]
Abstract
The COVID-19 pandemic has caused major damage and disruption to social, economic, and health systems (among others). In addition, it has posed unprecedented challenges to public health and policy/decision-makers who have been responsible for designing and implementing measures to mitigate its strong negative impact. The Portuguese health authorities have used decision analysis techniques to assess the impact of the pandemic and implemented measures for counties, regions, or across the entire country. These decision tools have been subject to some criticism and many stakeholders requested novel approaches. In particular, those which considered the dynamic changes in the pandemic's behaviour due to new virus variants and vaccines. A multidisciplinary team formed by researchers from the COVID-19 Committee of Instituto Superior Técnico at the University of Lisbon (CCIST analyst team) and physicians from the Crisis Office of the Portuguese Medical Association (GCOM expert team) collaborated to create a new tool to help politicians and decision-makers to fight the pandemic. This paper presents the main steps that led to the building of a pandemic impact assessment composite indicator applied to the specific case of COVID-19 in Portugal. A multiple criteria approach based on an additive multi-attribute value theory aggregation model was used to build the pandemic assessment composite indicator. The parameters of the additive model were devised based on an interactive socio-technical and co-constructive process between the CCIST and GCOM team members. The deck of cards method was the adopted technical tool to assist in the assessment the value functions as well as in the assessment of the criteria weights. The final tool was presented at a press conference and had a powerful impact on the Portuguese media and on the main health decision-making stakeholders in the country. In this paper, a completed mathematical and graphical description of this tool is presented.
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Affiliation(s)
- José Rui Figueira
- CEGIST, Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais, 1, Lisboa 1049-001, Portugal
| | | | - Ana Paula Serro
- CQE, Instituto Superior Técnico, Universidade de Lisboa, Portugal
| | - Rogério Colaço
- IDMEC, Instituto Superior Técnico, Universidade de Lisboa, Portugal
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Moura Cabral S, Abreu I, Madama D, Estevão A, Cordeiro E, Pimentel J, Miranda N, Ferreira AJ, Robalo Cordeiro C. Lung Cancer Screening: Low-Dose Thoracic Computed Tomography Performed in a High-Risk Portuguese Population. ACTA MEDICA PORT 2023; 36:559-566. [PMID: 37658722 DOI: 10.20344/amp.16847] [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: 07/10/2021] [Accepted: 12/02/2022] [Indexed: 09/03/2023]
Abstract
INTRODUCTION The Urgeiriça mines were once the main uranium producer in Portugal. The aim of this study was to estimate the benefit of low-dose chest computed tomography (LDCT) for lung cancer screening in former miners that were considered as being at high-risk. METHODS A subgroup of former miners of the Uranium National Company exposed to uranium and with a smoking load greater than 20 pack-years, agreed to perform a LDCT. The Fleischner Society Guidelines were used to classify the nodules and establish follow-up. RESULTS Initially, 265 former employees of the Uranium National Company were included. The mean time of employment was 15 (0 - 45) years. The non-smokers represented 50.9% and 30.2% were ever smokers; the remaining chose not to respond. One diagnosis of lung cancer was initially made. In the second phase, a subgroup of 66 former miner underwent a LDCT, 37 of whom presented pulmonary nodules. Most computed tomography (CT) scans revealed one single nodule (n = 13) and the mean size was 5 (1 - 16) mm. A suspicious 16 mm spiculated nodule was evaluated with PET/CT, and percutaneous and surgical biopsies, ultimately revealing a benign lesion. CONCLUSION The data highlights the importance of lung cancer screening in high-risk populations. This was, to the best of our knowledge, the first study performed in Portugal and can act as a bridge towards a wider implementation in the country.
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Affiliation(s)
- Sara Moura Cabral
- Pulmonology Department. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal
| | - Inês Abreu
- Radiology Department. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal
| | - Daniela Madama
- Pulmonology Department. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal
| | - Amélia Estevão
- Radiology Department. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal
| | - Eugénio Cordeiro
- Department of Public Health. Administração Regional de Saúde do Centro. Coimbra. Portugal
| | - João Pimentel
- Department of Public Health. Administração Regional de Saúde do Centro. Coimbra. Portugal
| | - Nuno Miranda
- Haematology Department. Instituto Português de Oncologia de Lisboa. National Programme for Oncological Diseases. Lisboa. Portugal
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Gil-de-Miguel Á, Díez-Domingo J, Martinón-Torres F, Margüello ER, de Lejarazu Leonardo RO, Pumarola T, de Sousa JC, Rabaçal C, Raposo J, Cordeiro CR, Froes F. Addressing influenza's underestimated burden - Iberian experts call to action. BMC Infect Dis 2023; 23:308. [PMID: 37158822 PMCID: PMC10165560 DOI: 10.1186/s12879-023-08277-x] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 04/25/2023] [Indexed: 05/10/2023] Open
Abstract
Having a proper understanding of the impact of influenza is a fundamental step towards improved preventive action. This paper reviews findings from the Burden of Acute Respiratory Infections study on the burden of influenza in Iberia, and its potential underestimation, and proposes specific measures to lessen influenza's impact.
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Affiliation(s)
- Ángel Gil-de-Miguel
- Public Health and Medical Specialties Department, Health Sciences Faculty, Rey Juan Carlos University, Madrid, Spain.
- Universidad Rey Juan Carlos, Avda. de Atenas, s/n, 28922, Alcorcón, Madrid, Spain.
| | | | - Federico Martinón-Torres
- Translational Pediatrics and Infectious Diseases, Hospital Clínico Universitario and Universidad de Santiago de Compostela, Galicia, Spain
- Genetics, Vaccines and Pediatric Infectious Diseases Research Group (GENVIP), Instituto de Investigación Sanitaria de Santiago and Universidad de Santiago de Compostela (USC), Galicia, Spain
- CIBER Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
| | | | | | - Tomàs Pumarola
- Department of Microbiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Jaime Correia de Sousa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, PT Government Associate Laboratory, University of Minho, Braga Portugal. ICVS/3B's, Braga/Guimarães, Portugal
| | | | - João Raposo
- APDP and Nova Medical School, Lisbon, Portugal
| | - Carlos Robalo Cordeiro
- Pulmonology Department, Coimbra University Hospital, University of Coimbra, Coimbra, Portugal
| | - Filipe Froes
- Thorax Department, ICU, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
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Ward B, Koziar Vašáková M, Robalo Cordeiro C, Yorgancioğlu A, Chorostowska-Wynimko J, Blum TG, Kauczor HU, Samarzija M, Henschke C, Wheelock C, Grigg J, Andersen ZJ, Koblížek V, Májek O, Odemyr M, Powell P, Seijo LM. Important steps towards a big change for lung health: a joint approach by the European Respiratory Society, the European Society of Radiology and their partners to facilitate implementation of the European Union's new recommendations on lung cancer screening. ERJ Open Res 2023; 9:00026-2023. [PMID: 37228272 PMCID: PMC10204812 DOI: 10.1183/23120541.00026-2023] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 02/21/2023] [Indexed: 05/27/2023] Open
Abstract
Enormous progress has been made on the epic journey towards implementation of lung cancer screening in Europe. A breakthrough for lung health has been achieved with the EU proposal for a Council recommendation on cancer screening. https://bit.ly/3J4O0Jb.
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Affiliation(s)
- Brian Ward
- Advocacy Department, European Respiratory Society, Brussels, Belgium
- These authors contributed equally
| | - Martina Koziar Vašáková
- Department of Respiratory Medicine, First Faculty of Medicine, Charles University, Thomayer University Hospital, Prague, Czech Republic
- These authors contributed equally
| | | | - Arzu Yorgancioğlu
- Chest Disease, Celal Bayar University Faculty of Medicine, Manisa, Turkey
| | - Joanna Chorostowska-Wynimko
- Department of Genetics and Clinical Immunology, National Institute of Tuberculosis and Lung Diseases, Warsaw, Poland
| | - Torsten Gerriet Blum
- Department of Pneumology, Lungenklinik Heckeshorn, HELIOS Klinikum Emil von Behring, Berlin, Germany
| | - Hans-Ulrich Kauczor
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, German Center of Lung Research, Heidelberg, Germany
| | - Miroslav Samarzija
- Clinical Department for Respiratory Diseases Jordanovac, University Hospital Centre Zagreb, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Claudia Henschke
- Department of Radiology, Mount Sinai Health System, New York, NY, USA
| | - Craig Wheelock
- Unit of Integrative Metabolomics, Institute of Environmental Medicine (IMM), Karolinska Institutet, Stockholm, Sweden
- Department of Respiratory Medicine and Allergy, Karolinska University Hospital, Stockholm, Sweden
| | | | | | - Vladimír Koblížek
- University Hospital, Pulmonary Department, Charles University, Hradec Kralove, Czech Republic
| | - Ondřej Májek
- National Screening Centre, Institute of Health Information and Statistics of the Czech Republic, Prague, Czech Republic
| | - Mikaela Odemyr
- Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | | | - Luis M. Seijo
- Department of Pulmonary Medicine, Clínica Universidad de Navarra, Madrid, Spain
- Ciberes, Madrid, Spain
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Sousa-Pinto B, Jácome C, Pereira AM, Regateiro FS, Almeida R, Czarlewski W, Kulus M, Shamji MH, Boulet LP, Bonini M, Brussino L, Canonica GW, Cruz AA, Gemicioglu B, Haahtela T, Kupczyk M, Kvedariene V, Larenas-Linnemann D, Louis R, Niedoszytko M, Pham-Thi N, Puggioni F, Romantowski J, Sastre J, Scichilone N, Taborda-Barata L, Ventura MT, Vieira RJ, Agache I, Bedbrook A, Bergmann KC, Amaral R, Azevedo LF, Bosnic-Anticevich S, Brusselle G, Buhl R, Cecchi L, Charpin D, Loureiro CC, de Blay F, Del Giacco S, Devillier P, Jassem E, Joos G, Jutel M, Klimek L, Kuna P, Laune D, Luna Pech J, Makela M, Morais-Almeida M, Nadif R, Neffen HE, Ohta K, Papadopoulos NG, Papi A, Pétré B, Pfaar O, Yeverino DR, Cordeiro CR, Roche N, Sá-Sousa A, Samolinski B, Sheikh A, Ulrik CS, Usmani OS, Valiulis A, Vandenplas O, Vieira-Marques P, Yorgancioglu A, Zuberbier T, Anto JM, Fonseca JA, Bousquet J. Development and validation of an electronic daily control score for asthma (e-DASTHMA): a real-world direct patient data study. Lancet Digit Health 2023; 5:e227-e238. [PMID: 36872189 DOI: 10.1016/s2589-7500(23)00020-1] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 01/23/2023] [Accepted: 01/24/2023] [Indexed: 03/06/2023]
Abstract
BACKGROUND Validated questionnaires are used to assess asthma control over the past 1-4 weeks from reporting. However, they do not adequately capture asthma control in patients with fluctuating symptoms. Using the Mobile Airways Sentinel Network for airway diseases (MASK-air) app, we developed and validated an electronic daily asthma control score (e-DASTHMA). METHODS We used MASK-air data (freely available to users in 27 countries) to develop and assess different daily control scores for asthma. Data-driven control scores were developed based on asthma symptoms reported by a visual analogue scale (VAS) and self-reported asthma medication use. We included the daily monitoring data from all MASK-air users aged 16-90 years (or older than 13 years to 90 years in countries with a lower age of digital consent) who had used the app in at least 3 different calendar months and had reported at least 1 day of asthma medication use. For each score, we assessed construct validity, test-retest reliability, responsiveness, and accuracy. We used VASs on dyspnoea and work disturbance, EQ-5D-VAS, Control of Allergic Rhinitis and Asthma Test (CARAT), CARAT asthma, and Work Productivity and Activity Impairment: Allergy Specific (WPAI:AS) questionnaires as comparators. We performed an internal validation using MASK-air data from Jan 1 to Oct 12, 2022, and an external validation using a cohort of patients with physician-diagnosed asthma (the INSPIRERS cohort) who had had their diagnosis and control (Global Initiative for Asthma [GINA] classification) of asthma ascertained by a physician. FINDINGS We studied 135 635 days of MASK-air data from 1662 users from May 21, 2015, to Dec 31, 2021. The scores were strongly correlated with VAS dyspnoea (Spearman correlation coefficient range 0·68-0·82) and moderately correlated with work comparators and quality-of-life-related comparators (for WPAI:AS work, we observed Spearman correlation coefficients of 0·59-0·68). They also displayed high test-retest reliability (intraclass correlation coefficients range 0·79-0·95) and moderate-to-high responsiveness (correlation coefficient range 0·69-0·79; effect size measures range 0·57-0·99 in the comparison with VAS dyspnoea). The best-performing score displayed a strong correlation with the effect of asthma on work and school activities in the INSPIRERS cohort (Spearman correlation coefficients 0·70; 95% CI 0·61-0·78) and good accuracy for the identification of patients with uncontrolled or partly controlled asthma according to GINA (area under the receiver operating curve 0·73; 95% CI 0·68-0·78). INTERPRETATION e-DASTHMA is a good tool for the daily assessment of asthma control. This tool can be used as an endpoint in clinical trials as well as in clinical practice to assess fluctuations in asthma control and guide treatment optimisation. FUNDING None.
