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Saway B, Cunningham C, Pereira M, Sowlat M, Elawady S, Porto G, Barley J, Nordmann N, Frankel B. Robotic endoscopic transforaminal lumbar interbody fusion: A single institution case series. World Neurosurg X 2024; 23:100390. [PMID: 38746041 PMCID: PMC11091683 DOI: 10.1016/j.wnsx.2024.100390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 04/29/2024] [Indexed: 05/16/2024] Open
Abstract
Background Robotic-assisted, endoscopic transforaminal lumbar interbody fusion (RE-TLIF) is a promising, minimally invasive surgical option for degenerative lumbar spondylosis/spondylolisthesis; however, outcomes data and efficacy are limited, especially in multilevel disease. Here, we present the first reported series of patients that underwent either single or multilevel RE-TLIF. Methods A retrospective review was performed on 23 consecutive patients who underwent a single level or multilevel RE-TLIF by a single surgeon. Variables included demographics, perioperative results, pain scores, and functional outcome scores. Results Eighteen patients (78.3 %) underwent single level RE-TLIF and 5 patients (21.7 %) underwent multilevel RE-TLIF. The median reduction of visual analog scale (VAS) for low back pain (LBP) of all subjects was 6 (IQR = 4.5, 6.5) with no significant difference between single level and multilevel RE-TLIF (p = 0.565). The median reduction of VAS for leg pain of all subjects 7 (IQR = 6, 8) with no significant difference between single level and multilevel RE-TLIF (p = 0.702). Median blood loss was 25 cc (IQR = 25, 25) and 50 cc (IQR = 25, 100) for single and multilevel RE-TLIF, respectively (p = 0.025), whereas median length of stay was 1 (IQR = 1, 1; mean = 1.0 ± 00.18) days and 1 (IQR = 1, 2; mean = 1.4 ± 00.54) days, respectively (p = 0.042). One major complication was observed requiring reoperation for demineralized bone matrix migration resulting in an L5 radiculopathy. Conclusions Single and multi-level RE-TLIF appears to be a safe and efficacious approach with comparable outcomes to open and other minimally invasive approaches. Additionally, we observed favorable accuracy in robot-assisted pedicle screw, endoscope, and interbody device placement.
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Affiliation(s)
- B.F. Saway
- Medical University of South Carolina, Department of Neurosurgery, Charleston, SC, 29425, USA
| | - C. Cunningham
- Medical University of South Carolina, Department of Neurosurgery, Charleston, SC, 29425, USA
| | - M. Pereira
- Medical University of South Carolina, Department of Neurosurgery, Charleston, SC, 29425, USA
| | - M. Sowlat
- Medical University of South Carolina, Department of Neurosurgery, Charleston, SC, 29425, USA
| | - S.S. Elawady
- Medical University of South Carolina, Department of Neurosurgery, Charleston, SC, 29425, USA
| | - G. Porto
- Medical University of South Carolina, Department of Neurosurgery, Charleston, SC, 29425, USA
| | - J. Barley
- Medical University of South Carolina, Department of Neurosurgery, Charleston, SC, 29425, USA
| | - Nathan Nordmann
- Southern Illinois University, School of Medicine, Division of Neurosurgery, Springfield, IL, 62702, USA
| | - B. Frankel
- Southern Illinois University, School of Medicine, Division of Neurosurgery, Springfield, IL, 62702, USA
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Pereira M, Tocino MLS, Mas-Fontao S, Manso P, Burgos M, Carneiro D, Ortiz A, Arenas MD, González-Parra E. Dependency and frailty in the older haemodialysis patient. BMC Geriatr 2024; 24:416. [PMID: 38730386 PMCID: PMC11088105 DOI: 10.1186/s12877-024-04973-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 04/12/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Frailty among older adults undergoing hemodialysis is increasingly prevalent, significantly impacting cognitive function, mobility, and social engagement. This study focuses on the clinical profiles of very older adults in hemodialysis, particularly examining the interplay of dependency and frailty, and their influence on dialysis regimens. METHODS In this observational, descriptive study, 107 patients aged over 75 from four outpatient centers and one hospital unit were examined over a year. Patient data encompassed sociodemographic factors, dialysis specifics, analytical outcomes, lifestyle elements, and self-reported post-treatment fatigue. Malnutrition-inflammation scale was used to measure the Nutritional status; MIS scale for malnutrition-inflammation, Barthel index for dependency, Charlson comorbidity index; FRIED scale for frailty and the SF12 quality of life measure. RESULTS The study unveiled that a substantial number of older adults on hemodialysis faced malnutrition (55%), dependency (21%), frailty (46%), and diminished quality of life (57%). Patients with dependency were distinctively marked by higher comorbidity, severe malnutrition, enhanced frailty, nursing home residency, dependency on ambulance transportation, and significantly limited mobility, with 77% unable to walk. Notably, 56% of participants experienced considerable post-dialysis fatigue, correlating with higher comorbidity, increased dependency, and poorer quality of life. Despite varying clinical conditions, dialysis patterns were consistent across the patient cohort. CONCLUSIONS The older adult cohort, averaging over four years on hemodialysis, exhibited high rates of comorbidity, frailty, and dependency, necessitating substantial support in transport and living arrangements. A third of these patients lacked residual urine output, yet their dialysis regimen mirrored those with preserved output. The study underscores the imperative for tailored therapeutic strategies to mitigate dependency, preserve residual renal function, and alleviate post-dialysis fatigue, ultimately enhancing the physical quality of life for these patients.
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Affiliation(s)
- M Pereira
- Fundación Renal Íñigo Álvarez de Toledo, Madrid, 28003, Spain
| | - M L Sanchez Tocino
- Fundación Renal Íñigo Álvarez de Toledo, Madrid, 28003, Spain
- Facultad de Enfermería, Universidad de Salamanca, Salamanca, Spain
| | - Sebastian Mas-Fontao
- Instituto de Investigación Sanitaria Fundación Jimenez Díaz, Madrid, 28040, Spain.
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain.
- Facultad de Medicina y Biomedicina, Universidad Alfonso X, Villanueva de la Cañada, Spain.
| | - P Manso
- Fundación Renal Íñigo Álvarez de Toledo, Madrid, 28003, Spain
| | - M Burgos
- Fundación Renal Íñigo Álvarez de Toledo, Madrid, 28003, Spain
| | - D Carneiro
- Fundación Renal Íñigo Álvarez de Toledo, Madrid, 28003, Spain
| | - A Ortiz
- Instituto de Investigación Sanitaria Fundación Jimenez Díaz, Madrid, 28040, Spain
- Servicio de Nefrología, Fundación Jiménez Díaz, Madrid, Spain
| | - M D Arenas
- Fundación Renal Íñigo Álvarez de Toledo, Madrid, 28003, Spain
| | - E González-Parra
- Fundación Renal Íñigo Álvarez de Toledo, Madrid, 28003, Spain.
- Instituto de Investigación Sanitaria Fundación Jimenez Díaz, Madrid, 28040, Spain.
- Servicio de Nefrología, Fundación Jiménez Díaz, Madrid, Spain.
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Torres C, Valerio O, Mendonça RT, Pereira M. Influence of chitosan protonation degree in nanofibrillated cellulose/chitosan composite films and their morphological, mechanical, and surface properties. Int J Biol Macromol 2024; 267:131587. [PMID: 38631587 DOI: 10.1016/j.ijbiomac.2024.131587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 03/25/2024] [Accepted: 04/11/2024] [Indexed: 04/19/2024]
Abstract
Composite films of nanofibrillated cellulose (NFC) and chitosan (CS) were prepared by spray deposition method, and the influence of polymers ratio and protonation degree (α) of chitosan was evaluated. Films were characterized using morphological, mechanical, and surface techniques. Higher NFC content increased Young's modulus of film composites and reduced air permeability, while higher CS content increased water contact angle. Variations in the degree of protonation of chitosan from non-protonated (α = 0) to fully protonated (α = 1) in the NFC/CS composite film with a fixed composition allowed to modulate surface, mechanical, and structural properties, such as water contact angle (31.3-109.2°), Young's modulus (1.7-5.3 GPa), elongation at break (3.1-1.2 %), oxygen transmission rate (9.0-5.5 cm3/m2day) and air permeability (2074-426 s). Highly protonated chitosan composite films showed similar contact angles to pure chitosan films, while low protonated chitosan composite films presented contact angles similar to pure NFC films, suggesting a possible coating effect of NFC by CS through electrostatic interactions, evidenced by microscopy and spectroscopy analysis. By mixing both polymers and adjusting composition and protonation degree it was possible to enhance their properties, making pH adjustment a useful tool for NFC/CS composite films formation.
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Affiliation(s)
- Camilo Torres
- Departamento de Ingeniería Química, Facultad de Ingeniería, Universidad de Concepción, Concepción 4030000, Chile; Facultad de Ciencias Forestales, Universidad de Concepción, Concepción 4030000, Chile
| | - Oscar Valerio
- Departamento de Ingeniería Química, Facultad de Ingeniería, Universidad de Concepción, Concepción 4030000, Chile
| | - Regis Teixeira Mendonça
- Facultad de Ciencias Forestales, Universidad de Concepción, Concepción 4030000, Chile; Centro de Biotecnología, Universidad de Concepción, Concepción 4030000, Chile
| | - Miguel Pereira
- Departamento de Ingeniería Química, Facultad de Ingeniería, Universidad de Concepción, Concepción 4030000, Chile; Unidad de Desarrollo Tecnológico (UDT), Universidad de Concepción, Coronel 4190000, Chile.
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Dramburg S, Grittner U, Potapova E, Travaglini A, Tripodi S, Arasi S, Pelosi S, Acar Şahin A, Aggelidis X, Barbalace A, Bourgoin A, Bregu B, Brighetti MA, Caeiro E, Caglayan Sozmen S, Caminiti L, Charpin D, Couto M, Delgado L, Di Rienzo Businco A, Dimier C, Dimou MV, Fonseca JA, Goksel O, Hernandez D, Hernandez Toro CJ, Hoffmann TM, Jang DT, Kalpaklioglu F, Lame B, Llusar R, Makris M, Mazon A, Mesonjesi E, Nieto A, Öztürk AB, Pahus L, Pajno G, Panasiti I, Papadopoulos NG, Pellegrini E, Pereira AM, Pereira M, Pinar NM, Priftanji A, Psarros F, Sackesen C, Sfika I, Suarez J, Thibaudon M, Uguz U, Verdier V, Villella V, Xepapadaki P, Yazici D, Matricardi PM. Heterogeneity of sensitization profiles and clinical phenotypes among patients with seasonal allergic rhinitis in Southern European countries-The @IT.2020 multicenter study. Allergy 2024; 79:908-923. [PMID: 38311961 DOI: 10.1111/all.16029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 11/30/2023] [Accepted: 12/04/2023] [Indexed: 02/06/2024]
Abstract
BACKGROUND Pollen allergy poses a significant health and economic burden in Europe. Disease patterns are relatively homogeneous within Central and Northern European countries. However, no study broadly assessed the features of seasonal allergic rhinitis (SAR) across different Southern European countries with a standardized approach. OBJECTIVE To describe sensitization profiles and clinical phenotypes of pollen allergic patients in nine Southern European cities with a uniform methodological approach. METHODS Within the @IT.2020 multicenter observational study, pediatric and adult patients suffering from SAR were recruited in nine urban study centers located in seven countries. Clinical questionnaires, skin prick tests (SPT) and specific IgE (sIgE) tests with a customized multiplex assay (Euroimmun Labordiagnostika, Lübeck, Germany) were performed. RESULTS Three hundred forty-eight children (mean age 13.1 years, SD: 2.4 years) and 467 adults (mean age 35.7 years SD: 10.0 years) with a predominantly moderate to severe, persistent phenotype of SAR were recruited. Grass pollen major allergenic molecules (Phl p 1 and/or Phl p 5) ranged among the top three sensitizers in all study centers. Sensitization profiles were very heterogeneous, considering that patients in Rome were highly poly-sensitized (sIgE to 3.8 major allergenic molecules per patient), while mono-sensitization was prominent and heterogeneous in other cities, such as Marseille (sIgE to Cup a 1: n = 55/80, 68.8%) and Messina (sIgE to Par j 2: n = 47/82, 57.3%). Co-sensitization to perennial allergens, as well as allergic comorbidities also broadly varied between study centers. CONCLUSIONS In Southern European countries, pollen allergy is heterogeneous in terms of sensitization profiles and clinical manifestations. Despite the complexity, a unique molecular, multiplex, and customized in-vitro IgE test detected relevant sensitization in all study centers. Nevertheless, this geographical diversity in pollen allergic patients imposes localized clinical guidelines and study protocols for clinical trials of SAR in this climatically complex region.
