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Palma R, Gomes I, Silva C, Pereira E, Almeida M. Spontaneous Hemoperitoneum Due to Ruptured Uterine Artery: A Rare Complication During Pregnancy. Cureus 2024; 16:e58033. [PMID: 38738117 PMCID: PMC11088285 DOI: 10.7759/cureus.58033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2024] [Indexed: 05/14/2024] Open
Abstract
Spontaneous rupture of the uterine artery is a rare and life-threatening cause of hemoperitoneum in pregnancy, associated with high maternal and perinatal morbidity and mortality. We present a case of a 29-year-old woman, in the 36th week of gestation, with acute abdomen due to hemoperitoneum. Ultrasound revealed free fluid in the abdominal cavity, with no signs of fetal distress, and the patient was mildly hypotensive. Exploratory laparotomy and cesarean section were performed, and extensive blood clots on the upper abdominal quadrants were discovered, as well as a bleeding left uterine artery. We expect that this case raises awareness of the ruptured uterine artery as a possible etiology of hemoperitoneum during pregnancy.
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Affiliation(s)
- Rita Palma
- Obstetrics and Gynaecology, Hospital Garcia de Orta, Almada, PRT
| | - Inês Gomes
- Gynaecology, Hospital Garcia de Orta, Almada, PRT
| | - Catarina Silva
- Obstetrics and Gynaecology, Hospital Garcia de Orta, Almada, PRT
| | - Elisa Pereira
- Gynaecologic Oncology, Hospital Garcia de Orta, Almada, PRT
| | - Manuela Almeida
- Maternal Fetal Medicine, Hospital Garcia de Orta, Almada, PRT
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Gomes I, Jesus E, Sousa GM. Rare Presentation and Diagnostic Challenge of a Germ Cell Tumor of the Yolk Sac Type. Cureus 2024; 16:e53138. [PMID: 38420071 PMCID: PMC10899893 DOI: 10.7759/cureus.53138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2024] [Indexed: 03/02/2024] Open
Abstract
Opsoclonus-ataxia paraneoplastic syndrome (OAPS) is a rare neurological disorder often associated with malignancies. This case report highlights an unusual instance of OAPS linked to a yolk sac (germ cell) tumor, a correlation underrepresented in the medical literature. The patient presented with distinct neurological symptoms alongside mediastinal lymphadenopathies. The subsequent diagnostic journey revealed a yolk sac germ cell tumor. Following incisional biopsies and treatment, the patient experienced fluctuations in mental status, leading to challenges in initiating chemotherapy. Despite these complications, a multidisciplinary approach involving neurologists, oncologists, and hematologists was pivotal. The case emphasizes the complexities of managing OAPS in tandem with a germ cell tumor, underscoring the need for further research and highlighting the significance of specialized neurological evaluation in similar cases.
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Affiliation(s)
- Inês Gomes
- Medical Oncology, Instituto Português de Oncologia de Coimbra Francisco Gentil, Coimbra, PRT
| | - Emanuel Jesus
- Medical Oncology, Instituto Português de Oncologia de Coimbra Francisco Gentil, Coimbra, PRT
| | - Gabriela M Sousa
- Medical Oncology, Instituto Português de Oncologia de Coimbra Francisco Gentil, Coimbra, PRT
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Gomes I, Galamba N. Protein stability in a natural deep eutectic solvent: Preferential hydration or solvent slaving? J Chem Phys 2023; 159:235101. [PMID: 38099555 DOI: 10.1063/5.0177095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 11/22/2023] [Indexed: 12/18/2023] Open
Abstract
Deep eutectic solvents (DESs) emerged as potential alternative solvent media in multiple areas, including biomolecular (cryo)preservation. Herein, we studied the stability of a small protein (ubiquitin) in water and a betaine-glycerol-water (B:G:W) (1:2:ζ; ζ = 0, 1, 2, 5, 10) DES, through molecular dynamics. An AMBER-based model that accurately describes the density and shear viscosity of the DES is proposed. We find that water molecules are largely trapped in the solvent, precluding the formation of a full hydration layer, seemingly opposite to osmolytes' preferential exclusion/preferential hydration mechanism. Although the protein is stable in the DES, structural fluctuations are largely suppressed and only recovered upon sufficient hydration. This is explained by a solvent-slaving mechanism where β-fluctuations are key, with the non-monotonic hydration of some amino acids with the water content providing an explanation to the non-monotonic folding of some proteins in aqueous DESs. A major thermal stability enhancement in the DES is also observed, caused by a similar slowdown of the backbone torsional dynamics. Our results support a kinetic stabilization of the protein in the DES, whereas a possible thermodynamic stabilization does not follow a preferential hydration or water entrapment mechanism.
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Affiliation(s)
- Inês Gomes
- BioISI-Biosystems and Integrative Sciences Institute, Faculty of Sciences of the University of Lisbon, C8, Campo Grande, 1749-016 Lisbon, Portugal
| | - Nuno Galamba
- BioISI-Biosystems and Integrative Sciences Institute, Faculty of Sciences of the University of Lisbon, C8, Campo Grande, 1749-016 Lisbon, Portugal
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Gomes I, Abreu C, Costa L, Casimiro S. The Evolving Pathways of the Efficacy of and Resistance to CDK4/6 Inhibitors in Breast Cancer. Cancers (Basel) 2023; 15:4835. [PMID: 37835528 PMCID: PMC10571967 DOI: 10.3390/cancers15194835] [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: 08/23/2023] [Revised: 09/28/2023] [Accepted: 09/30/2023] [Indexed: 10/15/2023] Open
Abstract
The approval of cyclin-dependent kinase 4 and 6 inhibitors (CDK4/6i) in combination with endocrine therapy (ET) has remarkably improved the survival outcomes of patients with advanced hormone receptor-positive (HR+) breast cancer (BC), becoming the new standard of care treatment in these patients. Despite the efficacy of this therapeutic combination, intrinsic and acquired resistance inevitably occurs and represents a major clinical challenge. Several mechanisms associated with resistance to CDK4/6i have been identified, including both cell cycle-related and cell cycle-nonspecific mechanisms. This review discusses new insights underlying the mechanisms of action of CDK4/6i, which are more far-reaching than initially thought, and the currently available evidence of the mechanisms of resistance to CDK4/6i in BC. Finally, it highlights possible treatment strategies to improve CDK4/6i efficacy, summarizing the most relevant clinical data on novel combination therapies involving CDK4/6i.
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Affiliation(s)
- Inês Gomes
- Luis Costa Lab, Instituto de Medicina Molecular, Faculdade de Medicina de Lisboa, Universidade de Lisboa, 1649-028 Lisbon, Portugal;
| | - Catarina Abreu
- Oncology Division, Hospital de Santa Maria—Centro Hospitalar Universitário Lisboa Norte, 1649-028 Lisbon, Portugal;
| | - Luis Costa
- Luis Costa Lab, Instituto de Medicina Molecular, Faculdade de Medicina de Lisboa, Universidade de Lisboa, 1649-028 Lisbon, Portugal;
- Oncology Division, Hospital de Santa Maria—Centro Hospitalar Universitário Lisboa Norte, 1649-028 Lisbon, Portugal;
| | - Sandra Casimiro
- Luis Costa Lab, Instituto de Medicina Molecular, Faculdade de Medicina de Lisboa, Universidade de Lisboa, 1649-028 Lisbon, Portugal;
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Gomes I, Jesus-Ribeiro J, Abuhaiba SI, Bento C, Teotónio R. Frontal lobe epilepsy in a patient with mosaic Turner syndrome. Epileptic Disord 2023; 25:787-790. [PMID: 37559190 DOI: 10.1002/epd2.20138] [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: 10/16/2022] [Revised: 07/08/2023] [Accepted: 07/14/2023] [Indexed: 08/11/2023]
Affiliation(s)
- Inês Gomes
- Neurology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Joana Jesus-Ribeiro
- Neurology, Centro Hospitalar de Leiria, Leiria, Portugal
- Center of Investigation on Environment, Genetics, and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Sulaiman I Abuhaiba
- Institute of Nuclear Sciences of Applied Health Sciences, University of Coimbra, Coimbra, Portugal
- CIBIT Coimbra Institute for Biomedical Imaging and Translational Research, Coimbra, Portugal
| | - Conceição Bento
- Neurology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
- Epilepsy and Sleep Monitoring Unit, Neurology Department, Coimbra University Hospital Center, Coimbra, Portugal
| | - Rute Teotónio
- Neurology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
- Epilepsy and Sleep Monitoring Unit, Neurology Department, Coimbra University Hospital Center, Coimbra, Portugal
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Magalhães JC, Sousa M, Basto R, Fraga T, Gomes I, Fernandes C, Mariano M, Paulo J, Madeira P, Sousa G. Adjuvant Hyperthermic Intravesical Chemotherapy in Intermediate- and High-Risk Non-muscle Invasive Bladder Cancer. Cureus 2023; 15:e45672. [PMID: 37745737 PMCID: PMC10512434 DOI: 10.7759/cureus.45672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2023] [Indexed: 09/26/2023] Open
Abstract
INTRODUCTION Non-muscle invasive bladder cancer (NMIBC) is a frequently diagnosed neoplasm, which is typically managed with transurethral resection of bladder tumor (TURBT) eventually followed by intravesical therapies. Bacillus Calmette-Guérin (BCG) is used as first-line adjuvant treatment in high- (HR) and intermediate-risk (IR) NMIBC, although, in the latter, mitomycin C (MMC) may also be used. Multiple limitations to the use of BCG encouraged the search for therapeutic alternatives. In this context, hyperthermic intravesical chemotherapy with MMC (HIVEC-MMC) emerged as a promising therapy in the adjuvant setting for NMIBC. The aim of our study was to evaluate the tolerability, compliance, and survival outcomes of HIVEC-MMC in patients with IR- and HR-NMIBC. MATERIAL AND METHODS This was a single-center retrospective analysis of IR- and HR- NMIBC patients who received HIVEC-MMC after TURBT between August 2018 and August 2022. Levels of risk stratification were defined using the European Association of Urology (EAU) criteria. The protocol consisted of four weekly HIVEC-MMC instillations (induction) followed by six monthly instillations (maintenance). The primary outcomes were to evaluate the tolerability and compliance with the HIVEC-MMC protocol and secondary outcomes were disease-free survival (DFS) and overall survival (OS). For the purpose of statistical analysis, methods of descriptive statistics, survival analysis (Kaplan-Meier estimation), and multivariate analysis (Cox regression, and binary logistic regression) were used. RESULTS Fifty-seven patients were enrolled with a median age of 67.9 (34.4-83.5) years old. In this cohort, 40 patients (70.2%) had primary tumors. At the time of referral for HIVEC-MMC, the majority of the patients had IR-NMIBC (n= 33, 57.9%). A total of 41 patients (71.9%) completed the HIVEC-MMC protocol. Disease recurrence and adverse events (AEs) were the most common reasons to stop the protocol. After a median follow-up of 31 months (95% CI, 5.0-54.0), 32 patients (61.4%) were disease-free, 22 (38.6%) experienced recurrent disease and six patients (10.5%) died, although only one death was directly attributable to bladder cancer. The median DFS was 42 months (95% CI, 28.0-56.0). Completion of the HIVEC-MMC maintenance phase protocol stood as a predictive factor for DFS (44 months, 95% CI 29.1-58.9 vs. 14 months, 95% CI 0.0-29.6, p < 0.001; HR 4.48, 95% CI 1.65-12.15). The median OS was not reached; the 24- and 48-month OS were 92.6% and 82.7%, respectively. EAU risk group, ECOG-PS, and completion of HIVEC protocol were found to be significant predictive factors of OS but lost their significance on multivariate analysis. However, if we exclude those who experienced recurrence during the maintenance phase protocol, treatment completion had a significant positive impact on OS (HR: 42.8, 95% CI 1.75-1045.072, p= 0.021). CONCLUSIONS Our study suggests that HIVEC is a secure and well-tolerated treatment with promising efficacy data, making this therapeutic approach a feasible option in IR- and HR-NMIBC patients, mainly in those who cannot tolerate or have contraindications to BCG therapy, but also as an alternative during BCG shortages.