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Affiliation(s)
- Bernardo Sousa-Pinto
- MEDicina da Comunidade, Informação e Decisão em Saúde, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; Centro de Investigação em Tecnologias e Serviços de Saúde, Rede de Investigação em Saúde, Health Research Network, MEDCIDS, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Cristina Jácome
- MEDicina da Comunidade, Informação e Decisão em Saúde, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; Centro de Investigação em Tecnologias e Serviços de Saúde, Rede de Investigação em Saúde, Health Research Network, MEDCIDS, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Ana Margarida Pereira
- MEDicina da Comunidade, Informação e Decisão em Saúde, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; Centro de Investigação em Tecnologias e Serviços de Saúde, Rede de Investigação em Saúde, Health Research Network, MEDCIDS, Faculty of Medicine, University of Porto, Porto, Portugal; Patient Centred Innovation and Technology, Centro de Investigação em Tecnologias e Serviços de Saúde, Centre for Health Technology and Services Research, University of Porto, Porto, Portugal
| | - Frederico S Regateiro
- Allergy and Clinical Immunology Unit, Centro Hospitalar e Universitário de Coimbra, Coimbra and Institute of Immunology, and Coimbra Institute for Clinical and Biomedical Research, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Rute Almeida
- MEDicina da Comunidade, Informação e Decisão em Saúde, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; Centro de Investigação em Tecnologias e Serviços de Saúde, Rede de Investigação em Saúde, Health Research Network, MEDCIDS, Faculty of Medicine, University of Porto, Porto, Portugal
| | | | - Marek Kulus
- Department of Pediatric Respiratory Diseases and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - Mohamed H Shamji
- National Heart and Lung Institute, Imperial College & National Institutes for Health Imperial Biomedical Research Centre, London, UK
| | | | - Matteo Bonini
- Department of Cardiovascular and Respiratory Sciences, Università Cattolica del Sacro Cuore, Rome, Italy; Department of Neurological, Ear, Nose, and Throat, and Thoracic Sciences, Fondazione Policlinico Universitario A Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy; National Heart and Lung Institute, Imperial College London, London, UK
| | - Luisa Brussino
- Department of Medical Sciences, Allergy and Clinical Immunology Unit, University of Torino & Mauriziano Hospital, Torino, Italy
| | - G Walter Canonica
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center IRCCS, Rozzano, Italy
| | - Alvaro A Cruz
- Fundaçao ProAR, Federal University of Bahia and Global Alliance Against Chronic Respiratory Diseases and WHO Planning Group, Salvador, Bahia, Brazil
| | - Bilun Gemicioglu
- Department of Pulmonary Diseases, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, Türkiye
| | - Tari Haahtela
- Skin and Allergy Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Maciej Kupczyk
- Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | - Violeta Kvedariene
- Institute of Biomedical Sciences, Department of Pathology and Institute of Clinical Medicine, Clinic of Chest Diseases and Allergology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Desirée Larenas-Linnemann
- Center of Excellence in Asthma and Allergy, Médica Sur Clinical Foundation and Hospital, México City, Mexico
| | - Renaud Louis
- Department of Pulmonary Medicine, Centre Hospitalier Universitaire Liege, and GIGA Infection, Immunity, Inflammation Laboratories research group, University of Liege, Liege, Belgium
| | - Marek Niedoszytko
- Department of Allergology, Medical University of Gdańsk, Gdansk, Poland
| | - Nhân Pham-Thi
- Institut de Recherche bio-Médicale des Armées, Bretigny sur Orge, France; École Polytechnique de Palaiseau, Palaiseau, France; Université Paris Cité, Paris, France
| | - Francesca Puggioni
- Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center IRCCS, Rozzano, Italy
| | - Jan Romantowski
- Department of Allergology, Medical University of Gdańsk, Gdansk, Poland
| | - Joaquin Sastre
- Allergy Service, Fundacion Jimenez Diaz, Faculty of Medicine Universidad Autonoma de Madrid, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Madrid, Spain
| | | | - Luis Taborda-Barata
- University of Beira Interior Air, Clinical & Experimental Lung Centre and Centro de Investigação em Ciências da Saúde-University of Beira Interior Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal; Department of Immunoallergology, Cova da Beira University Hospital Centre, Covilhã, Portugal
| | - Maria Teresa Ventura
- Unit of Geriatric Immunoallergology, University of Bari Medical School, Bari, Italy
| | - Rafael José Vieira
- MEDicina da Comunidade, Informação e Decisão em Saúde, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; Centro de Investigação em Tecnologias e Serviços de Saúde, Rede de Investigação em Saúde, Health Research Network, MEDCIDS, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Ioana Agache
- Faculty of Medicine, Transylvania University Brasov, Brasov, Romania
| | - Anna Bedbrook
- Allergic Rhinitis and its Impact on Asthma, Montpellier, France
| | - Karl C Bergmann
- Institute of Allergology, Charité, Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology, Allergology and Immunology, Berlin, Germany
| | - Rita Amaral
- MEDicina da Comunidade, Informação e Decisão em Saúde, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; Centro de Investigação em Tecnologias e Serviços de Saúde, Rede de Investigação em Saúde, Health Research Network, MEDCIDS, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Luís Filipe Azevedo
- MEDicina da Comunidade, Informação e Decisão em Saúde, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; Centro de Investigação em Tecnologias e Serviços de Saúde, Rede de Investigação em Saúde, Health Research Network, MEDCIDS, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Sinthia Bosnic-Anticevich
- Quality Use of Respiratory Medicine Group, Woolcock Institute of Medical Research, The University of Sydney, and Sydney Local Health District, Sydney, NSW, Australia
| | - Guy Brusselle
- Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Roland Buhl
- Department of Pulmonary Medicine, Mainz University Hospital, Mainz, Germany
| | - Lorenzo Cecchi
- Struttura Organizzativa Semplice Allergology and Clinical Immunology Unita Sanitaria Locale, Toscana Centro, Prato, Italy
| | - Denis Charpin
- Clinique des Bronches, Allergie et Sommeil, Hôpital Nord, Marseille, France
| | - Claudia Chaves Loureiro
- Pneumology Unit, Hospitais da Universidade de Coimbra, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Frédéric de Blay
- Allergy Division, Chest Disease Department, University Hospital of Strasbourg, Strasbourg, France; Federation of Translational Medicine, University of Strasbourg, Strasbourg, France
| | - Stefano Del Giacco
- Department of Medical Sciences and Public Health and Unit of Allergy and Clinical Immunology, University Hospital Duilio Casula, University of Cagliari, Cagliari, Italy
| | - Philippe Devillier
- Virologie et Immunologie Moléculaires Suresnes, Unités Mixtes de Recherche 0892, Pôle des Maladies des Voies Respiratoires, Hôpital Foch, Université Paris-Saclay, Suresnes, France
| | - Ewa Jassem
- Medical University of Gdańsk, Department of Pneumonology, Gdansk, Poland
| | - Guy Joos
- Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Marek Jutel
- Department of Clinical Immunology, Wrocław Medical University, Wroclaw, Poland; All-Medicine Medical Research Institute, Wroclaw, Poland
| | - Ludger Klimek
- Department of Otolaryngology, Head and Neck Surgery, Universitätsmedizin Mainz, Mainz, Germany; Center for Rhinology and Allergology, Wiesbaden, Germany
| | - Piotr Kuna
- Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | | | | | - Mika Makela
- Skin and Allergy Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | | | - Rachel Nadif
- Université Paris-Saclay, Université Versailles-St Quentin, Université Paris-Sud, Paris, France; Inserm, Equipe d'Epidémiologie Respiratoire Intégrative, Villejuif, France
| | - Hugo E Neffen
- Center of Allergy, Immunology and Respiratory Diseases, Santa Fe, Argentina
| | - Ken Ohta
- National Hospital Organization, Tokyo National Hospital, Tokyo, Japan; JATA Fukujuji Hospital, Tokyo, Japan
| | | | - Alberto Papi
- Respiratory Medicine, Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | - Benoit Pétré
- Department of Public Health, University of Liege, Liege, Belgium
| | - Oliver Pfaar
- Section of Rhinology and Allergy, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany
| | - Daniela Rivero Yeverino
- Allergy and Clinical Immunology Department, Hospital Universitario de Puebla, Puebla, Mexico
| | | | - Nicolas Roche
- Pneumologie, Assistance Publique - Hôpitaux de Paris, Centre Université de Paris Cité, Hôpital Cochin, Paris, France
| | - Ana Sá-Sousa
- MEDicina da Comunidade, Informação e Decisão em Saúde, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; Centro de Investigação em Tecnologias e Serviços de Saúde, Rede de Investigação em Saúde, Health Research Network, MEDCIDS, Faculty of Medicine, University of Porto, Porto, Portugal; Patient Centred Innovation and Technology, Centro de Investigação em Tecnologias e Serviços de Saúde, Centre for Health Technology and Services Research, University of Porto, Porto, Portugal
| | - Boleslaw Samolinski
- Department of Prevention of Environmental Hazards, Allergology and Immunology, Medical University of Warsaw, Warsaw, Poland
| | - Aziz Sheikh
- Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Charlotte Suppli Ulrik
- Department of Respiratory Medicine, Copenhagen University Hospital-Hvidovre, Hvidovre, Denmark; Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Omar S Usmani
- National Heart and Lung Institute, Imperial College London, London, UK; Royal Brompton Hospital, Airways Disease Section, London, UK
| | - Arunas Valiulis
- Institute of Clinical Medicine and Institute of Health Sciences and Medical Faculty of Vilnius University, Vilnius, Lithuania
| | - Olivier Vandenplas
- Department of Chest Medicine, Centre Hospitalier Universitaire UCL, Namur, Belgium; Université Catholique de Louvain, Yvoir, Belgium
| | - Pedro Vieira-Marques
- MEDicina da Comunidade, Informação e Decisão em Saúde, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; Centro de Investigação em Tecnologias e Serviços de Saúde, Rede de Investigação em Saúde, Health Research Network, MEDCIDS, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Arzu Yorgancioglu
- Department of Pulmonary Diseases, Celal Bayar University, Faculty of Medicine, Manisa, Türkiye
| | - Torsten Zuberbier
- Institute of Allergology, Charité, Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology, Allergology and Immunology, Berlin, Germany
| | - Josep M Anto
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; Centro de Investigación Biomédica en Red Epidemiología y Salud Pública, Barcelona, Spain
| | - João A Fonseca
- MEDicina da Comunidade, Informação e Decisão em Saúde, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; Centro de Investigação em Tecnologias e Serviços de Saúde, Rede de Investigação em Saúde, Health Research Network, MEDCIDS, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Jean Bousquet
- Institute of Allergology, Charité, Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology, Allergology and Immunology, Berlin, Germany; Inserm, Equipe d'Epidémiologie Respiratoire Intégrative, Villejuif, France; University Hospital Montpellier, Montpellier, France.
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Vieira RJ, Sousa-Pinto B, Pereira AM, Cordeiro CR, Loureiro CC, Regateiro F, Taborda-Barata L, Bousquet J, Fonseca J. Asthma hospitalizations: A call for a national strategy to fight health inequities. Pulmonology 2023; 29:179-183. [PMID: 36907817 DOI: 10.1016/j.pulmoe.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 11/30/2022] [Accepted: 12/01/2022] [Indexed: 03/12/2023] Open
Affiliation(s)
- R J Vieira
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Portugal; Centre for Health Technology and Services Research, Health Research Network (CINTESIS@RISE), Faculty of Medicine of the University of Porto, Portugal
| | - B Sousa-Pinto
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Portugal; Centre for Health Technology and Services Research, Health Research Network (CINTESIS@RISE), Faculty of Medicine of the University of Porto, Portugal.
| | - A M Pereira
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Portugal; Allergy Unit, CUF Porto Hospital & Institute, Portugal
| | - C R Cordeiro
- Department of Pulmonology, University Hospital of Coimbra, Portugal; Faculty of Medicine, University of Coimbra, Portugal
| | - C C Loureiro
- Department of Pulmonology, University Hospital of Coimbra, Portugal; Faculty of Medicine, University of Coimbra, Portugal
| | - F Regateiro
- Allergy and Clinical Immunology Unit, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal; Institute of Immunology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - L Taborda-Barata
- UBIAir - Clinical & Experimental Lung Centre, University of Beira Interior, Covilhã, Portugal; CICS-Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal; Department of Immunoallergology, Cova da Beira University Hospital Centre, Covilhã, Portugal
| | - J Bousquet
- Institute for Allergology, Charité - Universitätsmedizin Berlin, Corporate, Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany; University Hospital, Montpellier, France; ARIA, Montpellier, France
| | - J Fonseca
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Portugal; Centre for Health Technology and Services Research, Health Research Network (CINTESIS@RISE), Faculty of Medicine of the University of Porto, Portugal; Allergy Unit, CUF Porto Hospital & Institute, Portugal
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Papiris SA, Campo I, Mariani F, Kallieri M, Kolilekas L, Papaioannou AI, Gonca Chousein E, Cetinkaya E, Bonella F, Borie R, Kokosi M, Pickworth T, Molina-Molina M, Gasa M, Radzikowska E, Fijolek J, Jouneau S, Gomez E, McCarthy C, Bendstrup E, Piotrowski WJ, Pabary R, Hadchouel A, Coolen-Allou N, Alfaro T, Robalo Cordeiro C, Antonogiannaki EM, Tomos IP, Papakosta D, Kontakiotis T, Panagiotou P, Douros K, Schams A, Lettieri S, Papaevangelou V, Kanaka-Gantenbein C, Karakatsani A, Loukides S, Costabel U, Crestani B, Morgan C, Tazawa R, Bush A, Griese M, Manali ED. COVID-19 in patients with pulmonary alveolar proteinosis: a European multicentre study. ERJ Open Res 2023; 9:00199-2022. [PMID: 36601310 PMCID: PMC9271262 DOI: 10.1183/23120541.00199-2022] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 05/23/2022] [Indexed: 02/01/2023] Open
Abstract
Adult PAP patients experience similar #COVID19 rates to the general population, and high rates of hospitalisation and deaths, underscoring their vulnerability and the need for measures to prevent infection. The impact of iGM-CSF must be considered. https://bit.ly/3M0wKnZ.