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Affiliation(s)
- S Dramburg
- Department of Pediatric Respiratory Care, Immunology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - U Grittner
- Institute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - E Potapova
- Department of Pediatric Respiratory Care, Immunology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - A Travaglini
- Department of Biology, Tor Vergata University, Rome, Italy
- Italian Aerobiology Monitoring Network - Italian Aerobiology Association, Rome, Italy
| | - S Tripodi
- Pediatric Allergy Unit, Sandro Pertini Hospital, Rome, Italy
- Allergolology Service, Policlinico Casilino, Rome, Italy
| | - S Arasi
- Department of Pediatric Respiratory Care, Immunology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Pediatric Allergology Unit, Department of Pediatric Medicine, Bambino Gesù Children's Research Hospital (IRCCS), Rome, Italy
| | | | - A Acar Şahin
- Department of Biology, Faculty of Science, Ankara University, Ankara, Turkey
| | - X Aggelidis
- Allergy Unit, 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, University Hospital "Attikon", Athens, Greece
| | - A Barbalace
- Allergy Unit, Department of Pediatrics, University of Messina, Messina, Italy
| | - A Bourgoin
- Department of Pneumonology and Allergy, La Timone Hospital, APHM, Aix-Marseille University, Marseille, France
| | - B Bregu
- Department of Allergology and Clinical Immunology, UHC Mother Teresa, Medical University Tirana, Tirana, Albania
| | - M A Brighetti
- Department of Biology, Tor Vergata University, Rome, Italy
| | - E Caeiro
- MED- Mediterranean Institute for Agriculture, Environment and Development, Institute for Advanced Studies and Research, University of Évora, Évora, Portugal
- Portuguese Society of Allergology and Clinical Immunology, Lisbon, Portugal
| | | | - L Caminiti
- Allergy Unit, Department of Pediatrics, University of Messina, Messina, Italy
| | - D Charpin
- Department of Pneumonology and Allergy, La Timone Hospital, APHM, Aix-Marseille University, Marseille, France
| | - M Couto
- Immunoallergology, Hospital CUF Trindade, Porto, Portugal
| | - L Delgado
- Basic and Clinical Immunology Unit, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS@RISE, MEDCIDS, Faculty of Medicine of the University of Porto, Porto, Portugal
- Allergy Unit, Instituto & Hospital CUF Porto, Porto, Portugal
| | | | - C Dimier
- Department of Pneumonology and Allergy, La Timone Hospital, APHM, Aix-Marseille University, Marseille, France
| | - M V Dimou
- Allergy Department, 2nd Pediatric Clinic, Athens General Children's Hospital "P&A Kyriakou", University of Athens, Athens, Greece
| | - J A Fonseca
- CINTESIS@RISE, MEDCIDS, Faculty of Medicine of the University of Porto, Porto, Portugal
- Allergy Unit, Instituto & Hospital CUF Porto, Porto, Portugal
- MEDCIDS-Department of Community Medicine, Information, and Health Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
| | - O Goksel
- Department of Pulmonary Medicine, Division of Immunology, Allergy and Asthma. Faculty of Medicine, Ege University, Izmir, Turkey
| | - D Hernandez
- Department of Allergy, Health Research Institute Hospital La Fe, Valencia, Spain
| | - C J Hernandez Toro
- Department of Pediatric Respiratory Care, Immunology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Institute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - T M Hoffmann
- Department of Pediatric Respiratory Care, Immunology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - D T Jang
- Pediatric Allergy and Pneumology Unit, Children's Hospital La Fe; Health Research Institute La Fe, Valencia, Spain
| | - F Kalpaklioglu
- Department of Immunology and Allergic Diseases, Kırıkkale University School of Medicine, Kırıkkale, Turkey
| | - B Lame
- Department of Allergology and Clinical Immunology, UHC Mother Teresa, Medical University Tirana, Tirana, Albania
| | - R Llusar
- Pediatric Allergy and Pneumology Unit, Children's Hospital La Fe; Health Research Institute La Fe, Valencia, Spain
| | - M Makris
- Allergy Unit, 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, University Hospital "Attikon", Athens, Greece
| | - A Mazon
- Pediatric Allergy and Pneumology Unit, Children's Hospital La Fe; Health Research Institute La Fe, Valencia, Spain
| | - E Mesonjesi
- Department of Allergology and Clinical Immunology, UHC Mother Teresa, Medical University Tirana, Tirana, Albania
| | - A Nieto
- Pediatric Allergy and Pneumology Unit, Children's Hospital La Fe; Health Research Institute La Fe, Valencia, Spain
| | - A B Öztürk
- Division of Allergy and Immunology, Department of Pulmonary Medicine, Arel University, School of Medicine, Istanbul, Turkey
| | - L Pahus
- Aix Marseille Univ, APHM, INSERM CIC 1409, INSERM U1263, INRA 1260 (C2VN), Marseille, France
| | - G Pajno
- Allergy Unit, Department of Pediatrics, University of Messina, Messina, Italy
| | - I Panasiti
- Allergy Unit, Department of Pediatrics, University of Messina, Messina, Italy
| | - N G Papadopoulos
- Allergy Department, 2nd Pediatric Clinic, Athens General Children's Hospital "P&A Kyriakou", University of Athens, Athens, Greece
- Division of Infection, Immunity & Respiratory Medicine, Royal Manchester Children's Hospital, University of Manchester, Manchester, UK
| | - E Pellegrini
- Department of Reggio Calabria, ARPA - Regional Agency for Environmental Protection, Calabria, Italy
| | - A M Pereira
- Allergy Unit, Instituto & Hospital CUF Porto, Porto, Portugal
- MEDCIDS-Department of Community Medicine, Information, and Health Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
| | - M Pereira
- Basic and Clinical Immunology Unit, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS@RISE, MEDCIDS, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - N M Pinar
- Department of Biology, Faculty of Science, Ankara University, Ankara, Turkey
| | - A Priftanji
- Department of Allergology and Clinical Immunology, UHC Mother Teresa, Medical University Tirana, Tirana, Albania
| | - F Psarros
- Allergy Department, Athens Naval Hospital, Athens, Greece
| | - C Sackesen
- Division of Pediatric Allergy, Koç University School of Medicine, Istanbul, Turkey
| | - I Sfika
- Pediatric Allergy Unit, Sandro Pertini Hospital, Rome, Italy
| | - J Suarez
- Department of Biology of Organisms and Systems, Area of Botany, University of Oviedo, Oviedo, Spain
| | - M Thibaudon
- Réseau National de Surveillance Aérobiologique, Brussieu, France
| | - U Uguz
- Department of Biology, Faculty of Science, Ege University, Izmir, Turkey
| | - V Verdier
- Department of Pneumonology and Allergy, La Timone Hospital, APHM, Aix-Marseille University, Marseille, France
| | - V Villella
- Pediatric Allergy Unit, Sandro Pertini Hospital, Rome, Italy
| | - P Xepapadaki
- Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
| | - D Yazici
- Cellular and Molecular Medicine, KUTTAM, Graduate School of Health Sciences, Koç University, Istanbul, Turkey
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - P M Matricardi
- Department of Pediatric Respiratory Care, Immunology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Gallelli MF, Zampini E, Trasorras V, Carretero MI, Bertuzzi M, Amusquibar V, Pereira M, Bianchi CP. Haematology and biochemistry in healthy llamas at sea level. Vet Res Commun 2024; 48:1253-1256. [PMID: 38105361 DOI: 10.1007/s11259-023-10285-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 12/14/2023] [Indexed: 12/19/2023]
Abstract
In the last years, there has been an increasing interest in llamas, not only as part of a productive system, but mostly as companion animals. Most reports regarding clinical biochemistry and haematology include few llamas and details about their health status are not available. The present study aims to provide haematological and biochemical parameters for llamas of known health status. Twenty-three non-pregnant females and seven males that live in Buenos Aires, Argentina (34°36'S, 58°22'W, at sea level) were studied. Llamas were clinically healthy, in good nutritional status. Animals were kept at grass and were fed hay bale or pellets and water ad libitum. Blood samples were collected by jugular venipuncture in spring. Packed cell volume, leucocyte count, differential white cell count, platelets count, urea, creatinine, total proteins, albumin, alkaline phosphatase, aspartate aminotransferase, alanine aminotransferase, glucose, calcium and phosphate were assessed. No significant differences were observed between males and females, except for platelet count and calcium, which was greater in males (P˂0.01). Values obtained for the different parameters were similar to those previously reported, except for monocytes, alkaline phosphatase, glucose and calcium, that were lower and lymphocytes and platelets count, that were higher in this study. In conclusion, different ambient and methodological conditions might affect some parameters. The parameters hereby presented are representative of llama's population living at sea level in South America.
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Affiliation(s)
- M F Gallelli
- Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina.
- Instituto de Investigación y Tecnología en Reproducción Animal (INITRA), Facultad de Ciencias Veterinarias, UBA, Buenos Aires, Argentina.
| | - E Zampini
- Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina
- Instituto de Investigación y Tecnología en Reproducción Animal (INITRA), Facultad de Ciencias Veterinarias, UBA, Buenos Aires, Argentina
| | - V Trasorras
- Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina
- Instituto de Investigación y Tecnología en Reproducción Animal (INITRA), Facultad de Ciencias Veterinarias, UBA, Buenos Aires, Argentina
| | - M I Carretero
- Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina
- Instituto de Investigación y Tecnología en Reproducción Animal (INITRA), Facultad de Ciencias Veterinarias, UBA, Buenos Aires, Argentina
| | - M Bertuzzi
- Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina
- Instituto de Investigación y Tecnología en Reproducción Animal (INITRA), Facultad de Ciencias Veterinarias, UBA, Buenos Aires, Argentina
| | - V Amusquibar
- Instituto de Investigación y Tecnología en Reproducción Animal (INITRA), Facultad de Ciencias Veterinarias, UBA, Buenos Aires, Argentina
| | - M Pereira
- Laboratorio de Análisis Clínicos, Hospital Escuela, Facultad de Ciencias Veterinarias, UBA, Buenos Aires, Argentina
| | - C P Bianchi
- Laboratorio de Endocrinología, CIVETAN, Fac. de Cs. Veterinarias, UNCPBA, Ciudad de Tandil, Buenos Aires, Argentina
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Rêgo A, Nannoni S, Scherz A, Eskandari A, Salerno A, Pereira M, Strambo D, Michel P. Undiagnosed major risk factors in acute ischaemic stroke patients: frequency, profile, stroke mechanisms and outcome. Eur J Neurol 2024; 31:e16011. [PMID: 37525351 DOI: 10.1111/ene.16011] [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: 12/13/2022] [Revised: 07/17/2023] [Accepted: 07/26/2023] [Indexed: 08/02/2023]
Abstract
BACKGROUND AND PURPOSE There is scarce clinical information about the clinical profile of patients with acute ischaemic stroke with previously undiagnosed major vascular risk factors (UMRFs). METHODS This was a retrospective analysis of data from the Acute Stroke Registry and Analysis of Lausanne registry between 2003 and 2018 with univariate and multivariate logistic regression analyses comparing clinical profiles of patients with UMRFs to patients with at least one previously diagnosed MRF (DMRF). RESULTS In all, 4354 patients (median age 70 years [interquartile range 15.2], 44.7% female) were included after excluding 763 (14.9%) for lack of consent and three for missing information. Amongst 1125 (25.8%) UMRF patients, 69.7% (n = 784) had at least one newly diagnosed MRF and the others none. The newly detected MRFs were dyslipidaemia (61.4%), hypertension (23.7%), atrial fibrillation (10.2%), diabetes mellitus (5.2%), ejection fraction <35% (2.0%) and coronary disease (1.0%). Comparing UMRF patients to DMRF patients, multivariate analysis showed a positive association with lower age, non-Caucasian ethnicity, contraceptive use (<55 years old), smoking (≥55 years old) and patent-foramen-ovale-related stroke mechanism. A negative association was found with pre-stroke antiplatelet use and higher body mass index. Functional outcome did not differ. Cerebrovascular recurrences were similar between groups. CONCLUSIONS In this large single-centre cohort, 69.7% of patients with acute ischaemic stroke and UMRF were newly diagnosed with at least one new MRF, the most common being dyslipidaemia, hypertension or atrial fibrillation. Patients of the UMRF group were younger, more often smokers and on contraceptives, and had more patent-foramen-ovale-related strokes.
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Affiliation(s)
- André Rêgo
- Stroke Center, Service of Neurology, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Hospital Prof. Doutor Fernando Fonseca, Serviço de Neurologia, Amadora, Portugal
| | - Stefania Nannoni
- Stroke Research Group, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Ali Scherz
- Stroke Center, Service of Neurology, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Ashraf Eskandari
- Stroke Center, Service of Neurology, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Alexander Salerno
- Stroke Center, Service of Neurology, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | | | - Davide Strambo
- Stroke Center, Service of Neurology, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Patrik Michel
- Stroke Center, Service of Neurology, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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Kilfoy A, Panesar P, Hashemi E, Masama T, Pereira M, Liu W, Alexander S, Korenblum C, Jibb LA. "It just made me feel better": qualitative examination of the implementation of a novel virtual psychosocial support program for adolescents with cancer. Support Care Cancer 2023; 31:610. [PMID: 37792141 DOI: 10.1007/s00520-023-08054-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 09/18/2023] [Indexed: 10/05/2023]
Abstract
PURPOSE Adolescents with cancer routinely report feelings of isolation and exclusion, including from medical decision-making. To address this problem and support adolescents, we designed and implemented the novel, virtual, weekly Teens4Teens peer support group and patient education program. We examined the views of participating adolescents, program guest speakers, and program moderators as they pertained to the need for the program, its feasibility, acceptability, and perceived impact. METHODS We recruited all available adolescents, moderators, and guest speakers who participated in Teens4Teens to take part in audio-recorded, semi-structured interviews. Interviews were transcribed, coded, and analyzed using thematic analysis. RESULTS We conducted 21 interviews across participant groups. We identified four broad themes: pathways into the Teen4Teens program, Teens4Teens implementation capacity, perspectives of the positive impact of Teens4Teens, and suggestions to improve Teens4Teens. These themes described a perceived need for adolescent-centered psychosocial programming in pediatric cancer care, provided lessons on how best to build and apply such a program, and highlighted the value of the program for both adolescents' and clinicians' acceptability, feasibility, and perceived utility. CONCLUSION Adolescents, guest speakers, and moderators valued Teens4Teens and made suggestions to improve capacity to routinely implement the program. Adolescent-tailored psychosocial programming, such as Teens4Teens, is positioned to be integrated into clinical care with relative ease and may serve to improve the cancer care experience of adolescents and their families. This study has potential to provide researchers and clinicians with valuable information about the content, design, and delivery of virtual peer support programming for adolescents with cancer.
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Affiliation(s)
- A Kilfoy
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College St, Toronto, ON, M5T 1P8, Canada
- Division of Hematology and Oncology, Hospital for Sick Children, 170 Elizabeth St, Toronto, ON, M5G 1E8, Canada
- Child Health Evaluative Sciences, Hospital for Sick Children, 686 Bay Street, Toronto, ON, M5G 0A4, Canada
| | - P Panesar
- Faculty of Health Sciences, McMaster University, 1280 Main Street West, ON, Hamilton, L8S 4L8, Canada
| | - E Hashemi
- Child Health Evaluative Sciences, Hospital for Sick Children, 686 Bay Street, Toronto, ON, M5G 0A4, Canada
| | - T Masama
- Division of Hematology and Oncology, Hospital for Sick Children, 170 Elizabeth St, Toronto, ON, M5G 1E8, Canada
| | - M Pereira
- Child Health Evaluative Sciences, Hospital for Sick Children, 686 Bay Street, Toronto, ON, M5G 0A4, Canada
| | - W Liu
- Faculty of Medicine, University of British Columbia, 317-2194 Health Sciences Mall, Vancouver, BC, V6T 1Z3, Canada
| | - S Alexander
- Division of Hematology and Oncology, Hospital for Sick Children, 170 Elizabeth St, Toronto, ON, M5G 1E8, Canada
- Temerty Faculty of Medicine, University of Toronto, 1 King's College Cir, ON, Toronto, M5S 1A8, Canada
| | - C Korenblum
- Department of Supportive Care, University Health Network, Princess Margaret Cancer Centre, 610 University Ave, Toronto, ON, M6G 2C4, Canada
- Temerty Faculty of Medicine, University of Toronto, 1 King's College Cir, ON, Toronto, M5S 1A8, Canada
- Division of Adolescent Medicine, Hospital for Sick Children, 170 Elizabeth St, Toronto, ON, M5G 1E8, Canada
| | - L A Jibb
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College St, Toronto, ON, M5T 1P8, Canada.
- Division of Hematology and Oncology, Hospital for Sick Children, 170 Elizabeth St, Toronto, ON, M5G 1E8, Canada.
- Child Health Evaluative Sciences, Hospital for Sick Children, 686 Bay Street, Toronto, ON, M5G 0A4, Canada.
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8
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Coelho M, Abreu D, Silva L, Pereira M, Mautempo F. [Lead Exposure as Cause of a Clinical Scenario of Cardiac Arrhythmias]. ACTA MEDICA PORT 2023; 36:595-597. [PMID: 36252274 DOI: 10.20344/amp.18791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 09/15/2022] [Indexed: 06/16/2023]
Abstract
The recycling of used batteries has raised public health concerns as this activity is associated with occupational and environmental exposure to lead. We describe the case of a 26-year-old woman who experienced palpitations associated with headaches, fatigue and insomnia. Blood tests showed anemia (Hb 11.9 g/dL) and a lead concentration of 59 μg/dL. This was reported about four months after starting work in a battery recycling company. She left the company and, reported a gradual decrease in symptoms about one month later. The analytical study revealed a normalization of hemoglobin levels (12.2 g/dL) and a decrease in blood lead levels to 23.4 μg/dL. The health effects of lead exposure are nonspecific, and its diagnosis requires a high degree of suspicion. In this context, the collaboration between the Attending Physician and the Health and Safety Departments of companies is important.
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Affiliation(s)
- Margarida Coelho
- Serviço de Medicina do Trabalho e Saúde Ocupacional. Centro Hospitalar do Baixo Vouga. Aveiro. Portugal
| | - Diogo Abreu
- Serviço de Medicina do Trabalho e Saúde Ocupacional. Centro Hospitalar do Baixo Vouga. Aveiro. .
| | - Laura Silva
- Serviço de Medicina do Trabalho e Saúde Ocupacional. Centro Hospitalar do Baixo Vouga. Aveiro. Portugal
| | - Miguel Pereira
- Serviço de Medicina do Trabalho e Saúde Ocupacional. Centro Hospitalar do Baixo Vouga. Aveiro. Portugal
| | - Fernando Mautempo
- Serviço de Medicina do Trabalho e Saúde Ocupacional. Centro Hospitalar do Baixo Vouga. Aveiro. Portugal
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9
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Fernández K, Llanquileo A, Bustos M, Aedo V, Ruiz I, Carrasco S, Tapia M, Pereira M, Meléndrez MF, Aguayo C, Atanase LI. Self-Assembled CNF/rGO/Tannin Composite: Study of the Physicochemical and Wound Healing Properties. Polymers (Basel) 2023; 15:2752. [PMID: 37376399 DOI: 10.3390/polym15122752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 05/26/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
In this study, a conductive composite material, based on graphene oxide (GO), nanocellulose (CNF), and tannins (TA) from pine bark, reduced using polydopamine (PDA), was developed for wound dressing. The amount of CNF and TA was varied in the composite material, and a complete characterization including SEM, FTIR, XRD, XPS, and TGA was performed. Additionally, the conductivity, mechanical properties, cytotoxicity, and in vitro wound healing of the materials were evaluated. A successful physical interaction between CNF, TA, and GO was achieved. Increasing CNF amount in the composite reduced the thermal properties, surface charge, and conductivity, but its strength, cytotoxicity, and wound healing performance were improved. The TA incorporation slightly reduced the cell viability and migration, which may be associated with the doses used and the extract's chemical composition. However, the in-vitro-obtained results demonstrated that these composite materials can be suitable for wound healing.
