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Sousa B, Nunes J, Ribeiro AF. Single-centre case series report of regional anaesthesia for pain management in vaso-occlusive crisis. Indian J Anaesth 2024; 68:394-396. [PMID: 38586271 PMCID: PMC10993944 DOI: 10.4103/ija.ija_768_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 12/30/2023] [Accepted: 12/31/2023] [Indexed: 04/09/2024] Open
Abstract
Sickle cell disease is characterised by episodes of vaso-occlusive crisis, a painful complication. Regional anaesthesia has shown promising results in reducing opioid consumption and pain scores. Patients with vaso-occlusive crises who underwent regional anaesthesia in the paediatric intensive care unit were studied. Data regarding pain location, regional analgesia technique, the local anaesthetic used and dose, daily opioid consumption, daily pain scores, use of adjuvants and complications were recorded. The primary outcome was to evaluate the effect of regional anaesthesia on opioid consumption. In this study, we describe 10 cases, referring to six paediatric patients with the vaso-occlusive crisis who underwent regional anaesthesia for severe pain and were unresponsive to increasing doses of opioids. Six cases received epidural analgesia, three continuous peripheral nerve blocks and one received both techniques. Opioid consumption was reduced (58%), and pain scores decreased (72%), both statistically significant reductions.
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Affiliation(s)
- Bárbara Sousa
- Department of Anesthesiology, Hospital Professor Dr. Fernando Fonseca, Portugal
| | - Joana Nunes
- Department of Anesthesiology, Hospital Professor Dr. Fernando Fonseca, Portugal
| | - Andreia Fiúza Ribeiro
- Pediatric Special Intensive Care Unit, Hospital Professor Dr. Fernando Fonseca, Portugal
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Hierro F, Tomé ML, Grenha J, Santos H, Santos F, Nunes J. Molybdenum Cofactor Deficiency in the Neonate: Expanding the Phenotype. Pediatr Neurol 2024; 153:113-115. [PMID: 38367485 DOI: 10.1016/j.pediatrneurol.2024.01.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 12/24/2023] [Accepted: 01/22/2024] [Indexed: 02/19/2024]
Affiliation(s)
- Fátima Hierro
- Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.
| | - Maria Luís Tomé
- Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Joana Grenha
- Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Helena Santos
- Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Fátima Santos
- Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Joana Nunes
- Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
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Catarino S, Nunes J, Ganhão S, Aguiar F, Rodrigues M, Brito I. Application of the new PRINTO classification criteria for juvenile idiopathic arthritis in a sample of Portuguese patients. ARP Rheumatol 2024; 3:11-17. [PMID: 38558063 DOI: 10.63032/jxnd6393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2024]
Abstract
BACKGROUND The International League of Associations for Rheumatology (ILAR) classification system for juvenile idiopathic arthritis (JIA) does not depict homogenous subgroups of disease. As to unify our language with the adult rheumatic diseases, the Pediatric Rheumatology International Trials Organization (PRINTO) is attempting to revise these criteria. OBJECTIVE To reclassify a JIA sample according to the new provisional PRINTO subsets: systemic JIA (sJIA), RF-positive JIA (RF-JIA), early-onset ANA-positive JIA (eoANA-JIA), enthesitis/spondylitis-related JIA (ESR-JIA), "other JIA" and "unclassified JIA". METHODS Retrospective study including JIA patients followed in a Pediatric Rheumatology Unit at a university hospital. Medical records were reviewed, and patients were reclassified as per the provisional PRINTO criteria. RESULTS Of a total of 104 patients, 41 (39.4%) were reclassified as "other JIA", 36 (34.6%) as eoANA-JIA, 15 (14.4%) as ESR-JIA, 8 (7.7%) as sJIA and 4 (3.8%) as RF-JIA. More than 90% of the oligoarticular JIA were reclassified into either eoANA-JIA or "other JIA". Only one negative RF polyarticular JIA converted to RF-JIA due to the presence of a positive anti-citrulinated peptide antibody (ACPA). The psoriatic arthritis (PsA) subgroup disappeared into eoANA-JIA (25%), ESR-JIA (25%) or "other JIA" (50%). There were significant differences in age of onset, but not on the gender ratio or uveitis presence. Antinuclear antibody was more frequent in females (p=0.035) and younger patients (p<0.001). CONCLUSION The number of affected joints and PsA features elapsed in favour of laboratory RF, ACPA and ANA traits. PsA and oligoarticular JIA were abolished. The "other JIA" entity is heterogenous and prevalent, claiming reformulation.
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Affiliation(s)
- Sara Catarino
- Pediatrics Department, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Joana Nunes
- Pediatrics Department, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Sara Ganhão
- Pediatric and Young Adult Rheumatology Unit, Pediatrics Department, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Francisca Aguiar
- Pediatric and Young Adult Rheumatology Unit, Pediatrics Department, Centro Hospitalar Universitário São João, Porto; Faculty of Medicine, University of Porto, Portugal
| | - Mariana Rodrigues
- Pediatric and Young Adult Rheumatology Unit, Pediatrics Department, Centro Hospitalar Universitário São João, Porto; Faculty of Medicine, University of Porto, Portugal
| | - Iva Brito
- Pediatric and Young Adult Rheumatology Unit, Pediatrics Department, Centro Hospitalar Universitário São João, Porto; Faculty of Medicine, University of Porto, Portugal
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Hierro F, Nunes J, Fontão L. Teaching NeuroImage: Pneumorrhachis and Paraplegia After Spinal Anesthesia. Neurology 2023; 101:e1833-e1834. [PMID: 37596044 PMCID: PMC10634640 DOI: 10.1212/wnl.0000000000207824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 07/12/2023] [Indexed: 08/20/2023] Open
Affiliation(s)
- Fátima Hierro
- From the Neuroradiology Department (F.H.), Hospital Pedro Hispano, Senhora da Hora; Imagiology Department (J.N.), Centro Hospitalar de Vila Nova de Gaia/Espinho; and Neurology Department (L.F.), Centro Hospitalar de entre Douro e Vouga, Santa Maria da Feira, Portugal.
| | - Joana Nunes
- From the Neuroradiology Department (F.H.), Hospital Pedro Hispano, Senhora da Hora; Imagiology Department (J.N.), Centro Hospitalar de Vila Nova de Gaia/Espinho; and Neurology Department (L.F.), Centro Hospitalar de entre Douro e Vouga, Santa Maria da Feira, Portugal
| | - Luis Fontão
- From the Neuroradiology Department (F.H.), Hospital Pedro Hispano, Senhora da Hora; Imagiology Department (J.N.), Centro Hospitalar de Vila Nova de Gaia/Espinho; and Neurology Department (L.F.), Centro Hospitalar de entre Douro e Vouga, Santa Maria da Feira, Portugal
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Nunes J, Fettem S, Tahri S, Macke L, Chourak H, Barateau A, Lafond C, de Crevoisier R, Bessieres I, Marage L, Acosta O. PO-1611 Evaluation of synthetic-CT generated from prostate MRI (0.35T) with a 2D+ Pix2Pix method. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03575-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Nunes J, Macque L, Tahri S, Fettem S, Chourak H, Barateau A, Lafond C, de Crevoisier R, Acosta O, Bessieres I, Marage L. PO-1615 Evaluation of prostate synthetic CTs from 0.35T MR images using different deep training cohort sizes. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03579-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Chourak H, Barateau A, Cadin C, Lafond C, Nunes J, De Crevoiser R, Dowling J, Greer P, Acosta O. PO-1683 Spatial Characterization of errors in pseudo-CT generation for MRI-only radiotherapy. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)08134-2] [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: 11/24/2022]
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Tahri S, Cadin C, Chourak H, Barateau A, Ribault S, Acosta O, Greer P, Dawling J, Lafond C, De Crevoisier R, Nunes J. PO-1677 cGAN-based pseudo-CT generation for prostate MRI-only radiotherapy. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)08128-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Cortez-Pinto H, Liberal R, Lopes S, Machado MV, Carvalho J, Dias T, Santos A, Agostinho C, Figueiredo P, Loureiro R, Martins A, Alexandrino G, Cotrim I, Leal C, Presa J, Mesquita M, Nunes J, Gouveia C, Vale AHE, Alves AL, Coelho M, Maia L, Pedroto I, Banhudo A, Pinto JS, Gomes MV, Oliveira J, Andreozzi V, Calinas F. Predictors for incomplete response to ursodeoxycholic acid in primary biliary cholangitis. Data from a national registry of liver disease. United European Gastroenterol J 2021; 9:699-706. [PMID: 34102008 PMCID: PMC8280809 DOI: 10.1002/ueg2.12095] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 03/28/2021] [Indexed: 12/11/2022] Open
Abstract
Background The current standard of treatment in primary biliary cholangitis (PBC) is ursodeoxycholic acid (UDCA), although a considerable proportion of patients show incomplete response resulting in disease progression. Objective This study aimed to assess the prevalence of incomplete response to UDCA and determine associated patients' characteristics. Methods Patients with PBC as main diagnosis were included from a national multicentric patient registry—Liver.pt. Main endpoints included incomplete response to UDCA treatment according to Barcelona, Paris I and Paris II criteria, Globe and UK PBC scores and the association between baseline characteristics and incomplete response according to Paris II criteria. Results A total of 434 PBC patients were identified, with a mean age of 55 years and 89.2% females. Nearly half of patients were asymptomatic at diagnosis and 93.2% had positive anti‐mitochondrial antibodies. Almost all patients (95.6%) had been prescribed at least one drug for PBC treatment. At the last follow‐up visit, 93.3% were under treatment of which 99.8% received UDCA. Incomplete response to UDCA was observed in 30.7%, 35.3%, 53.7% and 36.4% of patients according to Barcelona, Paris I, Paris II criteria and Globe score, respectively. After adjusting for age and sex, and accordingly to Paris II criteria, the risk for incomplete biochemical response was 25% higher for patients with cirrhosis at diagnosis (odds ratio [OR] = 1.25; 95% confidence interval [95%CI]: 1.02–1.54; p = 0.033) and 35% (95%CI:1.06–1.72; p = 0.016) and 5% (OR = 1.05; 95%CI:1.01–1.10; p = 0.013) for those with elevated gamma‐glutamyl transferase (GGT) and alkaline phosphatase (ALP). Conclusion A considerable proportion of patients showed incomplete biochemical response to UDCA treatment according to Paris II criteria. Cirrhosis, elevated GGT and ALP at diagnosis were identified as associated risk factors for incomplete response. Early identification of patients at risk of incomplete response could improve treatment care and guide clinical decision to a more careful patient monitorization.
Summarise the established knowledge on this subject
Primary biliary cholangitis is a liver disease that can progress to end‐stage liver disease, with premature death or need for liver transplantation. Treatment with ursodeoxycholic acid (UDCA) significantly increases liver transplant‐free survival. However, incomplete response to UDCA reduces this beneficial effect.
What are the significant and/or new findings of this study?
By evaluating prevalence and risk factors for UDCA incomplete response through a large multicentric national registry it was found that 53.7% of patients were incomplete responders, according to Paris II criteria, with cirrhosis, elevated gamma‐glutamyl transferase and alkaline phosphatase at diagnosis as the main risk factors. These findings suggest that patients diagnosed at an advanced stage should be closely monitored and might benefit from novel therapies to improve outcomes if incomplete response is present.