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Affiliation(s)
- Joana C Magalhães
- Medical Oncology, Instituto Português de Oncologia de Coimbra Francisco Gentil, E.P.E., Coimbra, PRT
| | - Maria Sousa
- Medical Oncology, Centro Hospitalar Universitário do Porto, Porto, PRT
| | - Raquel Basto
- Medical Oncology, Centro Hospitalar Vila Nova de Gaia/Espinho, Gaia, PRT
| | - Teresa Fraga
- Medical Oncology, Instituto Português de Oncologia de Coimbra Francisco Gentil, E.P.E., Coimbra, PRT
| | - Inês Gomes
- Medical Oncology, Instituto Português de Oncologia de Coimbra Francisco Gentil, E.P.E., Coimbra, PRT
| | - Catarina Fernandes
- Medical Oncology, Centro Hospitalar Universitário de São João, Porto, PRT
| | - Mónica Mariano
- Medical Oncology, Centro Hospitalar e Universitário de Coimbra, Coimbra, PRT
| | - Judy Paulo
- Medical Oncology, Instituto Português de Oncologia de Coimbra Francisco Gentil, E.P.E., Coimbra, PRT
| | - Pedro Madeira
- Medical Oncology, Instituto Português de Oncologia de Coimbra Francisco Gentil, E.P.E., Coimbra, PRT
| | - Gabriela Sousa
- Medical Oncology, Instituto Português de Oncologia de Coimbra Francisco Gentil, E.P.E., Coimbra, PRT
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Gomes I, Gallego-Paez LM, Jiménez M, Santamaria PG, Mansinho A, Sousa R, Abreu C, Suárez EG, Costa L, Casimiro S. Co-targeting RANK pathway treats and prevents acquired resistance to CDK4/6 inhibitors in luminal breast cancer. Cell Rep Med 2023; 4:101120. [PMID: 37451269 PMCID: PMC10439176 DOI: 10.1016/j.xcrm.2023.101120] [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: 11/22/2022] [Revised: 05/11/2023] [Accepted: 06/21/2023] [Indexed: 07/18/2023]
Abstract
The combination of endocrine therapy (ET) and cyclin-dependent kinase 4/6 (CDK4/6) inhibitors (CDK4/6i) was a hallmark in metastatic luminal breast cancer (BC). However, intrinsic and acquired resistance affects long-term efficacy. Here, we study the role of the receptor activator of nuclear factor-κB (RANK) pathway in CDK4/6i resistance. We find that RANK overexpression in luminal BC is associated with intrinsic resistance to CDK4/6i, both in vitro and in mouse xenografts, and decreased proliferation rate and chronic interferon (IFN) γ response are highlighted as resistance drivers. Gene expression data from the NeoPalAna CDK4/6i clinical trial, and studies with palbociclib-resistant cell lines, show that RANK is upregulated after treatment with CDK4/6i, supporting a role in acquired resistance. Our study shows that RANK ligand (RANKL) inhibitors can restore sensitivity to CDK4/6i and prevent acquired resistance. On the basis of these findings, we conclude that pharmacological inhibition of the RANK pathway through RANKL blocking could represent an add-on to ET + CDK4/6i, warranting further clinical studies.
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Affiliation(s)
- Inês Gomes
- Luis Costa Laboratory, Institute of Molecular Medicine (iMM), Lisbon Medical School, 1649-028 Lisbon, Portugal
| | - Lina M Gallego-Paez
- Luis Costa Laboratory, Institute of Molecular Medicine (iMM), Lisbon Medical School, 1649-028 Lisbon, Portugal
| | - Maria Jiménez
- Spanish National Cancer Research Centre (CNIO), 28029 Madrid, Spain
| | | | - André Mansinho
- Oncology Division, Hospital de Santa Maria-CHULN, 1649-028 Lisbon, Portugal
| | - Rita Sousa
- Oncology Division, Hospital de Santa Maria-CHULN, 1649-028 Lisbon, Portugal
| | - Catarina Abreu
- Oncology Division, Hospital de Santa Maria-CHULN, 1649-028 Lisbon, Portugal
| | - Eva González Suárez
- Spanish National Cancer Research Centre (CNIO), 28029 Madrid, Spain; Oncobell, Bellvitge Biomedical Research Institute, IDIBELL, 08908 Barcelona, Spain
| | - Luis Costa
- Luis Costa Laboratory, Institute of Molecular Medicine (iMM), Lisbon Medical School, 1649-028 Lisbon, Portugal; Oncology Division, Hospital de Santa Maria-CHULN, 1649-028 Lisbon, Portugal.
| | - Sandra Casimiro
- Luis Costa Laboratory, Institute of Molecular Medicine (iMM), Lisbon Medical School, 1649-028 Lisbon, Portugal.
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Caramujo C, Gomes I, Fraga T, Paulo J, Broco S, Cunha N, Madeira P, Carvalho T, Teixeira M, Sousa G. Immune Response to SARS-CoV-2 Vaccination in Cancer Patients: A Prospective Study. Cureus 2023; 15:e37014. [PMID: 37139023 PMCID: PMC10151022 DOI: 10.7759/cureus.37014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2023] [Indexed: 04/03/2023] Open
Abstract
Introduction Cancer patients on active treatment are at increased risk of developing coronavirus disease 2019 (COVID-19), making effective immunization of the utmost importance. However, the effectiveness of vaccination in this population is still unclear. This study aims to evaluate the response against COVID-19 in a cohort of patients with active cancer under immunosuppressive therapy. Methods This was a prospective, cross-sectional, single-center study that included patients with cancer under immunosuppressive therapy vaccinated against COVID-19 between April and September 2021. Exclusion criteria were: previous known severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, single-dose vaccine or incomplete vaccination scheme. Immunoglobulin G (IgG) anti-SARS-CoV-2 antibody levels were assessed using 35.2 binding antibody units (BAU)/mL as the positive cut-off. Assessments were performed 14-31 days after the first and second dose and three months after the second dose. Results A total of 103 patients were included. The median age was 60 years. Most patients were being treated for gastrointestinal cancer (n=38, 36.9%), breast cancer (n=33, 32%) or head and neck cancer (n=18, 17.5%). At evaluation, 72 patients (69.9%) were being treated with palliative intent. The majority were being treated with chemotherapy (CT) alone (57.3%). At the first assessment, levels of circulating SARS-CoV-2 IgG consistent with seroconversion were present in 49 patients (47.6%). At the time of the second assessment, 91% (n=100) achieved seroconversion. Three months after the second dose, 83% (n=70) maintained levels of circulating SARS-CoV-2 IgG consistent with seroconversion. In this study, no SARS-CoV-2 infection was reported in the study population. Conclusions Our findings suggest that this group of patients had a satisfactory COVID-19 immunization response. Although promising, this study should be replicated on a wider scale in order to validate these findings.
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Gomes I, Garg T, Churchyard G, Gupta A, Hesseling AC, Swindells S, Gurupira W, Martel B, Mbata L, Patil S, Riviere C, Tonquin M, Dowdy D, Sohn H. The cascade of care for household contacts of people with drug-resistant TB. Int J Tuberc Lung Dis 2023; 27:154-156. [PMID: 36853100 PMCID: PMC10115168 DOI: 10.5588/ijtld.22.0473] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Affiliation(s)
- I Gomes
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - T Garg
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - G Churchyard
- Aurum Institute, Johannesburg, South Africa, School of Public Health, University of Witwatersrand, Johannesburg, South Africa, Department of Medicine, Vanderbilt University, Nashville, TN, USA
| | - A Gupta
- Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - A C Hesseling
- Desmond Tutu TB Centre, the Department of Paediatrics and Child Health, Stellenbosch University, Stellenbosch, South Africa
| | - S Swindells
- Division of Infectious Diseases, University of Nebraska Medical Center, Omaha, NB, USA
| | - W Gurupira
- Clinical Trials Research Centre (UZ-CTRC), University of Zimbabwe, Harare, Zimbabwe
| | - B Martel
- Socios En Salud Sucursal Peru, Lima, Peru
| | - L Mbata
- Aurum Institute, Rustenburg, South Africa
| | - S Patil
- Byramjee Jeejeebhoy Government Medical College CRS, Johns Hopkins University Baltimore-Washington-India Clinical Trials Unit, Pune, India
| | - C Riviere
- Les Centres GHESKIO, Port-au-Prince, Haiti
| | - M Tonquin
- Research Division, De La Salle Medical and Health Sciences Institute, Dasmarinas City, Cavite, The Philippines
| | - D Dowdy
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - H Sohn
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
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Oliveira TC, Santos LD, Aravechia MG, Gomes I, Blanco BP, Sampaio TB, Carneiro JDA, Bub CB, Kutner JM. ANEMIA HEMOLÍTICA IMUNE INDUZIDA POR CEFTRIAXONA: RELATO DE CASO. Hematol Transfus Cell Ther 2022. [DOI: 10.1016/j.htct.2022.09.038] [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: 11/11/2022] Open
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Gomes I, Jesus Ribeiro J, Palavra F. Monitoring and Managing Patients with Tuberous Sclerosis Complex: Current State of Knowledge. J Multidiscip Healthc 2022; 15:1469-1480. [PMID: 35860622 PMCID: PMC9292455 DOI: 10.2147/jmdh.s266990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 06/29/2022] [Indexed: 12/05/2022] Open
Abstract
Tuberous sclerosis complex (TSC) is a rare genetic disease of autosomal dominant transmission that, in most cases, results from the presence of pathogenic variants of the TSC1 or TSC2 genes, encoding hamartin and tuberin, respectively. It is a multisystemic disease, affecting most frequently the brain, skin, kidney, and heart. The wide variety of possible clinical manifestations, given this multisystem dimension, makes the follow-up of patients with TSC an exercise of multidisciplinarity. In fact, these patients may require the intervention of various medical specialties, which thus have to combine their efforts to practice a medicine that is truly holistic. The past few years have witnessed a dramatic leap not only in the diagnosis and management of TSC patients, with standard monitoring recommendations, but also in the therapeutic field, with the use of mTORC1 inhibitors. In this article, we review the clinical manifestations associated with TSC, as well as the treatment and follow-up strategies that should be implemented, from a multidisciplinary perspective.
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Affiliation(s)
- Inês Gomes
- Neurology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | | | - Filipe Palavra
- Center for Child Development - Neuropediatrics Unit, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.,Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Laboratory of Pharmacology and Experimental Therapeutics, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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de Pinho IS, Abreu C, Gomes I, Casimiro S, Pacheco TR, de Sousa RT, Costa L. Exploring new pathways in endocrine-resistant breast cancer. Exploration of Targeted Anti-tumor Therapy 2022; 3:337-361. [PMID: 36045911 PMCID: PMC9400750 DOI: 10.37349/etat.2022.00086] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 03/24/2022] [Indexed: 11/19/2022] Open
Abstract
The most common breast cancer (BC) subtypes are hormone-dependent, being either estrogen receptor-positive (ER+), progesterone receptor-positive (PR+), or both, and altogether comprise the luminal subtype. The mainstay of treatment for luminal BC is endocrine therapy (ET), which includes several agents that act either directly targeting ER action or suppressing estrogen production. Over the years, ET has proven efficacy in reducing mortality and improving clinical outcomes in metastatic and nonmetastatic BC. However, the development of ET resistance promotes cancer survival and progression and hinders the use of endocrine agents. Several mechanisms implicated in endocrine resistance have now been extensively studied. Based on the current clinical and pre-clinical data, the present article briefly reviews the well-established pathways of ET resistance and continues by focusing on the three most recently uncovered pathways, which may mediate resistance to ET, namely receptor activator of nuclear factor kappa B ligand (RANKL)/receptor activator of nuclear factor kappa B (RANK), nuclear factor kappa B (NFκB), and Notch. It additionally overviews the evidence underlying the approval of combined therapies to overcome ET resistance in BC, while highlighting the relevance of future studies focusing on putative mediators of ET resistance to uncover new therapeutic options for the disease.