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Affiliation(s)
- Spyros A. Papiris
- General University Hospital “Attikon”, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Ilaria Campo
- Laboratorio di Biochimica e Genetica, UOC Pneumologia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Francesca Mariani
- Laboratorio di Biochimica e Genetica, UOC Pneumologia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Maria Kallieri
- General University Hospital “Attikon”, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Andriana I. Papaioannou
- General University Hospital “Attikon”, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Efsun Gonca Chousein
- University of Health Sciences Turkey, Yedikule Chest Diseases and Thoracic Surgery Research and Training Hospital, Istanbul, Turkey
| | - Erdogan Cetinkaya
- University of Health Sciences Turkey, Yedikule Chest Diseases and Thoracic Surgery Research and Training Hospital, Istanbul, Turkey
| | - Francesco Bonella
- Center for Interstitial and Rare Lung Diseases, Pneumology Dept, Ruhrlandklinik, University Hospital, University of Essen, Essen, Germany; European Reference Network (ERN)-LUNG, ILD Core Net
| | - Raphael Borie
- Université de Paris, INSERM UMR 1152, APHP, Hôpital Bichat, Service de Pneumologie A, FHU APOLLO, Centre de référence des maladies pulmonaires rares, Paris, France
| | - Maria Kokosi
- Interstitial Lung Disease Unit, Royal Brompton Hospital & Harefield NHS Foundation Trust and Interstitial Lung Disease Unit, Guy's and St Thomas’ Hospital NHS Foundation Trust, London, UK
| | | | - Maria Molina-Molina
- ILD Multidisciplinary Unit, Hospital Universitari de Bellvitge-IDIBELL, L'Hospitalet del Llobregat, Barcelona, Spain
| | - Mercè Gasa
- ILD Multidisciplinary Unit, Hospital Universitari de Bellvitge-IDIBELL, L'Hospitalet del Llobregat, Barcelona, Spain
| | - Elżbieta Radzikowska
- 3rd Dept of Lung Diseases and Oncology, National Tuberculosis and Lung Diseases Research Institute, Warsaw, Poland
| | - Justyna Fijolek
- 3rd Dept of Lung Diseases and Oncology, National Tuberculosis and Lung Diseases Research Institute, Warsaw, Poland
| | - Stéphane Jouneau
- IRSET UMR 1085, Université de Rennes Service de Pneumologie, CHU de Rennes, Rennes, France
| | | | - Cormac McCarthy
- University College Dublin School of Medicine Education and Research Centre, St Vincent's University Hospital, Dublin, Ireland
| | - Elisabeth Bendstrup
- Center for Rare Lung diseases, Dept of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark
| | - Wojciech J. Piotrowski
- Dept of Pneumonology, 2nd Chair of Internal Medicine, Medical University of Lodz, Lodz, Poland
| | - Rishi Pabary
- Paediatrics and Paediatric Respirology, Imperial College and Imperial Centre for Paediatrics and Child Health, Royal Brompton & Harefield NHS Foundation Trust, London, UK
| | - Alice Hadchouel
- AP-HP, Hôpital Necker-Enfants Malades, Service de Pneumologie Pédiatrique, Centre de Référence pour les Maladies Respiratoires Rares de l'Enfant and INSERM U1151, Institut Necker Enfants Malades, Université de Paris, Faculté de Médecine, Paris, France
| | | | - Tiago Alfaro
- Dept of Pulmonology, Coimbra University Hospital, University of Coimbra, Coimbra, Portugal
| | - Carlos Robalo Cordeiro
- Dept of Pulmonology, Coimbra University Hospital, University of Coimbra, Coimbra, Portugal
| | - Elvira-Markela Antonogiannaki
- General University Hospital “Attikon”, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioannis P. Tomos
- General University Hospital “Attikon”, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Despoina Papakosta
- Dept of Pulmonary Medicine, Aristotle University of Thessaloniki, “G. Papanikolaou” Hospital, Exochi, Thessaloniki, Greece
| | - Theodoros Kontakiotis
- Dept of Pulmonary Medicine, Aristotle University of Thessaloniki, “G. Papanikolaou” Hospital, Exochi, Thessaloniki, Greece
| | - Panagiota Panagiotou
- First Dept of Paediatrics, Agia Sophia Children's Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Douros
- Third Dept of Pediatrics “Attikon” University Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Andrea Schams
- Dept of Pediatric Pneumology, Dr von Hauner Children's Hospital, Ludwig-Maximilians-University, German Center for Lung Research, Munich, Germany
| | - Sara Lettieri
- Laboratorio di Biochimica e Genetica, UOC Pneumologia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Vassiliki Papaevangelou
- Third Dept of Pediatrics “Attikon” University Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Christina Kanaka-Gantenbein
- First Dept of Paediatrics, Agia Sophia Children's Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Anna Karakatsani
- General University Hospital “Attikon”, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Stelios Loukides
- General University Hospital “Attikon”, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Ulrich Costabel
- Center for Interstitial and Rare Lung Diseases, Pneumology Dept, Ruhrlandklinik, University Hospital, University of Essen, Essen, Germany; European Reference Network (ERN)-LUNG, ILD Core Net
| | - Bruno Crestani
- Université de Paris, INSERM UMR 1152, APHP, Hôpital Bichat, Service de Pneumologie A, FHU APOLLO, Centre de référence des maladies pulmonaires rares, Paris, France
| | - Cliff Morgan
- Interstitial Lung Disease Unit, Royal Brompton Hospital & Harefield NHS Foundation Trust and Interstitial Lung Disease Unit, Guy's and St Thomas’ Hospital NHS Foundation Trust, London, UK
| | - Ryushi Tazawa
- Health Administration Center, Tokyo Medical and Dental University, Tokyo, Japan
| | - Andrew Bush
- Paediatrics and Paediatric Respirology, Imperial College and Imperial Centre for Paediatrics and Child Health, Royal Brompton & Harefield NHS Foundation Trust, London, UK
| | - Matthias Griese
- Dept of Pediatric Pneumology, Dr von Hauner Children's Hospital, Ludwig-Maximilians-University, German Center for Lung Research, Munich, Germany
| | - Effrosyni D. Manali
- General University Hospital “Attikon”, Medical School, National and Kapodistrian University of Athens, Athens, Greece,Effrosyni Manali ()
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10
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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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11
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Froes F, Carmo M, Lopes H, Bizouard G, Gomes C, Martins M, Bricout H, de Courville C, de Sousa JC, Rabaçal C, Raposo JF, Cordeiro CR. Excess hospitalizations and mortality associated with seasonal influenza in Portugal, 2008-2018. BMC Infect Dis 2022; 22:726. [PMID: 36071375 PMCID: PMC9450401 DOI: 10.1186/s12879-022-07713-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 08/19/2022] [Indexed: 11/12/2022] Open
Abstract
Background Influenza can have a domino effect, triggering severe conditions and leading to hospitalization or even death. Since influenza testing is not routinely performed, statistical modeling techniques are increasingly being used to estimate annual hospitalizations and deaths associated with influenza, to overcome the known underestimation from registers coded with influenza-specific diagnosis. The aim of this study was to estimate the clinical and economic burden of severe influenza in Portugal. Methods The study comprised ten epidemic seasons (2008/09–2017/18) and used two approaches: (i) a direct method of estimating the seasonal influenza hospitalization incidence, based on the number of National Health Service hospitalizations with influenza-specific International Classification of Diseases (ICD) codes (ICD-9: 487–488; ICD-10: J09-J11), as primary or secondary diagnosis; (ii) an indirect method of estimating excess hospitalizations and deaths using broader groups of ICD codes in time-series models, computed for six age groups and four groups of diagnoses: pneumonia or influenza (ICD-9: 480–488, 517.1; ICD-10: J09–J18), respiratory (ICD-9: 460–519; ICD-10: J00–J99), respiratory or cardiovascular (R&C, ICD-9: 390–459, 460–519; ICD-10: I00–I99, J00–J99), and all-cause. Means are reported excluding the H1N1pdm09 pandemic (2009/10). Results The mean number of hospitalizations coded as due to influenza per season was 1,207, resulting in 11.6 cases per 100,000 people. The mean direct annual cost of these hospitalizations was €3.9 million, of which 78.6% was generated by patients with comorbidities. Mean annual influenza-associated R&C hospitalizations were estimated at 5356 (min: 456; max: 8776), corresponding to 51.5 cases per 100,000 (95% CI: 40.9–62.0) for all age groups and 199.6 (95% CI: 163.9–235.8) for the population aged ≥ 65 years. The mean direct annual cost of the estimated excess R&C hospitalizations was €15.2 million for all age groups and €12.8 million for the population aged ≥ 65 years. Mean annual influenza-associated all-cause deaths per 100,000 people were estimated at 22.7 for all age groups. Conclusions The study findings suggest that there is an under-detection of influenza in the Portuguese population. A high burden of severe influenza remains to be addressed, not only in the elderly population but also in younger people. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07713-8.
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Affiliation(s)
- Filipe Froes
- ICU, Thorax Department, Centro Hospitalar Universitário Lisboa Norte, Av. Prof. Egas Moniz MB, 1649-028, Lisbon, Portugal.
| | | | - Hugo Lopes
- IQVIA, Lisbon, Portugal.,NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal.,Comprehensive Health Research Center (CHRC)-Universidade NOVA de Lisboa, Lisbon, Portugal
| | | | | | | | | | | | - Jaime Correia de Sousa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | | | - João F Raposo
- APDP and NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Carlos Robalo Cordeiro
- Pulmonology Department, Coimbra University Hospital, University of Coimbra, Coimbra, Portugal
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12
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Cavaco MJ, Alcobia C, Oliveiros B, Mesquita LA, Carvalho A, Matos F, Carvalho JM, Villar M, Duarte R, Mendes J, Ribeiro C, Cordeiro CR, Regateiro F, Silva HC. Clinical and Genetic Risk Factors for Drug-Induced Liver Injury Associated with Anti-Tuberculosis Treatment-A Study from Patients of Portuguese Health Centers. J Pers Med 2022; 12:jpm12050790. [PMID: 35629211 PMCID: PMC9144180 DOI: 10.3390/jpm12050790] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 05/08/2022] [Accepted: 05/10/2022] [Indexed: 12/07/2022] Open
Abstract
Drug-induced liver injury (DILI) is an unpredictable and feared side effect of antituberculosis treatment (AT). The present study aimed to identify clinical and genetic variables associated with susceptibility to AT-associated hepatotoxicity in patients with pulmonary tuberculosis treated with a standard protocol. Of 233 patients enrolled, 90% prospectively, 103 developed liver injury: 37 with mild and 66 with severe phenotype (DILI). All patients with mild hepatitis had a RUCAM score ≥4 and all patients with DILI had a RUCAM score ≥ 6. Eight clinical variables and variants in six candidate genes were assessed. A logistic multivariate regression analysis identified four risk factors for AT-DILI: age ≥ 55 years (OR:3.67; 95% CI:1.82−7.41; p < 0.001), concomitant medication with other hepatotoxic drugs (OR:2.54; 95% CI:1.23−5.26; p = 0.012), NAT2 slow acetylator status (OR:2.46; 95% CI:1.25−4.84; p = 0.009), and carriers of p.Val444Ala variant for ABCB11 gene (OR:2.06; 95%CI:1.02−4.17; p = 0.044). The statistical model explains 24.9% of the susceptibility to AT-DILI, with an 8.9 times difference between patients in the highest and in the lowest quartiles of risk scores. This study sustains the complex architecture of AT-DILI. Prospective studies should evaluate the benefit of NAT2 and ABCB11 genotyping in AT personalization, particularly in patients over 55 years.
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Affiliation(s)
| | - Celeste Alcobia
- Department of Pneumology, Coimbra Hospital and Universitary Centre, 3004-561 Coimbra, Portugal; (C.A.); (C.R.C.)
- Pneumological Diagnostic Center of the Centre, 3000-075 Coimbra, Portugal
| | - Bárbara Oliveiros
- Laboratory of Biostatistics and Medical Informatics, Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal;
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal;
| | - Luís Alcides Mesquita
- Institute of Medical Genetics/UC Genomics, Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal; (L.A.M.); (J.M.); (C.R.); (F.R.)
| | - Aurora Carvalho
- Department of Pneumology, Vila Nova de Gaia Hospitalar Centre, 4434-502 Vila Nova de Gaia, Portugal;
| | - Fernando Matos
- Pneumological Diagnostic Center of Aveiro, 3810-042 Aveiro, Portugal;
| | | | - Miguel Villar
- Pneumological Diagnostic Center of Venda Nova, 2700-220 Lisboa, Portugal;
| | - Raquel Duarte
- Pneumological Diagnostic Center of Vila Nova de Gaia, 4400-088 Vila Nova de Gaia, Portugal;
| | - João Mendes
- Institute of Medical Genetics/UC Genomics, Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal; (L.A.M.); (J.M.); (C.R.); (F.R.)
| | - Carolina Ribeiro
- Institute of Medical Genetics/UC Genomics, Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal; (L.A.M.); (J.M.); (C.R.); (F.R.)
| | - Carlos Robalo Cordeiro
- Department of Pneumology, Coimbra Hospital and Universitary Centre, 3004-561 Coimbra, Portugal; (C.A.); (C.R.C.)
| | - Fernando Regateiro
- Institute of Medical Genetics/UC Genomics, Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal; (L.A.M.); (J.M.); (C.R.); (F.R.)
| | - Henriqueta Coimbra Silva
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal;
- Institute of Medical Genetics/UC Genomics, Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal; (L.A.M.); (J.M.); (C.R.); (F.R.)
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13
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Nagavci B, Tonia T, Roche N, Genton C, Vaccaro V, Humbert M, Brightling C, Robalo Cordeiro C, Bush A. European Respiratory Society clinical practice guidelines: methodological guidance. ERJ Open Res 2022; 8:00655-2021. [PMID: 35083323 PMCID: PMC8784892 DOI: 10.1183/23120541.00655-2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 11/23/2021] [Indexed: 11/05/2022] Open
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14
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Abstract
Idiopathic pulmonary fibrosis (IPF) is characterized by progressive parenchymal scarring, leading to dyspnoea, respiratory failure and premature death. Although IPF is confined to the lungs, the importance of IPF comorbidities such as pulmonary hypertension and ischaemic heart disease, lung cancer, emphysema/chronic obstructive pulmonary disease, gastroesophageal reflux, sleep apnoea and depression has been increasingly recognized. These comorbidities may be associated with increased mortality and significant loss of quality of life, so their identification and management are vital. The development of good-quality biomarkers could lead to numerous gains in the management of these patients. Biomarkers can be used for the identification of predisposed individuals, early diagnosis, assessment of prognosis, selection of best treatment and assessment of response to treatment. However, the role of biomarkers for IPF comorbidities is still quite limited, and mostly based on evidence coming from populations without IPF. The future development of new biomarker studies could be informed by those that have been studied independently for each of these conditions. For now, clinicians should be mostly attentive to clinical manifestations of IPF comorbidities, and use validated diagnostic methods for diagnosis. As research on biomarkers of most common diseases continues, it is expected that useful biomarkers are developed for these diseases and then validated for IPF populations. The reviews of this paper are available via the supplemental material section.