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Affiliation(s)
- Katherina Fernández
- Laboratorio de Biomateriales, Departamento de Ingeniería Química, Facultad de Ingeniería, Universidad de Concepción, Concepción 4070386, Chile
| | - Aylen Llanquileo
- Laboratorio de Biomateriales, Departamento de Ingeniería Química, Facultad de Ingeniería, Universidad de Concepción, Concepción 4070386, Chile
| | - Monserrat Bustos
- Laboratorio de Biomateriales, Departamento de Ingeniería Química, Facultad de Ingeniería, Universidad de Concepción, Concepción 4070386, Chile
| | - Valentina Aedo
- Laboratorio de Biomateriales, Departamento de Ingeniería Química, Facultad de Ingeniería, Universidad de Concepción, Concepción 4070386, Chile
| | - Isleidy Ruiz
- Laboratorio de Biomateriales, Departamento de Ingeniería Química, Facultad de Ingeniería, Universidad de Concepción, Concepción 4070386, Chile
| | - Sebastián Carrasco
- Laboratorio de Biomateriales, Departamento de Ingeniería Química, Facultad de Ingeniería, Universidad de Concepción, Concepción 4070386, Chile
| | - Mauricio Tapia
- Laboratorio de Biomateriales, Departamento de Ingeniería Química, Facultad de Ingeniería, Universidad de Concepción, Concepción 4070386, Chile
| | - Miguel Pereira
- Laboratorio de Productos Forestales, Departamento de Ingeniería Química, Facultad de Ingeniería, Universidad de Concepción, Concepción 4070386, Chile
| | - Manuel F Meléndrez
- Grupo Interdisciplinario de Nanotecnología Aplicada (GINA), Laboratorio de Materiales Híbridos (HML), Departamento de Ingeniería de Materiales (DIMAT), Facultad de Ingeniería, Universidad de Concepción, Concepción 4070386, Chile
| | - Claudio Aguayo
- Departmento de Inmunología y Bioquímica Clínica, Facultad de Farmacia, Universidad de Concepción, Concepción 4070386, Chile
| | - Leonard I Atanase
- Faculty of Medical Dentistry, Apollonia University of Iasi, 700511 Iasi, Romania
- Academy of Romanian Scientists, 050045 Bucharest, Romania
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10
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Kis B, Pereira M, Kim J, El-Haddad G, Choi J, Fontaine J, Saltos A, Creelan B, Tanvetyanon T. Abstract No. 139 ▪ FEATURED ABSTRACT Transarterial Chemoperfusion Treatment of Unresectable Pleural Mesothelioma: A Phase 2 Prospective Study. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.191] [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: 02/27/2023] Open
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11
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Sánchez-Tocino ML, Mas-Fontao S, Gracia-Iguacel C, Pereira M, González-Ibarguren I, Ortiz A, Arenas MD, Parra EG. A Sarcopenia Index Derived from Malnutrition Parameters in Elderly Haemodialysis Patients. Nutrients 2023; 15:nu15051115. [PMID: 36904114 PMCID: PMC10005100 DOI: 10.3390/nu15051115] [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: 12/27/2022] [Revised: 02/12/2023] [Accepted: 02/20/2023] [Indexed: 02/25/2023] Open
Abstract
(1) Background: Persons with chronic kidney disease may have sarcopenia characterized by the loss of muscle mass and loss of muscle strength. However, EWGSOP2 criteria to diagnose sarcopenia are technically challenging, especially in elderly persons on hemodialysis. Sarcopenia may be associated with malnutrition. We aimed at defining a sarcopenia index derived from malnutrition parameters for use in elderly haemodialysis patients. (2) Methods: A retrospective study of 60 patients aged 75 to 95 years treated with chronic hemodialysis was conducted. Anthropometric and analytical variables, EWGSOP2 sarcopenia criteria and other nutrition-related variables were collected. Binomial logistic regressions were used to define the combination of anthropometric and nutritional parameters that best predict moderate or severe sarcopenia according to EWGSOP2, and performance for moderate and severe sarcopenia was assessed by the area under the curve (AUC) of receiver operating characteristic (ROC) curves. (3) Results: The combination of loss of strength, loss of muscle mass and low physical performance correlated with malnutrition. We developed regression-equation-related nutrition criteria that predicted moderate sarcopenia (elderly hemodialysis sarcopenia index-moderate, EHSI-M) and severe sarcopenia (EHSI-S) diagnosed according to EWGSOP2 with an AUC of 0.80 and 0.866, respectively. (4) Conclusions: There is a close relationship between nutrition and sarcopenia. The EHSI may identify EWGSOP2-diagnosed sarcopenia from easily accessible anthropometric and nutritional parameters.
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Affiliation(s)
| | - S. Mas-Fontao
- Servicio de Nefrología e Hipertensión, Fundación Jiménez Díaz, 28040 Madrid, Spain
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), 28029 Madrid, Spain
| | - C. Gracia-Iguacel
- Servicio de Nefrología e Hipertensión, Fundación Jiménez Díaz, 28040 Madrid, Spain
| | - M. Pereira
- Fundación Renal Íñigo Álvarez de Toledo, 28003 Madrid, Spain
| | - I. González-Ibarguren
- Servicio de Geriatría, Hospital Universitario de Guadalajara, 19002 Guadalajara, Spain
| | - A. Ortiz
- Servicio de Nefrología e Hipertensión, Fundación Jiménez Díaz, 28040 Madrid, Spain
| | - M. D. Arenas
- Fundación Renal Íñigo Álvarez de Toledo, 28003 Madrid, Spain
| | - E. González Parra
- Servicio de Nefrología e Hipertensión, Fundación Jiménez Díaz, 28040 Madrid, Spain
- Correspondence:
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12
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Elgueta E, Becerra Y, Martínez A, Pereira M, Carrillo-Varela I, Sanhueza F, Nuñez D, Rivas BL. Adsorbents Derived from Xylan Hemicellulose with Removal Properties of Pollutant Metals. Chin J Polym Sci 2023. [DOI: 10.1007/s10118-023-2897-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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13
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Lopes M, Bitton E, Pereira M, Dufresne A, Guilbot M. P-020 PERFORMANCE OF AN ATRAUMATIC AND VERSATILE LIGHT-ACTIVATED ADHESIVE FOR HERNIA MESH FIXATION. Br J Surg 2022. [DOI: 10.1093/bjs/znac308.120] [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]
Abstract
Abstract
Aim
This study evaluates the versatility and performance of a novel adhesive for atraumatic hernia mesh fixation. The TISSIUM adhesive is a biodegradable and biocompatible viscous liquid that can be precisely applied to different tissue and mesh.1 Once in place, the surgeon utilizes a light probe to polymerize the adhesive, creating a flexible elastomeric connection that provides strong, durable and atraumatic mesh fixation.
Materials and Methods
The performance of the TISSIUM adhesive when used with a range of marketed mesh and against peritoneum (n=7) and muscle (n=3) was evaluated using a standardized lap-shear bench method using porcine tissues. The shear strength was compared to resorbable tacks (n=8) (against peritoneum as standard of care in IPOM) and self-adhesive meshes (n=4) and fibrin glue (n=3) (against muscle as classically used in the retromuscular approach).
Results
Lap-shear data revealed that the TISSIUM adhesive performance was equivalent to resorbable tacks when fixing meshes to the peritoneum. Similar testing protocol demonstrated that the TISSIUM adhesive shear strength was 6 to 13 times superior to non- penetrating fixation devices such as fibrin glue or self-adhesive mesh.
Conclusions
The use of the TISSIUM Adhesive for hernia mesh fixation is compatible with various mesh materials used in hernia repair and, in a bench model, outperforms existing non-penetrating methods in diverse tissue planes demonstrating the potential to help the surgeon achieve more effective and efficient atraumatic repair in a range of hernia procedures.
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Affiliation(s)
- M Lopes
- Innovation Hub, TISSIUM , Paris , France
| | - E Bitton
- Innovation Hub, TISSIUM , Paris , France
| | - M Pereira
- Innovation Hub, TISSIUM , Paris , France
| | - A Dufresne
- Innovation Hub, TISSIUM , Paris , France
| | - M Guilbot
- Innovation Hub, TISSIUM , Paris , France
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14
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Pinto CMF, Oliveira JB, Steagell M, Mourão JVD, Altença JG, Pereira M. TELEMEDICINA NA QUALIFICAÇÃO DOS CUIDADOS ONCOLÓGICOS EM PEDIATRIA: RELATO DE CASO EXITOSO PROJETO ONCOTELEINTERCONSULTA. Hematol Transfus Cell Ther 2022. [DOI: 10.1016/j.htct.2022.09.608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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15
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Souza PIM, Costa LG, Pereira M, Neto MMS. ASSOCIAÇÃO ENTRE GRAUS DE OBESIDADE E DEFICIÊNCIA DE VITAMINA B12 E ÁCIDO FÓLICO: REVISÃO SISTEMÁTICA COM METANÁLISE. Hematol Transfus Cell Ther 2022. [DOI: 10.1016/j.htct.2022.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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16
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Speight B, Colvin E, Epurescu ED, Drummond J, Verhoef S, Pereira M, Evans DG, Tischkowitz M. Low-level constitutional mosaicism of BRCA1 in two women with young onset ovarian cancer. Hered Cancer Clin Pract 2022; 20:32. [PMID: 36068545 PMCID: PMC9446595 DOI: 10.1186/s13053-022-00237-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 08/12/2022] [Indexed: 11/10/2022] Open
Abstract
Germline pathogenic variants in BRCA1 and BRCA2 cause hereditary breast and ovarian cancer. The vast majority of these variants are inherited from a parent. De novo constitutional pathogenic variants are rare. Even fewer cases of constitutional mosaicism have been reported and these have mostly been described in women with breast cancer. Here we report low-level constitutional mosaicism identified by Next Generation Sequencing in two women with ovarian cancer. A BRCA1 c.5074G > A p.(Asp1692Asn) variant detected in the first female at 42 years, classed as likely pathogenic, was found in ~ 52% of reads in DNA extracted from tumour, ~ 10% of reads in DNA extracted from peripheral blood leukocytes and ~ 10% of reads in DNA extracted from buccal mucosa. The second BRCA1 c.2755_2758dupCCTG p.(Val920AlafsTer6) variant was detected in a female aged 53 years, classed as pathogenic, and was found in ~ 59% of reads in DNA extracted from tumour, ~ 14% of reads in DNA extracted from peripheral blood leukocytes and similarly in ~ 14% of reads in both DNA extracted from buccal mucosa and urine sample. Sanger sequencing confirmed the presence of these variants at a corresponding low level consistent with mosaicism that may not have been detected by this method alone. This report demonstrates the clinical benefit for two women of BRCA1/BRCA2 germline NGS testing at a depth that can detect low-level mosaicism. As well as informing appropriate treatments, tumour sequencing results may facilitate the detection and interpretation of low-level mosaic variants in the germline. Both results have implications for other cancer risks and for relatives when providing a family cancer risk assessment and reproductive risk. The implications for laboratory practice, clinical genetics management and genetic counselling for constitutional mosaicism of BRCA1/BRCA2 are discussed.
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Affiliation(s)
- B Speight
- East Anglian Medical Genetics Service, Cambridge Biomedical Campus, Box 134, Level 6, Addenbrooke's Treatment Centre, Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK.
| | - E Colvin
- Manchester Centre for Genomic Medicine, St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Oxford Road, Manchester, M13 9WL, UK
| | - E D Epurescu
- Oncology & Haematology Directorate, Norfolk & Norwich University Hospital, Colney Lane, Norwich, NR4 7UY, UK
| | - J Drummond
- East Anglian Medical Genetics Service, Cambridge Biomedical Campus, Box 134, Level 6, Addenbrooke's Treatment Centre, Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK
| | - S Verhoef
- Manchester Centre for Genomic Medicine, St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Oxford Road, Manchester, M13 9WL, UK.,Department of Clinical Genetics, Leiden University Medical Center, 2333 ZA, Leiden, Netherlands
| | - M Pereira
- Manchester Centre for Genomic Medicine, St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Oxford Road, Manchester, M13 9WL, UK
| | - D G Evans
- Manchester Centre for Genomic Medicine, St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Oxford Road, Manchester, M13 9WL, UK.,Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - M Tischkowitz
- East Anglian Medical Genetics Service, Cambridge Biomedical Campus, Box 134, Level 6, Addenbrooke's Treatment Centre, Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK.,Academic Department of Medical Genetics, University of Cambridge, Cambridge, UK
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Sousa M, Cunha M, Pereira M, Silva J, Gonçalves A, Viana P, Barros N, Pinto S, Geraldo M, Silva JTD, Oliveira C, Xavier P, Ferraz L, Juan A, Barros A. P-064 Clinical outcomes of 127 patients with recurrent implantation failure treated with testicular sperm aspiration (TESA). Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.060] [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
Study question
Are the embryological, clinical and newborn outcomes using aspirated testicular sperm improved in cases with recurrent implantation failure previously treated with ejaculated sperm?
Summary answer
Aspirated testicular sperm enabled to obtain significant higher embryological, clinical and newborn outcomes in cases with recurrent implantation failure previously treated with ejaculated sperm.
What is known already
High levels of sperm DNA fragmentation (SDF) were associated to poor clinical outcomes (1-Simon et al., 2017). Testicular sperm display lower SDF than ejaculated sperm (2-Sakas and Alvarez, 2010), improving clinical outcomes in cases with abnormal semen parameters (3-Awaga et al., 2018; 4-Kang et al., 2018), recurrent implantation failure (RIF) and pregnancy loss (RPL) (5-Esteves et al., 2017), and elevated SDF (6-Ambar et al., 2021). As only a few studies are specifically dedicated to RIF, we expanded the number of cases and first provided full demographic, stimulation, embryological, clinical and newborn outcomes.
References
1-(https://doi.org/10.4103/1008-682X.182822);
2-(https://doi.org/10.1016/j.fertnstert.2009.10.046);
3-(https://doi.org/10.1016/j.rbmo.2018.08.017);
4-(https://doi.org/10.1038/s41598-018-26280-0);
5-(https://doi.org/10.1016/j.fertnstert.2017.06.018);
6-(https://doi.org/10.5534/wjmh.200084
Study design, size, duration
We retrospectively evaluated during consecutive years (2010-2020) 63 patients with recurrent implantation failure, which accepted to perform testicular sperm aspiration (TESA) as an alternative treatment. These patients presented a long history of failed treatments (153 cycles) using ejaculated sperm. From these cycles, no pregnancy ensued. The present study compares 127 treatment cycles, 80 with testicular sperm (17 cases repeated TESA) and 47 with ejaculated sperm from the same patients performed at the present IVF clinic.
Participants/materials, setting, methods
Patients were screened for karyotype abnormalities, for Y-chromosome microdeletions (7-Gonçalves et al., 2016), and for SDF with the TUNEL assay (8-Sá et al., 2015). Conventional semen analysis was performed according to World Health Organization guidelines (9-WHO, 2010). Male evaluation and TESA was performed by the same experienced urologist (LF) according to established protocols (10-Madureira et al 2014). The procedure was performed entirely on an outpatient basis, with no complications reported.
References
7-(https://doi.org/10.4103/1008-682X.172827);
8-(https://doi.org/10.1016/j.rbmo.2015.06.019);
9-(https://apps.who.int/iris/handle/10665/44261);
10-(https://doi.org/10.1111/j.2047-2927.2014.00231.x).