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Affiliation(s)
- Inês Soares de Pinho
- 1Oncology Division, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, 1649-028 Lisboa, Portugal
| | - Catarina Abreu
- 1Oncology Division, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, 1649-028 Lisboa, Portugal 2Luis Costa Laboratory, Instituto de Medicina Molecular-João Lobo Antunes, Faculdade de Medicina de Lisboa, 1649-028 Lisboa, Portugal
| | - Inês Gomes
- 2Luis Costa Laboratory, Instituto de Medicina Molecular-João Lobo Antunes, Faculdade de Medicina de Lisboa, 1649-028 Lisboa, Portugal
| | - Sandra Casimiro
- 2Luis Costa Laboratory, Instituto de Medicina Molecular-João Lobo Antunes, Faculdade de Medicina de Lisboa, 1649-028 Lisboa, Portugal
| | - Teresa Raquel Pacheco
- 1Oncology Division, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, 1649-028 Lisboa, Portugal 2Luis Costa Laboratory, Instituto de Medicina Molecular-João Lobo Antunes, Faculdade de Medicina de Lisboa, 1649-028 Lisboa, Portugal
| | - Rita Teixeira de Sousa
- 1Oncology Division, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, 1649-028 Lisboa, Portugal
| | - Luís Costa
- 1Oncology Division, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, 1649-028 Lisboa, Portugal 2Luis Costa Laboratory, Instituto de Medicina Molecular-João Lobo Antunes, Faculdade de Medicina de Lisboa, 1649-028 Lisboa, Portugal
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Sousa MJD, Gomes I, Pereira TC, Magalhães J, Basto R, Paulo J, Jacinto P, Bonito N, Sousa G. The effect of prognostic factors at baseline on the efficacy of trifluridine/tipiracil in patients with metastatic colorectal cancer: A Portuguese exploratory analysis. Cancer Treat Res Commun 2022; 31:100531. [PMID: 35172243 DOI: 10.1016/j.ctarc.2022.100531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 02/03/2022] [Accepted: 02/04/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND The RECOURSE trial supported trifluridine/tipiracil as a treatment option in metastatic colorectal cancer (mCRC). Subsequent analysis demonstrated that low tumour burden and indolent disease are good prognosis factors improving progression-free survival (PFS) and overall survival (OS). This study aimed to evaluate the impact of prognosis group in the OS, PFS and safety of trifluridine/tipiracil in patients with mCRC. METHODS Single-centre, retrospective, and observational study of patients with mCRC who started trifluridine/tipiracil between February 2018 and July 2019. Patients were divided into good prognosis characteristics (GPC) [low tumour burden (less than 3 metastasis site) and indolent disease (≥18 months from first metastasis diagnosis)] and poor prognostic characteristics (PPC) group [high tumour burden (3 or more metastasis sites) and/or aggressive disease (<18 months since the first metastasis diagnosis)]. RESULTS Median age was 67 years (48-82), 67.3% of the patients were male, and 65.3% had stage IV disease at baseline. Overall, median OS was 7.5 months (95%CI:5.7-9.3). Twenty-two patients (44.9%) presented GPC and 29 (59.1%) had PPC. GPC patients had longer median OS [11.4 (95%CI:6.2-16.7)] versus 3.9 months [(95%CI: 3.3-4.6),p < 0.0001] and PFS [4.9 (95%CI:3.0-6.9) versus 2.6 months (95%CI:2.2-2.8),p < 0.0001]. These differences were more pronounced in GPC patients with no liver metastasis. Grade ≥3 adverse events incidence didn't vary between GPC and PPC subgroups. CONCLUSION Our study validates the improved trifluridine/tipiracil efficacy in patients with GPC in comparison with PPC while maintaining a well-tolerated safety profile. Indolent disease, low tumour burden and the absence of liver metastasis were shown to be good prognosis factors influencing sustained response to trifluridine/tipiracil.
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Affiliation(s)
- M João de Sousa
- Medical Oncology Service, Institute of Oncology Francisco Gentil (IPO Coimbra), Coimbra, Portugal.
| | - Inês Gomes
- Medical Oncology Service, Institute of Oncology Francisco Gentil (IPO Coimbra), Coimbra, Portugal
| | - Tatiana Cunha Pereira
- Medical Oncology Service, Institute of Oncology Francisco Gentil (IPO Coimbra), Coimbra, Portugal
| | - Joana Magalhães
- Medical Oncology Service, Institute of Oncology Francisco Gentil (IPO Coimbra), Coimbra, Portugal
| | - Raquel Basto
- Medical Oncology Service, Institute of Oncology Francisco Gentil (IPO Coimbra), Coimbra, Portugal
| | - Judy Paulo
- Medical Oncology Service, Institute of Oncology Francisco Gentil (IPO Coimbra), Coimbra, Portugal
| | - Paula Jacinto
- Medical Oncology Service, Institute of Oncology Francisco Gentil (IPO Coimbra), Coimbra, Portugal
| | - Nuno Bonito
- Medical Oncology Service, Institute of Oncology Francisco Gentil (IPO Coimbra), Coimbra, Portugal
| | - Gabriela Sousa
- Medical Oncology Service, Institute of Oncology Francisco Gentil (IPO Coimbra), Coimbra, Portugal
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14
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Gomes I, Girão A, Gomes J, Rebelo O, Jesus-Ribeiro J. Neurological impact of eosinophilic granulomatosis with polyangiitis. Acta Neurol Belg 2022; 122:123-128. [PMID: 33905106 DOI: 10.1007/s13760-021-01683-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 04/15/2021] [Indexed: 11/28/2022]
Abstract
Nervous system (NS) affection may occur in Eosinophilic Granulomatosis with Polyangiitis (EGPA), but its clinical manifestations and pathophysiology are rarely described. Our aims are to characterize central and peripheral NS (CNS/PNS) involvement and compare biological markers in EGPA patients with and without neurological manifestations. Retrospective observational study, including EGPA patients with and without neurological manifestations. Demographics, clinical data, and immunological markers were analyzed. Descriptive and inferential statistics were performed. Sixteen patients were included; 11 (68.8%) of whom were male, with a mean age of 63.38 years; 8 with (Group 1) and 8 without (Group 2) neurological findings. Neurological impairment preceded EGPA diagnosis in 5 patients, and occurred during follow-up in 3 patients after a median of 4.0 years. CNS manifestations observed were stroke (n = 2), bilateral central retinal artery occlusion (n = 1), and compressive dorsal myelopathy due to extradural granulation tissue (n = 1). PNS manifestations were axonal polyneuropathy (n = 3), sensorineural hearing loss (n = 3), and multiplex mononeuropathy (n = 1). Two patients had both PNS and CNS involvement. There were no statistical differences regarding biological markers [eosinophil count, myeloperoxidase (MPO) antibodies titers] between the 2 groups. One patient from Group 1 was unresponsive to treatment and permanent neurological sequelae were observed in 7 cases. EGPA-related NS involvement can be heterogeneous and is responsible for long-term sequelae. In our sample, the main neurological scenarios were peripheral neuropathy, VIII cranial nerve neuropathy, ischemic lesions and compressive myelopathy. Patients with and without neurological manifestations did not differ in eosinophilic count and MPO titer.
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Affiliation(s)
- Inês Gomes
- Neurology Department, Coimbra University Hospital Centre, Praceta Mota Pinto, 3000-075, Coimbra, Portugal.
| | - Adriana Girão
- Internal Medicine Department, Coimbra University Hospital Centre, Coimbra, Portugal
| | - João Gomes
- Internal Medicine Department, Coimbra University Hospital Centre, Coimbra, Portugal
| | - Olinda Rebelo
- Neuropathology Laboratory, Neurology Department, Coimbra University Hospital Centre, Coimbra, Portugal
| | - Joana Jesus-Ribeiro
- Neurology Department, Coimbra University Hospital Centre, Praceta Mota Pinto, 3000-075, Coimbra, Portugal
- Faculty of Medicine, Coimbra University, Coimbra, Portugal
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15
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Martins M, Carvalho L, Carvalho T, Gomes I. Impact of the COVID-19 pandemic on in-hospital diagnosis of tuberculosis in non-HIV patients. Pulmonology 2022; 28:481-483. [PMID: 35697607 PMCID: PMC9091262 DOI: 10.1016/j.pulmoe.2022.04.012] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 04/26/2022] [Accepted: 04/28/2022] [Indexed: 02/07/2023] Open
Affiliation(s)
- M. Martins
- Pulmonology Department, Centro Hospitalar Universitário de São João, EPE, Alameda Professor Hernâni Monteiro, Porto 4200-319, Portugal,Corresponding author
| | - L. Carvalho
- Clinical Pathology Department, Centro Hospitalar Universitário de São João, EPE, Porto, Portugal
| | - T. Carvalho
- Clinical Pathology Department, Centro Hospitalar Universitário de São João, EPE, Porto, Portugal
| | - I. Gomes
- Pulmonology Department, Centro Hospitalar Universitário de São João, EPE, Alameda Professor Hernâni Monteiro, Porto 4200-319, Portugal
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16
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Marques IJ, Gomes I, Pojo M, Pires C, Moura MM, Cabrera R, Santos C, van IJcken WFJ, Teixeira MR, Ramalho JS, Leite V, Cavaco BM. Identification of SPRY4 as a Novel Candidate Susceptibility Gene for Familial Nonmedullary Thyroid Cancer. Thyroid 2021; 31:1366-1375. [PMID: 33906393 DOI: 10.1089/thy.2020.0290] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Background: The molecular basis of familial nonmedullary thyroid cancer (FNMTC) is still poorly understood, representing a limitation for molecular diagnosis and clinical management. In this study, we aimed to identify new susceptibility genes for FNMTC through whole-exome sequencing (WES) analysis of leukocyte DNA of patients from a highly informative FNMTC family. Methods: We selected six affected family members to conduct WES analysis. Bioinformatic analyses were undertaken to filter and select the genetic variants shared by the affected members, which were subsequently validated by Sanger sequencing. To select the most likely pathogenic variants, several studies were performed, including family segregation analysis, in silico impact characterization, and gene expression (messenger RNA and protein) depiction in databases. For the most promising variant identified, we performed in vitro studies to validate its pathogenicity. Results: Several potentially pathogenic variants were identified in different candidate genes. After filtering with appropriate criteria, the variant c.701C>T, p.Thr234Met in the SPRY4 gene was prioritized for in vitro functional characterization. This SPRY4 variant led to an increase in cell viability and colony formation, indicating that it confers a proliferative advantage and potentiates clonogenic capacity. Phosphokinase array and Western blot analyses suggested that the effects of the SPRY4 variant were mediated through the mitogen-activated protein kinase/extracellular signal-regulated kinase pathway, which was further supported by a higher responsiveness of thyroid cancer cells with the SPRY4 variant to a MEK inhibitor. Conclusions: WES analysis in one family identified SPRY4 as a likely novel candidate susceptibility gene for FNMTC, allowing a better understanding of the cellular and molecular mechanisms underlying thyroid cancer development.
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Affiliation(s)
- Inês J Marques
- Unidade de Investigação em Patobiologia Molecular, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisboa, Portugal
- Chronic Diseases Research Centre, Universidade Nova de Lisboa, Lisboa, Portugal
- Nova Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Inês Gomes
- Unidade de Investigação em Patobiologia Molecular, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisboa, Portugal
| | - Marta Pojo
- Unidade de Investigação em Patobiologia Molecular, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisboa, Portugal
| | - Carolina Pires
- Unidade de Investigação em Patobiologia Molecular, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisboa, Portugal
| | - Margarida M Moura
- Unidade de Investigação em Patobiologia Molecular, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisboa, Portugal
| | - Rafael Cabrera
- Serviço de Anatomia Patológica, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisboa, Portugal
| | - Catarina Santos
- Serviço de Genética, Instituto Português de Oncologia do Porto Francisco Gentil, Porto, Portugal
| | - Wilfred F J van IJcken
- Center for Biomics, Department of Cell Biology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Manuel R Teixeira
- Serviço de Genética, Instituto Português de Oncologia do Porto Francisco Gentil, Porto, Portugal
- Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - José S Ramalho
- Chronic Diseases Research Centre, Universidade Nova de Lisboa, Lisboa, Portugal
- Nova Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Valeriano Leite
- Nova Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal
- Serviço de Endocrinologia, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisboa, Portugal
| | - Branca M Cavaco
- Unidade de Investigação em Patobiologia Molecular, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisboa, Portugal
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17
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Cunha IA, Gomes I, Gens H, Guimarães S, Martins AI, Bento C. Sporadic Creutzfeldt-Jakob disease presenting as epilepsia partialis continua and non-ictal nystagmus. Eur J Neurol 2021; 28:2456-2459. [PMID: 33786955 DOI: 10.1111/ene.14847] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 03/17/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND PURPOSE Creutzfeldt-Jakob disease (CJD) is a rare form of rapidly progressive neurodegenerative disorder. Seizures are uncommon in the early stage of CJD, increasing diagnostic difficulty. METHODS An autopsy-proven case of CJD presenting initially as an epilepsia partialis continua is reported, in which the initial workup was unremarkable. Retrospectively, the presence of nystagmus, which proved to be non-epileptic, pointed to a cerebellar lesion before a diagnosis of clinically probable CJD was made. RESULTS A 70-year-old man presented with a 3-week history of intermittent rhythmic jerking tremors in his left limbs, interfering with his gait. Examination showed left body clonic movements. Electroencephalography revealed an ictal right centroparietal pattern of focal status epilepticus. Video-oculography revealed right-beating nystagmus (mean slow phase velocity [SPV] 3.4º/s) in the dark and left-beating nystagmus (SPV 2.6º/s) in the light, left-beating nystagmus after head shaking (SPV 4º/s) and during mastoid vibration (SPV 11º/s) and mildly hypoactive horizontal head impulses. Search for occult malignancy, serologies, cerebrospinal fluid analyses, anti-onconeural antigen, auto-immune panel and brain magnetic resonance imaging were unrevealing. Rapid neurological decline was observed. Three weeks later, cerebrospinal fluid was positive for 14.3.3 protein, electroencephalography showed generalized periodic sharp wave complexes and brain magnetic resonance imaging revealed diffusion restriction and T2/fluid-attenuated inversion recovery hyperintensities in the cerebellum, basal ganglia, thalamus and cortex. He died 1 month later. Neuropathological study confirmed the diagnosis of CJD. CONCLUSION This case highlights that CJD should be considered in the differential diagnosis of new onset epilepsia partialis continua and that neuro-ophthalmological examination can be helpful in pointing to early asymmetric cerebellar involvement.
