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Olavarria OA, Lyons NB, Bernardi K, Dhanani NH, Neela N, Arakelians A, Cohen BL, Mohebzad K, Coelho R, Holihan JL, Liang MK. Impact of disclosure of radiographic test results on quality of life among patients with hernias: a randomized controlled trial. Hernia 2024; 28:411-418. [PMID: 37369887 DOI: 10.1007/s10029-023-02824-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: 03/01/2023] [Accepted: 06/10/2023] [Indexed: 06/29/2023]
Abstract
PURPOSE Hernias noted on radiographic imaging are common. We aimed to determine if informing patients of the presence of a clinically apparent or occult hernia on imaging would change their abdominal wall quality of life (AW-QOL). METHODS This study was registered on clinicaltrials.gov (NCT04355819) in April 2020. Patients with a ventral hernia on elective CT abdomen/pelvis were enrolled. Patients underwent standardized abdominal examination by surgeons, and completed the modified Activities Assessment Scale, a validated, hernia-specific AW-QOL survey. On this scale, 1 is poor AW-QOL, 100 is perfect, and the minimally clinically important difference is five for a minor change. Patients were randomized to complete the one-year follow-up survey before or after being informed of the presence of a hernia on their imaging results. Primary outcome was follow-up AW-QOL adjusted for baseline AW-QOL. RESULTS Of 169 patients randomized, 126 (75%) completed follow up at one-year. Among patients with occult hernias, those who completed the follow-up survey after being informed of having a hernia had a lower follow-up AW-QOL (mean difference - 7.6, 95% CI = - 20.8 to 5.7, p = 0.261) compared to those who completed the survey before being informed. Conversely, for patients with clinical hernias, those who completed the survey after being informed had higher adjusted follow-up AW-QOL (mean difference 10.3, 95% CI = - 3.0 to 23.6, p = 0.126) than those that completed it after. CONCLUSION Conveying findings of hernias found on CT imaging can influence patients' AW-QOL. Future research should focus on identifying and addressing patients' concerns after disclosure of CT results.
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Affiliation(s)
- O A Olavarria
- Department of Surgery, McGovern Medical School at the University of Texas Health Science Center Houston, Houston, TX, USA
- Center for Surgical Trials and Evidence-Based Practice, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX, USA
| | - N B Lyons
- Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.
- Ryder Trauma Center, Suite T-215, 1800 NW 10Th Ave, Miami, FL, 33136, USA.
| | - K Bernardi
- Department of Surgery, McGovern Medical School at the University of Texas Health Science Center Houston, Houston, TX, USA
- Center for Surgical Trials and Evidence-Based Practice, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX, USA
| | - N H Dhanani
- Department of Surgery, McGovern Medical School at the University of Texas Health Science Center Houston, Houston, TX, USA
- Center for Surgical Trials and Evidence-Based Practice, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX, USA
| | - N Neela
- Department of Surgery, McGovern Medical School at the University of Texas Health Science Center Houston, Houston, TX, USA
| | - A Arakelians
- Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - B L Cohen
- Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
- Ryder Trauma Center, Suite T-215, 1800 NW 10Th Ave, Miami, FL, 33136, USA
| | - K Mohebzad
- Department of Surgery, University of Houston, HCA Kingwood, Kingwood, TX, USA
| | - R Coelho
- Department of Surgery, University of Houston, HCA Kingwood, Kingwood, TX, USA
| | - J L Holihan
- Department of Surgery, McGovern Medical School at the University of Texas Health Science Center Houston, Houston, TX, USA
- Center for Surgical Trials and Evidence-Based Practice, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX, USA