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Affiliation(s)
- Helena Cortez-Pinto
- Clínica Universitária de Gastrenterologia, Departamento de Gastrenterologia, Faculdade de Medicina, Universidade de Lisboa, Centro Hospitalar Lisboa Norte, Lisboa, Portugal
| | - Rodrigo Liberal
- Gastroenterology Department, Centro Hospitalar e Universitário São João, Porto, Portugal.,Gastroenterology Department, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Susana Lopes
- Gastroenterology Department, Centro Hospitalar e Universitário São João, Porto, Portugal.,Gastroenterology Department, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Mariana V Machado
- Clínica Universitária de Gastrenterologia, Departamento de Gastrenterologia, Faculdade de Medicina, Universidade de Lisboa, Centro Hospitalar Lisboa Norte, Lisboa, Portugal.,Gastroenterology Department, Hospital Vila Franca de Xira, Vila Franca de Xira, Portugal
| | - Joana Carvalho
- Clínica Universitária de Gastrenterologia, Departamento de Gastrenterologia, Faculdade de Medicina, Universidade de Lisboa, Centro Hospitalar Lisboa Norte, Lisboa, Portugal
| | - Teresa Dias
- Department of Internal Medicine, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Arsénio Santos
- Department of Internal Medicine, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Cláudia Agostinho
- Gastroenterology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Pedro Figueiredo
- Gastroenterology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Rafaela Loureiro
- Gastroenterology Department, Central Lisbon Hospital Centre, Lisboa, Portugal
| | - Alexandra Martins
- Gastroenterology Department, Hospital Prof. Doutor Fernando da Fonseca, Lisboa, Portugal
| | - Gonçalo Alexandrino
- Gastroenterology Department, Hospital Prof. Doutor Fernando da Fonseca, Lisboa, Portugal
| | - Isabel Cotrim
- Gastroenterology Department, Centro Hospitalar de Leiria, Leiria, Portugal
| | - Carina Leal
- Gastroenterology Department, Centro Hospitalar de Leiria, Leiria, Portugal
| | - José Presa
- Internal Medicine Department, Liver Unit, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - Mónica Mesquita
- Internal Medicine Department, Liver Unit, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - Joana Nunes
- Gastroenterology Department, Hospital Beatriz Ângelo, Lisboa, Portugal
| | - Catarina Gouveia
- Gastroenterology Department, Hospital Beatriz Ângelo, Lisboa, Portugal
| | | | - Ana Luísa Alves
- Gastroenterology Department, Centro Hospitalar de Setúbal, Setúbal, Portugal
| | - Mariana Coelho
- Gastroenterology Department, Centro Hospitalar de Setúbal, Setúbal, Portugal
| | - Luís Maia
- Gastroenterology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Isabel Pedroto
- Gastroenterology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - António Banhudo
- Gastroenterology Department, Unidade Local de Saúde Castelo Branco, Castelo Branco, Portugal
| | - João Sebastião Pinto
- Gastroenterology Department, Unidade Local de Saúde Castelo Branco, Castelo Branco, Portugal
| | | | | | | | - Filipe Calinas
- Gastroenterology Department, Central Lisbon Hospital Centre, Lisboa, Portugal
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Carvalho M, Leal F, Mota S, Aguiar A, Sousa S, Nunes J, Calhaz-Jorge C. The effect of denudation and injection timing in the reproductive outcomes of ICSI cycles: new insights into the risk of in vitro oocyte ageing. Hum Reprod 2021; 35:2226-2236. [PMID: 32951048 DOI: 10.1093/humrep/deaa211] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 01/12/2020] [Revised: 07/23/2020] [Indexed: 12/30/2022] Open
Abstract
STUDY QUESTION Does the time elapsed between oocyte pick-up (OPU) and denudation or injection affect the probability of achieving a live birth (LB) in ICSI cycles? SUMMARY ANSWER Prolonged oocyte culture before denudation (>4 h) was associated with an increase in clinical pregnancy (CP), LB and cumulative LB (CLB) rates when compared with earlier denudation timings. WHAT IS KNOWN ALREADY Oocyte maturation is a complex and dynamic process involving structural and biochemical modifications in the cell necessary to support fertilization and early embryo development. While meiotic competence is easily identifiable by the presence of an extruded first polar body, cytoplasmic maturation cannot be assessed microscopically. Culturing oocytes with their surrounding cumulus cells (CCs) prior to ICSI can enhance the completion of in vitro cytoplasmic maturation; conversely, prolonged culture may induce cell degeneration. The optimal culture intervals prior to oocyte denudation and/or injection have not yet been established and may prove relevant for the improvement of ICSI reproductive outcomes. STUDY DESIGN, SIZE, DURATION This is a single-centre retrospective cohort analysis of 1378 ICSI cycles performed between January 2005 and October 2018. Data were categorized according to: (i) the time interval between OPU and denudation (<3 h, 3-4 h and ≥4 h), (ii) the time interval between denudation and ICSI (<1.5 h, 1.5-2 h, ≥2 h) and (iii) the time interval between OPU and ICSI (<5 h, 5-6 h and ≥6 h). The effect of these timings on fertilization, CP, LB and CLB rates were compared. The culture intervals between different procedures were dependent exclusively on laboratory workload. PARTICIPANTS/MATERIALS, SETTING, METHODS ICSI cycles performed in women younger than 40 years old using autologous gametes with at least one metaphase II injected oocyte were included. The effect of oocyte culture duration prior to denudation and injection of the oocytes was compared using multivariable regression accounting for potential confounding variables. MAIN RESULTS AND THE ROLE OF CHANCE Fertilization and oocyte damage rate after ICSI was found to be independent of the time interval to denudation (<3 h, 3-4 h and ≥4 h) and/or injection (<5 h, 5-6 h and ≥6 h). Extending oocyte culture before denudation significantly improved CP (29.5%, 42.7% and 50.6%, respectively), LB (25.1%, 34.4% and 40.7%, respectively) and CLB rates (26.0%, 36.1% and 42.2%, respectively), particularly if the time interval was at least 4 h. Additionally, LB (31.7%, 35.8% and 27.4%, respectively) and CLB rates (34.2%, 36.6% and 27.7%, respectively) were also dependent on the time from OPU to injection. LIMITATIONS, REASONS FOR CAUTION This study is limited by its retrospective nature and potential unmeasured confounding cannot be excluded. Furthermore, the effect of even shorter or longer periods of culture before denudation and/or injection were not evaluated and should not be extrapolated from these results. WIDER IMPLICATIONS OF THE FINDINGS Our findings propose new evidence of a previously unrecognized protective effect of the CCs-oocyte interactions in human ART, raising the question of a possible downstream effect in embryogenesis which significantly affects LB rates. Additionally, this is the first study to suggest a negative effect of further extending culture before ICSI on LB and CLB rates, thus potentially allowing for the narrowing of an optimal ICSI time interval. Simple strategies such as the establishment of more effective time frames to perform these procedures and adjusting laboratory practice may prove beneficial, ultimately improving ICSI reproductive outcomes. STUDY FUNDING/COMPETING INTEREST(S) None. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- M Carvalho
- Reproductive Medicine Unit, Department of Obstetrics, Gynaecology and Reproductive Medicine, Santa Maria University Hospital, Lisbon, Portugal
| | - F Leal
- Reproductive Medicine Unit, Department of Obstetrics, Gynaecology and Reproductive Medicine, Santa Maria University Hospital, Lisbon, Portugal
| | - S Mota
- Reproductive Medicine Unit, Department of Obstetrics, Gynaecology and Reproductive Medicine, Santa Maria University Hospital, Lisbon, Portugal
| | - A Aguiar
- Reproductive Medicine Unit, Department of Obstetrics, Gynaecology and Reproductive Medicine, Santa Maria University Hospital, Lisbon, Portugal
| | - S Sousa
- Reproductive Medicine Unit, Department of Obstetrics, Gynaecology and Reproductive Medicine, Santa Maria University Hospital, Lisbon, Portugal
| | - J Nunes
- Reproductive Medicine Unit, Department of Obstetrics, Gynaecology and Reproductive Medicine, Santa Maria University Hospital, Lisbon, Portugal
| | - C Calhaz-Jorge
- Reproductive Medicine Unit, Department of Obstetrics, Gynaecology and Reproductive Medicine, Santa Maria University Hospital, Lisbon, Portugal.,Faculdade de Medicina da Universidade de Lisboa,, Lisbon, Portugal
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Ferreira SS, Mesquita M, Nunes J, Alonso I, Leão M, Santos F, Real MV. Rett-like Syndrome in a Pediatric Patient—A Challenging Diagnosis. Journal of Pediatric Neurology 2021. [DOI: 10.1055/s-0040-1714105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
AbstractNeurodevelopmental disorders with features overlapping Rett's syndrome frequently remain unexplained in patients without disease-causing variants in MECP2. Variants in IQSEC2 frequently cause nonsyndromic X-linked intellectual disability (XLID), although de novo variants may cause a severe syndrome that resembles Rett and Angelman's syndrome. We report a 7-year-old girl presenting severe neurodevelopmental delay, stereotypic hand movements, hypotonia, autistic-like features, inappropriate laughing/screaming spells, and symmetrical hypomyelination. A whole exome sequencing detected a novel de novo heterozygous truncating variant within the IQSEC2 gene. Variants of IQSEC2 should be considered in patients with Rett–Angelman phenotype spectrum and autistic features when those causes were excluded.
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Affiliation(s)
- Sofia Simões Ferreira
- Department of Pediatrics, Centro Hospitalar de Vila Nova de Gaia/Espinho, EPE, Vila Nova de Gaia, Portugal
| | - Marta Mesquita
- Department of Paediatrics, Centro Hospitalar Baixo Vouga, Aveiro, Portugal
| | - Joana Nunes
- Division of Neuroradiology, Department of Imaging, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Isabel Alonso
- UnIGENe and CGPP, IBMC - Institute for Molecular and Cell Biology, i3S - Instituto de Investigação e Inovação em Saúde, University of Porto, Genetyca-ICM, Porto, Portugal
| | - Miguel Leão
- Pediatric Neurology Unit, Department of Paediatrics, Centro Hospitalar Universitário São João, Porto, Portugal
- Neurogenetics Unit, Department of Medical Genetics, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Fátima Santos
- Neuroscience Unit for Children and Adolescents, Department of Paediatrics, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Marta Vila Real
- Neuroscience Unit for Children and Adolescents, Department of Paediatrics, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
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Carvalho A, Nunes J, Taipa R, Melo Pires M, Pinto Basto J, Barros P. Adult polyglucosan body disease-an atypical compound heterozygous with a novel GBE1 mutation. Neurol Sci 2021; 42:2955-2959. [PMID: 33517539 DOI: 10.1007/s10072-021-05096-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 01/27/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Adult polyglucosan body disease (APBD) is an autosomal recessive leukodystrophy characterized by neurogenic bladder starting after 40 years old, spastic paraparesis and peripheral neuropathy. It is mainly resultant from the GBE1 homozygous p.Tyr329Ser (c.986A>C) mutation, especially in Ashkenazi-Jewish patients, although some cases of compound heterozygous have been reported. A genotype-phenotype correlation is not established, but atypical phenotypes have been described mainly in non-p.Tyr329Ser pathogenic variants. CASE REPORT We describe an atypical case in a 62-year-old Portuguese woman, presenting the typical clinical triad of APBD plus prominent autonomic dysfunction, suggested by orthostatic hypotension and thermoregulatory dysfunction; she has compound heterozygous GBE1 mutations, namely, p.Asn541Asp (c.1621A>G) and p.Arg515Gly (c.1543C>G), the last one not yet reported in literature and whose pathogenicity was suggested by bioinformatics analysis and confirmed by sural nerve biopsy that showed intra-axonal polyglucosan bodies. DISCUSSION Besides the report of a novel GBE1 mutation, this case also expands the phenotypic spectrum of this disorder, reinforcing autonomic dysfunction as a possible and prominent manifestation of APBD, mimicking autosomal dominant leukodystrophy with autonomic disease in some way. Therefore, we questioned a possible relationship between this genotype and the phenotype marked by dysautonomia. Additionally, we review previously reported cases of APBD in non-homozygous p.Tyr329Ser patients with atypical phenotypes.
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Affiliation(s)
- Andreia Carvalho
- Neurology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.
| | - Joana Nunes
- Neuroradiology Unit, Imagiology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Ricardo Taipa
- Neuropathology Unit, Hospital de Santo António - Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Manuel Melo Pires
- Neuropathology Unit, Hospital de Santo António - Centro Hospitalar Universitário do Porto, Porto, Portugal
| | | | - Pedro Barros
- Neurology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
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Tenente J, Gaia M, Stella L, Nunes J, Vila-Real M, Santos F. Sudden thoracic pain and paraplegia: a case of spinal cord infarction. Rev Neurol 2021; 72:221-222. [PMID: 33710612 DOI: 10.33588/rn.7206.2020598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- J Tenente
- Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - M Gaia
- Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - L Stella
- Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - J Nunes
- Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - M Vila-Real
- Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - F Santos
- Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
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14
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Stephane K, Houssayni A, Cassard U, Barateau A, Duvergé L, Largent A, Acosta O, Nunes J, Messai T, Simon A, Dowling J, Perichon N, De Crevoisier R. PO-1484: MRI only based planning to decrease toxicity in prostate cancer IMRT/IGRT: a dosimetric study. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01502-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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15
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Geraldo AF, Leitão C, Nunes J, Vila-Real M. Partially reversible confluent white matter lesions in a Caucasian child with moyamoya disease. Childs Nerv Syst 2020; 36:2605-2608. [PMID: 32754868 DOI: 10.1007/s00381-020-04854-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 07/30/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Ana Filipa Geraldo
- Department of Medical Imaging, Diagnostic Neuroradiology Unit, CHVNG/E- Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.
| | - Cátia Leitão
- Department of Pediatrics, CHVNG/E- Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Joana Nunes
- Department of Medical Imaging, Diagnostic Neuroradiology Unit, CHVNG/E- Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Marta Vila-Real
- Department of Pediatrics, CHVNG/E- Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
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16
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Miranda J, Pereira I, Nunes J, Santos F. Encefalitis/encefalopatía leve con lesión reversible del esplenio del cuerpo calloso asociada a pielonefritis aguda; a propósito de un caso clínico. Neurologia 2020; 35:530-534. [DOI: 10.1016/j.nrl.2018.07.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 06/11/2018] [Accepted: 07/09/2018] [Indexed: 11/29/2022] Open
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17
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Gouveia C, Flor de Lima M, Pereira F, Rosa B, Cotter J, Banhudo A, Duarte M, Ferreira A, Cravo M, Nunes J. Should patients with symptomatic cholelithiasis before 30 years of age be tested for ABCB4 gene mutations? Scand J Gastroenterol 2020; 55:958-962. [PMID: 32650689 DOI: 10.1080/00365521.2020.1790648] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND AIMS Low phospholipid-associated cholelithiasis syndrome (LPAC) is characterized by recurrent symptomatic cholelithiasis in young adults associated with ABCB4 gene mutations. Current diagnosing criteria are complex and heterogeneous, making this a largely underdiagnosed entity. Also, although recommended, genetic testing is not necessary for the diagnosis and its real advantages are not clear. The aim of our study was to explore the prevalence of ABCB4 mutations in symptomatic patients with cholelithiasis before the age of 30. METHODS We conducted a multicentric prospective cohort study including patients with symptomatic cholelithiasis presenting before 30 years of age in 4 Portuguese centres between January 2017 and December 2019. ABCB4 gene was analyzed by next generation sequencing (NGS) including all exons and flanking regions. In 17/32 patients ABCB11 and ATP8B1 variants were also analyzed by NGS. RESULTS Thirty-two patients were included (75% females, median age of symptom onset was 23 ± 5 years). We found that 8/32 (25%) patients had mutations in ABCB4 gene, 3/17 (18%) in ATP8B1 gene and 1/17 (6%) in ABCB11 gene. 44% (8/18) of patients with LPAC syndrome criteria had identified variants, while the prevalence of mutations in patients with symptoms onset before 30 as sole criteria was 29%. CONCLUSION Our results suggest that LPAC should be systematically suspected and investigated in patients with symptomatic cholelithiasis before age of thirty, but genetic testing should only be attempted in patients complying with the more stringent LPAC criteria.