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Affiliation(s)
- Inês Antunes Cunha
- Neurology Department, Coimbra University and Hospital Centre, Coimbra, Portugal
| | - Inês Gomes
- Neurology Department, Coimbra University and Hospital Centre, Coimbra, Portugal
| | - Helena Gens
- Neurology Department, Coimbra University and Hospital Centre, Coimbra, Portugal
| | | | - Ana Inês Martins
- Neurology Department, Coimbra University and Hospital Centre, Coimbra, Portugal
| | - Conceição Bento
- Neurology Department, Coimbra University and Hospital Centre, Coimbra, Portugal
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18
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Gomes I, Martins Ferreira M, Leitão J, Carvalho A. Multiresistent Cupriavidus pauculus infection in an immunocompromised elderly patient. BMJ Case Rep 2021; 14:14/7/e243328. [PMID: 34257122 DOI: 10.1136/bcr-2021-243328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Cupriavidus pauculus is a gram-negative bacillus aerobic bacteria widely distributed in nature that can cause, in rare cases, serious infections both in immunocompromised and immunocompetent patients. We describe a case of an elderly patient admitted in emergency room with septic shock and diagnosed with a urinary tract infection. During his hospital stay, his clinical and analytical conditions have deteriorated. Blood cultures were positive for C. pauculus only sensitive to minocycline. Despite every effort, due to multiple comorbidities and a nosocomial pneumonia, the patient ends up dying.
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Affiliation(s)
- Inês Gomes
- Instituto Português de Oncologia de Coimbra Francisco Gentil EPE, Coimbra, Coimbra, Portugal
| | | | - Jorge Leitão
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
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19
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Prudencio M, Garcia-Moreno H, Jansen-West KR, Al-Shaikh RH, Gendron TF, Heckman MG, Spiegel MR, Carlomagno Y, Daughrity LM, Song Y, Dunmore JA, Byron N, Oskarsson B, Nicholson KA, Staff NP, Gorcenco S, Puschmann A, Lemos J, Januário C, LeDoux MS, Friedman JH, Polke J, Labrum R, Shakkottai V, McLoughlin HS, Paulson HL, Konno T, Onodera O, Ikeuchi T, Tada M, Kakita A, Fryer JD, Karremo C, Gomes I, Caviness JN, Pittelkow MR, Aasly J, Pfeiffer RF, Veerappan V, Eggenberger ER, Freeman WD, Huang JF, Uitti RJ, Wierenga KJ, Marin Collazo IV, Tipton PW, van Gerpen JA, van Blitterswijk M, Bu G, Wszolek ZK, Giunti P, Petrucelli L. Toward allele-specific targeting therapy and pharmacodynamic marker for spinocerebellar ataxia type 3. Sci Transl Med 2021; 12:12/566/eabb7086. [PMID: 33087504 DOI: 10.1126/scitranslmed.abb7086] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 06/30/2020] [Indexed: 12/13/2022]
Abstract
Spinocerebellar ataxia type 3 (SCA3), caused by a CAG repeat expansion in the ataxin-3 gene (ATXN3), is characterized by neuronal polyglutamine (polyQ) ATXN3 protein aggregates. Although there is no cure for SCA3, gene-silencing approaches to reduce toxic polyQ ATXN3 showed promise in preclinical models. However, a major limitation in translating putative treatments for this rare disease to the clinic is the lack of pharmacodynamic markers for use in clinical trials. Here, we developed an immunoassay that readily detects polyQ ATXN3 proteins in human biological fluids and discriminates patients with SCA3 from healthy controls and individuals with other ataxias. We show that polyQ ATXN3 serves as a marker of target engagement in human fibroblasts, which may bode well for its use in clinical trials. Last, we identified a single-nucleotide polymorphism that strongly associates with the expanded allele, thus providing an exciting drug target to abrogate detrimental events initiated by mutant ATXN3. Gene-silencing strategies for several repeat diseases are well under way, and our results are expected to improve clinical trial preparedness for SCA3 therapies.
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Affiliation(s)
- Mercedes Prudencio
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA.,Neuroscience Graduate Program, Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, FL 32224, USA
| | - Hector Garcia-Moreno
- Ataxia Centre, Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK.,Ataxia Centre, National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Trust, London WC1N 3BG, UK
| | | | | | - Tania F Gendron
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA.,Neuroscience Graduate Program, Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, FL 32224, USA
| | - Michael G Heckman
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Matthew R Spiegel
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Yari Carlomagno
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA.,Neuroscience Graduate Program, Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, FL 32224, USA
| | | | - Yuping Song
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Judith A Dunmore
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Natalie Byron
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Björn Oskarsson
- Department of Neurology, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Katharine A Nicholson
- Sean M. Healey and AMG Center for ALS, Massachusetts General Hospital (MGH), Boston, MA 02114, USA
| | - Nathan P Staff
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA
| | - Sorina Gorcenco
- Lund University, Skåne University Hospital, Department of Clinical Sciences Lund, Neurology, Lund 22185, Sweden
| | - Andreas Puschmann
- Lund University, Skåne University Hospital, Department of Clinical Sciences Lund, Neurology, Lund 22185, Sweden
| | - João Lemos
- Coimbra University Hospital Centre, Coimbra University, Coimbra 3000-075, Portugal
| | - Cristina Januário
- Coimbra University Hospital Centre, Coimbra University, Coimbra 3000-075, Portugal
| | - Mark S LeDoux
- University of Memphis and Veracity Neuroscience LLC, Memphis, TN 38152, USA
| | - Joseph H Friedman
- Department of Neurology, Warren Alpert Medical School of Brown University, Providence, RI 02906, USA
| | - James Polke
- Ataxia Centre, Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK.,Ataxia Centre, National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Trust, London WC1N 3BG, UK
| | - Robin Labrum
- Ataxia Centre, Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK.,Ataxia Centre, National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Trust, London WC1N 3BG, UK
| | - Vikram Shakkottai
- Department of Neurology, University of Michigan, Ann Arbor, MI 48109, USA
| | | | - Henry L Paulson
- Department of Neurology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Takuya Konno
- Department of Neurology, Brain Research Institute, Niigata University, Niigata 951-8585, Japan
| | - Osamu Onodera
- Department of Neurology, Brain Research Institute, Niigata University, Niigata 951-8585, Japan
| | - Takeshi Ikeuchi
- Department of Molecular Genetics, Brain Research Institute, Niigata University, Niigata 951-8585, Japan
| | - Mari Tada
- Department of Pathology, Brain Research Institute, Niigata University, Niigata 951-8585, Japan
| | - Akiyoshi Kakita
- Department of Pathology, Brain Research Institute, Niigata University, Niigata 951-8585, Japan
| | - John D Fryer
- Neuroscience Graduate Program, Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, FL 32224, USA.,Department of Neuroscience, Mayo Clinic, Scottsdale, AZ 85259, USA
| | - Christin Karremo
- Lund University, Skåne University Hospital, Department of Clinical Sciences Lund, Neurology, Lund 22185, Sweden
| | - Inês Gomes
- Coimbra University Hospital Centre, Coimbra University, Coimbra 3000-075, Portugal
| | - John N Caviness
- Department of Neurology, Mayo Clinic, Scottsdale, AZ 85259, USA
| | - Mark R Pittelkow
- Department of Dermatology, Mayo Clinic, Scottsdale, AZ 85259, USA
| | - Jan Aasly
- Norwegian University of Science and Technology, 7006 Trondheim, Norway
| | - Ronald F Pfeiffer
- Department of Neurology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Venka Veerappan
- Department of Neurology, Oregon Health & Science University, Portland, OR 97239, USA
| | | | | | | | - Ryan J Uitti
- Department of Neurology, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Klaas J Wierenga
- Department of Neurology, Mayo Clinic, Jacksonville, FL 32224, USA
| | | | - Philip W Tipton
- Department of Neurology, Mayo Clinic, Jacksonville, FL 32224, USA
| | | | - Marka van Blitterswijk
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA.,Neuroscience Graduate Program, Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, FL 32224, USA
| | - Guojun Bu
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA.,Neuroscience Graduate Program, Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, FL 32224, USA
| | | | - Paola Giunti
- Ataxia Centre, Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK. .,Ataxia Centre, National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Trust, London WC1N 3BG, UK
| | - Leonard Petrucelli
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA. .,Neuroscience Graduate Program, Mayo Clinic Graduate School of Biomedical Sciences, Jacksonville, FL 32224, USA
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20
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Rêgo Salgueiro F, Vieira I, Gomes I, Petrova M. Primary angiosarcoma of superior vena cava: an unexpected diagnosis after an oncological emergency. BMJ Case Rep 2021; 14:14/4/e241266. [PMID: 33863773 PMCID: PMC8055115 DOI: 10.1136/bcr-2020-241266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Angiosarcoma (AS) is a rare malignant tumour representing 1%-2% of all sarcomas. Primary AS of superior vena cava (SVC) was reported in two cases worldwide. We report a 69-year-old woman with neck discomfort, headache and dyspnoea for 3 months. CT angiography showed thrombosis in SVC and brachiocephalic veins resulting in an SVC syndrome. The patient began anticoagulant therapy and underwent balloon angioplasty with clinical improvement. Additionally, a positron emission tomography scan confirmed the presence of a mediastinal mass involving the SVC locally. The tumour was excised and a prosthesis was placed on the SVC. Histology revealed a heterogeneous tumour matrix, either myxoid and composed by fusiform cells with vimentin, homogeneous CD31 and a 30% Ki67 immunoexpression, supporting the diagnosis of an AS. Due to multiple complications, the patient never started chemotherapy, and after tumour recurrence, she died within 5 months after diagnosis.
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Affiliation(s)
- Fábio Rêgo Salgueiro
- Medical Oncology, Instituto Português de Oncologia de Coimbra Francisco Gentil EPE, Coimbra, Portugal
| | - Inês Vieira
- Endocrinology and Metabolism, Centro Hospitalar Universitário de Coimbra EPE, Coimbra, Portugal
| | - Inês Gomes
- Medical Oncology, Instituto Português de Oncologia de Coimbra Francisco Gentil EPE, Coimbra, Portugal
| | - Maja Petrova
- Internal Medicine, Centro Hospitalar Universitário de Coimbra EPE, Coimbra, Portugal
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21
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Carvalho V, Soares C, Gomes I, Carvalho A, Serrazina F, Rodrigues SG, Pinheiro J, Marques IB, Correia F, Correia AS, de Sá J, Sousa L, Vale J, Sá MJ, Sousa C, Ferreira J. RISCOP-Cognitive profile in a Portuguese cohort of radiological isolated syndrome patients: A case-control study. Mult Scler Relat Disord 2021; 50:102832. [PMID: 33596492 DOI: 10.1016/j.msard.2021.102832] [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: 12/11/2020] [Revised: 01/31/2021] [Accepted: 02/05/2021] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Radiologically isolated syndrome (RIS) refers to the incidental discovery of white matter lesions suggestive of MS, on brain MRI, in asymptomatic patients. Recent studies suggest similar features of cognitive impairment between RIS and MS patients. Also, lower levels of health-related quality of life (QOL) and fatigue are reported in such patients. AIMS characterize and compare the cognitive profile of a multicentric Portuguese cohort of RIS patients with a control group. METHODS multicentric comparative study of a cohort of adult patients with RIS, and age and gender-matched controls followed in the headache outpatient clinic with prior MRI not fulfilling criteria for RIS diagnosis. We conducted interviews with participants, collected clinical data and applied the BICAMS battery and self-reported questionnaires (HADS, MFIS, MSQOL-54). RESULTS we evaluated 31 patients with RIS (median age 46 years, IQR [(Dusankova et al., 2012-52], 72% women) and 19 control individuals (median age 32 years, IQR [(O'Jile et al., 2005-48], 71% women). Prevalence of cognitive impairment did not differ between groups (16% of the RIS and 10% of the controls, p=0.579). We found no differences between groups on the BICAMS tests, although the results of the California Verbal Learning Test (CVLT-II) score presented a trend to significance, with a lower value on the RIS group (53.9 vs. 59.3, p=0.066). There were no significant differences regarding fatigue, QOL, anxiety/depression scores. CONCLUSION this is the first study on a Portuguese cohort of RIS patients assessing cognitive profile with BICAMS. A non-neglectable part of our cohort presented cognitive impairment. Our findings add to previous studies in suggesting that a more pronounced impairment of verbal memory and learning, evaluated by CVLT-II, may be present in RIS patients compared to controls. BICAMS should be assessed on future studies with larger cohorts.