Main results and the role of chance
The mean ages were 35.5±3.4 (26-42)-female and 38.1±5.7 (29-59)-male. There were 4 abnormal karyotypes (3-female, 1-male), all without known relevance. Most cases had asthenozoospermia and teratozoospermia (65.1%), or oligoasthenoteratozoospermia (41.8%). Of the 19 cases with <5M/ml, none presented Y-chromosome microdeletions. Although we do not routinely perform SDF testing, 15 patients had previous SDF values (12, >20%; 8, >36%). Female basal characteristics and testicular evaluation were under normal values. The TESA procedure took about 15-20 min, and the time of laboratorial search around 30-60 min. Cases using testicular sperm showed significant higher rates of fertilization (64% vs 73%-p=0.005), blastocyst development (47% vs 62%-p=0.010), implantation (6% vs 27%-p=0.000), clinical pregnancy (10% vs 39%-p=0.001), live birth delivery (5% vs 28%-p=0.005) and newborn (5% vs 32%-p=0.000) than ejaculated sperm. No significant differences were observed regarding the rates of embryo cleavage (95% vs 94.8%) and high quality embryos (89.4% vs 94%), in the mean number of transferred embryos (1.8±0.4 vs 1.9±0.4), or in the abortion rate (2 cases-50% vs 7 cases-25.9%). Cases using testicular sperm had 22 frozen-thawed embryo transfer cycles, enabling per initiated cycle a cumulative pregnancy rate of 45%, live birth delivery rate of 31.3% and newborn rate of 37.5% (32 newborn).
Limitations, reasons for caution
Although presenting the higher number of cycles using TESA in the treatment of RIF, this number needs to be increased for drawing more definitive conclusions, as these women present a diversity of conditions, rendering subgrouping difficult. In the future, it would also be important to evaluate SDF in all cases.
Wider implications of the findings
In conclusion, the present results gave further evidence for the superiority of using testicular sperm instead of ejaculated sperm in cases with recurrent implantation failure. Data also evidences the security of using testicular sperm aspiration, as there were no pregnancy or delivery complications, or congenital anomalies among the 32 newborn.
Trial registration number
Not Applicable
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Affiliation(s)
- M Sousa
- Institute of Biomedical Sciences Abel Salazar- University of Porto- Unit for Multidisciplinary Investigation in Biomedicine UMIB-- ITR - Laboratory for Integrative and Translational Research in Population Health, Laboratory of Cell Biology- Department
| | - M Cunha
- Centre for Reproductive Genetics A. Barros, IVF-Embryology , Porto, Portugal
| | - M Pereira
- Institute of Biomedical Sciences Abel Salazar- University of Porto UP- Unit for Multidisciplinary Investigation in Biomedicine UMIB, Laboratory of Cell Biology- Department of Microscopy , Porto, Portugal
| | - J Silva
- Centre for Reproductive Genetics A. Barros, IVF-Embryology , Porto, Portugal
| | - A Gonçalves
- Centre for Reproductive Genetics A. Barros, IVF-Andrology , Porto, Portugal
| | - P Viana
- Centre for Reproductive Genetics A. Barros, IVF-Embryology , Porto, Portugal
| | - N Barros
- Centre for Reproductive Genetics A. Barros, IVF-Embryology , Porto, Portugal
| | - S Pinto
- Centre for Reproductive Genetics A. Barros, IVF-Embryology , Porto, Portugal
| | - M Geraldo
- Centre for Reproductive Genetics A. Barros, IVF-Embryology , Porto, Portugal
| | - J. Teixeira da Silva
- Centre for Reproductive Genetics A. Barros, IVF Clinician-Gynecology & Obstetrics , Porto, Portugal
| | - C Oliveira
- Centre for Reproductive Genetics A. Barros, IVF-Clinician-Gynecology & Obstetrics , Porto, Portugal
| | - P Xavier
- Centre for Reproductive Genetics A. Barros, IVF-Clinician-Gynecology & Obstetrics , Porto, Portugal
| | - L Ferraz
- Department of Urology- Hospital Eduardo Santos Silva- Hospital Centre of Vila Nova de Gaia/Espinho, IVF-Clinician-Urology & Andrology , Porto, Portugal
| | - A Juan
- Center of Male Infertility- ANDROGEN, IVF-Clinician-Gynecology & Obstetrics , La Coruna, Spain
| | - A Barros
- Faculty of Medicine- University of Porto- Centre for Reproductive Genetics A. Barros- Institute of Health Research and Innovation IPATIMUP/i3S- University of Porto, Department of Genetics-Director- IVF Clinic-Director , Porto, Portugal
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Barros Lima C, Marini S, Ribeiro A, Luís D, Pereira M, Ferreira R, Cortesão E. PB1806: AZACITIDINE + VENETOCLAX IN PATIENTS WITH ACUTE MYELOID LEUKEMIA, POTENTIAL CANDIDATES TO ALLOGENIC HEMATOPOIETIC STEM CELL TRANSPLANT – RESULTS FROM A HOSPITAL CENTER. Hemasphere 2022. [PMCID: PMC9429614 DOI: 10.1097/01.hs9.0000850076.77011.41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Pereira M, Kulyk I, Redanz S, Ruff WE, Greiling TM, Dehner C, Pagovich O, Zegarra Ruiz D, Aguiar C, Erkan D, Kriegel M. POS0466 RESISTANT STARCH DIET IMPROVES DISTINCT GUT MICROBIOTA STRUCTURES IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS AND ANTIPHOSPHOLIPID SYNDROME. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundFiber-poor diets are linked to a reduction in gut microbiota diversity and gut barrier integrity, which is thought to promote the susceptibility to chronic inflammatory disorders1,2. We have previously shown that dietary resistant starch (RS) improves lupus-like disease in a murine model of SLE3 through the modulation of microbiota composition. If similar dysbiotic microbial community structures exist in subsets of SLE patients and if a RS intervention may be efficacious in those patients remains unclear.ObjectivesTo test if the dietary RS content in SLE and SLE-related antiphospholipid syndrome (APS) affect gut microbial taxa associated with SLE in published cohorts to date.MethodsWe obtained stool and blood samples as well as diet history for up to 3 visits (0, 4 and 8 weeks) from 12 SLE (n=28) and 15 APS (n=44) patients as well as 20 controls (n=48) as previously published4-6. Microbiota composition was defined by 16S rRNA V4 region sequencing on the Illumina platform and correlated with dietary fiber content extracted from a diet questionnaire. We used the FDA reference list to determine dietary RS contents in patients` regular diets and defined RS quantities as being low if less than 2.5 g/day and as medium if 2.5 to 15 g/day. None of the patients achieved high RS greater than 15 g/day. Mann-Whitney or Kruskal-Wallis tests were performed to compare bacteria relative abundances among the different groups. Simple linear regression was performed to relate the bacterial abundance to RS content and other metadata.ResultsMedium intake of RS was associated with beneficial Bifidobacterium spp. in SLE patients (p=0.016) but not APS (p=0.509). Instead, APS patients who consumed medium quantities of RS in their diets had less gut bacterial taxa that are capable of producing cardiolipins (among them Collinsella; p=0.009) and Ruminococcus gnavus (p=0.0142), a species previously associated with lupus nephritis7. A recent Japanese metagenome-wide study8 associated Streptococcus spp. and related redox reaction genes with SLE, which may also affect oxidative processes in APS9. We therefore also explored Streptococcus levels in SLE and APS patients and found unexpectedly a significant reduction of streptococci in a subset of APS (p=0.004) but not SLE patients (p=0.451) in medium compared to low RS dietary content. Streptococcus abundance was correlated with both Collinsella (R2=0.3141; p=<0,0001) and Ruminococcus gnavus (R2=0.1687; p=<0,0056) in APS patients.ConclusionMedium compared to low RS quantities in the regular diets of SLE and APS patients were associated with unique alterations in gut microbial community structures. Bifidobacterium increased in SLE patients with diets containing medium RS whereas APS patients with medium RS carried less cardiolipin-synthesizing taxa and lupus-related pathobionts. In particular, Streptococcus species recently strongly associated with SLE and redox reactions in Japanese patients in a metagenome-wide study8, were significantly suppressed in APS patients on medium RS diets. This modulatory effect was not seen in SLE patients or control subjects consuming medium RS. Together, these findings support distinct dietary effects on autoimmune gut microbiomes depending on the disease state. They also suggest potential beneficial effects of increased RS content on gut microbiota in SLE and APS patients. Fully resolving gut microbial signatures and clinical characteristics in these patients may identify the ideal subset to benefit from an interventional pilot trial with RS.References[1] Thorburn et al., 2014, Immunity 19, 833-842[2] Ruff et al, 2020, Nat Rev Microbiol 18, 521-538[3] Zegarra-Ruiz et al., 2019, Cell Host Microbe 25, 113-127[4] Greiling et al., 2018, Science Transl Med 10, 1–15[5] Manfredo Vieira et al, 2018, Science 359, 1156-1161[6] Ruff et al., 2019, Cell Host Microbe 26, 1–14[7] Azzouz et al., 2019, Ann Rheum Dis 78, 947–956[8] Tomofuji et al., 2021, Ann Rheum Dis 80, 1575–1583[9] Giannakopoulos and Krilis, 2013, New Engl J Med 368, 1033-1044AcknowledgementsThe work was supported by grants from the National Institutes of Health (NIH) (R01AI118855, T32AI07019), Arthritis National Research Foundation, Arthritis Foundation, Lupus Research Alliance, and Maren Foundation.Disclosure of InterestsMárcia Pereira: None declared, Iryna Kulyk: None declared, Sylvio Redanz: None declared, William E Ruff: None declared, Teri M. Greiling: None declared, Carina Dehner: None declared, Odelya Pagovich: None declared, Daniel Zegarra Ruiz: None declared, Cassyanne Aguiar: None declared, Doruk Erkan: None declared, Martin Kriegel Speakers bureau: Novartis, BMS, GSK, MSD, Grant/research support from: AbbVie, Employee of: Roche.
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Pereira M, Stroom J, Rocha A, Greco C, Nijsten S. PD-0805 3D Portal Dosimetry for extreme hypofraction: pre-treatment and in vivo verification. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02946-2] [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: 10/18/2022]
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Golob S, Uriel M, Batra J, Gaine M, Clerkin K, Raikhelkar J, Fried J, Griffin J, Restaino S, Lee S, Majure D, Yuzefpolskaya M, Colombo P, Latif F, Pereira M, Choe J, Jennings D, Sayer G, Uriel N. Use of Letermovir for Cytomegalovirus (CMV) Prophylaxis in Orthotopic Heart Transplant Recipients. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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22
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Suárez-Avendaño D, Martínez-Correa E, Cañas-Gutierrez A, Castro-Riascos M, Zuluaga-Gallego R, Gañán-Rojo P, Peresin M, Pereira M, Castro-Herazo C. Comparative Study on the Efficiency of Mercury Removal From Wastewater Using Bacterial Cellulose Membranes and Their Oxidized Analogue. Front Bioeng Biotechnol 2022; 10:815892. [PMID: 35372298 PMCID: PMC8965056 DOI: 10.3389/fbioe.2022.815892] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 02/07/2022] [Indexed: 11/25/2022] Open
Abstract
A comparative study was conducted on the efficiency of mercury removal using bacterial nanocellulose (BNC) membranes obtained from the fermentation of the microorganism Komagataeibacter medellinensis, in contrast with its oxidized analog obtained by modifying the bacterial nanocellulose membranes via oxidation with 2,2,6,6-Tetramethylpiperidine-1-oxyl. Both types of membranes (modified and unmodified) were characterized to identify variations in the Physico-chemical parameters after modification. FTIR spectra confirmed the chemical modification of cellulose in all reaction conditions by the presence of a new characteristic band at ∼1730 cm−1, corresponding to the new carboxylic groups produced by the oxidative process, and the decline of the band at ∼1,650 cm−1, corresponding to the hydroxyl groups of the C6 carbon. While the XRD profiles indicated that the percentage of BNC crystallinity decreased and the SEM images showed that the nanoribbon network was interrupted as the amount of oxidizing agent increased. The kinetics of mercury removal from both types of membrane was evaluated by calculating the concentration of mercury at different times and establishing a mathematical model to describe the kinetics of this process. The modified membranes improved significantly the adsorption process of the metal ion and it was found that the modification that results in the greatest adsorption efficiency was BNC-m 7.5 with a value of 92.97%. The results obtained suggest that the modification of the bacterial nanocellulose membranes by oxidation transcendentally improves the mercury removal capacity, outlining the modified membranes as an excellent material for mercury removal in wastewater.
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Affiliation(s)
- D. Suárez-Avendaño
- School of Engineering, Universidad Pontificia Bolivariana (Pontificia Bolivariana University), Medellín, Antioquia
| | - E. Martínez-Correa
- School of Engineering, Universidad Pontificia Bolivariana (Pontificia Bolivariana University), Medellín, Antioquia
| | - A. Cañas-Gutierrez
- School of Engineering, Universidad Pontificia Bolivariana (Pontificia Bolivariana University), Medellín, Antioquia
| | - M. Castro-Riascos
- Tourist and Agroindustrial Technological Complex of the West Antioquia, Servicio Nacional de Aprendizaje (National Training Service), Santafé de Antioquia, Antioquia
| | - R. Zuluaga-Gallego
- School of Engineering, Universidad Pontificia Bolivariana (Pontificia Bolivariana University), Medellín, Antioquia
| | - P. Gañán-Rojo
- School of Engineering, Universidad Pontificia Bolivariana (Pontificia Bolivariana University), Medellín, Antioquia
| | - M. Peresin
- Forest Products Development Center, School of Forestry and Wildlife Sciences, Auburn, AL, United States
| | - M. Pereira
- Departamento de Ingeniería Química, Universidad de Concepción, Concepción, Chile
| | - C. Castro-Herazo
- School of Engineering, Universidad Pontificia Bolivariana (Pontificia Bolivariana University), Medellín, Antioquia
- *Correspondence: C. Castro-Herazo,
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MARQUES F, Reis J, Oliveira J, Duarte I, Godinho I, Outerelo C, Pereira M, Gameiro J. POS-470 PROGNOSTIC IMPACT OF PROTEINURIA REDUCTION ON GLOMERULAR DISEASES - RETROSPECTIVE ANALYSIS. Kidney Int Rep 2022. [DOI: 10.1016/j.ekir.2022.01.500] [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] Open
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Da Silva Lodge M, Pullen N, Pereira M, Johnson TS. Urinary levels of pro-fibrotic transglutaminase 2 (TG2) may help predict progression of chronic kidney disease. PLoS One 2022; 17:e0262104. [PMID: 35041708 PMCID: PMC8765645 DOI: 10.1371/journal.pone.0262104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 12/16/2021] [Indexed: 01/04/2023] Open
Abstract
Renal clinical chemistry only detects kidney dysfunction after considerable damage has occurred and is imperfect in predicting long term outcomes. Consequently, more sensitive markers of early damage and better predictors of progression are being urgently sought, to better support clinical decisions and support shorter clinical trials. Transglutaminase 2 (TG2) is strongly implicated in the fibrotic remodeling that drives chronic kidney disease (CKD). We hypothesized that urinary TG2 and its ε-(γ-glutamyl)-lysine crosslink product could be useful biomarkers of kidney fibrosis and progression. Animal models: a rat 4-month 5/6th subtotal nephrectomy model of CKD and a rat 8-month streptozotocin model of diabetic kidney disease had 24-hour collection of urine, made using a metabolic cage, at regular periods throughout disease development. Patients: Urine samples from patients with CKD (n = 290) and healthy volunteers (n = 33) were collected prospectively, and progression tracked for 3 years. An estimated glomerular filtration rate (eGFR) loss of 2–5 mL/min/year was considered progressive, with rapid progression defined as > 5 mL/min/year. Assays: TG2 was measured in human and rat urine samples by enzyme-linked immunosorbent assay (ELISA) and ε-(γ-glutamyl)-lysine by exhaustive proteolytic digestion and amino acid analysis. Urinary TG2 and ε-(γ-glutamyl)-lysine increased with the development of fibrosis in both animal model systems. Urinary TG2 was 41-fold higher in patients with CKD than HVs, with levels elevated 17-fold by CKD stage 2. The urinary TG2:creatinine ratio (UTCR) was 9 ng/mmol in HV compared with 114 ng/mmol in non-progressive CKD, 1244 ng/mmol in progressive CKD and 1898 ng/mmol in rapidly progressive CKD. Both urinary TG2 and ε-(γ-glutamyl)-lysine were significantly associated with speed of progression in univariate logistic regression models. In a multivariate model adjusted for urinary TG2, ε-(γ-glutamyl)-lysine, age, sex, urinary albumin:creatinine ratio (UACR), urinary protein:creatinine ratio (UPCR), and CKD stage, only TG2 remained statistically significant. Receiver operating characteristic (ROC) curve analysis determined an 86.4% accuracy of prediction of progression for UTCR compared with 73.5% for UACR. Urinary TG2 and ε-(γ-glutamyl)-lysine are increased in CKD. In this pilot investigation, UTCR was a better predictor of progression in patients with CKD than UACR. Larger studies are now warranted to fully evaluate UTCR value in predicting patient outcomes.