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Affiliation(s)
| | | | - Flávio Pereira
- Gastroenterology Department, Hospital Amato Lusitano, Castelo Branco
| | - Bruno Rosa
- Gastroenterology Department, Hospital da Senhora da Oliveira, Guimarães.,Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Guimarães.,ICVS/3B's, PT Government Associate Laboratory, Braga, Guimarães
| | - José Cotter
- Gastroenterology Department, Hospital da Senhora da Oliveira, Guimarães.,Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Guimarães.,ICVS/3B's, PT Government Associate Laboratory, Braga, Guimarães
| | - António Banhudo
- Gastroenterology Department, Hospital Amato Lusitano, Castelo Branco
| | - Maria Duarte
- Gastroenterology Department, Hospital do Divino Espírito Santo, Ponta Delgada
| | | | - Marília Cravo
- Gastroenterology Department, Hospital Beatriz Ângelo, Loures
| | - Joana Nunes
- Gastroenterology Department, Hospital Beatriz Ângelo, Loures
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18
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Seixas A, Jin P, Liu M, Nunes J, Grandner M, Rogers A, McFarlane S, Jean-Louis G. 1062 The Role of Sleep in Sex and Racial/Ethnic Differences in 10-Year CVD Risk in the Sleep Heart Health Study: The Use of Machine-Learnt and Precision Insights to Understand Racial/Ethnic and Sex Differences in Sleep-CVD Disparity. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.1058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
The current study investigated whether insufficient sleep (<7 hrs.) explains differences in 10-year CVD risk, using Framingham risk (FRS) and Reynolds risk (RRS) scores, between blacks and whites and characterized risk and protective CVD risk profiles.
Methods
Using the Sleep Heart Health Study (SHHS) (N=6,441) data, we investigated the independent role of insufficient sleep in explaining differences in 10-years CVD between blacks and whites via a proportional odds model of four 10-year CVD risk groups: low (<5%), low-medium (5% to <10%), medium-high (10% to <20%) and high (≥20%), adjusting for age, sex, and apnea-hypopnea index (AHI). We performed two levels of cluster analyses; via hierarchical cluster algorithm with entire sample (Level 1), and latent profiles in the low (protective profiles) and high (risk profiles) CVD risk groups (Level 2) to determine overall CVD risk, and risk and protective CVD profiles.
Results
Blacks had a higher prevalence of smoking behavior, diabetes, mean systolic blood pressure, body mass index, total cholesterol compared to whites. Conversely, whites had a higher mean HDL cholesterol, sleep hours, and sleep efficiency compared to blacks. Men had higher 10-year CVD risk than women. AHI and race/ethnicity-sleep interaction were positively associated, while sleep was negatively associated with FRS and RRS. Across all CVD risk groups, whites who slept less than 5.5 hrs. had a higher CVD risk and those who slept more than 6.5 hrs. had a lower CVD risk compared to blacks. In Level 1 cluster analyses, we found two clusters: Cluster 1 (n= 3233): 6.17 sleep hours, apnea-index 11.84, age 59, SBP 125.43, total cholesterol 209, HDL 51.39, BMI 29.03, and slightly more than 50% female; and Cluster 2 (n=1657): 5.61 sleep hours, apnea-index 13.41, age 74, SBP 131, total cholesterol 204, HDL 50.30, BMI 26.45, and slightly less than 50% female. In Level 2 cluster analyses, we found two profiles within the low and high CVD risk groups.
Conclusion
These findings suggest that blacks may not receive full protection from long-term CVD risk with longer sleep duration, as their white counterparts.
Support
K01HL135452, R01MD007716, R01HL142066, K07AG052685
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Affiliation(s)
- A Seixas
- NYU Grossman School of Medicine, New York, NY
| | - P Jin
- NYU Grossman School of Medicine, New York, NY
| | - M Liu
- NYU Grossman School of Medicine, New York, NY
| | - J Nunes
- City University of New York School of Medicine, New York, NY
| | - M Grandner
- University of Arizona College of Medicine, Tuscon, AZ
| | - A Rogers
- St. John’s University, Queens, NY
| | - S McFarlane
- State University of New York, Downstate Health Science University, New York, NY
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19
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Aird C, Seixas A, Moore J, Nunes J, Gyamfi L, Garcia J, Blanc J, Williams N, Zizi F, Jean-Louis G. 1189 Recruiting, Training, And Implementing Sleep Health Educators In Community-based Research To Improve Sleep Health. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.1183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Introduction
Adherence to OSA assessment and treatment is low among racial/ethnic minorities, particularly among blacks. Navigating patients along the continuum of care from assessment to treatment adherence requires motivation, social support, and self-efficacy. Previous studies indicate that community health educators can provide motivation, social support, and skills to patients to better navigate the complex OSA care continuum. However, recruiting, training, and implementing sleep health educators in clinical or research settings is complex. For the current study, we describe how we recruit, train, and implement sleep health educators in research and clinical settings and assess what makes a sleep health educator successful.
Methods
We recruited and trained twenty-five self-identified black sleep health educators for a randomized clinical trial (R01MD007716) focused on increasing OSA assessment and treatment adherence among blacks. During recruitment, we assessed key personality attributes that translate to being an effective sleep health educator, via behavioral and personality surveys, focused groups, and process forms filled out by educators. Sleep health educators underwent an 8-week training program on sleep health and motivational interviewing. In order to be certified, sleep health educators had to pass a written and scenario-based assessment. During the implementation phase of the trial, we assessed how many interviews each health educator conducted and whether individual characteristics were related to how many interviews.
Results
Of the trained educators, 80% were female, ranging from 25 to 58 years old. They all completed at least high school. All educators rated the program highly and were very satisfied with dispensing tailored sleep health education. Educators who displayed the highest knowledge about sleep health, provided frequent emotional and strategic support, committed to helping their assigned participants, and who rated their rapport highly with their assigned participants were most effective in getting their participant to adhere to OSA assessment and treatment.
Conclusion
Sleep health educators can be vital to increasing OSA assessment and treatment adherence among blacks. In order to ensure success, sleep health educators must undergo a thorough recruitment, training, and implementation and dissemination process.
Support
K01HL135452, R01MD007716, R01HL142066, K01HL135452,and K07AG052685
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Affiliation(s)
- C Aird
- NYU Grossman School of Medicine, New York, NY
| | - A Seixas
- NYU Grossman School of Medicine, New York, NY
| | - J Moore
- NYU Grossman School of Medicine, New York, NY
| | - J Nunes
- City College/ CUNY, New York, NY
| | - L Gyamfi
- NYU Grossman School of Medicine, New York, NY
| | - J Garcia
- NYU Grossman School of Medicine, New York, NY
| | - J Blanc
- NYU Grossman School of Medicine, New York, NY
| | - N Williams
- NYU Grossman School of Medicine, New York, NY
| | - F Zizi
- NYU Grossman School of Medicine, New York, NY
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20
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Moore J, Seixas A, Casimir G, Nunes J, Matadiaby F, Khosrof A, Jean-Louis G. 1114 Urbanicity And The Sleep-mental Health Relationship. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.1109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Inadequate sleep has been found to be associated with poor mental health. This is especially true in low-income and minority populations, who are concentrated in cities. It is not understood to what degree living in a city vs. a rural environment affects sleep and resulting mental health outcomes. This study seeks to understand how living in an urban environment affects the relationship between inadequate sleep and mental health.
Methods
The study used data from the 2018 US Behavioral Risk Factor Surveillance System (BRFSS,) a nationwide health dataset collected by telephone. Respondents were classified as living in either an urban or rural environment based on their zip code. Respondents reported hours of sleep per night and mental health status. This study classified mental health status based on whether the respondent reported one or more incidences of poor mental health in the previous 30 days.
Results
After filtration, 348,540 respondents were split into urban and rural groups. Binary logistic regression was run in each group to compare how much living in an urban environment contributed to the relationship between sleep duration and mental health. Sleep in the analysis was found to significantly contribute to both models; urban X2(15, N=295,796) = 11,485.70, p <0.001 rural X2(15, N=52,744) = 2,465.64, p <0.001. The estimated odds ratio resulted in a decrease of 13.9% [Exp(B) = 0.861] in reported poor mental health for every unit increase of sleep in the urban population, and decrease of 14.9% [Exp(B) = 0.851] in the rural population.
Conclusion
In urban and rural dwellers, sleep duration predicted poor mental health. Contrary to expectations, sleep was more strongly tied to mental health in rural than urban populations. This was true even after controlling for sex, income, and education level. Further research should seek to understand how environment affects sleep and mental health.
Support
This study was supported by funding from the NIH: R01MD007716, R01HL142066, R01AG056531, K01HL135452, and K07AG052685.
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Affiliation(s)
- J Moore
- NYU Grossman School of Medicine, New York, NY
| | - A Seixas
- NYU Grossman School of Medicine, New York, NY
| | - G Casimir
- SUNY DownState Medical Center, Brooklyn, NY
| | - J Nunes
- City College / CUNY, New York, NY
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21
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Miranda S, Correia M, Dias AG, Pestana A, Soares P, Nunes J, Lima J, Máximo V, Boaventura P. Evaluation of the role of mitochondria in the non-targeted effects of ionizing radiation using cybrid cellular models. Sci Rep 2020; 10:6131. [PMID: 32273537 PMCID: PMC7145863 DOI: 10.1038/s41598-020-63011-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 11/13/2019] [Accepted: 03/18/2020] [Indexed: 01/21/2023] Open
Abstract
Radiobiology is moving towards a better understanding of the intercellular signaling that occurs upon radiation and how its effects relate to the dose applied. The mitochondrial role in orchestrating this biological response needs to be further explored. Cybrids (cytoplasmic hybrids) are useful cell models for studying the involvement of mitochondria in cellular processes. In the present study we used cybrid cell lines to investigate the role of mitochondria in the response to radiation exposure. Cybrid cell lines, derived from the osteosarcoma human cell line 143B, harboring, either wild-type mitochondrial DNA (Cy143Bwt), cells with mitochondria with mutated DNA that causes mitochondrial dysfunction (Cy143Bmut), as well as cells without mitochondrial DNA (mtDNA) (143B-Rho0), were irradiated with 0.2 Gy and 2.0 Gy. Evaluation of the non-targeted (or bystander) effects in non-irradiated cells were assessed by using conditioned media from the irradiated cells. DNA double stranded breaks were assessed with the γH2AX assay. Both directly irradiated cells and cells treated with the conditioned media, showed increased DNA damage. The effect of the irradiated cells media was different according to the cell line it derived from: from Cy143Bwt cells irradiated with 0.2 Gy (low dose) and from Cy143Bmut irradiated with 2.0 Gy (high dose) induced highest DNA damage. Notably, media obtained from cells without mtDNA, the143B-Rho0 cell line, produced no effect in DNA damage. These results point to a possible role of mitochondria in the radiation-induced non-targeted effects. Furthermore, it indicates that cybrid models are valuable tools for radiobiological studies.
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Affiliation(s)
- Silvana Miranda
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen, 208, 4200-135, Porto, Portugal.,Ipatimup - Institute of Molecular Pathology and Immunology of the University of Porto, Rua Júlio Amaral de Carvalho 45 4200-135, Porto, Portugal.,Radiotherapy Department, Portuguese Institute of Oncology of Porto (IPO Porto), Rua Dr. António Bernardino de Almeida, 4200-072, Porto, Portugal
| | - Marcelo Correia
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen, 208, 4200-135, Porto, Portugal.,Ipatimup - Institute of Molecular Pathology and Immunology of the University of Porto, Rua Júlio Amaral de Carvalho 45 4200-135, Porto, Portugal
| | - Anabela G Dias
- Medical Physics Department, Portuguese Institute of Oncology of Porto (IPO Porto), Rua Dr. António Bernardino de Almeida, 4200-072, Porto, Portugal.,Medical Physics, Radiobiology and Radiation Protection Group. Research Center, Portuguese Institute of Oncology of Porto (IPO Porto), Rua Dr. António Bernardino de Almeida, 4200-072, Porto, Portugal
| | - Ana Pestana
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen, 208, 4200-135, Porto, Portugal.,Ipatimup - Institute of Molecular Pathology and Immunology of the University of Porto, Rua Júlio Amaral de Carvalho 45 4200-135, Porto, Portugal.,Faculty of Medicine, University of Porto, 4200 - 319, Porto, Portugal
| | - Paula Soares
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen, 208, 4200-135, Porto, Portugal.,Ipatimup - Institute of Molecular Pathology and Immunology of the University of Porto, Rua Júlio Amaral de Carvalho 45 4200-135, Porto, Portugal.,Faculty of Medicine, University of Porto, 4200 - 319, Porto, Portugal.,Department of Pathology, Faculty of Medicine, University of Porto, 4200 - 319, Porto, Portugal
| | - Joana Nunes
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jorge Lima
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen, 208, 4200-135, Porto, Portugal.,Ipatimup - Institute of Molecular Pathology and Immunology of the University of Porto, Rua Júlio Amaral de Carvalho 45 4200-135, Porto, Portugal.,Faculty of Medicine, University of Porto, 4200 - 319, Porto, Portugal
| | - Valdemar Máximo
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen, 208, 4200-135, Porto, Portugal.,Ipatimup - Institute of Molecular Pathology and Immunology of the University of Porto, Rua Júlio Amaral de Carvalho 45 4200-135, Porto, Portugal.,Faculty of Medicine, University of Porto, 4200 - 319, Porto, Portugal.,Department of Pathology, Faculty of Medicine, University of Porto, 4200 - 319, Porto, Portugal
| | - Paula Boaventura
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen, 208, 4200-135, Porto, Portugal. .,Ipatimup - Institute of Molecular Pathology and Immunology of the University of Porto, Rua Júlio Amaral de Carvalho 45 4200-135, Porto, Portugal. .,Department of Pathology, Faculty of Medicine, University of Porto, 4200 - 319, Porto, Portugal.