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Affiliation(s)
- Vanessa Carvalho
- Department of Neurology, Hospital Pedro Hispano/Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal.
| | - Carolina Soares
- Department of Neurology, Centro Hospitalar Universitário de São João, EPE, Porto, Portugal
| | - Inês Gomes
- Department of Neurology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Andreia Carvalho
- Department of Neurology, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Filipa Serrazina
- Department of Neurology, Hospital Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal
| | | | - Joaquim Pinheiro
- Department of Neurology, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | | | - Filipe Correia
- Department of Neurology, Hospital Pedro Hispano/Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal
| | - Ana Sofia Correia
- Department of Neurology, Hospital Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal; CEDOC, Nova Medical School, Universidade Nova de Lisboa, Lisboa, Portugal
| | - João de Sá
- Department of Neurology, Hospital de Santa Maria, Centro Hospitalar Universitário de Lisboa Norte, Lisboa, Portugal
| | - Lívia Sousa
- Department of Neurology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - José Vale
- Department of Neurology, Hospital Beatriz Ângelo, Loures, Portugal
| | - Maria José Sá
- Department of Neurology, Centro Hospitalar Universitário de São João, EPE, Porto, Portugal; Health Sciences Faculty, Universidade Fernando Pessoa, Porto, Portugal
| | - Cláudia Sousa
- Department of Psychology, Centro Hospitalar Universitário de São João, EPE, Porto, Portugal
| | - João Ferreira
- Department of Neurology, Hospital de Santa Maria, Centro Hospitalar Universitário de Lisboa Norte, Lisboa, Portugal
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Jo Y, Gomes I, Shin H, Tucker A, Ngwira LG, Chaisson RE, Corbett EL, Dowdy DW. Health-related quality of life of inpatients and outpatients with TB in rural Malawi. Int J Tuberc Lung Dis 2020; 24:1165-1171. [PMID: 33172524 PMCID: PMC7847550 DOI: 10.5588/ijtld.20.0085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION: Patients being treated for TB may suffer reductions in health-related quality of life (HRQoL). This study aims to assess the extent of such reductions and the trajectory of HRQoL over the course of treatment in rural Malawi.METHODS: We collected patient demographic and socioeconomic status, TB-related characteristics, and HRQoL data (i.e., EQ-5D and a visual analogue scale VAS) from adults (age ≥18 years) being treated for TB in 12 primary health centers and one hospital in rural Thyolo District, Malawi, from 2014 to 2016. Associations between HRQoL and patient characteristics were estimated using multivariable linear regression.RESULTS: Inpatients (n = 197) consistently showed lower median HRQoL scores and suffered more severe health impairments during hospitalization than outpatients (n = 156) (EQ5D and VAS: 0.79, 55 vs. 0.84, 70). Longer treatment duration was associated with higher HRQoL among outpatients (EQ5D: 0.034 increase per 2 months, 95%CI 0.012-0.057). We found no substantial associations between patients´ demographic and socioeconomic characteristics and HRQoL in this setting.CONCLUSION: HRQoL scores among patients receiving treatment for TB in rural Malawi differ by clinical setting and duration of treatment, with greater impairment among inpatients and those early in their treatment course.
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Affiliation(s)
- Y Jo
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - I Gomes
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - H Shin
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - A Tucker
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - L G Ngwira
- Malawi-Liverpool-Wellcome Trust Clinical Research Center, Blantyre, Malawi
| | - R E Chaisson
- Center for Tuberculosis Research, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - E L Corbett
- Malawi-Liverpool-Wellcome Trust Clinical Research Center, Blantyre, Malawi, Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
| | - D W Dowdy
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA, Center for Tuberculosis Research, Johns Hopkins School of Medicine, Baltimore, MD, USA
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Silva Paiva R, Gomes I, Casimiro S, Fernandes I, Costa L. c-Met expression in renal cell carcinoma with bone metastases. J Bone Oncol 2020; 25:100315. [PMID: 33024658 PMCID: PMC7527574 DOI: 10.1016/j.jbo.2020.100315] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 08/26/2020] [Accepted: 08/27/2020] [Indexed: 12/12/2022] Open
Abstract
Bone is a common metastatic site in renal cell carcinoma (RCC). HGF/c-Met pathway is particularly relevant in tumors with bone metastases. c-Met/HGF pathway is involved in RCC progression, conferring poor prognosis. Several c-Met targeting therapies are currently in clinical development. c-Met expression is an important therapeutic target in RCC with bone metastases.
Hepatocyte growth factor (HGF)/c-Met pathway is implicated in embryogenesis and organ development and differentiation. Germline or somatic mutations, chromosomal rearrangements, gene amplification, and transcriptional upregulation in MET or alterations in autocrine or paracrine c-Met signalling have been associated with cancer cell proliferation and survival, including in renal cell carcinoma (RCC), and associated with disease progression. HGF/c-Met pathway has been shown to be particularly relevant in tumors with bone metastases (BMs). However, the efficacy of targeting c-Met in bone metastatic disease, including in RCC, has not been proven. Therefore, further investigation is required focusing the particular role of HGF/c-Met pathway in bone microenvironment (BME) and how to effectively target this pathway in the context of bone metastatic disease.
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Key Words
- ALK, anaplastic lymphoma kinase gene
- AR, androgen receptor
- ATP, adenosine triphosphate
- AXL, AXL Receptor Tyrosine Kinase
- BME, bone microenvironment
- BMPs, bone morphogenetic proteins
- BMs, bone metastases
- BPs, Bisphosphonates
- BTAs, Bone-targeting agents
- Bone metastases
- CCL20, chemokine (C-C motif) ligand 20
- CI, confidence interval
- CRPC, Castration Resistant Prostate Cancer
- CSC, cancer stem cells
- CTC, circulating tumor cells
- CaSR, calcium/calcium-sensing receptor
- EMA, European Medicines Agency
- EMT, epithelial-to-mesenchymal transition
- FDA, US Food and Drug Administration
- FLT-3, FMS-like tyrosine kinase 3
- GEJ, Gastroesophageal Junction
- HCC, Hepatocellular Carcinoma
- HGF, hepatocyte growth factor
- HGF/c-Met
- HIF, hypoxia-inducible factors
- HR, hazard ratio
- IGF, insulin-like growth factor
- IGF2BP3, insulin mRNA Binding Protein-3
- IL, interleukin
- IRC, independent review committees
- KIT, tyrosine-protein kinase KIT
- Kidney cancer
- M-CSF, macrophage colony-stimulating factor
- MET, MET proto-oncogene, receptor tyrosine kinase
- NSCLC, non-small cell lung carcinoma
- ORR, overall response rate
- OS, overall survival
- PDGF, platelet-derived growth factor
- PFS, progression free survival
- PTHrP, parathyroid hormone-related peptide
- RANKL, receptor activator of nuclear factor-κB ligand
- RCC, renal cell carcinoma
- RET, rearranged during transfection proto-oncogene
- ROS, proto-oncogene tyrosine-protein kinase ROS
- RTK, receptor tyrosine kinase
- SCLC, Squamous Cell Lung Cancer
- SREs, skeletal-related events
- SSE, symptomatic skeletal events
- TGF-β, transforming growth factor-β
- TIE-2, Tyrosine-Protein Kinase Receptor TIE-2
- TKI, tyrosine kinase inhibitor
- TRKB, Tropomyosin receptor kinase B
- Targeted therapy
- VEGFR, vascular endothelial growth factor receptor
- VHL, Hippel-Lindau tumor suppressor gene
- ZA, zoledronic acid
- ccRCC, clear-cell RCC
- mAb, monoclonal antibodies
- pRCC, papillary renal cell carcinoma
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Affiliation(s)
- Rita Silva Paiva
- Oncology Division, Hospital de Santa Maria, CHULN, 1649-035 Lisboa, Portugal
| | - Inês Gomes
- Instituto de Medicina Molecular - João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal
| | - Sandra Casimiro
- Instituto de Medicina Molecular - João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal
| | - Isabel Fernandes
- Oncology Division, Hospital de Santa Maria, CHULN, 1649-035 Lisboa, Portugal
- Instituto de Medicina Molecular - João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal
| | - Luís Costa
- Oncology Division, Hospital de Santa Maria, CHULN, 1649-035 Lisboa, Portugal
- Instituto de Medicina Molecular - João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal
- Corresponding author at: Oncology Division, Hospital de Santa Maria, 1649-035 Lisbon, Portugal.
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Gomes I, de Almeida BP, Dâmaso S, Mansinho A, Correia I, Henriques S, Cruz-Duarte R, Vilhais G, Félix P, Alves P, Corredeira P, Barbosa-Morais NL, Costa L, Casimiro S. Expression of receptor activator of NFkB (RANK) drives stemness and resistance to therapy in ER+HER2- breast cancer. Oncotarget 2020; 11:1714-1728. [PMID: 32477461 PMCID: PMC7233807 DOI: 10.18632/oncotarget.27576] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 04/10/2020] [Indexed: 12/30/2022] Open
Abstract
The role of RANKL-RANK pathway in progesterone-driven mammary carcinogenesis and triple negative breast cancer tumorigenesis has been well characterized. However, and despite evidences of the existence of RANK-positive hormone receptor (HR)-positive breast tumors, the implication of RANK expression in HR-positive breast cancers has not been addressed before. Here, we report that RANK pathway affects the expression of cell cycle regulators and decreases sensitivity to fulvestrant of estrogen receptor (ER)-positive (ER+)/HER2- breast cancer cells, MCF-7 and T47D. Moreover, RANK overexpressing cells had a staminal and mesenchymal phenotype, with decreased proliferation rate and decreased susceptibility to chemotherapy, but were more invasive in vivo. In silico analysis of the transcriptome of human breast tumors, confirmed the association between RANK expression and stem cell and mesenchymal markers in ER+HER2- tumors. Importantly, exposure of ER+HER2- cells to continuous RANK pathway activation by exogenous RANKL, in vitro and in vivo, induced a negative feedback effect, independent of RANK levels, leading to the downregulation of HR and increased resistance to hormone therapy. These results suggest that ER+HER2- RANK-positive cells may constitute an important reservoir of slow cycling, therapy-resistance cancer cells; and that RANK pathway activation is deleterious in all ER+HER2- breast cancer cells, independently of RANK levels.