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Affiliation(s)
- Tiago M Alfaro
- Pneumology Unit, Centro Hospital e Universitário de Coimbra, Coimbra, Portugal.,Centre of Pneumology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Carlos Robalo Cordeiro
- Pneumology Unit, Centro Hospital e Universitário de Coimbra, Praceta Mota Pinto, Coimbra 3000-085, Portugal.,Centre of Pneumology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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15
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Catarata MJ, Lourenço M, Martins MF, Frade J, Pêgo A, Cordeiro CR, Medeiros R, Ribeiro R. Pharmacogenetics of advanced lung cancer: Predictive value of functional genetic polymorphism AGXT Pro11Leu in clinical outcome? Pulmonology 2021; 27:116-123. [PMID: 33408043 DOI: 10.1016/j.pulmoe.2020.11.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 10/07/2020] [Accepted: 11/04/2020] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION AGXT gene codes for the enzyme alanine glyoxylate aminotransferase, which is involved in hepatic peroxisomal metabolism of platinum-based chemotherapeutic agents. The association of genetic variant AGXT rs34116584 on the clinical outcome and response to chemotherapy of patients with non-small cell lung cancer (NSCLC) remains to be established. Our aim was to evaluate the association of functional AGXT gene polymorphism in NSCLC progression, considering as primary and secondary endpoint, progression free survival (PFS) and overall survival (OS), respectively. METHODS Genotyping of theAGXT rs34116584 genetic polymorphism was performed by mass spectrometry on 168 DNA samples from patients with NSCLC (stages IIIA-IVB). Univariate survival analysis included the study of Kaplan-Meier curves with the Log-Rank test, while Cox regression was used as a multivariate analysis. RESULTS Multivariate analysis showed shorter PFS for T carriers [HR=2.0, 95% CI, 1.4-3.0, p<0.0001] and shorter OS [HR=1.8, 95% CI, 1.1-3.0, p=0.017] globally, as well as in a subgroup of patients (n=144) treated with first line platinum-based chemotherapy [HR=2.0, 95% CI, 1.3-3.1, p=0.001] and [HR=1.8, 95% CI, 1.1-3.1, p=0.026], respectively. CONCLUSION This polymorphism seems to have an impact on NSCLC progression, opening new perspectives for its inclusion as a pharmacogenetic predictor of response to platinum-based chemotherapy.
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Affiliation(s)
- Maria Joana Catarata
- i3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Portugal; Tumour & Microenvironment Interactions Group, INEB, Biomedical Engineering Institute, University of Porto, Portugal; Department of Pulmonology, University Hospital of Coimbra, Portugal; Faculty of Medicine, University of Porto, Portugal; Molecular Oncology and Viral Pathology Group - Research Centre, Portuguese Institute of Oncology, Porto, Portugal.
| | - Margarida Lourenço
- Department of Clinical Pathology, University Hospital of Coimbra, Portugal
| | - Maria Fátima Martins
- Department of Clinical Pathology, University Hospital of Coimbra, Portugal; Faculty of Medicine, University of Coimbra, Portugal
| | - João Frade
- Department of Clinical Pathology, University Hospital of Coimbra, Portugal
| | - Alice Pêgo
- Department of Pulmonology, University Hospital of Coimbra, Portugal
| | - Carlos Robalo Cordeiro
- Department of Pulmonology, University Hospital of Coimbra, Portugal; Faculty of Medicine, University of Coimbra, Portugal
| | - Rui Medeiros
- Faculty of Medicine, University of Porto, Portugal; Molecular Oncology and Viral Pathology Group - Research Centre, Portuguese Institute of Oncology, Porto, Portugal
| | - Ricardo Ribeiro
- i3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Portugal; Tumour & Microenvironment Interactions Group, INEB, Biomedical Engineering Institute, University of Porto, Portugal; Department of Clinical Pathology, University Hospital of Coimbra, Portugal; Laboratory of Genetics, Faculty of Medicine, University of Lisbon, Portugal
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16
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Davidsen JR, Miedema J, Wuyts W, Kilpeläinen M, Papiris S, Manali E, Robalo Cordeiro C, Morais A, Pérez M, Asijee G, Cendoya D, Soulard S. Economic Burden and Management of Systemic Sclerosis-Associated Interstitial Lung Disease in 8 European Countries: The BUILDup Delphi Consensus Study. Adv Ther 2021; 38:521-540. [PMID: 33156462 PMCID: PMC7854393 DOI: 10.1007/s12325-020-01541-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 10/19/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Systemic sclerosis (SSc) is a rare chronic autoimmune disease characterised by microvascular damage, immune dysregulation and fibrosis, affecting the skin, joints and internal organs. Interstitial lung disease (ILD) is frequently associated with systemic sclerosis (SSc-ILD), leading to a poor prognosis and a high mortality rate. The aim of the BUILDup study (BUrden of Interstitial Lung Disease Consensus Panel) was to investigate the overall disease management and to estimate the social and economic burden of SSc-ILD across 8 European countries. METHODS A modified Delphi method was used to obtain information on the management of SSc-ILD patients among 40 specialists (panellists) from 8 European countries. Average annual costs per patient and country were estimated by means of a direct cost-analysis study. RESULTS The panellists had managed 805 SSc-ILD patients in the last year, 39.1% with limited (L-SSc-ILD) and 60.9% with extensive (E-SSc-ILD) disease. Of these, 32.8% of the panellists started treatment at diagnosis, 42.3% after signs of deterioration/progression and 24.7% when the disease had become extensive. The average annual cost of SSc-ILD per patient ranged from €6191 in Greece to €25,354 in Sweden. Main cost drivers were follow-up procedures, accounting for 80% of the total annual costs. Hospitalisations were the most important cost driver of follow-up costs. Healthcare resource use was more important for E-SSc-ILD compared to L-SSc-ILD. Early retirement was taken by 40.4% of the patients with an average of 11.9 years before the statutory retirement age. CONCLUSIONS SSc-ILD entails not only a clinical but also a social and economic burden, and is higher for E-SSc-ILD.
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Affiliation(s)
- Jesper Rømhild Davidsen
- South Danish Center for Interstitial Lung Diseases, Department of Respiratory Medicine, Odense University Hospital, Odense, Denmark
| | - Jelle Miedema
- Department of Respiratory Medicine, Erasmus University Medical Centre, Rotterdam, Netherlands
| | - Wim Wuyts
- Unit for Interstitial Lung Diseases, Department of Respiratory Medicine, University Hospital of Leuven, Leuven, Belgium
| | - Maritta Kilpeläinen
- Division of Medicine, Department of Pulmonary Diseases and Clinical Allergology, Turku University Hospital and University of Turku, Turku, Finland
| | - Spyridon Papiris
- 2nd Respiratory Medicine Department, General University Hospital "Attikon", Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Effrosyni Manali
- 2nd Respiratory Medicine Department, General University Hospital "Attikon", Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Carlos Robalo Cordeiro
- Department of Pulmonology and Allergy, University Hospital of Coimbra, Coimbra, Portugal
| | - Antonio Morais
- Diffuse Lung Diseases Unit, Department of Pneumology of São João Hospital Centre, Oporto, Portugal
| | | | - Guus Asijee
- Boehringer Ingelheim, Amsterdam, The Netherlands
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17
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Pereira Catarata MJ, Ribeiro R, Pêgo A, Robalo Cordeiro C, Oliveira MJ, Medeiros R, Thomas M, Meister M, Muley T. Genetic polymorphisms of renin-angiotensin system and angiogenic factors in NSCLC progression: discovery and validation studies. Lung Cancer 2020. [DOI: 10.1183/13993003.congress-2020.1756] [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: 11/05/2022]
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18
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Morais-Almeida M, Pité H, Cardoso J, Costa R, Cordeiro CR, Silva E, Todo-Bom A, Vicente C, Marques JA. Asthma management with breath-triggered inhalers: innovation through design. Asthma Res Pract 2020; 6:4. [PMID: 32518663 PMCID: PMC7275490 DOI: 10.1186/s40733-020-00057-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 05/25/2020] [Indexed: 11/24/2022] Open
Abstract
Background Asthma affects the lives of hundred million people around the World. Despite notable progresses in disease management, asthma control remains largely insufficient worldwide, influencing patients’ wellbeing and quality of life. Poor patient handling of inhaling devices has been identified as a major persistent problem that significantly reduces inhaled drugs’ efficacy and is associated with poor adherence to treatment, impairing clinical results such as asthma control and increasing disease-related costs. We herein review key research and development (R&D) innovation in inhaler devices, highlighting major real-world critical errors in the handling and inhalation technique with current devices and considering potential solutions. Furthermore, we discuss current evidence regarding breath-triggered inhalers (BTI). Main body The two most common significant problems with inhalers are coordinating actuation and inhalation with pressurized metered-dose inhalers (pMDIs), and the need to inhale forcibly with a dry powder inhaler. BTI R&D plans were designed to overcome these problems. Its newest device k-haler® has several other important features, generating a less forceful aerosol plume than previous pMDIs, with efficient drug delivery and lung deposition, even in patients with low inspiratory flow. The local and systemic bioavailability of fluticasone propionate and formoterol (FP/FORM) administered via k-haler® has been shown to be therapeutically equivalent when administered via the previous FP/FORM pMDI. This device requires very few steps and has been considered easy to use (even at first attempt) and preferred by the patients in a randomized crossover study. In our country, FP/FORM k-haler is available without additional costs compared to FP/FORM pMDI. All devices continue to require education and regular checking of the correct inhalation technique. Conclusion BTI R&D can bring advantage over current available inhalers, avoiding the two most common identified critical errors in inhalation technique. K-haler® BTI is currently available, without an increased cost, and approved for adolescents and adults with asthma in whom treatment with inhaled combined therapy with long-acting beta2-agonists and corticosteroids is indicated. Its attractive and practical design to facilitate its use has been awarded. K-haler® represents added value through innovation to fulfill actual asthma patient needs, thus with potential relevant impact in asthma management and effective control.
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Affiliation(s)
| | - Helena Pité
- Allergy Center, CUF Descobertas Hospital and CUF Infante Santo Hospital, Lisbon, Portugal.,CEDOC (Chronic Diseases Research Center), NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - João Cardoso
- Pulmonology Department, Centro Hospitalar de Lisboa Central, Lisbon, Portugal.,NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Rui Costa
- Family Medicine, Porto, Portugal.,GRESP (Grupo de Estudos de Doenças Respiratórias da APMGF), Lisbon, Portugal
| | - Carlos Robalo Cordeiro
- Pulmonology Department, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal.,Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Eurico Silva
- Family Medicine USF João Semana, Aveiro, Ovar, Portugal.,GRESP Inhalers and Tecnhical Devices Working Group, Lisbon, Portugal
| | - Ana Todo-Bom
- Immunoallergology Department, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal.,Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Cláudia Vicente
- Family Medicine UCSP Soure, Coimbra, Portugal.,GRESP (Grupo de Estudos de Doenças Respiratórias da APMGF), Lisbon, Portugal
| | - José Agostinho Marques
- Pulmonology Department, Centro Hospitalar de São João, Porto, Portugal.,Faculty of Medicine, University of Porto, Porto, Portugal
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19
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Rodrigues JF, Mineiro A, Reis A, Ventura DG, Fernandez-Llimos F, Costa F, Gomes J, Silva JM, Lopes P, Cordeiro CR. Alpha-1 Antitrypsin Deficiency: Principles of Care. ACTA MEDICA PORT 2020; 33:433-439. [PMID: 32504520 DOI: 10.20344/amp.12950] [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: 10/11/2019] [Accepted: 03/10/2020] [Indexed: 11/20/2022]
Abstract
Alpha-1 antitrypsin deficiency is an autosomal co-dominant inherited disorder that results in decreased circulating levels of alpha-1 antitrypsin (also known as alpha-1 proteinase inhibitor) and predisposes affected individuals to early onset lung and liver disease. There is currently no cure for alpha-1 antitrypsin deficiency. However, appropriate treatment and a high standard of clinical care can prevent patients from being seriously affected and having to undergo major medical interventions, such as organ transplantation. Beyond managing the symptoms associated with alpha-1 antitrypsin deficiency, alpha-1 proteinase inhibitor therapy is the only treatment for the condition's underlying cause. Early diagnosis is important to ensure efficient therapeutic strategies and to minimize further deterioration of lung function. alpha-1 antitrypsin deficiency is under diagnosed globally, partly because the disease has no unique presenting symptoms. This document was prepared by a Portuguese multidisciplinary group and it aims to set out comprehensive principles of care for Alpha-1 antitrypsin deficiency. These include the importance of registries, the need for clinical research, the need for consistent recommendations (regarding diagnosis, treatment and monitoring), the role of reference centres, the requirement for sustained access to treatment, diagnostic and support services, and the role of patient organizations.