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Affiliation(s)
- Michelle Da Silva Lodge
- Academic Nephrology Unit and Sheffield Kidney Institute, University of Sheffield Medical School, Sheffield, United Kingdom
| | - Nick Pullen
- Pfizer Global Research and Development, Cambridge, MA, United States of America
| | - Miguel Pereira
- Statistical Sciences and Innovation, UCB Pharma, Slough, United Kingdom
| | - Timothy S. Johnson
- Academic Nephrology Unit and Sheffield Kidney Institute, University of Sheffield Medical School, Sheffield, United Kingdom
- * E-mail:
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Santos A, Silva L, Pereira M, Coelho M, Melo D, Sardo AP, Mautempo F. Reactive Airways Dysfunction Syndrome: A Review of a Less Known Yet Severe Occupational Disease. Saf Health Work 2022. [DOI: 10.1016/j.shaw.2021.12.1537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Ständer S, Zeidler C, Pereira M, Szepietowski JC, McLeod L, Qin S, Williams N, Sciascia T, Augustin M. Worst Itch Numerical Rating Scale for Prurigo Nodularis: A Psychometric Evaluation. J Eur Acad Dermatol Venereol 2021; 36:573-581. [PMID: 34908192 DOI: 10.1111/jdv.17870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 11/03/2021] [Accepted: 11/11/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Study TR03 evaluated the safety and efficacy of nalbuphine ER for prurigo nodularis (PN) (NCT02174419). OBJECTIVE We conducted supplementary analyses to assess the psychometric properties of the Worst Itch Numeric Rating Scale (WI-NRS), the TR03 primary endpoint. METHODS Study TR03 was a double-blind, placebo-controlled, phase 2 trial in PN patients with documented scores ≥5 on the WI-NRS (0 [no itch]-10 [worst itch imaginable]) on ≥5 of 7 days before baseline. Using TR03 data, the WI-NRS's psychometric properties, including reliability, validity, and ability to detect change, were evaluated. A responder threshold was estimated to facilitate interpretation of WI-NRS score changes. RESULTS Among 62 treated patients, improvements in mean [SD] (median) WI-NRS scores were observed between baseline (8.2 [1.21] (8.1)) and Week 10 (5.8 [2.43] (6.0)). The WI-NRS had an intraclass correlation coefficient of 0.96 (95% confidence interval, 0.93-0.98) in 42 patients who had stable Itch verbal rating scale (VRS) scores from Week 9-10, supporting strong test-retest reliability. Construct validity was supported, with strong correlations at Week 10 with Average Itch NRS (r=0.87) and Itch VRS single-day/weekly mean scores (r=0.81/0.89) and moderate correlations with ItchyQoLTM total/domain scores (r=0.41-0.43). The WI-NRS discriminated between predefined severity subgroups based on the Itch VRS and detected changes in itching severity (effect-size estimate: -2.05; standardized response mean: -1.21). An anchor-based threshold based on a two-category improvement in the single-day Itch VRS suggests a responder threshold of ≥3.8 points (~40% improvement). CONCLUSIONS The WI-NRS demonstrates good measurement properties, supporting its use in evaluating treatment change in PN.
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Affiliation(s)
- S Ständer
- University Hospital Münster, Münster
| | - C Zeidler
- University Hospital Münster, Münster
| | - M Pereira
- University Hospital Münster, Münster
| | - J C Szepietowski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | | | | | | | | | - M Augustin
- University Medical Center Hamburg-Eppendorf
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Dutra F, Navarro M, Romero A, Briano C, Pereira M, Uzal FA. Spatial and seasonal analysis and geovisualization of Fasciola hepatica-free bovine bacillary hemoglobinuria outbreaks in eastern Uruguay, 1999-2019. Prev Vet Med 2021; 199:105553. [PMID: 34920245 DOI: 10.1016/j.prevetmed.2021.105553] [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: 05/31/2021] [Revised: 11/28/2021] [Accepted: 11/29/2021] [Indexed: 11/18/2022]
Abstract
Bovine bacillary hemoglobinuria (BBH) produced by Clostridium novyi type D, is an endemic, highly fatal disease of cattle in the temperate grassland region of eastern Uruguay. A previous study showed that in this region, BBH is not associated with Fasciola hepatica or any other known focal-ischemic liver injury, so the reasons for its high incidence remains undetermined. The objective of this study was to analyze data from 45 Fasciola hepatica-free BBH outbreaks (1999-2019) in order to find common animal, seasonal and/or geographical risk factors, which may explain the occurrence of the epizootics. Fisher's goodness-of-fit testing showed a significantly higher case proportion of adult cows (N = 368, 80.5%) and lower of calves (N =8, 1.8%), as compared to the expected proportions of the censused population in the study area and historical submissions computed from the laboratory database (Chi-Sq = 346.2 and 174.8, df = 7, P < 0.00). Time series decomposition showed a bi-seasonal pattern, with a larger peak in spring and early summer (October to January) and a smaller increase in autumn (March-May). The lowest seasonal indices were on mid-summer (February) and winter (June-September). A combination of spatial statistics was used to assess the different spatial features of the disease and consistency of the findings. Global spatial autocorrelation showed BBH was significantly clustered (Moran's I = 0.407, P < 0.001). Both smoothed Anselin's Local Indicator of Spatial Autocorrelation and Kulldorff's spatial scan Poisson and Bernoulli models, detected roughly the same high-risk areas in the southeastern part of the Merin Lagoon basin, with the most likely cluster centered in the large wetland biosphere reserve "Eastern Wetlands and Coastal Strip" (RR = 9.12, P < 0.001). Outbreaks were georeferenced (latitude, longitude) and thematic dot-mapping geovisualization in Google Earth™ showed that the results were robust and truly geographic in nature. Most outbreaks (40/45, 88.8%) occurred on wetlands areas and large river valleys, characterized by poorly drained and frequently flooded soils, indicating that moisture-laden soils are the natural habitat of C. novyi type D. Grasslands in these endemic areas support rapid fattening of cattle during spring-summer, and somewhat less in autumn, in almost exact correspondence with BBH peaks, suggesting a close causal association in high-risk areas. Risk is significantly higher in adult cows probably because the spore content in the liver is highest in this category. The altered lipid metabolism and lipotoxicity in the liver may be the precipitating factor for spore germination and epizootic occurrence.
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Affiliation(s)
- F Dutra
- Dirección de Laboratorios Veterinarios (DILAVE), Miguel C. Rubino, Laboratorio Regional Este, Avelino Miranda 2045, CP 33000, Treinta y Tres, Uruguay.
| | - M Navarro
- California Animal Health and Food Safety Laboratory, University of California-Davis, San Bernardino, CA, USA
| | - A Romero
- Dirección de Laboratorios Veterinarios (DILAVE), Miguel C. Rubino, Laboratorio Regional Este, Avelino Miranda 2045, CP 33000, Treinta y Tres, Uruguay
| | - C Briano
- Dirección de Laboratorios Veterinarios (DILAVE), Miguel C. Rubino, Laboratorio Regional Este, Avelino Miranda 2045, CP 33000, Treinta y Tres, Uruguay
| | - M Pereira
- Dirección de Laboratorios Veterinarios (DILAVE), Miguel C. Rubino, Laboratorio Regional Este, Avelino Miranda 2045, CP 33000, Treinta y Tres, Uruguay
| | - F A Uzal
- California Animal Health and Food Safety Laboratory, University of California-Davis, San Bernardino, CA, USA
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Encina L, Elgueta E, Rivas BL, Pereira M, Sanhueza F. Hydrogels derived from galactoglucomannan hemicellulose with inorganic contaminant removal properties. RSC Adv 2021; 11:35960-35972. [PMID: 35492798 PMCID: PMC9043232 DOI: 10.1039/d1ra06278f] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 10/25/2021] [Indexed: 02/03/2023] Open
Abstract
The adsorption of Cu(ii), Cd(ii), and Pb(ii) ions onto hydrogels derived from modified galactoglucomannan (GGM) hemicellulose was studied. GGM hemicellulose was modified with methacrylate groups (GGM-MA) to incorporate vinyl groups into the polymeric structure, which reacted later with synthetic monomers such as 2-acrylamido-2-methyl-1-propanesulfonic acid (AMPS). The results show that all the synthesized hydrogels were capable of adsorbing contaminating ions with high adsorption efficiency during short periods of time. Furthermore, an increase in the content of GGM-MA generated a hydrogel (H3) with a similar ion adsorption property to the other hydrogels but with a lesser degree of swelling. The H3 hydrogel had an adsorption capacity of 60.0 mg g−1 Cd(ii), 78.9 mg g−1 Cu(ii), and 174.9 mg g−1 Pb(ii) at 25 °C. This result shows that modified GGM hemicelluloses can be employed as renewable adsorbents to remove Cu(ii), Cd(ii), and Pb(ii) ions from aqueous solutions. The adsorption of Cu(ii), Cd(ii), and Pb(ii) ions onto hydrogels derived from modified galactoglucomannan (GGM) hemicellulose was studied.![]()
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Affiliation(s)
- Leonidas Encina
- Polymer Department, Faculty of Chemistry, University of Concepción Casilla 160-C Concepción Chile
| | - Elizabeth Elgueta
- Centro de Investigación de Polímeros Avanzados, CIPA Avenida Collao 1202, Edificio de Laboratorios Concepción Chile
| | - Bernabé L Rivas
- Polymer Department, Faculty of Chemistry, University of Concepción Casilla 160-C Concepción Chile
| | - Miguel Pereira
- Departmento de Ingeniería Química, Facultad de Ingeniería, Universidad de Concepción Casilla 160-C Concepción Chile
| | - Felipe Sanhueza
- Instituto de Materiales y Procesos Termomecánicos, Facultad de Ingeniería, Universidad Austral de Chile Valdivia Chile
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Ribassin-Majed L, Pereira M, Magneron C, Levy-Bachelot L, Fagherazzi G, Baldauf JJ, Raude J. [Interest of a geostatistical approach to analyze the geographical disparities in human papillomavirus vaccine coverage in France]. Rev Epidemiol Sante Publique 2021; 69:321-328. [PMID: 34728109 DOI: 10.1016/j.respe.2021.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 08/12/2021] [Accepted: 09/10/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The use of geostatistical methods remains rare in health studies. In order to assess the usefulness of the geostatistical approach in epidemiology, we chose to apply these methods to the vaccination coverage rate (VCR) against human papillomavirus (HPV) in France. Indeed, HPV vaccine coverage remains low in France and geographical disparities are sizable. The objective of this study was to identify the socioecological factors that may explain these geographical variations. METHODS Sociological, economic and behavioral data for 2016 have been gathered (demographics and public health database, web and social networks) and were correlated with the HPV VCR vaccine coverage over the French territory. Homogeneous geographical areas defined by strong correlations for groups of variables were selected. In each homogeneous area, principal component analysis was performed and a geostatistical approach provided an estimate predicting vaccine coverage at a given scale. RESULTS HPV VCR spatial variations in France cannot be fully explained by a single model. In urban areas, a low rate of HPV VCR is preferentially associated with unfavorable socioeconomic factors (poverty, unemployment, immigration). In rural areas, HPV VCR is preferentially associated with sociocultural factors (socio-professional categories, education level, interest in alternative medicines the anti-vaccine movement). Two secondary geographical areas were defined: the Île-de-France region and 12 departments in northeastern France. In the Île-de-France region, the association with the economic factors one again appears as in urban areas in general. The northeasteran departments represent a particular case insofar as HPV VCR is relatively high, notwithstanding economic poverty indicators. CONCLUSION Geostatistical modeling successfully identifies new potential explanations for HPV VCR geographical disparities in France. These results could help to adapt or develop future vaccination programs in specific areas by taking into account the sociological, economic and behavioral characteristics of their populations.
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Affiliation(s)
- L Ribassin-Majed
- Health Economics and Outcomes Research, MSD France, Courbevoie, France.
| | - M Pereira
- ShoWhere, 132 bis rue Tahère, 92210 Saint-Cloud, France
| | - C Magneron
- ShoWhere, 132 bis rue Tahère, 92210 Saint-Cloud, France
| | - L Levy-Bachelot
- Health Economics and Outcomes Research, MSD France, Courbevoie, France
| | - G Fagherazzi
- Luxembourg Institute of Health (LIH), Department of Population Health, Strassen, Luxembourg
| | - J-J Baldauf
- Department of Obstetrics and Gynecology, University hospital of Strasbourg, France; EA 3181, LabEx LipSTIC ANR-11-LABX-0021, CIC-1431, University of Franche-Comté, Besançon, France; Association EVE, Illkirch Graffenstaden, France
| | - J Raude
- Unité des virus émergents (UVE), Université Aix-Marseille - IRD 190 - Inserm 1207 - IHU Méditerranée Infection), Marseille, France
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Cepeda Martins AR, Di Maria S, Afonso J, Pereira M, Pereira J, Vaz P. Assessment of the uterine dose in digital mammography and digital breast tomosynthesis. Radiography (Lond) 2021; 28:333-339. [PMID: 34565679 DOI: 10.1016/j.radi.2021.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 09/03/2021] [Accepted: 09/06/2021] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Digital Mammography (DM-2D) and more recently Digital Breast Tomosynthesis (DBT), are two of the most effective imaging modalities for breast cancer detection, often used in screening programmes. It may happen that exams using these two imaging modalities are inadvertently performed to pregnant women. The objective of this study is to assess the dose in the uterus due to DM-2D and DBT exams, according to two main irradiation scenarios: in the 1st scenario the exposure parameters were pre-selected directly by the imaging system, while in the 2nd scenario, the maximum exposure parameters were chosen. METHODS The mammography equipment used was a Siemens Mammomat Inspiration. A physical anthropomorphic phantom, PMMA plates (simulating a breast thickness of 6 cm) and thermoluminescent dosimeters (TLDs) were used to measure entrance air kerma values on the phantom's breast and abdomen in order to successively estimate the mean glandular dose (MGD) and the dose in the uterus. For the two irradiation scenarios chosen, two-breast imaging modalities were selected: 1) DBT in Cranio-Caudal (CC) view (with 28 kV and 160 mAs as exposure parameters), 2) DBT and DM in Medio Lateral-Oblique (MLO) and CC views (with 34 kV and 250 mAs as exposure parameters). RESULTS In the 1st scenario, the TLD measurements did not detect significant dose values in the abdomen whereas the MGD estimated using the D.R. Dance model was in close agreement with data available in the literature. In the 2nd scenario, there was no significant difference in MGD estimation between the different views, whereas the air kerma values in the abdomen (in DBT mode, CC and MLO) were 0.049 mGy and 0.004 mGy respectively. In CC DM-2D mode the abdomen air kerma value was 0.026 mGy, with no significant detected value in MLO view. CONCLUSIONS For the dose in the uterus, the obtained values seem to indicate that DM-2D and DBT examinations inadvertently performed during pregnancy do not pose a significant radiological risk, even considering the case of overexposure in both breasts. IMPLICATIONS FOR PRACTICE The accurate knowledge of the doses in DM-2D and DBT will contribute to raise the awareness among medical practitioners involved in breast imaging empowering them to provide accurate information about dose levels in the uterus, improving their radiation risk communication skills and consequently helping to reduce the anxiety of pregnant women undergoing this type of examinations.