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Affiliation(s)
- Inês Gomes
- Luis Costa Laboratory, Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal
| | - Bernardo P. de Almeida
- Nuno Morais Laboratory, Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal
- Current affiliation: Research Institute of Molecular Pathology (IMP), Vienna Biocenter (VBC), Vienna, Austria
| | - Sara Dâmaso
- Serviço de Oncologia, Hospital de Santa Maria-CHULN, Lisboa, Portugal
| | - André Mansinho
- Luis Costa Laboratory, Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal
- Serviço de Oncologia, Hospital de Santa Maria-CHULN, Lisboa, Portugal
| | - Inês Correia
- Luis Costa Laboratory, Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal
| | - Sara Henriques
- Luis Costa Laboratory, Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal
| | - Raquel Cruz-Duarte
- Luis Costa Laboratory, Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal
| | - Guilherme Vilhais
- Luis Costa Laboratory, Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal
| | - Pedro Félix
- Luis Costa Laboratory, Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal
| | - Patrícia Alves
- Luis Costa Laboratory, Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal
| | - Patrícia Corredeira
- Luis Costa Laboratory, Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal
| | - Nuno L. Barbosa-Morais
- Nuno Morais Laboratory, Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal
| | - Luis Costa
- Luis Costa Laboratory, Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal
- Serviço de Oncologia, Hospital de Santa Maria-CHULN, Lisboa, Portugal
| | - Sandra Casimiro
- Luis Costa Laboratory, Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal
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Correia T, Gomes I, Nunes P, Dussault G. Health workforce monitoring in Portugal: Does it support strategic planning and policy-making? Health Policy 2020; 124:303-310. [PMID: 31932075 DOI: 10.1016/j.healthpol.2019.12.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 09/17/2019] [Accepted: 12/24/2019] [Indexed: 10/25/2022]
Abstract
The quality of the available information on Human Resources for Health (HRH) is critical to planning strategically the future workforce needs. This article aims to assess HRH monitoring in Portugal: the data availability, comparability and quality. A scoping review of academic literature was conducted, which included 76 empirical studies. The content analysis was guided by the World Health Organization 'AAAQ framework' that covers availability, accessibility, acceptability and quality of the health workforce. The analysis identified three types of problems affecting HRH monitoring in Portugal: insufficient data, the non-use of available data, and the general lack of analysis of the HRH situation. As a consequence, the data availability, comparability and quality is poor, and therefore HRH monitoring in Portugal makes strategic planning of the future health workforce difficult. Recommendations to improve HRH monitoring include: 1) make data collection aligned with the standardized indicators and guidelines by the Joint Eurostat-OECD-World Health Organization questionnaire on Non-Monetary Health Care Statistics; 2) cover the whole workforce, which includes professions, sectors and services; 3) create a mechanism of permanent monitoring and analysis of HRH at the country level.
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Affiliation(s)
- Tiago Correia
- Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, UNL, Rua da Junqueira 100, 1349-008, Lisboa, Portugal; CIES-Instituto Universitário de Lisboa, Avenida das Forcas Armadas, 1649-026, Portugal.
| | - Inês Gomes
- CIES-Instituto Universitário de Lisboa, Avenida das Forcas Armadas, 1649-026, Portugal.
| | - Patrícia Nunes
- Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, UNL, Rua da Junqueira 100, 1349-008, Lisboa, Portugal.
| | - Gilles Dussault
- Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, UNL, Rua da Junqueira 100, 1349-008, Lisboa, Portugal.
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Loureiro S, Amorim A, Cainé L, Silva B, Gomes I. Evaluation of two DNA/RNA co-extraction methods for body fluid identification in forensics. Forensic Science International: Genetics Supplement Series 2019. [DOI: 10.1016/j.fsigss.2019.09.096] [Citation(s) in RCA: 2] [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: 10/25/2022]
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27
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Gomes I. [Instruments, objects, and collections as sources for the history of science education]. Hist Cienc Saude Manguinhos 2019; 26:1211-1222. [PMID: 31800837 DOI: 10.1590/s0104-59702019000400011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 08/06/2018] [Indexed: 06/10/2023]
Abstract
A large number of Portuguese secondary schools have scientific collections, which are central elements for the memory and identity of the institutions that maintain them, and contribute to understanding the characteristics that over time have defined public secondary education in Portugal. However, this heritage is still largely unknown. This article draws attention to the historiographic debate surrounding the use of material sources in the history of science education, describing the relevance of natural history collections in Portuguese secondary schools as well as their vulnerability, considering the lack of a general policy or guidelines related to conservation.
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Affiliation(s)
- Inês Gomes
- Pesquisadora, Instituto de Ciências Sociais/Universidade de Lisboa/Centro Interuniversitário de História das Ciências e da Tecnologia. Lisboa - Portugal
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Gomes I, Aguiar P, Miranda A, Nunes C. Overall Survival of Patients With Locoregional and Metastatic Breast Cancer: Is the Influence of Baseline Characteristics the Same? Anticancer Res 2019; 39:5135-5142. [PMID: 31519625 DOI: 10.21873/anticanres.13708] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 07/24/2019] [Accepted: 07/29/2019] [Indexed: 11/10/2022]
Abstract
AIM To compare the overall survival (OS) of patients with locoregional and metastatic breast cancer (BC) considering baseline demographic, clinical and contextual characteristics. MATERIALS AND METHODS A retrospective analysis of a cancer registry was conducted, using the Kaplan-Meier and Mantel-Cox analyses for the calculation of median OS and cumulative survival. RESULTS The median OS was 112 months, being longer in patients with locoregional versus those with metastatic BC at diagnosis (115 vs. 31 months, p<0.001). The cumulative survival at 1, 3 and 5 years were 94.9%, 85.6% and 76.5%, respectively. More recent year of diagnosis [hazard ratio (HR)=1.09] and age at diagnosis (≥65 vs. 40 years, HR=2.79) and presence of metastatic disease (HR=5.69) were associated with a shorter OS. The region of residence, morphology and topography of the tumor were also associated with survival in patients with BC. Rurality was only associated with lower survival in patients with metastatic BC. CONCLUSION This study identified significant differences in the median OS of patients with locoregional and those with metastatic BC considering their baseline characteristics.
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Affiliation(s)
- Inês Gomes
- National School of Public Health, NOVA University of Lisbon (ENSP/NOVA), Lisbon, Portugal .,Pfizer, Porto Salvo, Portugal.,Public Health Research Center, NOVA University of Lisbon, Lisbon, Portugal
| | - Pedro Aguiar
- National School of Public Health, NOVA University of Lisbon (ENSP/NOVA), Lisbon, Portugal.,Public Health Research Center, NOVA University of Lisbon, Lisbon, Portugal
| | - Ana Miranda
- Southern Portugal Cancer Registry (ROR-Sul), Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal
| | - Carla Nunes
- National School of Public Health, NOVA University of Lisbon (ENSP/NOVA), Lisbon, Portugal.,Public Health Research Center, NOVA University of Lisbon, Lisbon, Portugal
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Carneiro-Leão L, Gomes I, Freitas C, Costa E Silva M, Viseu R, Cernadas J. Multiple Drug Hypersensitivity Syndrome to Antituberculosis Drugs: A Case Report. J Investig Allergol Clin Immunol 2019; 30:70-71. [PMID: 31530510 DOI: 10.18176/jiaci.0446] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- L Carneiro-Leão
- Allergy and Clinical Immunology Department, Centro Hospitalar e Universitário de São João, Porto, Portugal.,Faculty of Medicine, University of Porto, Porto, Portugal
| | - I Gomes
- Pulmonology Department, Centro Hospitalar e Universitário de São João, Porto, Portugal
| | - C Freitas
- Faculty of Medicine, University of Porto, Porto, Portugal.,Pulmonology Department, Centro Hospitalar e Universitário de São João, Porto, Portugal
| | - M Costa E Silva
- Dermatology Department, Centro Hospitalar e Universitário de São João, Porto, Portugal
| | - R Viseu
- Immunology and Molecular Biology Lab, Allergy and Clinical Immunology Department, Centro Hospitalar de Setúbal, Setúbal, Portugal
| | - J Cernadas
- Allergy and Clinical Immunology Department, Centro Hospitalar e Universitário de São João, Porto, Portugal.,Allergy and Clinical Immunology Unit, Hospital dos Lusíadas, Porto, Portugal
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Casimiro S, Gomes I, Almeida B, Alves P, Félix P, Vilhais G, Mansinho A, Dionísio M, Barbosa-Morais N, Costa L. Biological features of estrogen receptor-positive breast cancer with elevated RANK (TNFRSF11A) expression. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz095.026] [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: 11/12/2022] Open
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Gomes I, Lopes LP, Fonseca M, Portugal J. Effect of Zirconia Pigmentation on Translucency. Eur J Prosthodont Restor Dent 2018; 26:136-142. [PMID: 30085483 DOI: 10.1922/ejprd_01779gomes07] [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] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
PURPOSE the aim of this study was to investigate the effect of shading on translucency and mean grain size of three Zirconia systems (Lava Frame, Ice Zirkon Translucent and Prettau Zirkon). MATERIALS AND METHODS specimens pigmented in A1, A4 and a non-pigmented specimen was evaluated with Scanning Electron Microscopy and spectrophotometery. RESULTS the transmittance ranged between 0.18 and 0.52, in Ice Zirkon Translucent A4 and Prettau Zircon non-pigmented, respectively. The pigmentation A1 and A4 significantly reduced the light transmission in all the systems evaluated (p⟨0.05), with the exception of Lava A1. The light transmittance of each ceramic system is different from each other in the three pigmentations, except for the Prettau Zirkon A1, which did not show a significant difference compared with Lava A1 (p⟩0.05). The mean grain size increased with pigmentation. The mean grain size ranged between 0.43 μm, for Prettau Zirkon non-pigmented, and 0.82 μm for Prettau Zirkon A4. CONCLUSION Light transmission and mean grain size was affected by pigmentation of dental zirconia ceramics.
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Affiliation(s)
- I Gomes
- Department of Oral Rehabilitation, Faculdade de Medicina Dentária, Universidade de Lisboa, 1649-003 Lisboa, Portugal
| | - L P Lopes
- Department of Oral Rehabilitation, Faculdade de Medicina Dentária, Universidade de Lisboa, 1649-003 Lisboa, Portugal
| | - M Fonseca
- Center Mathematic and Applications, Faculty of Sciences and Technology, New University of Lisbon, 2829-516 Portugal
| | - J Portugal
- Department of Dental Materials, Faculdade de Medicina Dentária, Universidade de Lisboa, 1649-003 Lisboa, Portugal
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Peixoto de Almeida M, Quaresma P, Sousa S, Couto C, Gomes I, Krippahl L, Franco R, Pereira E. Measurement of adsorption constants of laccase on gold nanoparticles to evaluate the enhancement in enzyme activity of adsorbed laccase. Phys Chem Chem Phys 2018; 20:16761-16769. [PMID: 29882945 DOI: 10.1039/c8cp03116a] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Adsorption of enzymes to nanoparticles and the mechanisms responsible for enzyme activity modulation of adsorbed enzymes are not well understood. In this work, gold nanoparticles were used for electrostatic adsorption of a plant-derived laccase. Adsorption constants were determined by four independent techniques: dynamic light scattering, electrophoretic light scattering, agarose gel electrophoresis and fluorescence quenching. Stable bionanoconjugates were formed with log K in the range 6.8-8.9. An increase in enzyme activity was detected, in particular at acidic and close to neutral pH values, a feature that expands the useful pH range of the enzyme. A model for the adsorption was developed, based on geometrical considerations and volume increase data from dynamic light scattering. This indicates that enzymes adsorbed to gold nanoparticles are ca. 9 times more active than the free enzyme.
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Affiliation(s)
- Miguel Peixoto de Almeida
- LAQV, REQUIMTE, Departamento de Química e Bioquímica, Rua do Campo Alegre s/n, 4169-007 Porto, Portugal.
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Franik S, Smeets D, van de Zande G, Gomes I, D'Hauwers K, Braat DDM, Fleischer K, Ramos L. Klinefelter syndrome and fertility-Impact of X-chromosomal inheritance on spermatogenesis. Andrologia 2018; 50:e13004. [PMID: 29512178 DOI: 10.1111/and.13004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2018] [Indexed: 11/26/2022] Open
Abstract
With the use of testicular sperm extraction (TESE), spermatozoa can be retrieved in about 30%-50% of men with Klinefelter syndrome (KS). The reason for the absence or presence of spermatozoa in half of the men with KS remains unknown. Therefore, the search for an objective marker for a positive prediction in finding spermatozoa is of significant clinical value to avoid unnecessary testicular biopsies in males with (mostly) low testicular volume and impaired testosterone. The objective of this study was to determine whether paternal or maternal inheritance of the additional X-chromosome can predict the absence or presence of spermatogenesis in men with KS. Men with KS who have had a testicular biopsy for diagnostic fertility workup TESE were eligible for inclusion. Buccal swabs from nine KS patients and parents (trios) were taken to compare X-chromosomal inheritance to determine the parental origin of both X-chromosomes in the males with KS. Spermatozoa were found in TESE biopsies 8 of 35 (23%) patients after performing a unilateral or bilateral TESE. Different levels of spermatogenesis (from the only presence of spermatogonia, up to maturation arrest or hypospermatogenesis) appeared to be present in 19 of 35 (54%) men, meaning that the presence of spermatogenesis not always yields mature spermatozoa. From the nine KS-trios that were genetically analysed for X-chromosomal inheritance origin, no evidence of a correlation between the maternal or paternal origin of the additional X-chromosome and the presence of spermatogenesis was found. In conclusion, the maternal or paternal origin of the additional X-chromosome in men with KS does not predict the presence or absence of spermatogenesis.