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Affiliation(s)
| | - Alexandra Mineiro
- Pulmonary Department. Centro Hospitalar Lisboa Central. Lisboa. Portugal
| | - António Reis
- Pulmonary Department. Centro Hospitalar Lisboa Central. Lisboa. Portugal
| | | | - Fernando Fernandez-Llimos
- Laboratory of Pharmacology. Department of Drug Sciences. Faculty of Pharmacy. University of Porto. Porto. Portugal
| | - Filipa Costa
- Pulmonary Department. Centro Hospitalar Universitário de Coimbra. Coimbra. Portugal
| | - Joana Gomes
- Pulmonary Department. Centro Hospitalar do Porto. Porto. Portugal
| | - José Manuel Silva
- Pulmonary Department. Unidade Local de Saúde da Guarda. Hospital Sousa Martins. Guarda. Portugal
| | - Paulo Lopes
- Pulmonary Department. Centro Hospitalar Universitário de Coimbra. Coimbra. Portugal
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Wuyts WA, Wijsenbeek M, Bondue B, Bouros D, Bresser P, Robalo Cordeiro C, Hilberg O, Magnusson J, Manali ED, Morais A, Papiris S, Shaker S, Veltkamp M, Bendstrup E. Idiopathic Pulmonary Fibrosis: Best Practice in Monitoring and Managing a Relentless Fibrotic Disease. Respiration 2019; 99:73-82. [PMID: 31830755 DOI: 10.1159/000504763] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 11/12/2019] [Indexed: 12/19/2022] Open
Abstract
Idiopathic pulmonary fibrosis (IPF) is a fibrosing interstitial lung disease that is, by definition, progressive. Progression of IPF is reflected by a decline in lung function, worsening of dyspnea and exercise capacity, and deterioration in health-related quality of life. In the short term, the course of disease for an individual patient is impossible to predict. A period of relative stability in forced vital capacity (FVC) does not mean that FVC will remain stable in the near future. Frequent monitoring using multiple assessments, not limited to pulmonary function tests, is important to evaluate disease progression in individual patients and ensure that patients are offered appropriate care. Optimal management of IPF requires a multidimensional approach, including both pharmacological therapy to slow decline in lung function and supportive care to preserve patients' quality of life.
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Affiliation(s)
- Wim A Wuyts
- Department of Respiratory Diseases, Unit for Interstitial Lung Diseases, University Hospitals Leuven, Leuven, Belgium,
| | - Marlies Wijsenbeek
- Department of Respiratory Medicine, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - Benjamin Bondue
- Department of Pneumology, Hôpital Erasme, Université libre de Bruxelles, Brussels, Belgium
| | - Demosthenes Bouros
- First Academic Department of Pneumonology, Interstitial Lung Diseases Unit, Department of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Paul Bresser
- Department of Respiratory Medicine, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
| | | | - Ole Hilberg
- Department of Respiratory Medicine and Allergology, Aarhus University Hospital, Aarhus, Denmark
| | - Jesper Magnusson
- Department of Internal Medicine/Respiratory Medicine and Allergology, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Effrosyni D Manali
- 2nd Pulmonary Medicine Department, General University Hospital "Attikon," Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - António Morais
- Department of Pulmonology, Hospital de São João, Porto, Portugal
| | - Spyridon Papiris
- 2nd Pulmonary Medicine Department, General University Hospital "Attikon," Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Saher Shaker
- Herlev and Gentofte University Hospital, Copenhagen, Denmark
| | - Marcel Veltkamp
- Department of Pulmonology ILD Center of Excellence, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - Elisabeth Bendstrup
- Center for Rare Lung Diseases, Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark
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21
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Moura Cabral SC, Abreu I, Madama D, Estevão A, Cordeiro E, Pimentel J, Miranda N, Robalo Cordeiro C. Lung cancer–CT screening performed in a high risk portuguesese population. Lung Cancer 2019. [DOI: 10.1183/13993003.congress-2019.pa3028] [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: 11/05/2022]
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22
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da Silva Alcobia MC, M Nogueira L, Oliveiros B, Robalo Cordeiro C, C Silva H. Antituberculosis drug- induced hepatitis, an unpredictable phenotype. Tuberculosis (Edinb) 2019. [DOI: 10.1183/13993003.congress-2019.pa2986] [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: 11/05/2022]
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23
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Santos LM, Ramos B, Almeida J, Loureiro CC, Cordeiro CR. The impact of weight loss beyond lung function: benefit with respect to asthma outcomes. Pulmonology 2019; 25:313-319. [PMID: 31526706 DOI: 10.1016/j.pulmoe.2019.07.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 07/15/2019] [Accepted: 07/31/2019] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE We evaluated the effect of weight loss (WL) on lung function (LF) in obese individuals who underwent bariatric surgery, and on asthma control, quality of life, LF, and controller medication in a sub-group of obese asthma (OA) patients. MATERIALS AND METHODS Obese individuals who underwent bariatric surgery between July 2015 and July 2017 were included in this prospective longitudinal study. They were classified as OA or obese non-asthmatics (O-NA). LF was assessed preoperatively and 6-9 months postoperatively. In OA patients, asthma control, quality of life, and treatment step were evaluated. P < 0.05 was considered significant. RESULTS Twenty-six patients (OA: n = 8; O-NA: n = 18), 84.6% with class III obesity were enrolled. Preoperatively, OA patients showed worse values of LF parameters, with upper and lower airway CARAT scores of 6.1 ± 3.1 and 13.4 ± 4.1, respectively, and 75% were in step 4 of treatment. After WL, improvements in dynamic volumes, lung capacities, and total resistance were observed in both groups. Despite greater increases in OA patients, no significant differences were observed between groups. In OA patients, improvements in CARAT score of upper (3.9 ± 1.9, p = 0.017) and lower (4.2 ± 4.4, p = 0.027) airways, and in Asthma Life Quality scores (8.1 ± 5.6, p = 0.017) were observed along with a decrease (-1.8 ± 1.0, p = 0.017) in treatment step. CONCLUSIONS All LF parameters improved after WL. Although the improvement was greater in OA patients, the difference between groups was not significant. Significant improvement from baseline in uncontrolled symptoms of OA patients and quality of life was observed after WL, along with a significant decrease in treatment step.
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Affiliation(s)
- Lília Maia Santos
- Pulmonology Department, Hospitais da Universidade de Coimbra, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
| | - Bárbara Ramos
- Pulmonology Department, Hospitais da Universidade de Coimbra, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - João Almeida
- General Surgery Department, Hospitais da Universidade de Coimbra, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Cláudia Chaves Loureiro
- Pulmonology Department, Hospitais da Universidade de Coimbra, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Clinical Academic Center of Coimbra, Portugal
| | - Carlos Robalo Cordeiro
- Pulmonology Department, Hospitais da Universidade de Coimbra, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Clinical Academic Center of Coimbra, Portugal
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Boléo-Tomé JP, Pamplona P, Rosa P, Cordeiro CR. [The Doctor, the Smoking Patient and the Challenge of Electronic Cigarettes]. ACTA MEDICA PORT 2019; 32:477-482. [PMID: 31445526 DOI: 10.20344/amp.12280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 05/03/2019] [Indexed: 11/20/2022]
Affiliation(s)
- José Pedro Boléo-Tomé
- Serviço de Pneumologia. Hospital Prof. Doutor Fernando Fonseca. Amadora. Comissão de Tabagismo. Sociedade Portuguesa de Pneumologia. Lisboa. Portugal
| | - Paula Pamplona
- Comissão de Tabagismo. Sociedade Portuguesa de Pneumologia. Lisboa. Serviço de Pneumologia. Hospital Pulido Valente. Centro Hospitalar de Lisboa Norte. Lisboa. Portugal
| | - Paula Rosa
- Comissão de Tabagismo. Sociedade Portuguesa de Pneumologia. Lisboa. Serviço de Pneumologia. Hospital de Vila Franca de Xira. Vila Franca de Xira. Portugal
| | - Carlos Robalo Cordeiro
- Serviço de Pneumologia. Centro Hospitalar e Universitário de Coimbra. Coimbra. Faculdade de Medicina. Universidade de Coimbra. Coimbra. Sociedade Europeia Respiratória. Lausanne. Suíça. Portugal
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25
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Gaga M, Powell P, Almagro M, Tsiligianni I, Loukides S, Roca J, Cullen M, Simonds AK, Ward B, Saraiva I, Troosters T, Robalo Cordeiro C. ERS Presidential Summit 2018: multimorbidities and the ageing population. ERJ Open Res 2019; 5:00126-2019. [PMID: 31579675 PMCID: PMC6759575 DOI: 10.1183/23120541.00126-2019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 07/29/2019] [Indexed: 11/12/2022] Open
Abstract
As the average age of the population increases, so will the prevalence of chronic respiratory diseases and associated multimorbidity. This will result in a more complex clinical environment. Part of the solution will be to allow patients to be co-creators in the design of their care. It will also require clinicians to shift in their current approaches to care, step out of the disease- or pathology-oriented approach and embrace new ideas. In an effort to prepare the respiratory community for the challenge, we reflect on concepts to empower patients via multidisciplinary systems, new technologies and transition from end-of-life care to advanced care planning.
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Affiliation(s)
- Mina Gaga
- 7th Resp. Med. Dept and Asthma Center, Athens, Greece
| | | | - Marta Almagro
- ELF Bronchiectasis Patient Advisory Committee, Sheffield, UK
| | | | | | - Josep Roca
- University of Barcelona, Barcelona, Spain
| | | | | | - Brian Ward
- European Respiratory Society, Brussels, Belgium
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26
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Horváth I, Barry M, Brusselle G, Burghuber OC, Bush A, Robalo Cordeiro C, Gaga M, Gratziou C, Saraiva I, Stolz D, Troosters T, Welte T, Migliori GB, Joos G. The European Respiratory Society's 10 Principles for Lung Health. Eur Respir J 2018; 52:52/5/1801373. [PMID: 30498051 DOI: 10.1183/13993003.01373-2018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 09/12/2018] [Indexed: 11/05/2022]
Affiliation(s)
| | - Maeve Barry
- European Respiratory Society, Brussels, Belgium
| | - Guy Brusselle
- Ghent University Hospital, Dept of Respiratory Diseases, Ghent, Belgium
| | | | - Andrew Bush
- Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | | | - Mina Gaga
- Athens Chest Hospital Sotiria, 7th Respiratory Medicine Dept, Athens, Greece
| | | | | | - Daiana Stolz
- University Hospital Basel, Pulmonary Care Division, Basel, Switzerland
| | | | - Tobias Welte
- University of Hannover, Dept of Respiratory Medicine, Member of the German Center of Lung Research (DZL), Hannover, Germany
| | | | - Guy Joos
- Ghent University Hospital, Dept of Respiratory Diseases, Ghent, Belgium
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27
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Afonso M, Alfaro T, Cemlyn-Jones J, Cordeiro CR. Poland syndrome and pneumothorax: the compelling evidence of an association. Pulmonology 2018; 24:316-317. [PMID: 30292324 DOI: 10.1016/j.pulmoe.2018.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 07/01/2018] [Accepted: 07/19/2018] [Indexed: 10/28/2022] Open
Affiliation(s)
- Margarida Afonso
- Pneumology Unit A, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
| | - Tiago Alfaro
- Pneumology Unit A, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Centre of Pneumology, Faculty of Medicine of the University of Coimbra, Coimbra, Portugal
| | - Jessica Cemlyn-Jones
- Pneumology Unit A, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Centre of Pneumology, Faculty of Medicine of the University of Coimbra, Coimbra, Portugal
| | - Carlos Robalo Cordeiro
- Pneumology Unit A, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Centre of Pneumology, Faculty of Medicine of the University of Coimbra, Coimbra, Portugal
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28
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da Silva Alcobia MC, Nogueira L, Villar M, Robalo Cordeiro C, Fontes Ribeiro C, Regateiro F, Coimbra Silva H. Precision medicine in tuberculosis treatment – a role for pharmacogenetics? Tuberculosis (Edinb) 2018. [DOI: 10.1183/13993003.congress-2018.pa2689] [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: 11/05/2022]
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29
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Pires L, Arrobas A, Fonseca JA, Bandeira T, Loureiro CS, Loureiro CC, Todo Bom F, Lima N, Robalo Cordeiro C. An overview of asthma exacerbation hospital management in Portugal. Epidemiology 2018. [DOI: 10.1183/13993003.congress-2018.pa4477] [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: 11/05/2022]
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30
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Farr A, Gaga M, Welte T, Troosters T, Joos G, Robalo Cordeiro C, Burghuber OC, Brusselle G, Gratziou CG, Bush A, Saraiva I, Pannetier C, Stolz D. The European Respiratory Society: ensuring excellence through education best practice. Eur Respir J 2018; 52:52/3/1801248. [PMID: 30219751 DOI: 10.1183/13993003.01248-2018] [Citation(s) in RCA: 2] [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: 07/11/2018] [Accepted: 07/27/2018] [Indexed: 11/05/2022]
Affiliation(s)
- Amy Farr
- European Respiratory Society, Lausanne, Switzerland
| | - Mina Gaga
- 7th Respiratory Medicine Dept, Athens Chest Hospital Sotiria, Athens, Greece
| | - Tobias Welte
- Pulmonary Medicine, University of Hannover, Hannover, Germany
| | - Thierry Troosters
- Dept of Rehabilitation Sciences, University of Leuven, Leuven, Belgium
| | - Guy Joos
- Dept of Respiratory Diseases, Ghent University Hospital, Ghent, Belgium
| | | | | | - Guy Brusselle
- Dept of Respiratory Diseases, Ghent University Hospital, Ghent, Belgium
| | | | - Andrew Bush
- Paediatrics Section, National Heart and Lung Institute, London, UK.,Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | | | | | - Daiana Stolz
- Pulmonary Care Division, University Hospital Basel, Basel, Switzerland
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31
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Fernandes V, Alfaro TM, Baptista JP, Regateiro FS, Fradinho F, Cordeiro CR. Severe ketorolac-induced asthma diagnosed by chest computed tomography. J Thorac Dis 2017; 9:S1567-S1569. [PMID: 29255644 DOI: 10.21037/jtd.2017.11.36] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Aspirin-exacerbated respiratory disease (AERD) affects 15% of severe asthmatics and drug reactions cause 200,000 annual deaths in Europe. A 65-year-old lady presented to emergency for progressive abdominal pain. Her medical history included gallstones, asthma, rhinosinusitis and hypertension. She was regularly medicated with inhaled fluticasone, vilanterol and tiotropium, nasal budesonide, pantoprazole, oxazepam and perindopril. She reported partial asthma control and an exacerbation requiring admission to a respiratory ward 6 weeks before. On examination, there was right upper quadrant tenderness and no other changes. Blood tests were normal, and an ultrasound showed gallbladder stones with normal wall. Intravenous ketorolac led to prompt pain resolution. After 30 minutes she became severely dyspnoeic, with an O2 saturation of 85% on high flow O2. She had no breath sounds on the left lung, and there was no wheezing or prolonged expiration. A chest X-ray showed no pneumothorax and a computed tomography (CT) angiography was performed showing bilateral mucoid impaction and sub-segmental atelectasis. Continuous bronchodilation and systemic steroids led to gradual improving in the following 6 hours. After 9 days of admission on a respiratory ward she was discharged home with no symptoms and normal oxygenation. Importantly, she denied previous allergies to nonsteroidal anti-inflammatory drugs (NSAIDs) and had actually taken diclofenac and nimesulid before with no reactions. This report illustrates both an intravenous NSAID causing severe AERD, and how a chest CT may be instrumental for the diagnosis of life-threatening asthma.