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Affiliation(s)
- A R Cepeda Martins
- Inspeção Geral da Agricultura, do Mar, do Ambiente, e do Ordenamento do Territorio (IGAMOT), Seção Radiações Ionizantes, Rua de O Seculo, N.51, 1200-433, Lisbon, Portugal
| | - S Di Maria
- Centro de Ciências e Tecnologias Nucleares, Instituto Superior Técnico, Campus Tecnológico e Nuclear, Estrada Nacional 10, km 139,7, 2695-066, Bobadela LRS, Portugal.
| | - J Afonso
- Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal
| | - M Pereira
- Agência Portuguesa do Ambiente, Departamento de Emergências e Proteção Radiológica, Divisão de Autorização e Segurança Nuclear, Rua da Murgueira 9 - Zambujal - Alfragide, 2610-124, Amadora, Portugal
| | - J Pereira
- Agência Portuguesa do Ambiente, Departamento de Emergências e Proteção Radiológica, Divisão de Autorização e Segurança Nuclear, Rua da Murgueira 9 - Zambujal - Alfragide, 2610-124, Amadora, Portugal
| | - P Vaz
- Centro de Ciências e Tecnologias Nucleares, Instituto Superior Técnico, Campus Tecnológico e Nuclear, Estrada Nacional 10, km 139,7, 2695-066, Bobadela LRS, Portugal
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Pereira AM, Pereira M, Araújo LM, Castel-Branco MG, Morete A, Almeida Fonseca J. Self-reported adverse reactions to subcutaneous airborne allergen immunotherapy: a real-life, single center study. Eur Ann Allergy Clin Immunol 2021; 55:131-140. [PMID: 33949174 DOI: 10.23822/eurannaci.1764-1489.212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Summary Objective. To estimate the prevalence of self-reported adverse reactions (AdR) to subcutaneous airborne allergen immunotherapy (SCIT) and to describe factors associated with its occurrence. Methods. Real-life, observational, descriptive study of all patients treated with SCIT at a Portuguese allergy unit between 03/2017 and 06/2019, and who answered ≥1 time to a pre-SCIT evaluation questionnaire assessing the occurrence of local and/or systemic AdR in the previous administration. Results. 939 questionnaires from 231 patients (42% female, 35% with asthma) were included. Most (60%) SCIT preparations had multiple allergens with concentration adjusted to prevent dilution (MA-NoDil), 26% were single allergen with standard concentration (SA-SC), 10% single allergen with higher than standard concentration (SA-HC), and 4% mixtures without concentration adjustment (MA-Dil). SCIT-related AdR were self-reported in 313 (33%) administrations, 97% at the injection site and 11% grade 1 systemic symptoms. In a multivariable model, being a female and having asthma were associated with higher risk of AdR. MA-NoDil SCIT presented a lower risk of AdR compared to SA-SC SCIT. Conclusions. SCIT-related AdR were self-reported in 1/3 of the administrations, most at the injection site. The risk of AdR was higher in females and in patients with asthma. The lower risk of adverse reactions observed in SCIT preparations with multiple allergens with no dilutional effect should be further explored in future, targeted studies.
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Affiliation(s)
- A M Pereira
- Allergy Unit, CUF-Porto (Hospital and Instituto), Estrada da Circunvalação, Porto, Portugall.,CINTESIS - Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Portugal.,MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Portugal
| | - M Pereira
- Allergy Unit, CUF-Porto (Hospital and Instituto), Estrada da Circunvalação, Porto, Portugal.,CINTESIS - Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Portugal.,Medicina, EDucação, I and D e Avaliação, Lda (MEDIDA), Porto, Portugal
| | - L M Araújo
- Allergy Unit, CUF-Porto (Hospital and Instituto), Estrada da Circunvalação, Porto, Portugal.,CINTESIS - Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Portugal.,Basic and Clinical Immunology, Pathology Department, Faculty of Medicine, University of Porto, Portugal
| | - M G Castel-Branco
- Allergy Unit, CUF-Porto (Hospital and Instituto), Estrada da Circunvalação, Porto, Portugal
| | - A Morete
- Allergy Unit, CUF-Porto (Hospital and Instituto), Estrada da Circunvalação, Porto, Portugal
| | - J Almeida Fonseca
- Allergy Unit, CUF-Porto (Hospital and Instituto), Estrada da Circunvalação, Porto, Portugal.,CINTESIS - Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Portugal.,MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Portugal.,Medicina, EDucação, I and D e Avaliação, Lda (MEDIDA), Porto, Portugal
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Pereira M, Neves C, Neves JS, Carvalho D. Quality of Life in Patients With Hypothyroidism. J Endocr Soc 2021. [DOI: 10.1210/jendso/bvab048.1698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Abstract
Introduction: The quality of life (QoL) of thyroid diseases has been less studied than other chronic diseases. There is however evidence suggesting long lasting physical and psychological symptomatology related to thyroid diseases.
Objective: To analyze the QoL in patients with hypothyroidism.
Methods: We evaluated 274 patients with a mean age of 56.2 ± 14.2 years, 89.1 % female and divided them by diagnosis: autoimmune thyroiditis (AIT, n = 145), multinodular goiter (MG, n = 31), total thyroidectomy (TT) for thyroid cancer (n = 46), total thyroidectomy for MG (n = 36), TT for Graves disease (GD, n = 9) and radioactive iodine therapy (RAI) for GD (n = 7), and assessed thyroid function tests, thyroid antibodies, lipid profile, high-sensitivity C-reactive protein, vitamin B12, folic acid and applied the Thyroid Dependent Quality of Life questionnaire (ThyDQoL). Statistical analysis was performed with the One-way ANOVA test and Pearson’s correlation test. P values ≤ 0.05 were considered as statistically significant.
Results: In this sample, the subgroups who reported worse QoL were the TT for thyroid cancer (-2.47 points) followed by the RAI for GD (-2.14 points) and the AIT (-2.11 points), although these differences were not statistically significant. Regarding the internal domains of the ThyDQoL, we found a significant difference between the subgroup TT for thyroid cancer and MG in bodily discomfort (-4.03 ± 3.61 vs -1.47 ± 1.66; p = 0.04) and household tasks (-2.95 ± 2.92 vs -0.90 vs 1.61; p = 0.02). Within the subgroups, we observed significant correlations involving QoL and vitamin B12 in the AIT subgroup (r = 0.16; p = 0.05), between QoL and lipoprotein(a) (r = -0.50; p = 0.03) in the MG subgroup, between QoL and free T3 (r = -0.31; p = 0.03) in the TT for thyroid cancer subgroup and between QoL and free T3 (r = -0.76; p = 0.04) in the RAI for GD subgroup.
Conclusions: In this study we found that patients submitted to TT for thyroid cancer had the worse QoL among patients with hypothyroidism. This may be related to the use of thyroid hormone suppressive therapy. We also observed that certain domains of QoL are more affected by some causes of hypothyroidism. Further studies are needed to analyze more deeply the symptomatology that contributes to worsening of QoL in these patients.
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Affiliation(s)
- Miguel Pereira
- Department of Endocrinology, Diabetes and Metabolism, São João Hospital Center, Faculty of Medicine of University of Porto, Porto, Portugal
| | - Celestino Neves
- Department of Endocrinology, Diabetes and Metabolism, São João Hospital Center, Faculty of Medicine of University of Porto, Porto, Portugal
| | - João Sérgio Neves
- Department of Endocrinology, Diabetes and Metabolism, São João Hospital Center, Faculty of Medicine of University of Porto, Porto, Portugal
| | - Davide Carvalho
- Department of Endocrinology, Diabetes and Metabolism, São João Hospital Center, Faculty of Medicine of University of Porto, IS Instituto de Investigação e Inovação em Saúde, Porto, Portugal
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Pereira M, Pereira A, Araujo A, Soares M, Sobral J, Mota D, Maia B, Macedo A. The relationship between perfectionism, generalized problematic internet use and bulimic behaviours. Eur Psychiatry 2021. [PMCID: PMC9470390 DOI: 10.1192/j.eurpsy.2021.332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Perfectionism is a consistent risk factor for various psychopathological conditions, including psychological distress and eating disorders. Recently, we have shown, for the first time, that there is a relationship between perfectionism and generalized problematic internet use/GPIU (Sobral et al. 2020). Specifically, we found that the role of perfectionism in psychological disorder is partially mediated by GPIU. On the other hand, it has been suggested that the widespread use of digital media can lead to negative body image perception and abnormal eating attitudes and behaviors. Objectives To explore, for the first time, the relationship between perfectionism, GPIU and disordered eating behavior. Methods 475 university students (78.9% girls; mean age 20.22±1.695) answered the Portuguese validated versions of: Composite Multidimensional Perfectionism Scale, GPIU Scale and Eating Attitudes Test-25. SPSS and Hayes’ Process Macro (2020) were used. Results Bulimic Behaviours/BB significantly and moderately correlated with Perfectionist efforts (r=.263), Perfectionist concerns (r=.284) and GPIU (r=.25) (all p<.001). The mediation analyses revealed that GPIU is a partial mediator of the relationship between both perfectionism dimensions and BB. Conclusions The evidence that both negative and “positive” perfectionism dimensions are associated to eating pathology is in line with our previous research. The present study adds, for the first time, that one of the perfectionism pathways of influence on BB operates through UGPI. Assessment and intervention to diminish eating psychopathology should focus on perfectionism and compulsive traits which could be involved in both ED and GPIU and in their comorbidity. Disclosure No significant relationships.
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Arancibia F, Izquierdo E, Pereira M. Stabilization of the emulsion of Alkenyl Succinic Anhydride (ASA) in water using cellulose nanofibrils. Chem Eng Sci 2021. [DOI: 10.1016/j.ces.2020.116407] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Jácome C, Almeida R, Pereira AM, Araújo L, Correia MA, Pereira M, Couto M, Lopes C, Chaves Loureiro C, Catarata MJ, Santos LM, Ramos B, Mendes A, Pedro E, Cidrais Rodrigues JC, Oliveira G, Aguiar AP, Arrobas AM, Costa J, Dias J, Todo Bom A, Azevedo J, Ribeiro C, Alves M, Pinto PL, Neuparth N, Palhinha A, Marques JG, Martins P, Trincão D, Neves A, Todo Bom F, Santos MA, Branco J, Loyoza C, Costa A, Silva Neto A, Silva D, Vasconcelos MJ, Teixeira MF, Ferreira-Magalhães M, Taborda Barata L, Carvalhal C, Santos N, Sofia Pinto C, Rodrigues Alves R, Moreira AS, Morais Silva P, Fernandes R, Ferreira R, Alves C, Câmara R, Ferraz de Oliveira J, Bordalo D, Calix MJ, Marques A, Nunes C, Menezes F, Gomes R, Almeida Fonseca J. Asthma App Use and Interest Among Patients With Asthma: A Multicenter Study. J Investig Allergol Clin Immunol 2021; 30:137-140. [PMID: 32327403 DOI: 10.18176/jiaci.0456] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- C Jácome
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto (FMUP), Porto, Portugal
| | - R Almeida
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto (FMUP), Porto, Portugal
| | - A M Pereira
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto (FMUP), Porto, Portugal.,Allergy Unit, Instituto and Hospital CUF, Porto, Portugal
| | - L Araújo
- Allergy Unit, Instituto and Hospital CUF, Porto, Portugal
| | - M A Correia
- Allergy Unit, Instituto and Hospital CUF, Porto, Portugal
| | - M Pereira
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto (FMUP), Porto, Portugal.,MEDIDA - Medicina, Educação, Investigação, Desenvolvimento e Avaliação, Porto, Portugal
| | - M Couto
- Allergy Unit, Instituto and Hospital CUF, Porto, Portugal
| | - C Lopes
- Unidade de Imunoalergologia, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal.,Imunologia Básica e Clínica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - C Chaves Loureiro
- Serviço de Pneumologia A, Hospital Universitário de Coimbra, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - M J Catarata
- Serviço de Pneumologia A, Hospital Universitário de Coimbra, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - L M Santos
- Serviço de Pneumologia A, Hospital Universitário de Coimbra, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - B Ramos
- Serviço de Pneumologia A, Hospital Universitário de Coimbra, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - A Mendes
- Serviço de Imunoalergologia, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisboa, Portugal
| | - E Pedro
- Serviço de Imunoalergologia, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisboa, Portugal
| | - J C Cidrais Rodrigues
- Serviço de Pediatria, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal
| | - G Oliveira
- Serviço de Pediatria, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal
| | - A P Aguiar
- Serviço de Pediatria, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal
| | - A M Arrobas
- Serviço de Pneumologia B, Hospital Geral, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - J Costa
- Serviço de Pneumologia B, Hospital Geral, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - J Dias
- Serviço de Pneumologia B, Hospital Geral, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - A Todo Bom
- Serviço de Imunoalergologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - J Azevedo
- Serviço de Imunoalergologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - C Ribeiro
- Serviço de Imunoalergologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - M Alves
- Serviço de Imunoalergologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - P L Pinto
- Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
| | - N Neuparth
- Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal.,Pathophysiology, CEDOC, Integrated Pathophysiological Mechanisms Research Group, Nova Medical School, Lisboa, Portugal
| | - A Palhinha
- Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
| | - J G Marques
- Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
| | - P Martins
- Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal.,Pathophysiology, CEDOC, Integrated Pathophysiological Mechanisms Research Group, Nova Medical School, Lisboa, Portugal
| | - D Trincão
- Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
| | - A Neves
- Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
| | - F Todo Bom
- Serviço de Pneumologia, Hospital Beatriz Ângelo, Loures, Portugal
| | - M A Santos
- Serviço de Pneumologia, Hospital Beatriz Ângelo, Loures, Portugal
| | - J Branco
- Serviço de Pneumologia, Hospital Beatriz Ângelo, Loures, Portugal
| | - C Loyoza
- Serviço de Imunoalergologia, Hospital Amato Lusitano, Unidade Local de Saúde de Castelo Branco, Castelo Branco, Portugal
| | - A Costa
- Serviço de Pediatria, Hospital da Senhora da Oliveira, Guimarães, Portugal
| | - A Silva Neto
- Serviço de Pediatria, Hospital da Senhora da Oliveira, Guimarães, Portugal
| | - D Silva
- Serviço de Imunoalergologia, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - M J Vasconcelos
- Serviço de Imunoalergologia, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - M F Teixeira
- Serviço de Pediatria, Centro Materno Infantil do Norte, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - M Ferreira-Magalhães
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto (FMUP), Porto, Portugal.,Serviço de Pediatria, Centro Materno Infantil do Norte, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - L Taborda Barata
- Serviço de Imunoalergologia, Hospital Pêro da Covilhã, Centro Hospitalar Universitário Cova da Beira, Covilhã, Portugal
| | - C Carvalhal
- Serviço de Imunoalergologia, Hospital Pêro da Covilhã, Centro Hospitalar Universitário Cova da Beira, Covilhã, Portugal
| | - N Santos
- Serviço de Imunoalergologia, Centro Hospitalar Universitário do Algarve, Portimão, Portugal
| | - C Sofia Pinto
- Serviço de Pneumologia, Hospital São Pedro de Vila Real, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - R Rodrigues Alves
- Unidade de Imunoalergologia, Hospital do Divino Espirito Santo, Ponta Delgada, Portugal
| | - A S Moreira
- Unidade de Imunoalergologia, Hospital do Divino Espirito Santo, Ponta Delgada, Portugal
| | | | - R Fernandes
- Serviço de Pediatria, Departamento de Pediatria, Hospital de Santa Maria, Centro Hospitalar Universitário de Lisboa Norte, Lisboa, Portugal.,Laboratório de Farmacologia Clínica e Terapêutica, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Portugal
| | - R Ferreira
- Serviço de Pediatria, Departamento de Pediatria, Hospital de Santa Maria, Centro Hospitalar Universitário de Lisboa Norte, Lisboa, Portugal
| | - C Alves
- Serviço de Pneumologia, Hospital Nossa Senhora do Rosário, Centro Hospitalar Barreiro Montijo, Barreiro, Portugal
| | - R Câmara
- Serviço de Pneumologia, Hospital Nossa Senhora do Rosário, Centro Hospitalar Barreiro Montijo, Barreiro, Portugal
| | | | - D Bordalo
- Serviço de Pediatria, Unidade Hospitalar de Famalicão, Centro Hospitalar do Médio Ave, Vila Nova de Famalicão, Portugal
| | - M J Calix
- Serviço de Pediatria, Hospital de São Teotónio, Centro Hospitalar Tondela-Viseu, Viseu, Portugal
| | - A Marques
- Serviço de Pediatria, Hospital de São Teotónio, Centro Hospitalar Tondela-Viseu, Viseu, Portugal
| | - C Nunes
- Imunoalergologia, Centro de Imunoalergologia do Algarve, Portimão, Portugal
| | - F Menezes
- Serviço de Pneumologia, Hospital Garcia de Orta, Almada, Portugal
| | - R Gomes
- Serviço de Pneumologia, Hospital Garcia de Orta, Almada, Portugal
| | - J Almeida Fonseca
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto (FMUP), Porto, Portugal.,Allergy Unit, Instituto and Hospital CUF, Porto, Portugal.,MEDIDA - Medicina, Educação, Investigação, Desenvolvimento e Avaliação, Porto, Portugal.,Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
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Delgado M, Zúñiga-Feest A, Reyes-Díaz M, Barra PJ, Ruiz S, Bertin-Benavides A, Valle S, Pereira M, Lambers H. Ecophysiological Performance of Proteaceae Species From Southern South America Growing on Substrates Derived From Young Volcanic Materials. Front Plant Sci 2021; 12:636056. [PMID: 33679850 PMCID: PMC7933449 DOI: 10.3389/fpls.2021.636056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 02/01/2021] [Indexed: 06/12/2023]
Abstract
Southern South American Proteaceae thrive on young volcanic substrates, which are extremely low in plant-available phosphorus (P). Most Proteaceae exhibit a nutrient-acquisition strategy based on the release of carboxylates from specialized roots, named cluster roots (CR). Some Proteaceae colonize young volcanic substrates which has been related to CR functioning. However, physiological functioning of other Proteaceae on recent volcanic substrates is unknown. We conducted an experiment with seedlings of five Proteaceae (Gevuina avellana, Embothrium coccineum, Lomatia hirsuta, L. ferruginea, and L. dentata) grown in three volcanic materials. Two of them are substrates with very low nutrient concentrations, collected from the most recent deposits of the volcanoes Choshuenco and Calbuco (Chile). The other volcanic material corresponds to a developed soil that exhibits a high nutrient availability. We assessed morphological responses (i.e., height, biomass, and CR formation), seed and leaf macronutrient and micronutrient concentrations and carboxylates exuded by roots. The results show that G. avellana was less affected by nutrient availability of the volcanic substrate, probably because it had a greater nutrient content in its seeds and produced large CR exuding carboxylates that supported their initial growth. Embothrium coccineum exhibited greater total plant height and leaf P concentration than Lomatia species. In general, in all species leaf macronutrient concentrations were reduced on nutrient-poor volcanic substrates, while leaf micronutrient concentrations were highly variable depending on species and volcanic material. We conclude that Proteaceae from temperate rainforests differ in their capacity to grow and acquire nutrients from young and nutrient-poor volcanic substrates. The greater seed nutrient content, low nutrient requirements (only for G. avellana) and ability to mobilize nutrients help explain why G. avellana and E. coccineum are better colonizers of recent volcanic substrates than Lomatia species.