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Affiliation(s)
- S Franik
- Department of Obstetrics and Gynaecology, Radboudumc Nijmegen, Nijmegen, The Netherlands.,Department of Obstetrics and Gynaecology, University Hospital Münster, Münster, Germany
| | - D Smeets
- Department of Human Genetics, Radboudumc Nijmegen, Nijmegen, The Netherlands
| | - G van de Zande
- Department of Human Genetics, Radboudumc Nijmegen, Nijmegen, The Netherlands
| | - I Gomes
- Department of Human Genetics, Radboudumc Nijmegen, Nijmegen, The Netherlands
| | - K D'Hauwers
- Department of Urology, Radboudumc Nijmegen, Nijmegen, The Netherlands
| | - D D M Braat
- Department of Obstetrics and Gynaecology, Radboudumc Nijmegen, Nijmegen, The Netherlands
| | - K Fleischer
- Department of Obstetrics and Gynaecology, Radboudumc Nijmegen, Nijmegen, The Netherlands
| | - L Ramos
- Department of Obstetrics and Gynaecology, Radboudumc Nijmegen, Nijmegen, The Netherlands
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Gomes I, Miranda A, Nunes C. Spatiotemporal Analysis of Breast Cancer Incidence: A Study in Southern Portugal Between 2005 and 2012. Anticancer Res 2018; 38:1797-1805. [PMID: 29491119 DOI: 10.21873/anticanres.12418] [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: 12/22/2017] [Revised: 01/24/2018] [Accepted: 01/30/2018] [Indexed: 11/10/2022]
Abstract
AIM To characterize the spatiotemporal patterns of breast cancer (BC) incidence in females in the area with the highest incidence rate (IR) of the country in 2005-2012. MATERIALS AND METHODS The BC-IR was studied using mapping techniques, analysis of spatiotemporal clusters and analysis of spatial variations in temporal trends. RESULTS The overall BC-IR was 119.13/105 inhabitants. The annual BC-IRs were 17.7, 156.9, 213.3 and 232.9/105 inhabitants for women diagnosed at <40, 40-49, 50-64 and ≥65 years of age. This IR increased overall (by 4.113%/year) and for the four age groups (by 5.935, 3.833, 4.114 and 2.194%/year, respectively). In patients with locoregional and metastatic disease, the IRs were 93.6 and 7.4/105 inhabitants, increasing by 6.976 and 0.303%/year, respectively. Several spatiotemporal clusters and two spatial-variations in temporal trends were detected. The Lisbon region showed high IR clusters for most groups. CONCLUSION This study identified critical areas of high IR and increasing trends for female BC-IR, providing evidence of heterogeneities in this area.
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Affiliation(s)
- Inês Gomes
- Epidemiology and Statistics Department, National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal.,Pfizer, Porto Salvo, Portugal
| | - Ana Miranda
- Southern Portugal Cancer Registry, Portuguese Institute of Oncology of Lisbon, Lisbon, Portugal
| | - Carla Nunes
- Epidemiology and Statistics Department, National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal .,Public Health Research Center, NOVA University of Lisbon, Lisbon, Portugal
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Nolasco R, Gomes I, Peteiro L, Albuquerque R, Luna T, Dubert J, Swearer SE, Queiroga H. Independent estimates of marine population connectivity are more concordant when accounting for uncertainties in larval origins. Sci Rep 2018; 8:2641. [PMID: 29422505 PMCID: PMC5805787 DOI: 10.1038/s41598-018-19833-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 12/21/2017] [Indexed: 11/09/2022] Open
Abstract
Marine larval dispersal is a complex biophysical process that depends on the effects of species biology and oceanography, leading to logistical difficulties in estimating connectivity among populations of marine animals with biphasic life cycles. To address this challenge, the application of multiple methodological approaches has been advocated, in order to increase confidence in estimates of population connectivity. However, studies seldom account for sources of uncertainty associated with each method, which undermines a direct comparative approach. In the present study we explicitly account for the statistical uncertainty in observed connectivity matrices derived from elemental chemistry of larval mussel shells, and compare these to predictions from a biophysical model of dispersal. To do this we manipulate the observed connectivity matrix by applying different confidence levels to the assignment of recruits to source populations, while concurrently modelling the intrinsic misclassification rate of larvae to known sources. We demonstrate that the correlation between the observed and modelled matrices increases as the number of observed recruits classified as unknowns approximates the observed larval misclassification rate. Using this approach, we show that unprecedented levels of concordance in connectivity estimates (r = 0.96) can be achieved, and at spatial scales (20-40 km) that are ecologically relevant.
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Affiliation(s)
- R Nolasco
- Departamento de Física & CESAM - Centro de Estudos do Ambiente e do Mar, Universidade de Aveiro, 3810-193, Aveiro, Portugal.,Instituto de Investigacións Mariñas (CSIC), Eduardo Cabello 6, 36208, Vigo, Spain
| | - I Gomes
- Departamento de Biologia & CESAM - Centro de Estudos do Ambiente e do Mar, Universidade de Aveiro, 3810-193, Aveiro, Portugal.,Mar. Biol. Research Group, Ghent University, 9000, Ghent, Belgium
| | - L Peteiro
- Departamento de Biologia & CESAM - Centro de Estudos do Ambiente e do Mar, Universidade de Aveiro, 3810-193, Aveiro, Portugal.,Coastal Ecology Research Group (EcoCost), Department of Ecology and Animal Biology, University of Vigo, Vigo, Spain
| | - R Albuquerque
- Departamento de Biologia & CESAM - Centro de Estudos do Ambiente e do Mar, Universidade de Aveiro, 3810-193, Aveiro, Portugal
| | - T Luna
- Departamento de Física & CESAM - Centro de Estudos do Ambiente e do Mar, Universidade de Aveiro, 3810-193, Aveiro, Portugal
| | - J Dubert
- Departamento de Física & CESAM - Centro de Estudos do Ambiente e do Mar, Universidade de Aveiro, 3810-193, Aveiro, Portugal
| | - S E Swearer
- School of BioSciences, University of Melbourne, Parkville, Victoria, 3010, Australia
| | - H Queiroga
- Departamento de Física & CESAM - Centro de Estudos do Ambiente e do Mar, Universidade de Aveiro, 3810-193, Aveiro, Portugal.
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Henriques F, Gomes I. Consciência morfológica em crianças do pré-escolar dos meios rural e urbano: estudo comparativo. R Est Inv Psico y Educ 2017. [DOI: 10.17979/reipe.2017.0.09.2670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Pretende-se com este estudo analisar o papel do meio no desenvolvimento da capacidade de refletir, analisar e manipular intencionalmente a estrutura morfológica das palavras. Foram observadas 60 crianças portuguesas (30 do meio urbano + 30 do meio rural), de 4 e 5 anos de idade, em tarefas de consciência morfológica. O desempenho das crianças de ambos os grupos foi globalmente baixo. Ainda assim observou-se uma vantagem significativa do meio urbano em tarefas de identificação e de categorização de morfemas radicais e derivacionais. Tais resultados alertam para a importância de se implementar programas de consciência morfológica em idade pré-escolar.
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Sereno D, Gomes I. Escrever melhor com o método Cloze: um programa de intervenção para crianças. R Est Inv Psico y Educ 2017. [DOI: 10.17979/reipe.2017.0.05.2795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Este estudo pretendeu avaliar a eficácia do programa “Era uma vez…” no desempenho ortográfico de crianças do 4º ano. Baseado no método Cloze, este programa contempla 8 histórias originais. As 65 crianças foram distribuídas pelos grupos experimental (GE; com intervenção) e controlo (GC; sem intervenção) e avaliadas em dois momentos (pré e pós-teste) com uma prova de escrita. Os resultados evidenciaram uma melhoria significativa do desempenho do pré para o pós-teste apenas no GE. No pós-teste, observaram-se diferenças intergrupo significativas, com vantagem para o GE, o que sugere tratar-se de um método promissor no desenvolvimento das habilidades ortográficas.
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Affiliation(s)
- Inês Gomes
- Consulta de Risco Cardiovascular, Hospital de Santa Marta, Centro Hospitalar Lisboa Central, Lisboa, Portugal.
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Gomes I. Obesity and hypertension in children – A growing problem. Revista Portuguesa de Cardiologia (English Edition) 2017. [DOI: 10.1016/j.repce.2017.09.006] [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: 11/16/2022] Open
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Gomes I, Brandão C, Bourbon M, Pinto F. Cardiovascular risk in children: The clinical relevance of early and timely stratification. Atherosclerosis 2017. [DOI: 10.1016/j.atherosclerosis.2017.06.327] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Cardoso B, Gomes I, Loureiro P, Trigo C, Ferreira Pinto F. Clinical and genetic diagnosis of familial hypertrophic cardiomyopathy: Results in pediatric cardiology. Rev Port Cardiol 2017; 36:155-165. [PMID: 28214152 DOI: 10.1016/j.repc.2016.09.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Revised: 07/28/2016] [Accepted: 09/26/2016] [Indexed: 01/25/2023] Open
Abstract
INTRODUCTION Hypertrophic cardiomyopathy (HCM) is most often of autosomal dominant inheritance with incomplete penetrance and variable expression. The main purpose of family screening is to identify relatives with unrecognized HCM and to monitor those at risk for disease, in order to minimize complications and to assess risk of sudden cardiac death. The ESC and ACCF/AHA guidelines on the diagnosis and management of HCM recommend the screening of child relatives from the age of 10-12 years. OBJECTIVES We studied the outcome of clinical screening and genetic testing of child probands and relatives (<18 years of age) from families with HCM and assessed the age-related penetrance of HCM during the follow-up of these young relatives. METHODS AND RESULTS Twenty patients from ten families were included between 2004 and 2013, consisting of three probands and 17 first-degree relatives (80% male; median age 10 years). Fourteen child relatives were mutation carriers (70%; median age eight years). Seven (50%) of the 14 mutation carriers were diagnosed with HCM at initial assessment. At-risk child relatives were defined as those with a positive mutation but a negative phenotype at enrollment. After 3.5±0.8 years of follow-up, two of the phenotype-negative mutation carriers developed HCM at 10 and 15 years of age (28% penetrance rate). CONCLUSIONS The penetrance of HCM in phenotype-negative child relatives was 28% after 3.5 years of follow-up. This underlines the need for long-term monitoring of mutation carriers irrespective of the presence of a positive phenotype.
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Affiliation(s)
- Bárbara Cardoso
- Serviço de Cardiologia Pediátrica, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, Lisboa, Portugal.
| | - Inês Gomes
- Serviço de Cardiologia Pediátrica, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, Lisboa, Portugal
| | - Petra Loureiro
- Serviço de Cardiologia Pediátrica, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, Lisboa, Portugal
| | - Conceição Trigo
- Serviço de Cardiologia Pediátrica, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, Lisboa, Portugal
| | - Fátima Ferreira Pinto
- Serviço de Cardiologia Pediátrica, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, Lisboa, Portugal
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Cardoso B, Loureiro P, Gomes I, Gordo A, Banazol N, Fragata I, Trigo C, Pinto F, Fragata J. Mitral Valve Surgery for Rheumatic Lesions in Young Patients. World J Pediatr Congenit Heart Surg 2017; 7:321-8. [PMID: 27142399 DOI: 10.1177/2150135116637806] [Citation(s) in RCA: 5] [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: 10/04/2015] [Accepted: 02/12/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND The appropriateness of rheumatic mitral valve repair remains controversial due to the risks of recurrent mitral dysfunction and need for reoperation. The aims of this study were to determine the overall short- and long-term outcomes of pediatric rheumatic mitral valve surgery in our center. METHODS Single-center, observational, retrospective study that analyzed the results of rheumatic mitral valve surgery in young patients, consecutively operated by the same team, between 1999 and 2014. RESULTS We included 116 patients (mean age = 12.6 ± 3.5 years), of which 66 (57%) were females. A total of 116 primary surgical interventions and 22 reoperations were performed. Primary valve repair was possible in 86 (74%) patients and valve replacement occurred in 30 (26%). Sixty percent of the patients were followed up beyond three months after surgery (median follow-up time = 9.2 months [minimum = 10 days; maximum = 15 years]). Long-term clinical outcomes were favorable, with most patients in New York Heart Association functional class I (89.6%) and in sinus rhythm (85%). Freedom from reoperation for primary valve repair at six months, five years, and ten years was 96.4% ± 0.25%, 72% ± 0.72%, and 44.7% ± 1.34%, respectively. Freedom from reoperation for primary valve replacement at six months, five years, and ten years was 100%, 91.7% ± 0.86%, and 91.7% ± 0.86%, respectively. Mitral stenosis as the primary lesion dictated early reintervention. CONCLUSIONS Despite the greater rate of reoperation, especially when the primary lesion was mitral stenosis, rheumatic mitral valve repair provides similar clinical outcomes as compared with replacement, with the advantage of avoiding anticoagulation.