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22
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Abstract
We present a case of a 68-year-old man with chronic hepatitis C infection, with no evidence of chronic liver disease during the first years of follow-up, diagnosed with a hepatocellular carcinoma (HCC) with 40 mm (α-fetoprotein (AFP) 205 ng/mL). He underwent segmental liver resection and pathology analysis was consistent with HCC and cirrhosis in the adjacent liver. Four months after surgery, AFP raised up to 126 661 ng/mL and abdominal MRI revealed a multinodular HCC. Patient rejected treatment with sorafenib and started megestrol and an herbal medicine, soursop (Annona muricata). Six months later, AFP markedly decreased (28 ng/mL) and abdominal MRI showed decreasing size and number of lesions. At 5 years of follow-up, he has no evidence of HCC. Spontaneous regression of HCC is a rare condition and the underlying mechanism is unclear. In this case there is a temporal relation between the start of megestrol and Annona muricata and HCC regression.
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Affiliation(s)
| | | | | | - Joana Nunes
- Gastroenterology Department, Hospital Beatriz Ângelo, Loures, Portugal
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23
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Largent A, Barateau A, Nunes J, Lafond C, Greer P, Dowling J, Baxter J, Saint-Jalmes H, Acosta O, de Crevoisier R. 45 A comparison of pseudo-CT generation methods for prostate MRI-based dose planning: deep learning, patch-based, atlas-based and bulk-density methods. Phys Med 2019. [DOI: 10.1016/j.ejmp.2019.09.126] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Fonseca MJ, Oliveira A, Azevedo I, Nunes J, Santos AC. Association of Pubertal Development With Adiposity and Cardiometabolic Health in Girls and Boys-Findings From the Generation XXI Birth Cohort. J Adolesc Health 2019; 65:558-563. [PMID: 31377165 DOI: 10.1016/j.jadohealth.2019.05.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 05/20/2019] [Accepted: 05/20/2019] [Indexed: 12/28/2022]
Abstract
PURPOSE Early timing of pubertal development is associated with worse cardiometabolic health in adulthood. We aimed to evaluate this association in 10-year-old girls and boys and clarify if it is independent of previous body mass index (BMI). METHODS Pubertal development was evaluated through the Tanner scale in 4,548 children from the birth cohort Generation XXI. Data on anthropometrics, body composition, blood pressure, lipid profile, fasting plasma glucose, insulin, homeostatic model assessment-insulin resistance (HOMA-IR), and high-sensitivity C-reactive protein were collected. Bonferroni correction was applied, using an alpha of .004 for statistical significance. Regression coefficients and 99.6% confidence intervals were computed using linear regression models. RESULTS Girls with a Tanner stage ≥2 presented statistically significant higher values of BMI, waist circumference (WC), waist-to-height ratio, fat mass index, blood pressure, glucose, insulin, HOMA-IR, triglycerides, and high-sensitivity C-reactive protein and lower values of high-density lipoprotein cholesterol. Boys with a Tanner stage ≥2 presented statistically significant higher values of BMI, WC, systolic blood pressure, and HOMA-IR and lower values of high-density lipoprotein cholesterol. After adjustment, including previous BMI, a Tanner stage ≥2 remained associated with BMI z-score (girls β = .41 [.32, .50]; boys β = .10 [.01, .19]) and WC (girls β = 2.64 cm [1.86, 3.43]; boys β = .81 cm [.11, 1.51]), and only in girls with waist-to-height ratio (β = .01 [.00, .01]), fat mass index (β = .31 kg/m2 [.08; .54]), glucose (β = 1.59 mg/dL [.85, 2.33]), insulin (β = 1.73 μU/mL [.68, 2.78]), and HOMA-IR (β = .40 [.16, .64]). CONCLUSIONS Independently of previous BMI, preteens with early puberty already had more adiposity at age 10 years. In addition, girls had higher glucose, insulin, and HOMA-IR, which may predict a worse glucose metabolism. These preteens should be a target for public health interventions.
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Affiliation(s)
- Maria J Fonseca
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.
| | - Andreia Oliveira
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Inês Azevedo
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Departamento de Ginecologia-Obstetrícia e Pediatria, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Joana Nunes
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Luz Saúde, Porto, Portugal
| | - Ana C Santos
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
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25
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Espírito Santo VL, Passos J, Pimentel T, Nunes J, Costa I, Salgado D. P14.89 What happens after 15 years? A clinical picture of a cohort of survivors of CNS tumors treated with whole-brain irradiation in a National Cancer Center. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz126.324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
BACKGROUND
Radiotherapy (RT) is standard curative treatment for many tumours, specially brain tumours. However, RT causes damage to normal brain tissue due to genetic instability, impairment of synaptic plasticity and increased oxidative stress and inflammation. With improved treatment, patient survival also increased in years, making long-term effect of RT more evident. Late toxicities of RT are well described for pediatric survivors but there is scant literature on late toxicities in adult survivors and, in general, the adult brain is considered less susceptible to radiation damage.
MATERIAL AND METHODS
Retrospective analysis of adult patients treated with whole-brain RT with more than 15 years of follow-up. Clinical charts were reviewed to collect clinical, demographic and outcome data.
RESULTS
From 18 patients found (mean age at diagnosis of 27 years, 13 male/ 5 female), 5 were diagnosed with medulloblastoma, 5 CNS lymphoma, 5 with germinoma, 3 with ependymoma and 1 with teratocarcinoma. Most common presentations were headache (61,1%), seizure (16,7%) and dizziness (16,7%). 5 patients (27,8%) had hydrocephalus at diagnosis. All patients received whole-brain RT (mean 40Gys, varying between 21 to 60Gys), alongside with complete surgical resection in 11 patients (61,1%) and chemotherapy in 10 patients (55,6%). Mean follow-up time was 23,6 years and only 1 patient died due to lymphoma recurrence 16,7 years after the initial diagnosis. During follow-up, all patients had late RT induced changes, leukoencephalopathy in 16 patients (88,9%; mean 8,6 years after RT), ischemic stroke in 9 patients (50,0%; mean 16,0 years after RT), cerebral microbleeds in 14 patients (77,8%; mean 15,4 years after RT), cognitive decline in 12 patients (66,7%; mean 15,8 years after RT), radio-induced meningioma in 3 patients (16,7%; mean 18,1 years after RT) and epilepsy in 2 patients (11,1%; mean 10,5 years after RT). Also 1 patient had neurosensorial loss 14,2 years after RT and another one had subarachnoid haemorrhage due to ruptured aneurysm 19 years after RT.
CONCLUSION
Our results show that late RT induced effects are progressive and irreversible in the adult survivors, in a very similar manner as has been reported in the pediatric survivors. The impact on quality of live is increasing as patients survive longer. RT is still an important tool in neuro-oncology, but its role in curing brain tumors needs further study.
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Affiliation(s)
| | - J Passos
- Instituto Português de Oncologia Francisco Gentil, Lisboa, Portugal
| | - T Pimentel
- Instituto Português de Oncologia Francisco Gentil, Lisboa, Portugal
| | - J Nunes
- Instituto Português de Oncologia Francisco Gentil, Lisboa, Portugal
| | - I Costa
- Instituto Português de Oncologia Francisco Gentil, Lisboa, Portugal
| | - D Salgado
- Instituto Português de Oncologia Francisco Gentil, Lisboa, Portugal
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Carvalho A, Rodrigues M, Rocha M, Nunes J, Cunha A, Costa H, Barros P. Multiple recurrent intracerebral hemorrhages and hepatopulmonary syndrome. Neurol Clin Pract 2019; 9:e27-e29. [PMID: 31583193 DOI: 10.1212/cpj.0000000000000593] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 11/02/2018] [Indexed: 12/15/2022]
Affiliation(s)
- Andreia Carvalho
- Department of Neurology (AC, MR, HC, PB) and Department of Imagiology (MR, JN, AC); and Neuroradiology Unit, Centro Hospitalar Vila Nova de Gaia/Espinho; and Stroke Unit (HC, PB), Centro Hospitalar Vila Nova de Gaia/Espinho, Portugal
| | - Marta Rodrigues
- Department of Neurology (AC, MR, HC, PB) and Department of Imagiology (MR, JN, AC); and Neuroradiology Unit, Centro Hospitalar Vila Nova de Gaia/Espinho; and Stroke Unit (HC, PB), Centro Hospitalar Vila Nova de Gaia/Espinho, Portugal
| | - Mariana Rocha
- Department of Neurology (AC, MR, HC, PB) and Department of Imagiology (MR, JN, AC); and Neuroradiology Unit, Centro Hospitalar Vila Nova de Gaia/Espinho; and Stroke Unit (HC, PB), Centro Hospitalar Vila Nova de Gaia/Espinho, Portugal
| | - Joana Nunes
- Department of Neurology (AC, MR, HC, PB) and Department of Imagiology (MR, JN, AC); and Neuroradiology Unit, Centro Hospitalar Vila Nova de Gaia/Espinho; and Stroke Unit (HC, PB), Centro Hospitalar Vila Nova de Gaia/Espinho, Portugal
| | - André Cunha
- Department of Neurology (AC, MR, HC, PB) and Department of Imagiology (MR, JN, AC); and Neuroradiology Unit, Centro Hospitalar Vila Nova de Gaia/Espinho; and Stroke Unit (HC, PB), Centro Hospitalar Vila Nova de Gaia/Espinho, Portugal
| | - Henrique Costa
- Department of Neurology (AC, MR, HC, PB) and Department of Imagiology (MR, JN, AC); and Neuroradiology Unit, Centro Hospitalar Vila Nova de Gaia/Espinho; and Stroke Unit (HC, PB), Centro Hospitalar Vila Nova de Gaia/Espinho, Portugal
| | - Pedro Barros
- Department of Neurology (AC, MR, HC, PB) and Department of Imagiology (MR, JN, AC); and Neuroradiology Unit, Centro Hospitalar Vila Nova de Gaia/Espinho; and Stroke Unit (HC, PB), Centro Hospitalar Vila Nova de Gaia/Espinho, Portugal
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Denysiuk R, Gonçalves N, Pinto R, Silva H, Duarte F, Nunes J, Gaspar-Cunha A. Optimization of Injection Stretch Blow Molding: Part I – Defining Part Thickness Profile. INT POLYM PROC 2019. [DOI: 10.3139/217.3746] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract
This paper suggests a methodology based on a neuroevolutionary approach to optimize the use of material in blow molding applications. This approach aims at determining the optimal thickness distribution for a certain blow molded product as a function of its geometry. Multiobjective search is performed by neuroevolution to reflect the conflicting nature of the design problem and to capture some possible trade-offs. During the search, each design alternative is evaluated through a finite element analysis. The coordinates of the mesh elements are the inputs to an artificial neural network whose output determines the thickness for the corresponding location. The proposed approach is applied to the design of an industrial bottle. The results reveal the validity and usefulness of the proposed technique, which was able to distribute the material along the most critical regions to obtain adequate mechanical properties. The approach is general and can be applied to products with different geometries.
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Affiliation(s)
- R. Denysiuk
- IPC , Institute for Polymer and Composites, University of Minho, Guimarães , Portugal
| | - N. Gonçalves
- PIEP , Innovation in Polymer Engineering, University of Minho, Guimarães , Portugal
| | - R. Pinto
- IPC , Institute for Polymer and Composites, University of Minho, Guimarães , Portugal
| | - H. Silva
- IPC , Institute for Polymer and Composites, University of Minho, Guimarães , Portugal
| | - F. Duarte
- IPC , Institute for Polymer and Composites, University of Minho, Guimarães , Portugal
| | - J. Nunes
- IPC , Institute for Polymer and Composites, University of Minho, Guimarães , Portugal
| | - A. Gaspar-Cunha
- IPC , Institute for Polymer and Composites, University of Minho, Guimarães , Portugal
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Queirós AM, Stephens N, Widdicombe S, Tait K, McCoy SJ, Ingels J, Rühl S, Airs R, Beesley A, Carnovale G, Cazenave P, Dashfield S, Hua E, Jones M, Lindeque P, McNeill CL, Nunes J, Parry H, Pascoe C, Widdicombe C, Smyth T, Atkinson A, Krause‐Jensen D, Somerfield PJ. Connected macroalgal‐sediment systems: blue carbon and food webs in the deep coastal ocean. ECOL MONOGR 2019. [DOI: 10.1002/ecm.1366] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
| | - Nicholas Stephens
- Plymouth Marine Laboratory Plymouth PL1 3DH United Kingdom
- Nereis Bioengineering Llansadwrn SA19 8NA United Kingdom
| | | | - Karen Tait
- Plymouth Marine Laboratory Plymouth PL1 3DH United Kingdom
| | - Sophie J. McCoy
- Plymouth Marine Laboratory Plymouth PL1 3DH United Kingdom
- Department of Biological Science Florida State University Tallahassee Florida 32306 USA
| | - Jeroen Ingels
- Plymouth Marine Laboratory Plymouth PL1 3DH United Kingdom
- Coastal and Marine Laboratory Florida State University St Teresa Florida 32358 USA
| | - Saskia Rühl
- Plymouth Marine Laboratory Plymouth PL1 3DH United Kingdom
| | - Ruth Airs
- Plymouth Marine Laboratory Plymouth PL1 3DH United Kingdom
| | - Amanda Beesley
- Plymouth Marine Laboratory Plymouth PL1 3DH United Kingdom
| | | | | | | | - Er Hua
- Plymouth Marine Laboratory Plymouth PL1 3DH United Kingdom
- Ocean University of China Qingdao 266003 China
| | - Mark Jones
- Plymouth Marine Laboratory Plymouth PL1 3DH United Kingdom
| | | | | | - Joana Nunes
- Plymouth Marine Laboratory Plymouth PL1 3DH United Kingdom
| | - Helen Parry
- Plymouth Marine Laboratory Plymouth PL1 3DH United Kingdom
| | | | | | - Tim Smyth
- Plymouth Marine Laboratory Plymouth PL1 3DH United Kingdom
| | - Angus Atkinson
- Plymouth Marine Laboratory Plymouth PL1 3DH United Kingdom
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29
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Rodrigues M, Nunes J, Figueiredo S, Martins de Campos A, Geraldo AF. Neuroimaging assessment in Down syndrome: a pictorial review. Insights Imaging 2019; 10:52. [PMID: 31111268 PMCID: PMC6527671 DOI: 10.1186/s13244-019-0729-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 03/07/2019] [Indexed: 02/08/2023] Open
Abstract
Down syndrome (DS), or trisomy 21, is the leading genetic cause of intellectual incapacity worldwide, with a reported incidence of about 1 in 1,000 to 1 in 1,100 live births. Besides the several commonly known physical features characteristic of this syndrome present at birth, DS may additionally affect every organ system. In addition, despite the large number of published papers concerning this syndrome, there is scarce literature focusing specifically in the typical neuroimaging features associated with this condition. The aim of this paper is to review and systematize the distinctive characteristics and abnormalities of the central nervous system, head and neck, and spine present in DS patients that should actively be searched for and evaluated by radiologists and/or neuroradiologists.