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Affiliation(s)
- M. Delgado
- Center of Plant, Soil Interaction and Natural Resources Biotechnology, Scientific and Technological Bioresource Nucleus (BIOREN), Universidad de La Frontera, Temuco, Chile
| | - A. Zúñiga-Feest
- Laboratorio de Biología Vegetal, Instituto de Ciencias Ambientales y Evolutivas, Facultad de Ciencias, Universidad Austral de Chile, Valdivia, Chile
- Centro de Investigación en Suelos Volcánicos (CISVo), Valdivia, Chile
| | - M. Reyes-Díaz
- Center of Plant, Soil Interaction and Natural Resources Biotechnology, Scientific and Technological Bioresource Nucleus (BIOREN), Universidad de La Frontera, Temuco, Chile
- Departamento de Ciencias Químicas y Recursos Naturales, Facultad de Ingeniería y Ciencias, Universidad de La Frontera, Temuco, Chile
| | - P. J. Barra
- Center of Plant, Soil Interaction and Natural Resources Biotechnology, Scientific and Technological Bioresource Nucleus (BIOREN), Universidad de La Frontera, Temuco, Chile
| | - S. Ruiz
- Laboratorio de Biología Vegetal, Instituto de Ciencias Ambientales y Evolutivas, Facultad de Ciencias, Universidad Austral de Chile, Valdivia, Chile
| | - A. Bertin-Benavides
- Laboratorio de Epigenética Vegetal, Departamento de Silvicultura, Facultad de Ciencias Forestales, Universidad de Concepción, Concepción, Chile
| | - S. Valle
- Centro de Investigación en Suelos Volcánicos (CISVo), Valdivia, Chile
- Facultad de Ciencias Agrarias, Instituto de Ingeniería Agraria y Suelos, Universidad Austral de Chile, Valdivia, Chile
| | - M. Pereira
- Laboratorio de Biología Vegetal, Instituto de Ciencias Ambientales y Evolutivas, Facultad de Ciencias, Universidad Austral de Chile, Valdivia, Chile
| | - H. Lambers
- School of Biological Sciences, The University of Western Australia, Perth, WA, Australia
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Carneiro A, Guimarães T, Gomes D, Mendonça C, Pesquero J, Palmisano G, Moreira J, Pereira M. Rabdomiólise em militares: uma missão de reconhecimento para prevenção. ACTA ACUST UNITED AC 2021. [DOI: 10.29073/jim.v2i1.323] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
O treinamento físico regular faz parte do cotidiano militar, com intuito de aprimorar competências físicas essenciais para tarefas de combate. No entanto, quando executado de forma extenuante ou desenvolvido em condições climáticas adversas pode ocasionar o desenvolvimento da rabdomiólise por esforço físico. A rabdomiólise por esforço físico é definida como uma síndrome decorrente da necrose das células musculares, com sintomas variáveis, como dor muscular, fraqueza e aumento plasmático de enzimas musculares. A severidade da rabdomiólise por esforço físico varia individualmente, porém, pode se tornar clinicamente relevante, contribuindo para a hospitalização, insuficiência renal aguda, incapacidade permanente ou óbito. Sendo assim, o objetivo desta revisão narrativa é apresentar possíveis causas e fatores de risco para rabdomiólise, discutir sua fisiopatologia, seus possíveis diagnósticos e suas principais complicações, enfatizando o contexto militar.
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Borges T, Montero J, Leitão B, Pereira M, Galindo-Moreno P. Periimplant bone changes in different abutment heights and insertion timing in posterior mandibular areas: Three-year results from a randomized prospective clinical trial. Clin Oral Implants Res 2020; 32:203-211. [PMID: 33230873 DOI: 10.1111/clr.13691] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 11/06/2020] [Accepted: 11/11/2020] [Indexed: 12/22/2022]
Abstract
AIM To compare the influence of the abutment height and its insertion timing on the marginal bone change (MBC) variation of implants placed at posterior mandibular partial edentulous areas in a medium follow-up period. MATERIAL AND METHODS This randomized clinical trial (RCT) comprised a sample of patients with posterior mandibular edentulous areas, treated with at least two implants and distributed into three groups: implants connected to a 2 mm height abutment during the surgical stage (Group A); implants connected to a 1 mm height abutment during the surgical stage (Group B); and implants connected to a 2 mm height abutment after 2 months (Group C). Clinical and radiographic measurements were performed during a 36-month period (T4). The MBC was set as the main variable in study. Statistical significance was set at 0.05. RESULTS A total of 29 subjects and 59 implants were enrolled in this study. A mean MBC of 0.35 ± 0.46 mm, 0.60 ± 0.81 mm, and 0.71 ± 0.90 mm was computed for groups A, B and C, respectively, at T4. Significant differences were found between groups A and C in terms of MBC variation after 3 years of treatment (p = .048). Multiple linear regression analysis showed a significant influence of the first-year MBC and the abutment insertion timing has independent predictor variables for the MBC assessed at T4. CONCLUSION The installation of 2-mm prosthetic abutments, at the time of implant placement, in areas with limited keratinized mucosa presents as a favorable treatment option in terms of periimplant marginal bone maintenance.
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Affiliation(s)
- Tiago Borges
- Head of Oral Surgery, Faculty of Dental Medicine, Centre for Interdisciplinary Research in Health, Universidade Católica Portuguesa, Portugal
| | - Javier Montero
- Department of Surgery. Faculty of Medicine, University of Salamanca, Salamanca, Spain
| | - Bruno Leitão
- Faculty of Dental Medicine, Centre for Interdisciplinary Research in Health, Universidade Católica Portuguesa, Viseu, Portugal
| | - Miguel Pereira
- Faculty of Dental Medicine, Universidade Católica Portuguesa, Viseu, Portugal
| | - Pablo Galindo-Moreno
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Granada, Spain
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Portas L, Pereira M, Shaheen SO, Wyss AB, London SJ, Burney PGJ, Hind M, Dean CH, Minelli C. Lung Development Genes and Adult Lung Function. Am J Respir Crit Care Med 2020; 202:853-865. [PMID: 32392078 PMCID: PMC7491406 DOI: 10.1164/rccm.201912-2338oc] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [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] [Indexed: 12/25/2022] Open
Abstract
Rationale: Poor lung health in adult life may occur partly through
suboptimal growth and development, as suggested by epidemiological evidence
pointing to early life risk factors. Objectives: To systematically investigate the effects of lung
development genes on adult lung function. Methods: Using UK Biobank data, we tested the association of 391
genes known to influence lung development with FVC and FEV1/FVC. We
split the dataset into two random subsets of 207,616 and 138,411 individuals,
using the larger subset to select the most promising signals and the smaller
subset for replication. Measurements and Main Results: We identified 55 genes, of which 36
(16 for FVC, 19 for FEV1/FVC, and one for both) had not been
identified in the largest, most recent genome-wide study of lung function. Most
of these 36 signals were intronic variants; expression data from blood and lung
tissue showed that the majority affect the expression of the genes they lie
within. Further testing of 34 of these 36 signals in the CHARGE and SpiroMeta
consortia showed that 16 replicated after Bonferroni correction and another 12
replicated at nominal significance level. Of the 55 genes, 53 fell into four
biological categories whose function is to regulate organ size and cell
integrity (growth factors; transcriptional regulators; cell-to-cell adhesion;
extracellular matrix), suggesting that these specific processes are important
for adult lung health. Conclusions: Our study demonstrates the importance of lung
development genes in regulating adult lung function and influencing both
restrictive and obstructive patterns. Further investigation of these
developmental pathways could lead to druggable targets.
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Affiliation(s)
- Laura Portas
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Miguel Pereira
- National Heart and Lung Institute, Imperial College London, London, United Kingdom.,Congenica Ltd., Wellcome Genome Campus, Cambridge, United Kingdom
| | - Seif O Shaheen
- Institute of Population Health Sciences, Queen Mary University of London, London, United Kingdom
| | - Annah B Wyss
- Department of Health and Human Services, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, North Carolina
| | - Stephanie J London
- Department of Health and Human Services, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, North Carolina
| | - Peter G J Burney
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Matthew Hind
- National Heart and Lung Institute, Imperial College London, London, United Kingdom.,Department of Respiratory Medicine, Royal Brompton & Harefield NHS Foundation Trust, London, United Kingdom; and
| | - Charlotte H Dean
- National Heart and Lung Institute, Imperial College London, London, United Kingdom.,MRC Harwell Institute, Oxfordshire, United Kingdom
| | - Cosetta Minelli
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
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Warburton L, Meniawy TM, Calapre L, Pereira M, McEvoy A, Ziman M, Gray ES, Millward M. Stopping targeted therapy for complete responders in advanced BRAF mutant melanoma. Sci Rep 2020; 10:18878. [PMID: 33139839 PMCID: PMC7606504 DOI: 10.1038/s41598-020-75837-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 10/21/2020] [Indexed: 12/27/2022] Open
Abstract
BRAF inhibitors revolutionised the management of melanoma patients and although resistance occurs, there is a subgroup of patients who maintain durable disease control. For those cases with durable complete response (CR) it is not clear whether it is safe to cease therapy. Here we identified 13 patients treated with BRAF +/- MEK inhibitors, who cease therapy after prolonged CR (median = 34 months, range 20-74). Recurrence was observed in 3/13 (23%) patients. In the remaining 10 patients with sustained CR off therapy, the median follow up after discontinuation was 19 months (range 8-36). We retrospectively measured ctDNA levels using droplet digital PCR (ddPCR) in longitudinal plasma samples. CtDNA levels were undetectable in 11/13 cases after cessation and remained undetectable in patients in CR (10/13). CtDNA eventually became detectable in 2/3 cases with disease recurrence, but remained undetectable in 1 patient with brain only progression. Our study suggests that consideration could be given to ceasing targeted therapy in the context of prolonged treatment, durable response and no evidence of residual disease as measured by ctDNA.
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Affiliation(s)
- L Warburton
- Department of Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - T M Meniawy
- Department of Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
- School of Medicine and Pharmacology, University of Western Australia, Crawley, WA, Australia
| | - L Calapre
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - M Pereira
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - A McEvoy
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - M Ziman
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
- School of Biomedical Science, University of Western Australia, Crawley, WA, Australia
| | - E S Gray
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.