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Affiliation(s)
- Vânia Fernandes
- Pneumology Unit A, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Tiago M Alfaro
- Pneumology Unit A, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - João P Baptista
- Intensive Care Unit, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Frederico S Regateiro
- Immunoallergology Unit, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Fátima Fradinho
- Pneumology Unit A, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
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Borisov SE, Dheda K, Enwerem M, Romero Leyet R, D’Ambrosio L, Centis R, Sotgiu G, Tiberi S, Alffenaar JW, Maryandyshev A, Belilowski E, Ganatra S, Skrahina A, Akkerman O, Aleksa A, Amale R, Artsukevich J, Bruchfeld J, Caminero JA, Carpena Martinez I, Codecasa L, Dalcolmo M, Denholm J, Douglas P, Duarte R, Esmail A, Fadul M, Filippov A, Davies Forsman L, Gaga M, Garcia-Fuertes JA, Garcia-Garcia JM, Gualano G, Jonsson J, Kunst H, Lau JS, Lazaro Mastrapa B, Lazaro Teran Troya J, Manga S, Manika K, González Montaner P, Mullerpattan J, Oelofse S, Ortelli M, Palmero DJ, Palmieri F, Papalia A, Papavasileiou A, Payen MC, Pontali E, Robalo Cordeiro C, Sadutshang TD, Sanukevich T, Solodovnikova V, Spanevello A, Topgyal S, Toscanini F, Tramontana A, Udwadia ZF, Viggiani P, White V, Zumla A, Migliori GB. Bedaquiline (BQ)-containing regimen at the programmatic level for MDR-TB: preliminary results. Tuberculosis (Edinb) 2017. [DOI: 10.1183/1393003.congress-2017.oa4852] [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: 11/05/2022]
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33
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Joos G, Bush A, Burghuber OC, Robalo Cordeiro C, Gaga M, Gibson GJ, Gratziou C, Rigau D, Rohde G, Smyth D, Stolz D, Tonia T, Vestbo J, Welte T, Brusselle G, Miravitlles M. Taken to task: what is and is not an appropriate response to an ERS guidelines task force? Eur Respir J 2017; 50:50/1/1700952. [DOI: 10.1183/13993003.00952-2017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 05/09/2017] [Indexed: 11/05/2022]
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34
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Alfaro TM, Monteiro RA, Cunha RA, Cordeiro CR. Chronic coffee consumption and respiratory disease: A systematic review. Clin Respir J 2017; 12:1283-1294. [PMID: 28671769 DOI: 10.1111/crj.12662] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 06/20/2017] [Accepted: 06/28/2017] [Indexed: 01/23/2023]
Abstract
PURPOSE The widespread consumption of coffee means that any biological effects from its use can lead to significant public health consequences. Chronic pulmonary diseases are extremely prevalent and responsible for one of every six deaths on a global level. METHODS Major medical databases for studies reporting on the effects of coffee or caffeine consumption on a wide range of non-malignant respiratory outcomes, including incidence, prevalence, evolution or severity of respiratory disease in adults were searched. Studies on lung function and respiratory mortality were also considered. RESULTS Fifteen studies, including seven cohort, six cross-sectional, one case control and one randomized control trial were found. Coffee consumption was generally associated with a reduction in prevalence of asthma. The association of coffee with natural honey was an effective treatment for persistent post-infectious cough. One case-control study found higher risk of chronic obstructive pulmonary disease (COPD) with coffee consumption. No association was found with the evolution of COPD or sarcoidosis. Coffee was associated with a reduction in respiratory mortality, and one study found improved lung function in coffee consumers. Smoking was a significant confounder in most studies. CONCLUSIONS Coffee consumption was associated with some positive effects on the respiratory system. There was however limited available evidence, mostly from cross sectional and retrospective studies. The only prospective cohort studies were those reporting on respiratory mortality. These results suggest that coffee consumption may be a part of a healthy lifestyle leading to reduced respiratory morbidity.
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Affiliation(s)
- Tiago M Alfaro
- FMUC - Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,CNC - Centre for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal.,Unit of Pneumology A, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Rita A Monteiro
- FMUC - Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Rodrigo A Cunha
- CNC - Centre for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal
| | - Carlos Robalo Cordeiro
- FMUC - Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Unit of Pneumology A, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
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35
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Oliveira RC, Carvalho L, Ferreira AJ, Cordeiro CR. Bronchial mucous gland adenoma: A rare tumor. Rev Port Pneumol (2006) 2017; 23:241-242. [PMID: 28558921 DOI: 10.1016/j.rppnen.2017.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 04/08/2017] [Accepted: 04/10/2017] [Indexed: 10/19/2022] Open
Affiliation(s)
- R C Oliveira
- Serviço de Anatomia Patológica, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
| | - L Carvalho
- Serviço de Anatomia Patológica, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Instituto de Anatomia Patológica, Faculdade de Medicina da Universidade de Coimbra, Coimbra, Portugal
| | - A J Ferreira
- Serviço de Pneumologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - C R Cordeiro
- Serviço de Pneumologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
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36
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Borisov SE, Dheda K, Enwerem M, Romero Leyet R, D'Ambrosio L, Centis R, Sotgiu G, Tiberi S, Alffenaar JW, Maryandyshev A, Belilovski E, Ganatra S, Skrahina A, Akkerman O, Aleksa A, Amale R, Artsukevich J, Bruchfeld J, Caminero JA, Carpena Martinez I, Codecasa L, Dalcolmo M, Denholm J, Douglas P, Duarte R, Esmail A, Fadul M, Filippov A, Davies Forsman L, Gaga M, Garcia-Fuertes JA, García-García JM, Gualano G, Jonsson J, Kunst H, Lau JS, Lazaro Mastrapa B, Teran Troya JL, Manga S, Manika K, González Montaner P, Mullerpattan J, Oelofse S, Ortelli M, Palmero DJ, Palmieri F, Papalia A, Papavasileiou A, Payen MC, Pontali E, Robalo Cordeiro C, Saderi L, Sadutshang TD, Sanukevich T, Solodovnikova V, Spanevello A, Topgyal S, Toscanini F, Tramontana AR, Udwadia ZF, Viggiani P, White V, Zumla A, Migliori GB. Effectiveness and safety of bedaquiline-containing regimens in the treatment of MDR- and XDR-TB: a multicentre study. Eur Respir J 2017; 49:49/5/1700387. [PMID: 28529205 DOI: 10.1183/13993003.00387-2017] [Citation(s) in RCA: 194] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 03/16/2017] [Indexed: 11/05/2022]
Abstract
Large studies on bedaquiline used to treat multidrug-resistant (MDR-) and extensively drug-resistant tuberculosis (XDR-TB) are lacking. This study aimed to evaluate the safety and effectiveness of bedaquiline-containing regimens in a large, retrospective, observational study conducted in 25 centres and 15 countries in five continents.428 culture-confirmed MDR-TB cases were analysed (61.5% male; 22.1% HIV-positive, 45.6% XDR-TB). MDR-TB cases were admitted to hospital for a median (interquartile range (IQR)) 179 (92-280) days and exposed to bedaquiline for 168 (86-180) days. Treatment regimens included, among others, linezolid, moxifloxacin, clofazimine and carbapenems (82.0%, 58.4%, 52.6% and 15.3% of cases, respectively).Sputum smear and culture conversion rates in MDR-TB cases were 63.6% and 30.1%, respectively at 30 days, 81.1% and 56.7%, respectively at 60 days; 85.5% and 80.5%, respectively at 90 days and 88.7% and 91.2%, respectively at the end of treatment. The median (IQR) time to smear and culture conversion was 34 (30-60) days and 60 (33-90) days. Out of 247 culture-confirmed MDR-TB cases completing treatment, 71.3% achieved success (62.4% cured; 8.9% completed treatment), 13.4% died, 7.3% defaulted and 7.7% failed. Bedaquiline was interrupted due to adverse events in 5.8% of cases. A single case died, having electrocardiographic abnormalities that were probably non-bedaquiline related.Bedaquiline-containing regimens achieved high conversion and success rates under different nonexperimental conditions.
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Affiliation(s)
- Sergey E Borisov
- Moscow Research and Clinical Center for TB Control, Moscow Government's Health Department, Moscow, Russian Federation.,These authors contributed equally
| | - Keertan Dheda
- UCT Lung Institute, Division of Pulmonology, University of Cape Town, Cape Town, South Africa.,These authors contributed equally
| | - Martin Enwerem
- Amity Health Consortium, Country Club Estate, Johannesburg, South Africa.,These authors contributed equally
| | - Rodolfo Romero Leyet
- Clinical Unit, District Clinical Specialist Team, Springbok, South Africa.,These authors contributed equally
| | - Lia D'Ambrosio
- World Health Organization Collaborating Centre for Tuberculosis and Lung Diseases, Maugeri Care and Research Institute, Tradate, Italy.,Public Health Consulting Group, Lugano, Switzerland.,These authors contributed equally
| | - Rosella Centis
- World Health Organization Collaborating Centre for Tuberculosis and Lung Diseases, Maugeri Care and Research Institute, Tradate, Italy.,These authors contributed equally
| | - Giovanni Sotgiu
- Clinical Epidemiology and Medical Statistics Unit, Dept of Biomedical Sciences, University of Sassari, Sassari, Italy.,These authors contributed equally
| | - Simon Tiberi
- Division of Infection, Royal London Hospital, Barts Health NHS Trust, London, UK.,Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.,These authors contributed equally
| | - Jan-Willem Alffenaar
- University of Groningen, University Medical Center Groningen, Dept of Clinical Pharmacy and Pharmacology, Groningen, The Netherlands.,These authors contributed equally
| | - Andrey Maryandyshev
- Northern State Medical University, Arkhangelsk, Russian Federation.,These authors contributed equally
| | - Evgeny Belilovski
- Moscow Research and Clinical Center for TB Control, Moscow Government's Health Department, Moscow, Russian Federation.,These authors contributed equally
| | - Shashank Ganatra
- Dept of Respiratory Medicine, P.D. Hinduja National Hospital and MRC, Mumbai, India.,These authors contributed equally
| | - Alena Skrahina
- Republican Research and Practical Centre for Pulmonology and Tuberculosis, Minsk, Belarus.,These authors contributed equally
| | - Onno Akkerman
- University of Groningen, University Medical Center Groningen, Tuberculosis Center Beatrixoord, Haren, The Netherlands.,University of Groningen, University Medical Center Groningen, Dept of Pulmonary Diseases and Tuberculosis, Groningen, The Netherlands
| | - Alena Aleksa
- Dept of Phthisiology, Grodno State Medical University, GRCC "Phthisiology", Grodno, Belarus
| | - Rohit Amale
- Dept of Respiratory Medicine, P.D. Hinduja National Hospital and MRC, Mumbai, India
| | - Janina Artsukevich
- Dept of Phthisiology, Grodno State Medical University, GRCC "Phthisiology", Grodno, Belarus
| | - Judith Bruchfeld
- Unit of Infectious Diseases, Dept of Medicine, Solna, Karolinska Institute, Dept of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Jose A Caminero
- Pneumology Dept, Hospital General de Gran Canaria "Dr Negrin", Las Palmas de Gran Canaria, Spain.,MDR-TB Unit, Tuberculosis Division, International Union against Tuberculosis and Lung Disease (The Union), Paris, France
| | | | - Luigi Codecasa
- TB Reference Centre, Villa Marelli Institute/Niguarda Hospital, Milan, Italy
| | | | - Justin Denholm
- Victorian Tuberculosis Program, Melbourne Health, Dept of Microbiology and Immunology, University of Melbourne, Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Paul Douglas
- Health Policy and Performance Branch, Health Services and Policy Division, Dept of Immigration and Border Protection, Sydney, Australia
| | - Raquel Duarte
- National Reference Centre for MDR-TB, Hospital Centre Vila Nova de Gaia, Dept of Pneumology, Public Health Science and Medical Education Department, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Aliasgar Esmail
- UCT Lung Institute, Lung Infection and Immunity Unit, Division of Pulmonology, Dept of Medicine, University of Cape Town, Groote Schuur Hospital, Cape Town, South Africa
| | - Mohammed Fadul
- UCT Lung Institute, Lung Infection and Immunity Unit, Division of Pulmonology, Dept of Medicine, University of Cape Town, Groote Schuur Hospital, Cape Town, South Africa
| | - Alexey Filippov
- Moscow Research and Clinical Center for TB Control, Moscow Government's Health Department, Moscow, Russian Federation
| | - Lina Davies Forsman
- Unit of Infectious Diseases, Dept of Medicine, Solna, Karolinska Institute, Dept of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Mina Gaga