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Affiliation(s)
- Marta Rodrigues
- Neuroradiology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, R. Conceição Fernandes, 1079, Vila Nova de Gaia, Portugal.
| | - Joana Nunes
- Neuroradiology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, R. Conceição Fernandes, 1079, Vila Nova de Gaia, Portugal
| | - Sofia Figueiredo
- Neurology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | | | - Ana Filipa Geraldo
- Neuroradiology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, R. Conceição Fernandes, 1079, Vila Nova de Gaia, Portugal
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30
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Mani R, Rajgolikar G, Nunes J, Zapolnik K, Wasmuth R, Mo X, Byrd J, Lee D, Muthusamy N, Vasu S. Fc engineered anti-CD33mAb potentiates cytotoxicity of mbIL-21 expanded NK-cells against primary AML pre-treated with decitabine. Cytotherapy 2019. [DOI: 10.1016/j.jcyt.2019.03.318] [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: 11/15/2022]
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31
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Largent A, Barateau A, Nunes J, Lafond C, Greer P, Dowling J, Saint-Jalmes H, Acosta O, De Crevoisier R. PO-1007 Comparison of deep learning with three other methods to generate pseudo-CT for MRI-only radiotherapy. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31427-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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32
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Largent A, Barateau A, Nunes J, Lafond C, Greer P, Dowling JA, Saint-Jalmes H, Acosta O, Crevoisier R. 29 Pseudo-CT generation for MRI-only radiotherapy treatment planning: comparison between patch-based, atlas-based and bulk density methods. Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.09.042] [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: 11/25/2022] Open
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33
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Ferreira-Dos-Santos G, Nunes J, Gonçalves SB, Quental C, Horta LGG, Branco PS, Tavares da Silva M. A Review on the Effects of Disturbances in Scapulothoracic and Scapulohumeral Rhythms in Shoulder Biomechanics. Arch Phys Med Rehabil 2018. [DOI: 10.1016/j.apmr.2018.07.407] [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: 10/28/2022]
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Geraldo AF, Valente F, Almeida N, Nunes J. Posterior fossa lipoma without T1 hyperintensity in foetal magnetic resonance imaging performed in the third trimester. Pediatr Radiol 2018; 48:1178-1179. [PMID: 29876683 DOI: 10.1007/s00247-018-4168-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 04/15/2018] [Accepted: 05/23/2018] [Indexed: 10/14/2022]
Affiliation(s)
- Ana Filipa Geraldo
- Department of Radiology, Neuroradiology unit, CHVNG/E- Centro Hospitalar Vila Nova de Gaia/Espinho, Rua Conceição Fernandes, 4434-502, Vila Nova de Gaia, Portugal.
| | - Francisco Valente
- Department of Gynecology-Obstetrics, Prenatal Diagnosis unit, CHVNG/E- Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Nuno Almeida
- Department of Radiology, Neuroradiology unit, CHVNG/E- Centro Hospitalar Vila Nova de Gaia/Espinho, Rua Conceição Fernandes, 4434-502, Vila Nova de Gaia, Portugal
| | - Joana Nunes
- Department of Radiology, Neuroradiology unit, CHVNG/E- Centro Hospitalar Vila Nova de Gaia/Espinho, Rua Conceição Fernandes, 4434-502, Vila Nova de Gaia, Portugal
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35
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Amaro T, Bertocci I, Queiros AM, Rastelli E, Borgersen G, Brkljacic M, Nunes J, Sorensen K, Danovaro R, Widdicombe S. Effects of sub-seabed CO 2 leakage: Short- and medium-term responses of benthic macrofaunal assemblages. Mar Pollut Bull 2018; 128:519-526. [PMID: 29571404 DOI: 10.1016/j.marpolbul.2018.01.068] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 01/30/2018] [Accepted: 01/31/2018] [Indexed: 06/08/2023]
Abstract
The continued rise in atmospheric carbon dioxide (CO2) levels is driving climate change and temperature shifts at a global scale. CO2 Capture and Storage (CCS) technologies have been suggested as a feasible option for reducing CO2 emissions and mitigating their effects. However, before CCS can be employed at an industrial scale, any environmental risks associated with this activity should be identified and quantified. Significant leakage of CO2 from CCS reservoirs and pipelines is considered to be unlikely, however direct and/or indirect effects of CO2 leakage on marine life and ecosystem functioning must be assessed, with particular consideration given to spatial (e.g. distance from the source) and temporal (e.g. duration) scales at which leakage impacts could occur. In the current mesocosm experiment we tested the potential effects of CO2 leakage on macrobenthic assemblages by exposing infaunal sediment communities to different levels of CO2 concentration (400, 1000, 2000, 10,000 and 20,000 ppm CO2), simulating a gradient of distance from a hypothetic leakage, over short-term (a few weeks) and medium-term (several months). A significant impact on community structure, abundance and species richness of macrofauna was observed in the short-term exposure. Individual taxa showed idiosyncratic responses to acidification. We conclude that the main impact of CO2 leakage on macrofaunal assemblages occurs almost exclusively at the higher CO2 concentration and over short time periods, tending to fade and disappear at increasing distance and exposure time. Although under the cautious perspective required by the possible context-dependency of the present findings, this study contributes to the cost-benefit analysis (environmental risk versus the achievement of the intended objectives) of CCS strategies.
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Affiliation(s)
- T Amaro
- Hellenic Center for Marine Research (HCMR), 710 03 Heraklion, Crete, Greece; Norwegian Institute for Water Research, Oslo, Norway; Stazione Zoologica Anton Dohrn, Villa Comunale, Naples, Italy.
| | - I Bertocci
- Stazione Zoologica Anton Dohrn, Villa Comunale, Naples, Italy
| | - A M Queiros
- Plymouth Marine Laboratory, Prospect Place, West Hoe, PL1 3DH, Plymouth, UK
| | - E Rastelli
- Stazione Zoologica Anton Dohrn, Villa Comunale, Naples, Italy; Department of Life and Environmental Sciences, Polytechnic University of Marche, Ancona, Italy
| | - G Borgersen
- Norwegian Institute for Water Research, Oslo, Norway
| | - M Brkljacic
- Norwegian Institute for Water Research, Oslo, Norway
| | - J Nunes
- Plymouth Marine Laboratory, Prospect Place, West Hoe, PL1 3DH, Plymouth, UK
| | - K Sorensen
- Norwegian Institute for Water Research, Oslo, Norway
| | - R Danovaro
- Stazione Zoologica Anton Dohrn, Villa Comunale, Naples, Italy; Department of Life and Environmental Sciences, Polytechnic University of Marche, Ancona, Italy
| | - S Widdicombe
- Plymouth Marine Laboratory, Prospect Place, West Hoe, PL1 3DH, Plymouth, UK
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36
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Nunes B, Nunes J, Soares AMVM, Figueira E, Freitas R. Toxicological effects of paracetamol on the clam Ruditapes philippinarum: exposure vs recovery. Aquat Toxicol 2017; 192:198-206. [PMID: 28982071 DOI: 10.1016/j.aquatox.2017.09.015] [Citation(s) in RCA: 11] [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: 06/16/2017] [Revised: 07/27/2017] [Accepted: 09/19/2017] [Indexed: 06/07/2023]
Abstract
Exposure of wild organisms to anthropogenic substances never follows a definite time-course and pulsed events can often determine biological responses to such chemicals, confounding the interpretation of toxicological data. This is the case of specific chemicals such as pharmaceutical drugs, which are commonly released by sewage systems into sensitive areas, including estuaries. The presence and amount of these chemicals in the wild can be modulated by events such as dilution due to heavy rain, floods, or by varying patterns of domestic water use (daily vs. seasonal). The present study aimed to obtain additional data about the toxicity of paracetamol towards the marine clam species Ruditapes philippinarum, following realistic modes of exposure. Thus, the toxicity assessment was made after an acute exposure to different concentrations of paracetamol, followed by a recovery period. The adopted toxicological endpoints included energy-related parameters (glycogen content, GLY; protein content, PROT; electron transport system activity, ETS), activity of antioxidant and biotransformation enzymes (superoxide dismutase, SOD; glutathione peroxidase, GPx; Glutathione-S-transferases, GSTs), levels of reduced glutathione (GSH), neurotoxicity (cholinesterases activity, ChEs), and indicators of oxidative damage (lipid peroxidation, LPO). The here obtained results showed an increase in SOD and GPx activities after exposure. In organisms exposed to the highest concentration tested it was also possible to observe a significant increase in GSTs activity. However, these alterations in the antioxidant defence system were not able to prevent the occurrence of oxidative stress in exposed organisms. Furthermore, exposure to paracetamol induced neurotoxicity in clams, with a concentration-dependent ChEs inhibition along the exposure concentrations. Exposure to paracetamol also led to an increase of GLY content which resulted from metabolic activity depression along the increasing exposure gradient. In recovering organisms the activities of SOD, GPx and GSTs decreased back towards control values presenting lower values than the ones observed in organisms after acute exposure to paracetamol. No LPO was registered in organisms after the recovery period. In addition, after recovery, clams showed no signs of neurotoxicity, with ChEs activities in previously exposed organisms similar to control clams. After recovery clams seemed to re-establish their metabolic capacity, especially evidenced in clams previously exposed to the highest paracetamol concentration as demonstrated by the increase of ETS activity up to control values. Furthermore, the decrease of GLY content after recovery may indicate that clams increased their metabolic activity and started to use their energetic reserves to re-establish their oxidative status. This set of data shows that an acute exposure to paracetamol can exert deleterious effects that may compromise specific biochemical pathways in sensitive aquatic species, such as R. philippinarum, but organisms can re-establish their biochemical status to control levels after a recovery period.
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Affiliation(s)
- Bruno Nunes
- Departamento de Biologia & CESAM, Universidade de Aveiro, 3810-193 Aveiro, Portugal
| | - Joana Nunes
- Departamento de Biologia & CESAM, Universidade de Aveiro, 3810-193 Aveiro, Portugal
| | - Amadeu M V M Soares
- Departamento de Biologia & CESAM, Universidade de Aveiro, 3810-193 Aveiro, Portugal
| | - Etelvina Figueira
- Departamento de Biologia & CESAM, Universidade de Aveiro, 3810-193 Aveiro, Portugal
| | - Rosa Freitas
- Departamento de Biologia & CESAM, Universidade de Aveiro, 3810-193 Aveiro, Portugal.
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37
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Gouveia PJ, Rosa S, Ricotti L, Abecasis B, Almeida HV, Monteiro L, Nunes J, Carvalho FS, Serra M, Luchkin S, Kholkin AL, Alves PM, Oliveira PJ, Carvalho R, Menciassi A, das Neves RP, Ferreira LS. Flexible nanofilms coated with aligned piezoelectric microfibers preserve the contractility of cardiomyocytes. Biomaterials 2017. [PMID: 28622605 DOI: 10.1016/j.biomaterials.2017.05.048] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [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: 01/09/2023]
Abstract
The use of engineered cardiac tissue for high-throughput drug screening/toxicology assessment remains largely unexplored. Here we propose a scaffold that mimics aspects of cardiac extracellular matrix while preserving the contractility of cardiomyocytes. The scaffold is based on a poly(caprolactone) (PCL) nanofilm with magnetic properties (MNF, standing for magnetic nanofilm) coated with a layer of piezoelectric (PIEZO) microfibers of poly(vinylidene fluoride-trifluoroethylene) (MNF+PIEZO). The nanofilm creates a flexible support for cell contraction and the aligned PIEZO microfibers deposited on top of the nanofilm creates conditions for cell alignment and electrical stimulation of the seeded cells. Our results indicate that MNF+PIEZO scaffold promotes rat and human cardiac cell attachment and alignment, maintains the ratio of cell populations overtime, promotes cell-cell communication and metabolic maturation, and preserves cardiomyocyte (CM) contractility for at least 12 days. The engineered cardiac construct showed high toxicity against doxorubicin, a cardiotoxic molecule, and responded to compounds that modulate CM contraction such as epinephrine, propranolol and heptanol.