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Affiliation(s)
- B Cardoso
- Department of Pediatric Cardiology, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, EPE, Lisbon, Portugal
| | - P Loureiro
- Department of Pediatric Cardiology, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, EPE, Lisbon, Portugal
| | - I Gomes
- Department of Pediatric Cardiology, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, EPE, Lisbon, Portugal
| | - A Gordo
- Department of Cardiothoracic Surgery, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, EPE, Lisbon, Portugal
| | - N Banazol
- Department of Cardiothoracic Surgery, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, EPE, Lisbon, Portugal
| | - I Fragata
- Department of Anesthesiology, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, EPE, Lisbon, Portugal
| | - C Trigo
- Department of Pediatric Cardiology, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, EPE, Lisbon, Portugal
| | - F Pinto
- Department of Pediatric Cardiology, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, EPE, Lisbon, Portugal
| | - José Fragata
- Department of Cardiothoracic Surgery, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, EPE, Lisbon, Portugal
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Antunes W, Fonseca P, Freitas J, Gomes I, Alonso C, Matos A. Ultrastructural characterization of Bacillus anthracis spores: The existence of two spores subpopulations? Ultrastruct Pathol 2017. [DOI: 10.1080/01913123.2016.1274117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- W. Antunes
- Laboratory of Biological Defense, Laboratorial Military Unit of Biological and Chemical Defense, Military Academy Research Center, Lisboa, Portugal
| | - P. Fonseca
- Laboratory of Biological Defense, Laboratorial Military Unit of Biological and Chemical Defense, Military Academy Research Center, Lisboa, Portugal
| | - J. Freitas
- Laboratory of Biological Defense, Laboratorial Military Unit of Biological and Chemical Defense, Military Academy Research Center, Lisboa, Portugal
| | - I. Gomes
- Laboratory of Biological Defense, Laboratorial Military Unit of Biological and Chemical Defense, Military Academy Research Center, Lisboa, Portugal
| | - C. Alonso
- Laboratory of Biological Defense, Laboratorial Military Unit of Biological and Chemical Defense, Military Academy Research Center, Lisboa, Portugal
| | - A. Matos
- Centro de Investigação Interdisciplinar Egas Moniz – Egas Moniz Cooperativa de Ensino Superior CRL, Quinta da Granja, Monte da Caparica, Portugal
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Sirker M, Fimmers R, Schneider PM, Gomes I. Evaluating the forensic application of 19 target microRNAs as biomarkers in body fluid and tissue identification. Forensic Sci Int Genet 2016; 27:41-49. [PMID: 27940410 DOI: 10.1016/j.fsigen.2016.11.012] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 11/18/2016] [Accepted: 11/30/2016] [Indexed: 01/03/2023]
Abstract
RNA-based body fluid and tissue identification has evolved as a promising and reliable new technique to classify type and source of biological evidence in crime cases. In particular, mRNA-based approaches are currently on the rise to replace conventional protein-based methods and are increasingly implemented into forensic casework. However, degradation of these nucleic acid molecules can cause issues on laboratory scale and need to be considered for a credible investigation. For this reason, the analysis of miRNAs using qPCR has been proposed to be a sensitive and specific approach to identify the origin of a biological trace taking advantage of their small size and resistance to degradation. Despite the straightforward workflow of this method, suitable endogenous controls are inevitable when performing real-time PCR to ensure accurate normalization of gene expression data in order to allow a meaningful interpretation. In this regard, we have validated reference genes for a set of forensically relevant body fluids and tissues (blood, saliva, semen, vaginal secretions, menstrual blood and skin) and tested 15 target genes aiming to identify abovementioned sample types. Our data showed that preselected endogenous controls (miR26b, miR92 and miR484) and miR144, initially selected as potential marker for the detection of menstrual blood, were the most stable expressed genes among our set of samples. Normalizing qPCR data with these four validated references revealed that only five miRNA markers are necessary to differentiate between the six different cell types selected in this study. Nevertheless, our observations in the present study indicate that miRNA analysis methods may not provide straightforward data interpretation strategies required for an implementation in forensic casework.
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Affiliation(s)
- M Sirker
- Institute of Legal Medicine, Faculty of Medicine, University of Cologne, Cologne, Germany.
| | - R Fimmers
- Institute of Biometrics, Informatics and Epidemiology, University of Bonn, Bonn, Germany
| | - P M Schneider
- Institute of Legal Medicine, Faculty of Medicine, University of Cologne, Cologne, Germany
| | - I Gomes
- Institute of Legal Medicine, Faculty of Medicine, University of Cologne, Cologne, Germany
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Malheiro J, Gomes I, Borges A, Bastos MMSM, Maillard JY, Borges F, Simões M. Phytochemical profiling as a solution to palliate disinfectant limitations. Biofouling 2016; 32:1007-1016. [PMID: 27552663 DOI: 10.1080/08927014.2016.1220550] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 07/30/2016] [Indexed: 06/06/2023]
Abstract
The indiscriminate use of biocides for general disinfection has contributed to the increased incidence of antimicrobial tolerant microorganisms. This study aims to assess the potential of seven phytochemicals (tyrosol, caffeic acid, ferulic acid, cinnamaldehyde, coumaric acid, cinnamic acid and eugenol) in the control of planktonic and sessile cells of Staphylococcus aureus and Escherichia coli. Cinnamaldehyde and eugenol showed antimicrobial properties, minimum inhibitory concentrations of 3-5 and 5-12 mM and minimum bactericidal concentrations of 10-12 and 10-14 mM against S. aureus and E. coli, respectively. Cinnamic acid was able to completely control adhered bacteria with effects comparable to peracetic acid and sodium hypochlorite and it was more effective than hydrogen peroxide (all at 10 mM). This phytochemical caused significant changes in bacterial membrane hydrophilicity. The observed effectiveness of phytochemicals makes them interesting alternatives and/or complementary products to commonly used biocidal products. Cinnamic acid is of particular interest for the control of sessile cells.
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Affiliation(s)
- J Malheiro
- a LEPABE, Department of Chemical Engineering, Faculty of Engineering of University of Porto , Porto , Portugal
- b CIQUP, Department of Chemistry and Biochemistry, Faculty of Sciences University of Porto , Porto , Portugal
- c Cardiff School of Pharmacy and Pharmaceutical Sciences, Cardiff University , Cardiff , UK
| | - I Gomes
- a LEPABE, Department of Chemical Engineering, Faculty of Engineering of University of Porto , Porto , Portugal
| | - A Borges
- a LEPABE, Department of Chemical Engineering, Faculty of Engineering of University of Porto , Porto , Portugal
- b CIQUP, Department of Chemistry and Biochemistry, Faculty of Sciences University of Porto , Porto , Portugal
| | - M M S M Bastos
- a LEPABE, Department of Chemical Engineering, Faculty of Engineering of University of Porto , Porto , Portugal
| | - J-Y Maillard
- c Cardiff School of Pharmacy and Pharmaceutical Sciences, Cardiff University , Cardiff , UK
| | - F Borges
- b CIQUP, Department of Chemistry and Biochemistry, Faculty of Sciences University of Porto , Porto , Portugal
| | - M Simões
- a LEPABE, Department of Chemical Engineering, Faculty of Engineering of University of Porto , Porto , Portugal
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Cardoso B, Laranjo S, Gomes I, Freitas I, Trigo C, Fragata I, Fragata J, Pinto FF. Acute kidney injury after pediatric cardiac surgery: Risk factors and outcomes. Proposal for a predictive model. Revista Portuguesa de Cardiologia (English Edition) 2016. [DOI: 10.1016/j.repce.2016.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Cardoso B, Laranjo S, Gomes I, Freitas I, Trigo C, Fragata I, Fragata J, Pinto F. [Acute kidney injury after pediatric cardiac surgery: risk factors and outcomes. Proposal for a predictive model]. Rev Port Cardiol 2016; 35:99-104. [PMID: 26831910 DOI: 10.1016/j.repc.2015.06.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 06/24/2015] [Accepted: 06/25/2015] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES To characterize the epidemiology and risk factors for acute kidney injury (AKI) after pediatric cardiac surgery in our center, to determine its association with poor short-term outcomes, and to develop a logistic regression model that will predict the risk of AKI for the study population. METHODS This single-center, retrospective study included consecutive pediatric patients with congenital heart disease who underwent cardiac surgery between January 2010 and December 2012. Exclusion criteria were a history of renal disease, dialysis or renal transplantation. RESULTS Of the 325 patients included, median age three years (1 day-18 years), AKI occurred in 40 (12.3%) on the first postoperative day. Overall mortality was 13 (4%), nine of whom were in the AKI group. AKI was significantly associated with length of intensive care unit stay, length of mechanical ventilation and in-hospital death (p<0.01). Patients' age and postoperative serum creatinine, blood urea nitrogen and lactate levels were included in the logistic regression model as predictor variables. The model accurately predicted AKI in this population, with a maximum combined sensitivity of 82.1% and specificity of 75.4%. CONCLUSIONS AKI is common and is associated with poor short-term outcomes in this setting. Younger age and higher postoperative serum creatinine, blood urea nitrogen and lactate levels were powerful predictors of renal injury in this population. The proposed model could be a useful tool for risk stratification of these patients.
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Affiliation(s)
- Bárbara Cardoso
- Serviço de Cardiologia Pediátrica, Hospital Santa Marta - Centro Hospitalar de Lisboa Central, Lisboa, Portugal.
| | - Sérgio Laranjo
- Serviço de Cardiologia Pediátrica, Hospital Santa Marta - Centro Hospitalar de Lisboa Central, Lisboa, Portugal
| | - Inês Gomes
- Serviço de Cardiologia Pediátrica, Hospital Santa Marta - Centro Hospitalar de Lisboa Central, Lisboa, Portugal
| | - Isabel Freitas
- Serviço de Cardiologia Pediátrica, Hospital Santa Marta - Centro Hospitalar de Lisboa Central, Lisboa, Portugal
| | - Conceição Trigo
- Serviço de Cardiologia Pediátrica, Hospital Santa Marta - Centro Hospitalar de Lisboa Central, Lisboa, Portugal
| | - Isabel Fragata
- Serviço de Anestesiologia, Hospital de Santa Marta - Centro Hospitalar de Lisboa Central, Lisboa, Portugal
| | - José Fragata
- Serviço de Cirurgia Cardiotorácica, Hospital de Santa Marta - Centro Hospitalar de Lisboa Central, Lisboa, Portugal
| | - Fátima Pinto
- Serviço de Cardiologia Pediátrica, Hospital Santa Marta - Centro Hospitalar de Lisboa Central, Lisboa, Portugal
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48
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Sirker M, Liang W, Zhang L, Fimmers R, Rothschild M, Gomes I, Schneider P. Impact of using validated or standard reference genes for miRNA qPCR data normalization in cell type identification. Forensic Science International: Genetics Supplement Series 2015. [DOI: 10.1016/j.fsigss.2015.09.080] [Citation(s) in RCA: 4] [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: 01/22/2023]
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49
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Liapi E, Rothschild M, Schneider P, Gomes I. Effect of RNA integrity on reference gene expression stability in human post-mortem wounded and normal skin. Forensic Science International: Genetics Supplement Series 2015. [DOI: 10.1016/j.fsigss.2015.09.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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50
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Haas C, Hanson E, Banemann R, Bento A, Berti A, Carracedo Á, Courts C, Cock GD, Drobnic K, Fleming R, Franchi C, Gomes I, Hadzic G, Harbison S, Hjort B, Hollard C, Hoff-Olsen P, Keyser C, Kondili A, Maroñas O, McCallum N, Miniati P, Morling N, Niederstätter H, Noël F, Parson W, Porto M, Roeder A, Sauer E, Schneider P, Shanthan G, Sijen T, Syndercombe Court D, Turanská M, van den Berge M, Vennemann M, Vidaki A, Zatkalíková L, Ballantyne J. RNA/DNA co-analysis from human skin and contact traces – results of a sixth collaborative EDNAP exercise. Forensic Sci Int Genet 2015; 16:139-147. [DOI: 10.1016/j.fsigen.2015.01.002] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Revised: 12/12/2014] [Accepted: 01/04/2015] [Indexed: 11/25/2022]
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