- 7th Respiratory Medicine Dept, Athens Chest Hospital, Athens, Greece
| | | | | | - Gina Gualano
- Respiratory Infectious Diseases Unit, National Institute for Infectious Diseases "L. Spallanzani", IRCCS, Rome, Italy
| | - Jerker Jonsson
- National TB Surveillance Unit, Public Health Agency, Stockholm, Sweden
| | - Heinke Kunst
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Jillian S Lau
- Dept of Infectious Diseases, Box Hill Hospital, Victoria, Australia
| | | | | | - Selene Manga
- Dept of Infectious Diseases, University National San Antonio Abad Cusco, Cusco, Perù
| | - Katerina Manika
- Pulmonary Dept, 'G. Papanikolaou' Hospital, Aristotle University, Thessaloniki, Greece
| | | | - Jai Mullerpattan
- Dept of Respiratory Medicine, P.D. Hinduja National Hospital and MRC, Mumbai, India
| | - Suzette Oelofse
- UCT Lung Institute, Lung Infection and Immunity Unit, Division of Pulmonology, Dept of Medicine, University of Cape Town, Groote Schuur Hospital, Cape Town, South Africa
| | | | | | - Fabrizio Palmieri
- Respiratory Infectious Diseases Unit, National Institute for Infectious Diseases "L. Spallanzani", IRCCS, Rome, Italy
| | - Antonella Papalia
- AOVV Eugenio Morelli Hospital, Reference Hospital for MDR and HIV-TB, Sondalo, Italy
| | | | - Marie-Christine Payen
- Division of Infectious Diseases, CHU Saint-Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | | | | | - Laura Saderi
- Clinical Epidemiology and Medical Statistics Unit, Dept of Biomedical Sciences, University of Sassari, Sassari, Italy
| | | | - Tatsiana Sanukevich
- Dept of Phthisiology, Grodno State Medical University, GRCC "Phthisiology", Grodno, Belarus
| | - Varvara Solodovnikova
- Republican Research and Practical Centre for Pulmonology and Tuberculosis, Minsk, Belarus
| | - Antonio Spanevello
- Pneumology Dept, Maugeri Care and Research Institute, Tradate, Italy.,Dept of Clinical and Experimental Medicine, University of Insubria, Varese, Italy
| | | | - Federica Toscanini
- University Hospital San Martino, Care and Research Institute, National Institute for Cancer Research, Genoa, Italy
| | | | - Zarir Farokh Udwadia
- Dept of Respiratory Medicine, P.D. Hinduja National Hospital and MRC, Mumbai, India
| | - Pietro Viggiani
- AOVV Eugenio Morelli Hospital, Reference Hospital for MDR and HIV-TB, Sondalo, Italy
| | - Veronica White
- Dept of Respiratory Medicine, Barts Healthcare NHS Trust, London, UK
| | - Alimuddin Zumla
- Division of Infection and Immunity, University College London and NIHR Biomedical Research Centre, UCL Hospitals NHS Foundation Trust, London, UK
| | - Giovanni Battista Migliori
- World Health Organization Collaborating Centre for Tuberculosis and Lung Diseases, Maugeri Care and Research Institute, Tradate, Italy .,These authors contributed equally
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37
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Alfaro TM, Rodrigues DI, Tomé ÂR, Cunha RA, Robalo Cordeiro C. Adenosine A 2A receptors are up-regulated and control the activation of human alveolar macrophages. Pulm Pharmacol Ther 2017; 45:90-94. [PMID: 28499635 DOI: 10.1016/j.pupt.2017.04.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 01/24/2017] [Accepted: 04/27/2017] [Indexed: 12/15/2022]
Abstract
Chronic inflammatory lung diseases remain a health concern and new anti-inflammatory treatments are needed. Targeting adenosine A2A receptors (A2AR) affords robust anti-inflammatory effects in animal models, but the translation of this promising strategy to humans has been challenging, possibly due to interspecies differences in receptor distribution and effects. Thus, we now assessed the efficiency of a selective A2AR agonist to control the activation of fresh human alveolar inflammatory cells. We collected bronchoalveolar lavage fluid from patients with interstitial lung disease and loaded alveolar cells with the intracellular free calcium probe FURA-2/AM. Calcium transients were then recorded in response to superfusion with a proinflammatory peptide (N-formylmethionyl-leucyl-phenylalanine - FMLP), in the absence or presence of the selective A2AR agonist CGS21680. In a second experiment, cells were continuously exposed to FMLP and A2AR density was assessed by immunocytochemistry. Sixteen patients were included, nine for analysis of calcium transients, and seven for immunocytochemistry. When alveolar macrophages were exposed to 100 nM FMLP for 120 s, a peak elevation of intracellular free calcium levels (97.0% over baseline) was recorded; CGS21680 (100 and 300 mM) significantly reduced this peak to 89.5% and 81.5%, respectively. The immunofluorescence analysis revealed a time-dependent increase of A2AR density in alveolar macrophage upon exposure to 1 μM FMLP, up to 148% of control at 6 h. These results show that pro-inflammatory stimuli up-regulate A2AR and their activation dampens the impact of pro-inflammatory stimuli. This supports that targeting A2AR is a promising therapy for human lung inflammatory diseases, especially for diseases with a strong inflammatory component.
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Affiliation(s)
- Tiago M Alfaro
- FMUC-Faculty of Medicine, University of Coimbra, Portugal; Pneumology Unit A, Centro Hospitalar e Universitário de Coimbra, Portugal; CNC - Centre for Neuroscience and Cell Biology, University of Coimbra, Portugal.
| | - Diana I Rodrigues
- CNC - Centre for Neuroscience and Cell Biology, University of Coimbra, Portugal
| | - Ângelo R Tomé
- CNC - Centre for Neuroscience and Cell Biology, University of Coimbra, Portugal; Department of Life Sciences, Faculty of Sciences and Technology, University of Coimbra, Portugal
| | - Rodrigo A Cunha
- FMUC-Faculty of Medicine, University of Coimbra, Portugal; CNC - Centre for Neuroscience and Cell Biology, University of Coimbra, Portugal
| | - Carlos Robalo Cordeiro
- FMUC-Faculty of Medicine, University of Coimbra, Portugal; Pneumology Unit A, Centro Hospitalar e Universitário de Coimbra, Portugal
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38
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Duarte JC, Cordeiro CR, Ferreira AJ. Role of flexible bronchoscopy in non-resolving community-acquired pneumonia - A retrospective analysis. Rev Port Pneumol (2006) 2017; 23:168-169. [PMID: 28412145 DOI: 10.1016/j.rppnen.2017.01.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 01/17/2017] [Accepted: 01/23/2017] [Indexed: 11/30/2022] Open
Affiliation(s)
- J C Duarte
- Pulmonology Unit, Hospitais da Universidade de Coimbra - Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; University of Coimbra, Faculty of Medicine, Coimbra, Portugal.
| | - C R Cordeiro
- Pulmonology Unit, Hospitais da Universidade de Coimbra - Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; University of Coimbra, Faculty of Medicine, Coimbra, Portugal
| | - A J Ferreira
- Pulmonology Unit, Hospitais da Universidade de Coimbra - Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; University of Coimbra, Faculty of Medicine, Coimbra, Portugal
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39
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Bousquet J, Barbara C, Bateman E, Bel E, Bewick M, Chavannes NH, Cruz AA, Haahtela T, Hellings PW, Khaltaev N, Lodrup Carlsen K, Muraro A, Cordeiro CR, Rosado-Pinto J, Samolinski B, Strandberg T, Valiulis A, Yorgancioglu A, Zuberbier T. AIRWAYS-ICPs (European Innovation Partnership on Active and Healthy Ageing) from concept to implementation. Eur Respir J 2017; 47:1028-33. [PMID: 27037308 DOI: 10.1183/13993003.01856-2015] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 11/09/2015] [Indexed: 11/05/2022]
Affiliation(s)
- Jean Bousquet
- University Hospital, Montpellier, France MACVIA-LR, Contre les Maladies Chroniques pour un VIeillissement Actif en Languedoc Roussillon, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France INSERM, VIMA: Ageing and chronic diseases Epidemiological and public health approaches, U1168, Paris, and UVSQ, UMR-S 1168, Université Versailles St-Quentin-en-Yvelines, Versailles, France GARD, Global Alliance against Chronic Respiratory Diseases (GARD) EIP on AHA Commitment for Action
| | - Cristina Barbara
- EIP on AHA Commitment for Action PNDR, Portuguese National Programme for Respiratory Diseases, Faculdade de Medicina de Lisboa, Lisbon, Portugal
| | - Eric Bateman
- GARD, Global Alliance against Chronic Respiratory Diseases (GARD) Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Elisabeth Bel
- Department of Respiratory Medicine, Academic Medical Center (AMC), University of Amsterdam, Amsterdam, The Netherlands ERS Past President, European Respiratory Society
| | - Mike Bewick
- Deputy National Medical Director, NHS England, UK
| | - Niels H Chavannes
- GARD, Global Alliance against Chronic Respiratory Diseases (GARD) Dept of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands International Primary Care Respiratory Group
| | - Alvaro A Cruz
- GARD, Global Alliance against Chronic Respiratory Diseases (GARD) ProAR - Nucleo de Excelencia em Asma, Federal University of Bahia, Brasil and GARD Executive Committee
| | - Tari Haahtela
- EIP on AHA Commitment for Action Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
| | - Peter W Hellings
- Laboratory of Clinical Immunology, Dept of Microbiology and Immunology, KU Leuven, Leuven, Belgium EAACI, European Academy of Allergy and Clinical Immunology
| | - Nikolai Khaltaev
- GARD, Global Alliance against Chronic Respiratory Diseases (GARD)
| | - Karin Lodrup Carlsen
- EIP on AHA Commitment for Action Dept of Paediatrics, Oslo University Hospital, Oslo, Norway Faculty of Medicine, University of Oslo, Institute of Clinical Medicine, Oslo, Norway
| | - Antonella Muraro
- EAACI, European Academy of Allergy and Clinical Immunology Dept of Women and Child Health, Food Allergy Referral Centre Veneto Region, Padua General University Hospital, Padua, Italy
| | | | - Jose Rosado-Pinto
- GARD, Global Alliance against Chronic Respiratory Diseases (GARD) Serviço de Imunoalergologia, Hospital da Luz, Lisbon, Portugal
| | - Boleslaw Samolinski
- EIP on AHA Commitment for Action Dept of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Poland
| | - Timo Strandberg
- Dept of Paediatrics, Universities of Helsinki and Oulu, Finland European Union Geriatric Medicine Society, EUGMS Helsinki University Central Hospital, Helsinki, Finland
| | - Arunas Valiulis
- GARD, Global Alliance against Chronic Respiratory Diseases (GARD) Vilnius University Clinic of Children's Diseases, Vilnius, Lithuania European Academy of Pediatrics (EAP/UEMS-SP)
| | - Arzu Yorgancioglu
- GARD, Global Alliance against Chronic Respiratory Diseases (GARD) EIP on AHA Commitment for Action Dept of Pulmonology, Celal Bayar University, Manisa, Turkey Turkish Thoracic Society
| | - Torsten Zuberbier
- Allergy-Centre-Charité at the Department of Dermatology, Charité - Universitätsmedizin Berlin, Berlin, Germany Secretary General of the Global Allergy and Asthma European Network (GA2LEN)
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40
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Sousa I, Abrantes P, Francisco V, Teixeira G, Monteiro M, Neves J, Norte A, Robalo Cordeiro C, Moura e Sá J, Reis E, Santos P, Oliveira M, Sousa S, Fradinho M, Malheiro F, Negrão L, Feijó S, Oliveira SA. Multicentric Genome-Wide Association Study for Primary Spontaneous Pneumothorax. PLoS One 2016; 11:e0156103. [PMID: 27203581 PMCID: PMC4874577 DOI: 10.1371/journal.pone.0156103] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 05/08/2016] [Indexed: 11/18/2022] Open
Abstract
Despite elevated incidence and recurrence rates for Primary Spontaneous Pneumothorax (PSP), little is known about its etiology, and the genetics of idiopathic PSP remains unexplored. To identify genetic variants contributing to sporadic PSP risk, we conducted the first PSP genome-wide association study. Two replicate pools of 92 Portuguese PSP cases and of 129 age- and sex-matched controls were allelotyped in triplicate on the Affymetrix Human SNP Array 6.0 arrays. Markers passing quality control were ranked by relative allele score difference between cases and controls (|RASdiff|), by a novel cluster method and by a combined Z-test. 101 single nucleotide polymorphisms (SNPs) were selected using these three approaches for technical validation by individual genotyping in the discovery dataset. 87 out of 94 successfully tested SNPs were nominally associated in the discovery dataset. Replication of the 87 technically validated SNPs was then carried out in an independent replication dataset of 100 Portuguese cases and 425 controls. The intergenic rs4733649 SNP in chromosome 8 (between LINC00824 and LINC00977) was associated with PSP in the discovery (P = 4.07E-03, ORC[95% CI] = 1.88[1.22–2.89]), replication (P = 1.50E-02, ORC[95% CI] = 1.50[1.08–2.09]) and combined datasets (P = 8.61E-05, ORC[95% CI] = 1.65[1.29–2.13]). This study identified for the first time one genetic risk factor for sporadic PSP, but future studies are warranted to further confirm this finding in other populations and uncover its functional role in PSP pathogenesis.