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Affiliation(s)
- P José Gouveia
- CNC-Center of Neurosciences and Cell Biology, University of Coimbra, 3004-517 Coimbra, Portugal; Instituto de Investigação Interdisciplinar, University of Coimbra, Casa Costa Alemão - Pólo II, Rua Dom Francisco de Lemos, 3030-789 Coimbra, Portugal
| | - S Rosa
- CNC-Center of Neurosciences and Cell Biology, University of Coimbra, 3004-517 Coimbra, Portugal
| | - L Ricotti
- The BioRobotics Institute, Scuola Superiore Sant' Anna, Viale Rinaldo Piaggio 34, 56025 Pontedera (PI), Italy
| | - B Abecasis
- Instituto de Tecnologia Química e Biologica António Xavier, New University of Lisbon, Av. da Republica, 2780-157 Oeiras, Portugal
| | - H V Almeida
- CNC-Center of Neurosciences and Cell Biology, University of Coimbra, 3004-517 Coimbra, Portugal
| | - L Monteiro
- CNC-Center of Neurosciences and Cell Biology, University of Coimbra, 3004-517 Coimbra, Portugal
| | - J Nunes
- Center for Mechanical Engineering, University of Coimbra, 3030-788 Coimbra, Portugal
| | - F Sofia Carvalho
- CNC-Center of Neurosciences and Cell Biology, University of Coimbra, 3004-517 Coimbra, Portugal; Instituto de Investigação Interdisciplinar, University of Coimbra, Casa Costa Alemão - Pólo II, Rua Dom Francisco de Lemos, 3030-789 Coimbra, Portugal
| | - M Serra
- Instituto de Tecnologia Química e Biologica António Xavier, New University of Lisbon, Av. da Republica, 2780-157 Oeiras, Portugal
| | - S Luchkin
- CICECO - Materials Institute of Aveiro & Physics Department, University of Aveiro, Campus de Santiago, 3810-193 Aveiro, Portugal
| | - A Leonidovitch Kholkin
- CICECO - Materials Institute of Aveiro & Physics Department, University of Aveiro, Campus de Santiago, 3810-193 Aveiro, Portugal; School of Natural Sciences and Mathematics, Ural Federal University, 620000 Ekaterinburg, Russia
| | - P Marques Alves
- Instituto de Tecnologia Química e Biologica António Xavier, New University of Lisbon, Av. da Republica, 2780-157 Oeiras, Portugal
| | - P Jorge Oliveira
- Instituto de Investigação Interdisciplinar, University of Coimbra, Casa Costa Alemão - Pólo II, Rua Dom Francisco de Lemos, 3030-789 Coimbra, Portugal
| | - R Carvalho
- Instituto de Investigação Interdisciplinar, University of Coimbra, Casa Costa Alemão - Pólo II, Rua Dom Francisco de Lemos, 3030-789 Coimbra, Portugal; Department of Life Sciences, Faculty of Sciences and Technology, University of Coimbra, 3000-456 Coimbra, Portugal
| | - A Menciassi
- The BioRobotics Institute, Scuola Superiore Sant' Anna, Viale Rinaldo Piaggio 34, 56025 Pontedera (PI), Italy
| | - R Pires das Neves
- CNC-Center of Neurosciences and Cell Biology, University of Coimbra, 3004-517 Coimbra, Portugal; Instituto de Investigação Interdisciplinar, University of Coimbra, Casa Costa Alemão - Pólo II, Rua Dom Francisco de Lemos, 3030-789 Coimbra, Portugal
| | - L Silva Ferreira
- CNC-Center of Neurosciences and Cell Biology, University of Coimbra, 3004-517 Coimbra, Portugal.
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Richards S, Seixas A, Chung D, Nunes J, Grandner M, Zizi F, Tan N, Jean-Louis G. 1150 SLEEP IMPACTS QUALITY OF LIFE AND NEUROCOGNITIVE CHARACTERISTICS OF BLACK AND HISPANIC STROKE SURVIVORS. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.1149] [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: 11/13/2022] Open
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Nunes J, Brigadeiro D, Andrade J, Costa APD. Neuroleptic-induced Parkinsonism in Patient with Obsessive Compulsive Disorder: A Case Report. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.1063] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Obsessive-compulsive disorder (OCD) is a neuropsychiatric disorder characterized by either obsessions (recurrent unwanted thoughts, images or impulses) or compulsions (repetitive behaviors often performed to relieve anxiety or distress). In some cases, it is considered antipsychotic enhancement. However, in high doses, it can exacerbate OCD symptoms and cause extrapyramidal effects such as neuroleptic-induced Parkinsonism.Here, the authors present a clinic case of a single male patient with 50 years old, in which with the age of 42, started with a obsessive-compulsive framework about the developed task at the work place (production of fabric) followed by several verifications of the assembled pieces, which interfered with his work performance. This patient was admitted to the psychiatric hospital due to the deterioration of the symptoms with obsessive ideas of HIV contamination resulting in rigid cleaning rituals. He was medicated with several OCD medications including Clozapine 50 mg.In the following years and complaining of insomnia, the clozapine dose was increased by the patient reaching the dose of 200 mg. In 2016 he started secondary Parkinsonism framework to antipsychotics, characterized by akinesia, facial hypomimia, stiff, coarse tremor and stooped posture. Therapeutic setting was made with a reduction of clozapine at doses of 50 mg occurring fading of extrapyramidal symptoms and decrease the symptoms of OCD.The authors intend with this presented case to highlight the importance of surveillance of patients receiving antipsychotics for OCD to avoid worsening of symptoms and the development of extrapyramidal effects, which deeply contribute to the decrease of quality life of these patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Abstract
The term refeeding syndrome has been used to describe the adverse consequences that can occur in all malnourished patients in the early stages of nutrition repletion whether the method of refeeding is oral, enteral or parenteral. Those consequences include acute thiamine deficiency resulting in Wernicke's encephalopathy and Korsakoff syndrome, with the potential for permanent cognitive impairment; hypophosphatemia, hypokalemia, hypomagnesemia and fluid overload resulting in cardiac failure. Adaptive changes in metabolism occur during a period of starvation or fasting: levels of glucose fall within 24 to 72 hours, as response, glucagon levels rise and insulin concentrations decrease. Glucose levels are maintained by glycogenolysis at first and gluconeogenesis latter. The reintroduction of nutrition leads to a switch from fat to carbohydrate metabolism and an increase of insulin concentration. Insulin stimulates the movement of potassium, phosphate, and magnesium into the cell leading to its depletion in extracellular compartment. Reactivation of carbohydrate metabolism increases degradation of thiamine, a cofactor required for cellular enzymatic reactions in Kreb's cycle. Deficiency in all these nutrients can then occur. Patients with anorexia nervosa are at risk of suffering from refeeding syndrome. This psychiatric disorder causes potentially life-threatening, physical complications and has the highest mortality rate among psychiatric disorders. The purpose of this review is to clarify recommendations for prevention and treatment of refeeding syndrome in anorexia nervosa.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Brigadeiro D, Nunes J, Gil TV, Costa P. Poststroke depression. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.701] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Psychiatric symptoms are the complications most often ignored in patients who suffered a stroke. Depression is the most common psychiatric complication in post-stroke patients with a prevalence of about 20–50% in the first year and with a peak in first six months after the stroke. Depression in turn, constitutes itself a factor of cerebrovascular risk. Despite its high prevalence this disorder remains under diagnosed and under treated. One explanation for this fact is that depressive symptoms are often misinterpreted as consequences of stroke itself. This reality is even more striking in patients with aphasia. Poststroke depression (PSD) results from the interaction between biological, as the location of the stroke, social and psychological factors. The presence of this disorder is associated with deleterious consequences for rehabilitation process. These patients suffer more often from attention deficits, cognitive difficulties, lower response to rehabilitation programs, poor quality of life and increased mortality.ObjectivesTo review epidemiology, pathogenesis, risk factors, consequences and current recommendations for therapeutic intervention.MethodsMedline/Pubmed database search using the terms poststroke depression, depression and stroke, depression and cerebral vascular accident, stroke patients, published in the last 16 years.ConclusionThe treatment of PSD has been shown effective in improving the evolution and prognosis of these patients, therefore it is very important early diagnosis.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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St. Louis J, Bukowski A, Paulino E, Ferreyra ME, Nunes J, Mejia G, Duarte C, Ruiz R, Touya D, Polo S, Chavarri-Guerra Y, Moreno J, Georgieva N, Tsolko T, Obayedullah Baki M, Luna HC, Goss PE. Abstract P4-17-03: Global Cancer Institute online tumor boards to improve global patterns of clinical practice for breast cancer. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p4-17-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: The Global Cancer Institute (GCI) breast cancer multi-disciplinary tumor boards (MTBs) are live, online telemedicine discussions of breast cancer patient case scenarios between breast cancer specialists in low- and middle-income countries (LMICs) and expert breast cancer specialists in the United States (US). In the US MTBs are routinely held in most cancer centers and have been shown to improve patient outcomes and patient and family quality of life. GCI launched breast cancer MTBs in 2012 with the goals to improve breast cancer patient care in underserved populations globally, to establish an online platform to allow live communication and collaboration among oncologists, and to serve as an educational tool for oncologists.
Methods: During our MTBs case scenarios are presented by global oncologists for discussion and input by a panel of both community/tertiary care expert breast oncologists from our global network. During each MTB, three cancer centers present challenging breast cancer patient scenarios. Patient scenarios are presented in English, according to a standard PowerPoint template. After presentation guideline - or clinical trial-based discussions are held for each case. As the patient cases originate from oncologists in LMICs, optimal and best locally available clinical care in rural and remote settings are discussed. For educational purposes the MTBs and the associated YouTube panel discussions are archived online and can subsequently be viewed by practicing oncologists and trainees globally. Links to relevant international guidelines, published and ongoing clinical trials, and other educational resources are also provided to all MTB attendees.
Results: Since its initiation in 2012, the GCI MTBs have engaged a network of 370 oncologists in LMICs and 20 expert panelists from nine cancer centers in the United States. Together the oncologists in LMICs represent 28 tertiary cancer centers and 116 community oncologists in 19 countries across Latin America, Eastern Europe, Asia, and Africa.
Conclusions: GCI breast cancer MTBs are a powerful educational and networking tool for oncologists in LMICs to improve their patterns of clinical practice, conduct multi-disciplinary discussions and access research collaborations. GCI invites oncologists throughout Latin America, Europe, Asia, and Africa to join our tumor boards and further expansion of its MTB network. GCI currently surveys oncologists in our network before and after attendance of MTBs to measure modifications in oncologists' practice and adherence to international clinical practice guidelines.
Citation Format: St. Louis J, Bukowski A, Paulino E, Ferreyra ME, Nunes J, Mejia G, Duarte C, Ruiz R, Touya D, Polo S, Chavarri-Guerra Y, Moreno J, Georgieva N, Tsolko T, Obayedullah Baki M, Luna HC, Goss PE. Global Cancer Institute online tumor boards to improve global patterns of clinical practice for breast cancer [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P4-17-03.