| | - M Millward
- Department of Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
- School of Medicine and Pharmacology, University of Western Australia, Crawley, WA, Australia
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41
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Szafron V, Pereira M, Vogel T, Leung D, Forbes-Satter L. M412 A BALANCING ACT: TREATMENT OF COVID-19 AND CYTOMEGALOVIRUS IN A PATIENT WITH PRIMARY IMMUNODEFICIENCY. Ann Allergy Asthma Immunol 2020. [PMCID: PMC7661922 DOI: 10.1016/j.anai.2020.08.359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Hoffmann TM, Travaglini A, Brighetti MA, Acar Şahin A, Arasi S, Bregu B, Caeiro E, Caglayan Sozmen S, Charpin D, Delgado L, Dimou M, Fiorilli M, Fonseca JA, Goksel O, Kalpaklioglu F, Lame B, Mazon A, Mesonjesi E, Nieto A, Öztürk A, Pajno G, Papadopoulos NG, Pellegrini E, Pereira AM, Pereira M, Pinar NM, Pinter E, Priftanji A, Sackesen C, Sfika I, Suarez J, Thibaudon M, Tripodi S, Ugus U, Villella V, Matricardi PM, Dramburg S. Cumulative Pollen Concentration Curves for Pollen Allergy Diagnosis. J Investig Allergol Clin Immunol 2020; 31:340-343. [PMID: 32959781 DOI: 10.18176/jiaci.0646] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- T M Hoffmann
- Department of Pediatric Pneumology, Immunology and Intensive Care Medicine, Charité Medical University, Berlin, Germany
| | - A Travaglini
- Department of Biology, Tor Vergata University, Rome, Italy.,Italian Aerobiology Monitoring Network - Italian Aerobiology Association, Italy
| | - M A Brighetti
- Department of Biology, Tor Vergata University, Rome, Italy
| | - A Acar Şahin
- Department of Biology, Faculty of Science, Ankara University, Ankara, Turkey
| | - S Arasi
- Pediatric Allergology Unit, Department of Pediatric Medicine, Bambino Gesù Children´s research Hospital (IRCCS), Rome, Italy
| | - B Bregu
- Department of Allergology and Clinical Immunology, UHC Mother Teresa, Medical University Tirana, Albania
| | - E Caeiro
- Mediterranean Institute for Agriculture, Environmental and Development, University of Évora, Évora, Portugal.,Portuguese Society of Allergology and Clinical Immunology, Lisbon, Portugal
| | - S Caglayan Sozmen
- Department of Pediatric Allergy and Immunology, Okan University Faculty of Medicine, Istanbul, Turkey
| | - D Charpin
- Department of Pneumonology and Allergy, La Timone Hospital, APHM, Aix-Marseille University, Marseille, France
| | - L Delgado
- Basic and Clinical Immunology Unit, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal.,CINTESIS, Center for Health Technology and Services Research, Porto, Portugal.,Allergy Unit, Instituto & Hospital CUF Porto, Porto, Portugal
| | - M Dimou
- Allergy Department, 2nd Pediatric Clinic, Athens General Children´s Hospital "P&A Kyriakou," University of Athens, Athens, Greece
| | - M Fiorilli
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - J A Fonseca
- CINTESIS, Center for Health Technology and Services Research, Porto, Portugal.,Allergy Unit, Instituto & Hospital CUF Porto, Porto, Portugal.,MEDCIDS-Department of Community Medicine, Information, and Health Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
| | - O Goksel
- Department of Pulmonary Medicine, Division of Immunology, Allergy and Asthma, Faculty of Medicine, Ege University, Izmir, Turkey
| | - F Kalpaklioglu
- Kırıkkale University School of Medicine, Department of Chest Diseases, Division of Immunology and Allergic Diseases, Turkey
| | - B Lame
- Department of Allergology and Clinical Immunology, UHC Mother Teresa, Medical University Tirana, Albania
| | - A Mazon
- Pediatric Allergy and Pneumology Unit, Children´s Hospital La Fe; Health Research Institute La Fe, Valencia, Spain
| | - E Mesonjesi
- Department of Allergology and Clinical Immunology, UHC Mother Teresa, Medical University Tirana, Albania
| | - A Nieto
- Pediatric Allergy and Pneumology Unit, Children´s Hospital La Fe; Health Research Institute La Fe, Valencia, Spain
| | - A Öztürk
- Department of Allergy and Immunology, Koç University Hospital, İstanbul, Turkey
| | - G Pajno
- Department of Pediatrics- Allergy Unit, University of Messina, Messina, Italy
| | - N G Papadopoulos
- Allergy Department, 2nd Pediatric Clinic, Athens General Children´s Hospital "P&A Kyriakou," University of Athens, Athens, Greece.,Division of Infection, Immunity & Respiratory Medicine, Royal Manchester Children´s Hospital, University of Manchester, Manchester, UK
| | - E Pellegrini
- ARPACal- Regional Agency for Environmental Protection, Department of Reggio Calabria, Italy
| | - A M Pereira
- CINTESIS, Center for Health Technology and Services Research, Porto, Portugal.,Allergy Unit, Instituto & Hospital CUF Porto, Porto, Portugal
| | - M Pereira
- CINTESIS, Center for Health Technology and Services Research, Porto, Portugal.,Allergy Unit, Instituto & Hospital CUF Porto, Porto, Portugal
| | - N M Pinar
- Department of Biology, Faculty of Science, Ankara University, Ankara, Turkey
| | - E Pinter
- Allergy Department, 2nd Pediatric Clinic, Athens General Children´s Hospital "P&A Kyriakou," University of Athens, Athens, Greece
| | - A Priftanji
- Department of Allergology and Clinical Immunology, UHC Mother Teresa, Medical University Tirana, Albania
| | - C Sackesen
- Division of Pediatric Allergy, Koç University School of Medicine, Istanbul, Turkey
| | - I Sfika
- Pediatric Allergy Unit, Sandro Pertini Hospital, Rome, Italy
| | - J Suarez
- Department of Biology of Organisms and Systems, Area of Botany, University of Oviedo, Oviedo, Spain
| | - M Thibaudon
- Réseau National de Surveillance Aérobiologique, Brussieu, France
| | - S Tripodi
- Pediatric Allergy Unit, Sandro Pertini Hospital, Rome, Italy
| | - U Ugus
- Department of Biology, Faculty of Science, Ege University, Izmir, Turkey
| | - V Villella
- Pediatric Allergy Unit, Sandro Pertini Hospital, Rome, Italy
| | - P M Matricardi
- Department of Pediatric Pneumology, Immunology and Intensive Care Medicine, Charité Medical University, Berlin, Germany
| | - S Dramburg
- Department of Pediatric Pneumology, Immunology and Intensive Care Medicine, Charité Medical University, Berlin, Germany
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43
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Costa A, Cunha Teixeira V, Pereira M, Mota Ferreira P, Kuplich P, Dohnert M, da Silva Guths J, Boff Daitx R. Associated Strengthening Exercises to Undenatured Oral Type II Collagen UCII. A Randomized Study in Patients Affected by Knee Osteoarthritis. Muscles Ligaments Tendons J 2020. [DOI: 10.32098/mltj.03.2020.18] [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: 11/05/2022]
Affiliation(s)
- A.P. Costa
- Department of Physiotherapy, Lutheran University of Brazil, Torres RS, Brazil
| | | | - M. Pereira
- Physiotherapist, Capao da Canoa RS, Brazil
| | | | - P.A. Kuplich
- Private Practice, Department of Orthopedics and Traumatology, Santa Luzia Hospital, Capao da Canoa, RS, Brazil
| | - M.B. Dohnert
- Research, Teaching and Extension Laboratory in Orthopedic Trauma Physiotherapy LAPEFITO, Department of Physiotherapy, University of Gurupi UnirG, Gurupi TO, Brazil
| | - J.F. da Silva Guths
- Department of Physiotherapy, Lutheran University of Brazil, Torres RS, Brazil
| | - R. Boff Daitx
- Department of Physiotherapy, Lutheran University of Brazil, Torres RS, Brazil
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Pereira M, Santos D, Alves H, Lima V, Carvalho Cerqueira S, Almeida A, Jure F, Rosemberg R, de Fernandes O. The Situation Room as a management tool: the case of the Municipal Health Secretariat of Salvador. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.061] [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
Problem
The Salvador Municipal Health Secretariat (MHS) utilizes health data to elaborate technical documents to manage and respond to instances requiring internal or external control. In answer to demands for the modernization and transparency of municipal management, the constitution of a Health Situation Room (HSR) was included in the political agenda of the Secretary, thereby guaranteeing political, technical and operational support for its implementation.
Description of the Problem
To describe the process of construction of the HSR in the Salvador MHS in 2020. The HSR is a physical, virtual and collective space for the analysis of information, which begins with a data search which allows to understand the information flow, identifying the solicitor and the constructor of the information, the data source and the informational object itself.
Results
130 technicians and managers were interviewed, and their responses then categorized into 161 indicators across different themes. The results point out the need to define a spatial analysis unit to be adopted, and to communicate with external actors who demand information, as well as to develop a communication plan for the HSR.
Lessons
To develop an informational culture oriented by local and central protagonism, generating evidence for decision-making and information transparency for the whole of society.
Key messages
The Health Situation Room reduces the time between information-decision-action. The Health Situation Room prioritizes interdisciplinary collaboration and increases the efficiency of the health system.
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Affiliation(s)
- M Pereira
- Municipal Health Secretariat, Salvador, Brazil
| | - dos Santos
- Municipal Health Secretariat, Salvador, Brazil
| | - H Alves
- Municipal Health Secretariat, Salvador, Brazil
| | - Vieira Lima
- Municipal Health Secretariat, Salvador, Brazil
| | | | - A Almeida
- Municipal Health Secretariat, Salvador, Brazil
| | - F Jure
- SAMCo Esperanza Hospital, Esperanza, Argentina
| | - R Rosemberg
- Municipal Health Secretariat, Salvador, Brazil
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45
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Borges T, Fernandes D, Almeida B, Pereira M, Martins D, Azevedo L, Marques T. Correlation between alveolar bone morphology and volumetric dimensional changes in immediate maxillary implant placement: A 1‐year prospective cohort study. J Periodontol 2020; 91:1167-1176. [DOI: 10.1002/jper.19-0606] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 01/06/2020] [Accepted: 01/14/2020] [Indexed: 11/09/2022]
Affiliation(s)
- Tiago Borges
- Center for Interdisciplinary Research in Health (CIIS) Institute of Health Sciences (ICS) Universidade Católica Portuguesa Viseu Portugal
| | - Danilo Fernandes
- Institute of Health Sciences (ICS) Universidade Católica Portuguesa Viseu Portugal
| | - Bruno Almeida
- Center for Interdisciplinary Research in Health (CIIS) Institute of Health Sciences (ICS) Universidade Católica Portuguesa Viseu Portugal
| | - Miguel Pereira
- Center for Interdisciplinary Research in Health (CIIS) Institute of Health Sciences (ICS) Universidade Católica Portuguesa Viseu Portugal
| | - David Martins
- Institute of Health Sciences (ICS) Universidade Católica Portuguesa Viseu Portugal
| | - Luís Azevedo
- Institute of Health Sciences (ICS) Universidade Católica Portuguesa Viseu Portugal
| | - Tiago Marques
- Center for Interdisciplinary Research in Health (CIIS) Institute of Health Sciences (ICS) Universidade Católica Portuguesa Viseu Portugal
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Antunes C, Pereira M, Rodrigues L, Organista D, Cysneiros A, Paula F, Nunes B, Barbosa P, Bárbara C, Escoval A, Diniz A, Froes F. Hospitalization direct cost of adults with community-acquired pneumonia in Portugal from 2000 to 2009. Pulmonology 2020; 26:264-267. [PMID: 32482604 DOI: 10.1016/j.pulmoe.2020.02.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 01/05/2020] [Accepted: 02/26/2020] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Hospitalizations due to community-acquired pneumonia (CAP) in mainland Portugal from 2000 to 2009 accounted for 3.7% of all hospital admissions in population with 18 or more years of age. There is no direct-cost data regarding these admissions. METHODS In this observational descriptive study all adult hospitalizations associated with CAP diagnosis were retrospectively analyzed for the period between 2000 and 2009. Patients under 18 years old, those with pneumonia as secondary diagnosis, patients with tuberculous or obstructive pneumonia, and immunocompromised patients were excluded from the study. The direct cost of hospitalization was calculated according to the diagnosis-related groups (DRG), established for the respective year of hospitalization. RESULTS There were 294,026 hospital admissions with an average annual direct cost of 80 million Euros, which almost doubled between 2000 and 2009. The average direct hospitalization costs per admission, including wards and Intensive Care Units (ICU), amounted to €2,707, with an increasing trend. The average hospitalization cost was €2,515 for admissions resulting in live discharge, and €3,457 for the deceased. CONCLUSION The average direct cost of adult hospitalizations associated with CAP amounted to €2,707 in mainland Portugal from 2000 to 2009, showing an increase of 37.5% in hospitalization cost of living and deceased patients. The economic impact of CAP-related hospital admissions justifies the need for better implementation of preventive measures.
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Affiliation(s)
- C Antunes
- Thoracic Department, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal.
| | - M Pereira
- Thoracic Department, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - L Rodrigues
- Thoracic Department, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - D Organista
- Thoracic Department, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - A Cysneiros
- Pulmonology Department, Hospital São Bernardo, Setúbal, Portugal
| | - F Paula
- Thoracic Department, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - B Nunes
- Epidemiology Department, Instituto Nacional de Saúde Pública Dr. Ricardo Jorge, Lisbon, Portugal; Public Health Research Center, National School of Public Health, Lisbon, Portugal
| | - P Barbosa
- National School of Public Health, Lisbon, Portugal
| | - C Bárbara
- Thoracic Department, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal; Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - A Escoval
- National School of Public Health, Lisbon, Portugal
| | - A Diniz
- Thoracic Department, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - F Froes
- Thoracic Department, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal; Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
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Almeida J, Pires A, Oliveira M, Pereira M. ABOUT THE RELATIONSHIP BETWEEN PSICOTHERAPISTS IN SUPERVISION. Psic , Saúde & Doenças 2020. [DOI: 10.15309/20psd210204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Affiliation(s)
| | - R. Pereira
- Centro Hospitalar Universitário do Porto Porto Portugal
| | - M. Pereira
- Centro Hospitalar Universitário do Porto Porto Portugal
| | - I. Madeira
- Centro Hospitalar Universitário do Porto Porto Portugal
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Baptista M, Di Maria S, Vieira S, Pereira J, Pereira M, Vaz P. Organ dose measurements using an adult anthropomorphic phantom and risk estimation of cancer incidence from CBCT exposures. Radiat Phys Chem Oxf Engl 1993 2020. [DOI: 10.1016/j.radphyschem.2020.108715] [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] [Indexed: 11/15/2022]
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Oliveira MMO, Cunha PSC, Valente BV, Portugal G, Lousinha A, Pereira M, Braz M, Delgado AS, Ferreira RC. P1377Substrate-based ablation in patients with frequent appropriate ICD therapy and dilated cardiomyopathy: long-term experience with high-density mapping. Europace 2020. [DOI: 10.1093/europace/euaa162.204] [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: 11/12/2022] Open
Abstract
Abstract
Recurrent ventricular tachydisrhythmias (VT) episodes have a negative impact in the outcome of patients (P) already with an implantable cardioverter-defibrillator (ICD). Elimination of arrhythmic reentry circuits represents a difficult challenge, mainly due to the induction of intolerable VTs, with multiple ECG morphologies, requiring rapid interruption. Substrate guided ablation has been used as a promising approach strategy to treat recurrent VTs. Aim: to assess long-term results of a VT substrate-based ablation using high-density mapping in P with an ICD, severe left ventricular (LV) dysfunction and recurrent appropriate ICD therapy. Methods: 16P (12 men, non-ischemic cardiomyopathy 67%, 55 ± 13 years, LV ejection fraction 32 ± 6%) and recurrent appropriate shocks despite antiarrhythmic drug therapy and optimal heart failure medication. All P underwent a protocol of ventricular programmed stimulation (600 ms/S3) to obtain baseline VT documentation. A sinus rhythm (SR) voltage map was created using a 3D electroanatomic mapping system (CARTO) with a high-density mapping catheter (PentaRay) to delineate areas of scarred myocardium (ventricular bipolar voltage ≤0,5 mV – dense scar; 0,5-1,5 mV – border zone; ≥1,5 mV – healthy tissue) and provide high-resolution electrophysiological mapping. The substrate modification included catheter elimination of local abnormal ventricular activities (LAVA) - fractionated, splited, low-amplitude/long-lasting, late potentials, pre-systolic potentials - and linear ablation to obtain scars homogenization and scar dechanneling. Pace-mapping techniques were used when capture was possible. LV approach was retrograde in 6 cases, transeptal in 4 and endo-epicardial in 2 cases. In 2P the ablation was performed in the right ventricle. Results: VTs were induced and interrupted with bursts or external DC shocks. LAVA were identified and ablated in all P. Eleven P underwent modification of scar areas. The mean duration of the procedure was 153 mn (103-218 mn), with radiofrequency ranging from 18 to 60 mn (mean 33 min), and a mean fluoroscopy time of 16 mn. Non-inducibility was achieved in 75% of the cases. There was 1 pericardial tamponade drained successfully. During a follow-up of 48 ± 18 months, 75% had no VT recurrences, 2P underwent redo ablation, 1P died from stroke. Conclusion: Catheter ablation of VT based on substrate modification guided by high-density mapping is feasible and safe in P with LV dysfunction. This approach may be of clinical relevance, with potential benefits in reducing VT burden.
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Affiliation(s)
| | - P S C Cunha
- Hospital Santa Marta, CHLC, Lisbon, Portugal
| | - B V Valente
- Hospital Santa Marta, CHLC, Lisbon, Portugal
| | - G Portugal
- Hospital Santa Marta, CHLC, Lisbon, Portugal
| | - A Lousinha
- Hospital Santa Marta, CHLC, Lisbon, Portugal
| | | | - M Braz
- Hospital Santa Marta, CHLC, Lisbon, Portugal
| | - A S Delgado
- Hospital Santa Marta, CHLC, Lisbon, Portugal
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