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Affiliation(s)
- Inês Sousa
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
- Instituto Gulbenkian de Ciência, Oeiras, Portugal
| | - Patrícia Abrantes
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
- Instituto Gulbenkian de Ciência, Oeiras, Portugal
| | - Vânia Francisco
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
- Instituto Gulbenkian de Ciência, Oeiras, Portugal
| | | | | | - João Neves
- Centro Hospitalar do Porto, Porto, Portugal
| | - Ana Norte
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | | | - João Moura e Sá
- Centro Hospitalar de Vila Nova de Gaia, Vila Nova de Gaia, Portugal
| | | | - Patrícia Santos
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
- Instituto Gulbenkian de Ciência, Oeiras, Portugal
| | | | - Susana Sousa
- Hospital de São Bernardo (Centro Hospitalar de Setúbal, E.P.E.), Setúbal, Portugal
| | - Marta Fradinho
- Hospital Egas Moniz (Centro Hospitalar de Lisboa Ocidental), Lisboa, Portugal
| | | | - Luís Negrão
- Instituto Português do Sangue e da Transplantacão, Centro Regional de Sangue de Lisboa, Lisboa, Portugal
| | | | - Sofia A. Oliveira
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
- Instituto Gulbenkian de Ciência, Oeiras, Portugal
- * E-mail:
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41
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Migliori GB, Bel E, Joos G, Elliott M, Rohde G, Holgate ST, Gratziou C, Smyth D, Gaga M, Cordeiro CR, Burghuber OC, Brusselle G, Martin-Burrieza F, Bill W, Sax B, Vestbo J. The European Respiratory Society evaluates its 2013–2018 strategic plan implementation. Eur Respir J 2016; 47:693-8. [DOI: 10.1183/13993003.02110-2015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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42
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Reis Ferreira JM, Figueiredo A, Boléo-Tomé JP, Robalo Cordeiro C. [Electronic Cigarette: Position of the Portuguese Society of Pneumology]. ACTA MEDICA PORT 2015; 28:548-550. [PMID: 26667855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Accepted: 12/29/2014] [Indexed: 06/05/2023]
Affiliation(s)
- José M Reis Ferreira
- Editor. Boletim 'Oxigénio'. Sociedade Portuguesa de Pneumologia. Lisboa. Portugal. Comissão de Trabalho de Tabagismo. Sociedade Portuguesa de Pneumologia. Lisboa. Portugal
| | - Ana Figueiredo
- Coordenadora. Comissão de Trabalho de Tabagismo. Sociedade Portuguesa de Pneumologia. Lisboa. Portugal
| | - José Pedro Boléo-Tomé
- Secretário. Comissão de Trabalho de Tabagismo. Sociedade Portuguesa de Pneumologia. Lisboa. Portugal
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43
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Cordeiro CR, Alfaro TM, Freitas S, Cemlyn-Jones J. Idiopathic pulmonary fibrosis. Lung Cancer 2015. [DOI: 10.1183/2312508x.10009414] [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: 11/05/2022]
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44
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Reis Ferreira JM, Figueiredo A, Boléo-Tomé JP, Robalo Cordeiro C. Cigarro Eletrónico: Posição da Sociedade Portuguesa de Pneumologia. ACTA MEDICA PORT 2015. [DOI: 10.20344/amp.6120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
<strong>Keywords:</strong> Electronic Cigarettes/adverse effects; Nicotine; Portugal; Smoking Cessation/methods.<br />
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45
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Lönnroth K, Migliori GB, Abubakar I, D'Ambrosio L, de Vries G, Diel R, Douglas P, Falzon D, Gaudreau MA, Goletti D, González Ochoa ER, LoBue P, Matteelli A, Njoo H, Solovic I, Story A, Tayeb T, van der Werf MJ, Weil D, Zellweger JP, Abdel Aziz M, Al Lawati MR, Aliberti S, Arrazola de Oñate W, Barreira D, Bhatia V, Blasi F, Bloom A, Bruchfeld J, Castelli F, Centis R, Chemtob D, Cirillo DM, Colorado A, Dadu A, Dahle UR, De Paoli L, Dias HM, Duarte R, Fattorini L, Gaga M, Getahun H, Glaziou P, Goguadze L, del Granado M, Haas W, Järvinen A, Kwon GY, Mosca D, Nahid P, Nishikiori N, Noguer I, O'Donnell J, Pace-Asciak A, Pompa MG, Popescu GG, Robalo Cordeiro C, Rønning K, Ruhwald M, Sculier JP, Simunović A, Smith-Palmer A, Sotgiu G, Sulis G, Torres-Duque CA, Umeki K, Uplekar M, van Weezenbeek C, Vasankari T, Vitillo RJ, Voniatis C, Wanlin M, Raviglione MC. Towards tuberculosis elimination: an action framework for low-incidence countries. Eur Respir J 2015; 45:928-52. [PMID: 25792630 PMCID: PMC4391660 DOI: 10.1183/09031936.00214014] [Citation(s) in RCA: 528] [Impact Index Per Article: 58.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Accepted: 01/02/2015] [Indexed: 12/31/2022]
Abstract
This paper describes an action framework for countries with low tuberculosis (TB) incidence (<100 TB cases per million population) that are striving for TB elimination. The framework sets out priority interventions required for these countries to progress first towards "pre-elimination" (<10 cases per million) and eventually the elimination of TB as a public health problem (less than one case per million). TB epidemiology in most low-incidence countries is characterised by a low rate of transmission in the general population, occasional outbreaks, a majority of TB cases generated from progression of latent TB infection (LTBI) rather than local transmission, concentration to certain vulnerable and hard-to-reach risk groups, and challenges posed by cross-border migration. Common health system challenges are that political commitment, funding, clinical expertise and general awareness of TB diminishes as TB incidence falls. The framework presents a tailored response to these challenges, grouped into eight priority action areas: 1) ensure political commitment, funding and stewardship for planning and essential services; 2) address the most vulnerable and hard-to-reach groups; 3) address special needs of migrants and cross-border issues; 4) undertake screening for active TB and LTBI in TB contacts and selected high-risk groups, and provide appropriate treatment; 5) optimise the prevention and care of drug-resistant TB; 6) ensure continued surveillance, programme monitoring and evaluation and case-based data management; 7) invest in research and new tools; and 8) support global TB prevention, care and control. The overall approach needs to be multisectorial, focusing on equitable access to high-quality diagnosis and care, and on addressing the social determinants of TB. Because of increasing globalisation and population mobility, the response needs to have both national and global dimensions.
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Affiliation(s)
- Knut Lönnroth
- Global TB Programme, World Health Organization, Geneva, Switzerland
- Both authors contributed equally
| | - Giovanni Battista Migliori
- WHO Collaborating Centre for Tuberculosis and Lung Diseases, Fondazione S. Maugeri, IRCCS, Tradate, Italy
- Both authors contributed equally
| | - Ibrahim Abubakar
- TB Section, University College London and Public Health England, London, UK
| | - Lia D'Ambrosio
- WHO Collaborating Centre for Tuberculosis and Lung Diseases, Fondazione S. Maugeri, IRCCS, Tradate, Italy
| | | | - Roland Diel
- University Hospital Schleswig Holstein, Institute for Epidemiology, Kiel, Germany
| | - Paul Douglas
- Global Health Borders Refugee and Onshore Services, Dept of Immigration and Border Protection, Sydney, Australia
| | - Dennis Falzon
- Global TB Programme, World Health Organization, Geneva, Switzerland
| | - Marc-Andre Gaudreau
- Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, Montreal, QC, Canada
| | - Delia Goletti
- National Institute for Infectious Diseases, Rome, Italy
| | - Edilberto R. González Ochoa
- Research and Surveillance Group on TB, Leprosy and ARI, Epidemiology Board, Institute of Tropical Medicine “Pedro Kourí”, Havana, Cuba
| | - Philip LoBue
- Division of TB Elimination, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Howard Njoo
- Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, Montreal, QC, Canada
| | - Ivan Solovic
- TB Dept, National Institute for TB, Respiratory Diseases and Thoracic Surgery, Vysne Hagy, Catholic University, Ružomberok, Slovakia
| | | | - Tamara Tayeb
- National TB Control Programme, Ministry of Health, Riyadh, Saudi Arabia
| | | | - Diana Weil
- Global TB Programme, World Health Organization, Geneva, Switzerland
| | | | | | | | - Stefano Aliberti
- Università degli Studi di Milano – Bicocca, UO Clinica Pneumologica, AO San Gerardo, Monza, Italy
| | | | | | - Vineet Bhatia
- Global TB Programme, World Health Organization, Geneva, Switzerland
| | - Francesco Blasi
- Dipartimento Fisiopatologia Medico-Chirurgica e dei Trapianti, University of Milan, IRCCS Fondazione Cà Granda, Milan, Italy
| | - Amy Bloom
- US Agency for International Development, Washington, DC, USA
| | - Judith Bruchfeld
- Unit of Infectious Diseases, Institution of Medicine, Karolinska Institute Solna and Karolinska University Hospital, Stockholm, Sweden
| | | | - Rosella Centis
- WHO Collaborating Centre for Tuberculosis and Lung Diseases, Fondazione S. Maugeri, IRCCS, Tradate, Italy
| | | | | | | | - Andrei Dadu
- TB and M/XDR-TB Control Programme, WHO Regional Office for Europe, Copenhagen, Denmark
| | - Ulf R. Dahle
- Norwegian Institute of Public Health, Oslo, Norway
| | | | - Hannah M. Dias
- Global TB Programme, World Health Organization, Geneva, Switzerland
| | | | | | - Mina Gaga
- National Referral Centre for Mycobacteria, Athens Chest Hospital, Ministry of Health, Athens, Greece
| | | | - Philippe Glaziou
- Global TB Programme, World Health Organization, Geneva, Switzerland
| | - Lasha Goguadze
- International Federation of Red Cross and Red Crescent Societies, Geneva, Switzerland
| | | | - Walter Haas
- Dept of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Asko Järvinen
- Finnish Lung Health Association, Helsinki, Finland
- Helsinki University Central Hospital, Division of Infectious Diseases, Helsinki, Finland
| | - Geun-Yong Kwon
- Korea Centers for Disease Control and Prevention (KCDC), Ministry of Health and Welfare, Seoul, Republic of Korea
| | - Davide Mosca
- International Organization for Migration, Geneva, Switzerland
| | - Payam Nahid
- University of California, San Francisco, CA, USA
- American Thoracic Society (ATS), New York, NY, USA
| | - Nobuyuki Nishikiori
- Stop TB and Leprosy Elimination, WHO Regional Office for the Western Pacific, Manila, Philippines
| | | | - Joan O'Donnell
- HSE Health Protection Surveillance Centre, Dublin, Ireland
| | | | | | | | | | | | | | | | | | | | - Giovanni Sotgiu
- Clinical Epidemiology and Medical Statistics Unit, Dept of Biomedical Sciences, University of Sassari, Research, Medical Education and Professional Development Unit, AOU Sassari, Sassari, Italy
| | - Giorgia Sulis
- Global TB Programme, World Health Organization, Geneva, Switzerland
| | - Carlos A. Torres-Duque
- Asociacion Latinoamericana de Torax (ALAT) - Fundacion Neumologica Colombiana, Bogota, Colombia
| | | | - Mukund Uplekar
- Global TB Programme, World Health Organization, Geneva, Switzerland
| | | | | | | | | | - Maryse Wanlin
- Fonds des Affections Respiratoires (FARES), Brussels, Belgium
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Cordeiro CR. IN MEMORIAM. Rev Port Pneumol (2006) 2015; 21:107-108. [PMID: 26120617 DOI: 10.1016/j.rppnen.2015.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
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Affiliation(s)
- António Morais
- Portuguese Journal of Pulmonology, Lisbon, Portugal, Editor-in-Chief of the Portuguese Journal of Pulmonology, Lisbon, Portugal
| | - Carlos Robalo Cordeiro
- Portuguese Society of Pulmonology, Lisbon, Portugal, President of the Portuguese Society of Pulmonology, Lisbon, Portugal
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Paupério GS, Matos P, Cordeiro CR, Antunes MJ. Post thyroidectomy gossypiboma. Rev Port Cir Cardiotorac Vasc 2014; 21:111-113. [PMID: 26182454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Gossypiboma is an unfrequent surgical complication wich consists in the presence of a mass of textile origin surrounded by a foreign body reaction. The authors present a clinical case of a left paratracheal gossypiboma, diagnosed during the follow-up of a patient submitted to a total thyroidectomy two years before for a papilary carcinoma.
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Travis WD, Costabel U, Hansell DM, King TE, Lynch DA, Nicholson AG, Ryerson CJ, Ryu JH, Selman M, Wells AU, Behr J, Bouros D, Brown KK, Colby TV, Collard HR, Cordeiro CR, Cottin V, Crestani B, Drent M, Dudden RF, Egan J, Flaherty K, Hogaboam C, Inoue Y, Johkoh T, Kim DS, Kitaichi M, Loyd J, Martinez FJ, Myers J, Protzko S, Raghu G, Richeldi L, Sverzellati N, Swigris J, Valeyre D. An official American Thoracic Society/European Respiratory Society statement: Update of the international multidisciplinary classification of the idiopathic interstitial pneumonias. Am J Respir Crit Care Med 2013; 188:733-48. [PMID: 24032382 DOI: 10.1164/rccm.201308-1483st] [Citation(s) in RCA: 2586] [Impact Index Per Article: 235.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND In 2002 the American Thoracic Society/European Respiratory Society (ATS/ERS) classification of idiopathic interstitial pneumonias (IIPs) defined seven specific entities, and provided standardized terminology and diagnostic criteria. In addition, the historical "gold standard" of histologic diagnosis was replaced by a multidisciplinary approach. Since 2002 many publications have provided new information about IIPs. PURPOSE The objective of this statement is to update the 2002 ATS/ERS classification of IIPs. METHODS An international multidisciplinary panel was formed and developed key questions that were addressed through a review of the literature published between 2000 and 2011. RESULTS Substantial progress has been made in IIPs since the previous classification. Nonspecific interstitial pneumonia is now better defined. Respiratory bronchiolitis-interstitial lung disease is now commonly diagnosed without surgical biopsy. The clinical course of idiopathic pulmonary fibrosis and nonspecific interstitial pneumonia is recognized to be heterogeneous. Acute exacerbation of IIPs is now well defined. A substantial percentage of patients with IIP are difficult to classify, often due to mixed patterns of lung injury. A classification based on observed disease behavior is proposed for patients who are difficult to classify or for entities with heterogeneity in clinical course. A group of rare entities, including pleuroparenchymal fibroelastosis and rare histologic patterns, is introduced. The rapidly evolving field of molecular markers is reviewed with the intent of promoting additional investigations that may help in determining diagnosis, and potentially prognosis and treatment. CONCLUSIONS This update is a supplement to the previous 2002 IIP classification document. It outlines advances in the past decade and potential areas for future investigation.
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