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Affiliation(s)
- J St. Louis
- The Global Cancer Institute, Boston, MA; Massachusetts General Hospital Cancer Center, Boston, MA; Instituto Nacional do Câncer, Rio de Janeiro, RJ, Brazil; Harvard Medical School, Boston, MA; Marie Curie Hospital, Buenos Aires, Argentina; Hospital Erasto Gaertner, Curitiba, Brazil; Hospital Clinico Viedma, Cochabamba, Bolivia; Institution Nacional de Cancerologia, Bogota, Colombia; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Hospital de Clinicas, Montevideo, Uruguay; INCAN, Guatemala City, Guatemala; Instituto Nacional de Ciencias y Nutrition Salvador Zubiran, Mexico D.F., Mexico; Instituto Oncologico Nacional, Panama City, Panama; MHAT Nadezhda, Sofia, Bulgaria; Lviv State Oncological Regional Centre, Lviv, Ukraine; Obayedullah-Ferdousi Cancer Foundation, Dhaka, Bangladesh; National Kidney and Transplant Institute, Quezon City, Manila, Philippines
| | - A Bukowski
- The Global Cancer Institute, Boston, MA; Massachusetts General Hospital Cancer Center, Boston, MA; Instituto Nacional do Câncer, Rio de Janeiro, RJ, Brazil; Harvard Medical School, Boston, MA; Marie Curie Hospital, Buenos Aires, Argentina; Hospital Erasto Gaertner, Curitiba, Brazil; Hospital Clinico Viedma, Cochabamba, Bolivia; Institution Nacional de Cancerologia, Bogota, Colombia; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Hospital de Clinicas, Montevideo, Uruguay; INCAN, Guatemala City, Guatemala; Instituto Nacional de Ciencias y Nutrition Salvador Zubiran, Mexico D.F., Mexico; Instituto Oncologico Nacional, Panama City, Panama; MHAT Nadezhda, Sofia, Bulgaria; Lviv State Oncological Regional Centre, Lviv, Ukraine; Obayedullah-Ferdousi Cancer Foundation, Dhaka, Bangladesh; National Kidney and Transplant Institute, Quezon City, Manila, Philippines
| | - E Paulino
- The Global Cancer Institute, Boston, MA; Massachusetts General Hospital Cancer Center, Boston, MA; Instituto Nacional do Câncer, Rio de Janeiro, RJ, Brazil; Harvard Medical School, Boston, MA; Marie Curie Hospital, Buenos Aires, Argentina; Hospital Erasto Gaertner, Curitiba, Brazil; Hospital Clinico Viedma, Cochabamba, Bolivia; Institution Nacional de Cancerologia, Bogota, Colombia; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Hospital de Clinicas, Montevideo, Uruguay; INCAN, Guatemala City, Guatemala; Instituto Nacional de Ciencias y Nutrition Salvador Zubiran, Mexico D.F., Mexico; Instituto Oncologico Nacional, Panama City, Panama; MHAT Nadezhda, Sofia, Bulgaria; Lviv State Oncological Regional Centre, Lviv, Ukraine; Obayedullah-Ferdousi Cancer Foundation, Dhaka, Bangladesh; National Kidney and Transplant Institute, Quezon City, Manila, Philippines
| | - ME Ferreyra
- The Global Cancer Institute, Boston, MA; Massachusetts General Hospital Cancer Center, Boston, MA; Instituto Nacional do Câncer, Rio de Janeiro, RJ, Brazil; Harvard Medical School, Boston, MA; Marie Curie Hospital, Buenos Aires, Argentina; Hospital Erasto Gaertner, Curitiba, Brazil; Hospital Clinico Viedma, Cochabamba, Bolivia; Institution Nacional de Cancerologia, Bogota, Colombia; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Hospital de Clinicas, Montevideo, Uruguay; INCAN, Guatemala City, Guatemala; Instituto Nacional de Ciencias y Nutrition Salvador Zubiran, Mexico D.F., Mexico; Instituto Oncologico Nacional, Panama City, Panama; MHAT Nadezhda, Sofia, Bulgaria; Lviv State Oncological Regional Centre, Lviv, Ukraine; Obayedullah-Ferdousi Cancer Foundation, Dhaka, Bangladesh; National Kidney and Transplant Institute, Quezon City, Manila, Philippines
| | - J Nunes
- The Global Cancer Institute, Boston, MA; Massachusetts General Hospital Cancer Center, Boston, MA; Instituto Nacional do Câncer, Rio de Janeiro, RJ, Brazil; Harvard Medical School, Boston, MA; Marie Curie Hospital, Buenos Aires, Argentina; Hospital Erasto Gaertner, Curitiba, Brazil; Hospital Clinico Viedma, Cochabamba, Bolivia; Institution Nacional de Cancerologia, Bogota, Colombia; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Hospital de Clinicas, Montevideo, Uruguay; INCAN, Guatemala City, Guatemala; Instituto Nacional de Ciencias y Nutrition Salvador Zubiran, Mexico D.F., Mexico; Instituto Oncologico Nacional, Panama City, Panama; MHAT Nadezhda, Sofia, Bulgaria; Lviv State Oncological Regional Centre, Lviv, Ukraine; Obayedullah-Ferdousi Cancer Foundation, Dhaka, Bangladesh; National Kidney and Transplant Institute, Quezon City, Manila, Philippines
| | - G Mejia
- The Global Cancer Institute, Boston, MA; Massachusetts General Hospital Cancer Center, Boston, MA; Instituto Nacional do Câncer, Rio de Janeiro, RJ, Brazil; Harvard Medical School, Boston, MA; Marie Curie Hospital, Buenos Aires, Argentina; Hospital Erasto Gaertner, Curitiba, Brazil; Hospital Clinico Viedma, Cochabamba, Bolivia; Institution Nacional de Cancerologia, Bogota, Colombia; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Hospital de Clinicas, Montevideo, Uruguay; INCAN, Guatemala City, Guatemala; Instituto Nacional de Ciencias y Nutrition Salvador Zubiran, Mexico D.F., Mexico; Instituto Oncologico Nacional, Panama City, Panama; MHAT Nadezhda, Sofia, Bulgaria; Lviv State Oncological Regional Centre, Lviv, Ukraine; Obayedullah-Ferdousi Cancer Foundation, Dhaka, Bangladesh; National Kidney and Transplant Institute, Quezon City, Manila, Philippines
| | - C Duarte
- The Global Cancer Institute, Boston, MA; Massachusetts General Hospital Cancer Center, Boston, MA; Instituto Nacional do Câncer, Rio de Janeiro, RJ, Brazil; Harvard Medical School, Boston, MA; Marie Curie Hospital, Buenos Aires, Argentina; Hospital Erasto Gaertner, Curitiba, Brazil; Hospital Clinico Viedma, Cochabamba, Bolivia; Institution Nacional de Cancerologia, Bogota, Colombia; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Hospital de Clinicas, Montevideo, Uruguay; INCAN, Guatemala City, Guatemala; Instituto Nacional de Ciencias y Nutrition Salvador Zubiran, Mexico D.F., Mexico; Instituto Oncologico Nacional, Panama City, Panama; MHAT Nadezhda, Sofia, Bulgaria; Lviv State Oncological Regional Centre, Lviv, Ukraine; Obayedullah-Ferdousi Cancer Foundation, Dhaka, Bangladesh; National Kidney and Transplant Institute, Quezon City, Manila, Philippines
| | - R Ruiz
- The Global Cancer Institute, Boston, MA; Massachusetts General Hospital Cancer Center, Boston, MA; Instituto Nacional do Câncer, Rio de Janeiro, RJ, Brazil; Harvard Medical School, Boston, MA; Marie Curie Hospital, Buenos Aires, Argentina; Hospital Erasto Gaertner, Curitiba, Brazil; Hospital Clinico Viedma, Cochabamba, Bolivia; Institution Nacional de Cancerologia, Bogota, Colombia; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Hospital de Clinicas, Montevideo, Uruguay; INCAN, Guatemala City, Guatemala; Instituto Nacional de Ciencias y Nutrition Salvador Zubiran, Mexico D.F., Mexico; Instituto Oncologico Nacional, Panama City, Panama; MHAT Nadezhda, Sofia, Bulgaria; Lviv State Oncological Regional Centre, Lviv, Ukraine; Obayedullah-Ferdousi Cancer Foundation, Dhaka, Bangladesh; National Kidney and Transplant Institute, Quezon City, Manila, Philippines
| | - D Touya
- The Global Cancer Institute, Boston, MA; Massachusetts General Hospital Cancer Center, Boston, MA; Instituto Nacional do Câncer, Rio de Janeiro, RJ, Brazil; Harvard Medical School, Boston, MA; Marie Curie Hospital, Buenos Aires, Argentina; Hospital Erasto Gaertner, Curitiba, Brazil; Hospital Clinico Viedma, Cochabamba, Bolivia; Institution Nacional de Cancerologia, Bogota, Colombia; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Hospital de Clinicas, Montevideo, Uruguay; INCAN, Guatemala City, Guatemala; Instituto Nacional de Ciencias y Nutrition Salvador Zubiran, Mexico D.F., Mexico; Instituto Oncologico Nacional, Panama City, Panama; MHAT Nadezhda, Sofia, Bulgaria; Lviv State Oncological Regional Centre, Lviv, Ukraine; Obayedullah-Ferdousi Cancer Foundation, Dhaka, Bangladesh; National Kidney and Transplant Institute, Quezon City, Manila, Philippines
| | - S Polo
- The Global Cancer Institute, Boston, MA; Massachusetts General Hospital Cancer Center, Boston, MA; Instituto Nacional do Câncer, Rio de Janeiro, RJ, Brazil; Harvard Medical School, Boston, MA; Marie Curie Hospital, Buenos Aires, Argentina; Hospital Erasto Gaertner, Curitiba, Brazil; Hospital Clinico Viedma, Cochabamba, Bolivia; Institution Nacional de Cancerologia, Bogota, Colombia; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Hospital de Clinicas, Montevideo, Uruguay; INCAN, Guatemala City, Guatemala; Instituto Nacional de Ciencias y Nutrition Salvador Zubiran, Mexico D.F., Mexico; Instituto Oncologico Nacional, Panama City, Panama; MHAT Nadezhda, Sofia, Bulgaria; Lviv State Oncological Regional Centre, Lviv, Ukraine; Obayedullah-Ferdousi Cancer Foundation, Dhaka, Bangladesh; National Kidney and Transplant Institute, Quezon City, Manila, Philippines
| | - Y Chavarri-Guerra
- The Global Cancer Institute, Boston, MA; Massachusetts General Hospital Cancer Center, Boston, MA; Instituto Nacional do Câncer, Rio de Janeiro, RJ, Brazil; Harvard Medical School, Boston, MA; Marie Curie Hospital, Buenos Aires, Argentina; Hospital Erasto Gaertner, Curitiba, Brazil; Hospital Clinico Viedma, Cochabamba, Bolivia; Institution Nacional de Cancerologia, Bogota, Colombia; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Hospital de Clinicas, Montevideo, Uruguay; INCAN, Guatemala City, Guatemala; Instituto Nacional de Ciencias y Nutrition Salvador Zubiran, Mexico D.F., Mexico; Instituto Oncologico Nacional, Panama City, Panama; MHAT Nadezhda, Sofia, Bulgaria; Lviv State Oncological Regional Centre, Lviv, Ukraine; Obayedullah-Ferdousi Cancer Foundation, Dhaka, Bangladesh; National Kidney and Transplant Institute, Quezon City, Manila, Philippines
| | - J Moreno
- The Global Cancer Institute, Boston, MA; Massachusetts General Hospital Cancer Center, Boston, MA; Instituto Nacional do Câncer, Rio de Janeiro, RJ, Brazil; Harvard Medical School, Boston, MA; Marie Curie Hospital, Buenos Aires, Argentina; Hospital Erasto Gaertner, Curitiba, Brazil; Hospital Clinico Viedma, Cochabamba, Bolivia; Institution Nacional de Cancerologia, Bogota, Colombia; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Hospital de Clinicas, Montevideo, Uruguay; INCAN, Guatemala City, Guatemala; Instituto Nacional de Ciencias y Nutrition Salvador Zubiran, Mexico D.F., Mexico; Instituto Oncologico Nacional, Panama City, Panama; MHAT Nadezhda, Sofia, Bulgaria; Lviv State Oncological Regional Centre, Lviv, Ukraine; Obayedullah-Ferdousi Cancer Foundation, Dhaka, Bangladesh; National Kidney and Transplant Institute, Quezon City, Manila, Philippines
| | - N Georgieva
- The Global Cancer Institute, Boston, MA; Massachusetts General Hospital Cancer Center, Boston, MA; Instituto Nacional do Câncer, Rio de Janeiro, RJ, Brazil; Harvard Medical School, Boston, MA; Marie Curie Hospital, Buenos Aires, Argentina; Hospital Erasto Gaertner, Curitiba, Brazil; Hospital Clinico Viedma, Cochabamba, Bolivia; Institution Nacional de Cancerologia, Bogota, Colombia; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Hospital de Clinicas, Montevideo, Uruguay; INCAN, Guatemala City, Guatemala; Instituto Nacional de Ciencias y Nutrition Salvador Zubiran, Mexico D.F., Mexico; Instituto Oncologico Nacional, Panama City, Panama; MHAT Nadezhda, Sofia, Bulgaria; Lviv State Oncological Regional Centre, Lviv, Ukraine; Obayedullah-Ferdousi Cancer Foundation, Dhaka, Bangladesh; National Kidney and Transplant Institute, Quezon City, Manila, Philippines
| | - T Tsolko
- The Global Cancer Institute, Boston, MA; Massachusetts General Hospital Cancer Center, Boston, MA; Instituto Nacional do Câncer, Rio de Janeiro, RJ, Brazil; Harvard Medical School, Boston, MA; Marie Curie Hospital, Buenos Aires, Argentina; Hospital Erasto Gaertner, Curitiba, Brazil; Hospital Clinico Viedma, Cochabamba, Bolivia; Institution Nacional de Cancerologia, Bogota, Colombia; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Hospital de Clinicas, Montevideo, Uruguay; INCAN, Guatemala City, Guatemala; Instituto Nacional de Ciencias y Nutrition Salvador Zubiran, Mexico D.F., Mexico; Instituto Oncologico Nacional, Panama City, Panama; MHAT Nadezhda, Sofia, Bulgaria; Lviv State Oncological Regional Centre, Lviv, Ukraine; Obayedullah-Ferdousi Cancer Foundation, Dhaka, Bangladesh; National Kidney and Transplant Institute, Quezon City, Manila, Philippines
| | - M Obayedullah Baki
- The Global Cancer Institute, Boston, MA; Massachusetts General Hospital Cancer Center, Boston, MA; Instituto Nacional do Câncer, Rio de Janeiro, RJ, Brazil; Harvard Medical School, Boston, MA; Marie Curie Hospital, Buenos Aires, Argentina; Hospital Erasto Gaertner, Curitiba, Brazil; Hospital Clinico Viedma, Cochabamba, Bolivia; Institution Nacional de Cancerologia, Bogota, Colombia; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Hospital de Clinicas, Montevideo, Uruguay; INCAN, Guatemala City, Guatemala; Instituto Nacional de Ciencias y Nutrition Salvador Zubiran, Mexico D.F., Mexico; Instituto Oncologico Nacional, Panama City, Panama; MHAT Nadezhda, Sofia, Bulgaria; Lviv State Oncological Regional Centre, Lviv, Ukraine; Obayedullah-Ferdousi Cancer Foundation, Dhaka, Bangladesh; National Kidney and Transplant Institute, Quezon City, Manila, Philippines
| | - HC Luna
- The Global Cancer Institute, Boston, MA; Massachusetts General Hospital Cancer Center, Boston, MA; Instituto Nacional do Câncer, Rio de Janeiro, RJ, Brazil; Harvard Medical School, Boston, MA; Marie Curie Hospital, Buenos Aires, Argentina; Hospital Erasto Gaertner, Curitiba, Brazil; Hospital Clinico Viedma, Cochabamba, Bolivia; Institution Nacional de Cancerologia, Bogota, Colombia; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Hospital de Clinicas, Montevideo, Uruguay; INCAN, Guatemala City, Guatemala; Instituto Nacional de Ciencias y Nutrition Salvador Zubiran, Mexico D.F., Mexico; Instituto Oncologico Nacional, Panama City, Panama; MHAT Nadezhda, Sofia, Bulgaria; Lviv State Oncological Regional Centre, Lviv, Ukraine; Obayedullah-Ferdousi Cancer Foundation, Dhaka, Bangladesh; National Kidney and Transplant Institute, Quezon City, Manila, Philippines
| | - PE Goss
- The Global Cancer Institute, Boston, MA; Massachusetts General Hospital Cancer Center, Boston, MA; Instituto Nacional do Câncer, Rio de Janeiro, RJ, Brazil; Harvard Medical School, Boston, MA; Marie Curie Hospital, Buenos Aires, Argentina; Hospital Erasto Gaertner, Curitiba, Brazil; Hospital Clinico Viedma, Cochabamba, Bolivia; Institution Nacional de Cancerologia, Bogota, Colombia; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Hospital de Clinicas, Montevideo, Uruguay; INCAN, Guatemala City, Guatemala; Instituto Nacional de Ciencias y Nutrition Salvador Zubiran, Mexico D.F., Mexico; Instituto Oncologico Nacional, Panama City, Panama; MHAT Nadezhda, Sofia, Bulgaria; Lviv State Oncological Regional Centre, Lviv, Ukraine; Obayedullah-Ferdousi Cancer Foundation, Dhaka, Bangladesh; National Kidney and Transplant Institute, Quezon City, Manila, Philippines
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Gorjão-Clara J, Nunes J, Martins-Silva J. Haemorheological studies in Raynaud’s syndrome1. Clin Hemorheol Microcirc 2016. [DOI: 10.3233/ch-1986-6305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- J. Gorjão-Clara
- Department of Medicine I, Hosp. St. Maria and Institute of Biochemistry, Fac. Medicine of Lisbon, 1600 Lisbon, Portugal
| | - J. Nunes
- Department of Medicine I, Hosp. St. Maria and Institute of Biochemistry, Fac. Medicine of Lisbon, 1600 Lisbon, Portugal
| | - J. Martins-Silva
- Department of Medicine I, Hosp. St. Maria and Institute of Biochemistry, Fac. Medicine of Lisbon, 1600 Lisbon, Portugal
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Bonito CA, Nunes J, Leandro J, Louro F, Leandro P, Ventura FV, Guedes RC. Unveiling the Pathogenic Molecular Mechanisms of the Most Common Variant (p.K329E) in Medium-Chain Acyl-CoA Dehydrogenase Deficiency by in Vitro and in Silico Approaches. Biochemistry 2016; 55:7086-7098. [PMID: 27976856 DOI: 10.1021/acs.biochem.6b00759] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Medium-chain acyl-CoA dehydrogenase deficiency (MCADD) is the most common genetic disorder affecting the mitochondrial fatty acid β-oxidation pathway. The mature and functional form of human MCAD (hMCAD) is a homotetramer assembled as a dimer of dimers (monomers A/B and C/D). Each monomer binds a FAD cofactor, necessary for the enzyme's activity. The most frequent mutation in MCADD results from the substitution of a lysine with a glutamate in position 304 of mature hMCAD (p.K329E in the precursor protein). Here, we combined in vitro and in silico approaches to assess the impact of the p.K329E mutation on the protein's structure and function. Our in silico results demonstrated for the first time that the p.K329E mutation, despite lying at the dimer-dimer interface and being deeply buried inside the tetrameric core, seems to affect the tetramer surface, especially the β-domain that forms part of the catalytic pocket wall. Additionally, the molecular dynamics data indicate a stronger impact of the mutation on the protein's motions in dimer A/B, while dimer C/D remains similar to the wild type. For dimer A/B, severe disruptions in the architecture of the pockets and in the FAD and octanoyl-CoA binding affinities were also observed. The presence of unaffected pockets (C/D) in the in silico studies may explain the decreased enzymatic activity determined for the variant protein (46% residual activity). Moreover, the in silico structural changes observed for the p.K329E variant protein provide an explanation for the structural instability observed experimentally, namely, the disturbed oligomeric profile, thermal stability, and conformational flexibility, with respect to the wild-type.
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Affiliation(s)
- Cátia A Bonito
- Department of Biochemistry and Human Biology, §Medicinal Chemistry, Research Institute for Medicines, iMed.ULisboa, ‡Metabolism and Genetics Group, Research Institute for Medicines, iMed.ULisboa, and ∥Department of Pharmaceutical Chemistry and Therapeutics, Faculty of Pharmacy, Universidade de Lisboa , Av. Prof. Gama Pinto, 1649-003 Lisboa, Portugal
| | - Joana Nunes
- Department of Biochemistry and Human Biology, §Medicinal Chemistry, Research Institute for Medicines, iMed.ULisboa, ‡Metabolism and Genetics Group, Research Institute for Medicines, iMed.ULisboa, and ∥Department of Pharmaceutical Chemistry and Therapeutics, Faculty of Pharmacy, Universidade de Lisboa , Av. Prof. Gama Pinto, 1649-003 Lisboa, Portugal
| | - João Leandro
- Department of Biochemistry and Human Biology, §Medicinal Chemistry, Research Institute for Medicines, iMed.ULisboa, ‡Metabolism and Genetics Group, Research Institute for Medicines, iMed.ULisboa, and ∥Department of Pharmaceutical Chemistry and Therapeutics, Faculty of Pharmacy, Universidade de Lisboa , Av. Prof. Gama Pinto, 1649-003 Lisboa, Portugal
| | - Filipa Louro
- Department of Biochemistry and Human Biology, §Medicinal Chemistry, Research Institute for Medicines, iMed.ULisboa, ‡Metabolism and Genetics Group, Research Institute for Medicines, iMed.ULisboa, and ∥Department of Pharmaceutical Chemistry and Therapeutics, Faculty of Pharmacy, Universidade de Lisboa , Av. Prof. Gama Pinto, 1649-003 Lisboa, Portugal
| | - Paula Leandro
- Department of Biochemistry and Human Biology, §Medicinal Chemistry, Research Institute for Medicines, iMed.ULisboa, ‡Metabolism and Genetics Group, Research Institute for Medicines, iMed.ULisboa, and ∥Department of Pharmaceutical Chemistry and Therapeutics, Faculty of Pharmacy, Universidade de Lisboa , Av. Prof. Gama Pinto, 1649-003 Lisboa, Portugal
| | - Fátima V Ventura
- Department of Biochemistry and Human Biology, §Medicinal Chemistry, Research Institute for Medicines, iMed.ULisboa, ‡Metabolism and Genetics Group, Research Institute for Medicines, iMed.ULisboa, and ∥Department of Pharmaceutical Chemistry and Therapeutics, Faculty of Pharmacy, Universidade de Lisboa , Av. Prof. Gama Pinto, 1649-003 Lisboa, Portugal
| | - Rita C Guedes
- Department of Biochemistry and Human Biology, §Medicinal Chemistry, Research Institute for Medicines, iMed.ULisboa, ‡Metabolism and Genetics Group, Research Institute for Medicines, iMed.ULisboa, and ∥Department of Pharmaceutical Chemistry and Therapeutics, Faculty of Pharmacy, Universidade de Lisboa , Av. Prof. Gama Pinto, 1649-003 Lisboa, Portugal
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Marques P, Ferreira F, Soares AP, Nunes J, Sousa S, Aguiar A, Calhaz-Jorge C. Clinico-biochemical characteristics of 229 Portuguese infertile women with polycystic ovary syndrome: clinical relevance and relationship with fertility treatment results. CLIN EXP OBSTET GYN 2016. [DOI: 10.12891/ceog3147.2016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Moreira H, Carona C, Silva N, Nunes J, Canavarro MC. Exploring the link between maternal attachment-related anxiety and avoidance and mindful parenting: The mediating role of self-compassion. Psychol Psychother 2016; 89:369-384. [PMID: 26493983 DOI: 10.1111/papt.12082] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Revised: 06/13/2015] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Mindful parenting has been described as a set of parental practices or skills that seek to enhance moment-to-moment awareness in the parent-child relationship. Although it has been suggested that adopting a mindful approach in parenting may foster positive parent-child relationships and promote the psychological functioning of children and parents, little is known about the factors that may be associated with this parental skill. In this study, we aimed to examine whether attachment-related anxiety and avoidance were associated with mindful parenting through self-compassion. DESIGN AND METHODS The sample included 290 mothers of school-aged children and adolescents recruited in school settings, who completed self-reported measures of adult attachment (Experiences in Close Relationships - Relationships Structures), self-compassion (Self-compassion Scale), and mindful parenting (Interpersonal Mindfulness in Parenting Scale). RESULTS Structural equation modelling was used to test the proposed mediation model and to ascertain direct and indirect effects among study variables. Whereas attachment avoidance had a direct effect on mindful parenting, attachment anxiety was indirectly associated with mindful parenting through self-compassion. Specifically, higher levels of anxiety were associated with lower self-compassion, which, in turn, was associated with lower levels of mindful parenting. Higher levels of avoidance were directly associated with lower levels of mindful parenting. CONCLUSIONS These results demonstrate that mothers' attachment dimensions play an important role in their levels of mindful parenting, although through different pathways. Interventions aimed at promoting mindful parenting skills should attempt to promote parents' self-compassion and consider parents' levels of attachment insecurity. PRACTITIONER POINTS The results underline the important role of mothers' attachment on levels of mindful parenting and evidence different pathways through which attachment anxiety and attachment avoidance are associated with this parental skill. Higher levels of attachment avoidance were directly associated with lower levels of mindful parenting, whereas higher levels of anxiety were indirectly associated with lower levels of mindful parenting through lower levels of self-compassion. Mothers who are more self-compassionate are more able to adopt a mindful stance in the parent-child relationship. Parenting interventions aimed at promoting mindfulness skills in the parenting context can benefit from including self-compassionate exercises and are particularly important for insecurely attached parents.
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Affiliation(s)
- Helena Moreira
- Faculty of Psychology and Education Sciences, University of Coimbra, Portugal.
| | - Carlos Carona
- Faculty of Psychology and Education Sciences, University of Coimbra, Portugal.,Coimbra Cerebral Palsy Association, Portugal
| | - Neuza Silva
- Faculty of Psychology and Education Sciences, University of Coimbra, Portugal
| | - Joana Nunes
- Faculty of Psychology and Education Sciences, University of Coimbra, Portugal
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Oliveira Ferreira A, Fidalgo C, Palmela C, Costa Santos MP, Torres J, Nunes J, Loureiro R, Ferreira R, Barjas E, Glória L, Santos AA, Cravo M. Adenoma Detection Rate: I Will Show You Mine if You Show Me Yours. GE Port J Gastroenterol 2016; 24:61-67. [PMID: 28848785 DOI: 10.1159/000450901] [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] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 09/13/2016] [Indexed: 12/25/2022]
Abstract
BACKGROUND Colorectal cancer (CRC) is the first cause of cancer-related mortality in Portugal. CRC screening reduces disease-specific mortality. Colonoscopy is currently the preferred method for screening as it may contribute to the reduction of CRC incidence. This beneficial effect is strongly associated with the adenoma detection rate (ADR). AIM Our aim was to evaluate the quality of colonoscopy at our unit by measuring the currently accepted quality parameters and publish them as benchmarking indicators. METHODS From 5,860 colonoscopies, 654 screening procedures (with and without previous fecal occult blood testing) were analyzed. RESULTS The mean age of the patients was 66.4 ± 7.8 years, and the gender distribution was 1:1. The overall ADR was 36% (95% confidence interval [CI] 32-39), the mean number of adenomas per colonoscopy was 0.66 (95% CI 0.56-0.77), and the sessile serrate lesion detection rate was 1% (95% CI 0-2). The bowel preparation was rated as adequate in 496 (76%) patients. The adjusted cecal intubation rate (CIR) was 93.7% (95% CI 91.7-95.8). Most colonoscopies were performed under monitored anesthesia care (53%), and 35% were unsedated. The use of sedation (propofol or midazolam based) was associated with a higher CIR with an odds ratio of 3.60 (95% CI 2.02-6.40, p < 0.001). CONCLUSION Our data show an above-standard ADR. The frequency of poor bowel preparation and the low sessile serrated lesion detection rate were acknowledged, and actions were implemented to improve both indicators. Quality auditing in colonoscopy should be compulsory, and while many units may do so internally, this is the first national report from a high-throughput endoscopy unit.
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Affiliation(s)
| | - Catarina Fidalgo
- Gastroenterology Department, Hospital Beatriz Ângelo, Loures, Portugal
| | - Carolina Palmela
- Gastroenterology Department, Hospital Beatriz Ângelo, Loures, Portugal
| | | | - Joana Torres
- Gastroenterology Department, Hospital Beatriz Ângelo, Loures, Portugal
| | - Joana Nunes
- Gastroenterology Department, Hospital Beatriz Ângelo, Loures, Portugal
| | - Rui Loureiro
- Gastroenterology Department, Hospital Beatriz Ângelo, Loures, Portugal
| | - Rosa Ferreira
- Gastroenterology Department, Hospital Beatriz Ângelo, Loures, Portugal
| | - Elídio Barjas
- Gastroenterology Department, Hospital Beatriz Ângelo, Loures, Portugal
| | - Luísa Glória
- Gastroenterology Department, Hospital Beatriz Ângelo, Loures, Portugal
| | | | - Marília Cravo
- Gastroenterology Department, Hospital Beatriz Ângelo, Loures, Portugal
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Nunes J, Nunes S, Veiga M, Cortez M, Seifert I. Estudo prospectivo, randômico, controlado e de avaliação cega do desfecho – infusão peridural contínua versus bolus epidural intermitente programado em analgesia de parto. Braz J Anesthesiol 2016; 66:439-44. [DOI: 10.1016/j.bjan.2015.10.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2014] [Accepted: 12/11/2014] [Indexed: 01/06/2023] Open
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Antunes A, Nunes J, Martins I, Charneira C, Pogribny I, De Conti A, Beland F, Marques M, Jacob C. Modification of histone H2b in a rat model by a reactive metabolite of the chemical carcinogen and food contaminant furan. Toxicol Lett 2016. [DOI: 10.1016/j.toxlet.2016.06.1405] [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: 10/21/2022]
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Gomes R, Nunes J, Marques M. Synthesis and characterization of biomarkers of exposure to 1-bromopropane. Toxicol Lett 2016. [DOI: 10.1016/j.toxlet.2016.06.1368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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