| | - M K Liang
- Department of Surgery, University of Houston, HCA Kingwood, Kingwood, TX, USA
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Moutinho-Ribeiro P, Adem B, Batista I, Silva M, Silva S, Ruivo CF, Morais R, Peixoto A, Coelho R, Costa-Moreira P, Lopes S, Vilas-Boas F, Durães C, Lopes J, Barroca H, Carneiro F, Melo SA, Macedo G. Exosomal glypican-1 discriminates pancreatic ductal adenocarcinoma from chronic pancreatitis. Dig Liver Dis 2022; 54:871-877. [PMID: 34840127 DOI: 10.1016/j.dld.2021.10.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 10/19/2021] [Accepted: 10/27/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS Pancreatic ductal adenocarcinoma (PDAC) diagnosis can be difficult in a chronic pancreatitis (CP) background, especially in its mass forming presentation. We aimed to assess the accuracy of glypican-1-positive circulating exosomes (GPC1+crExos) to distinguish PDAC from CP versus the state-of-the-art CA 19-9 biomarker. METHODS This was a unicentric prospective cohort. Endoscopic ultrasound with fine-needle aspiration or biopsy and blood tests (GPC1+crExos and serum CA 19-9) were performed. RESULTS The cohort comprised 60 PDAC and 29 CP (7 of which mass forming - MF) patients. Median levels of GPC1+crExos were significantly higher in PDAC (99.7%) versus CP (28.4%; p<0.0001) with an AUROC of 0.96 with 98.3% sensitivity and 86.2% specificity for a cut-off of 45.0% (p<0.0001); this outperforms CA 19-9 AUROC of 0.82 with 78.3% sensitivity and 65.5% specificity at a cut-off of 37 U/mL (p<0.0001). The superiority of% GPC1+crExos over CA 19-99 in differentiating PDAC from CP was observed in both early (stage I) and advanced tumors (stages II-IV). CONCLUSION Levels of GPC1+crExos coupled to beads enable differential diagnosis between PDAC and CP including its mass-forming presentation.
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Affiliation(s)
- P Moutinho-Ribeiro
- Serviço de Gastrenterologia, Centro Hospitalar Universitário de São João, Porto, Portugal; Medical Faculty of the University of Porto, Porto, Portugal
| | - B Adem
- Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Porto, Portugal; Instituto de Patologia e Imunologia Molecular da Universidade do Porto (IPATIMUP), Porto, Portugal; Instituto de Ciências Biomédicas Abel Salazar (ICBAS), University of Porto, Porto, Portugal
| | - I Batista
- Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Porto, Portugal; Instituto de Patologia e Imunologia Molecular da Universidade do Porto (IPATIMUP), Porto, Portugal
| | - M Silva
- Serviço de Gastrenterologia, Centro Hospitalar Universitário de São João, Porto, Portugal; Medical Faculty of the University of Porto, Porto, Portugal
| | - S Silva
- Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Porto, Portugal; Instituto de Patologia e Imunologia Molecular da Universidade do Porto (IPATIMUP), Porto, Portugal; iBiMED - Institute of Biomedicine, University of Aveiro
| | - C F Ruivo
- Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Porto, Portugal; Instituto de Patologia e Imunologia Molecular da Universidade do Porto (IPATIMUP), Porto, Portugal; Instituto de Ciências Biomédicas Abel Salazar (ICBAS), University of Porto, Porto, Portugal
| | - R Morais
- Serviço de Gastrenterologia, Centro Hospitalar Universitário de São João, Porto, Portugal; Medical Faculty of the University of Porto, Porto, Portugal
| | - A Peixoto
- Serviço de Gastrenterologia, Centro Hospitalar Universitário de São João, Porto, Portugal; Medical Faculty of the University of Porto, Porto, Portugal
| | - R Coelho
- Serviço de Gastrenterologia, Centro Hospitalar Universitário de São João, Porto, Portugal; Medical Faculty of the University of Porto, Porto, Portugal
| | - P Costa-Moreira
- Serviço de Gastrenterologia, Centro Hospitalar Universitário de São João, Porto, Portugal; Medical Faculty of the University of Porto, Porto, Portugal
| | - S Lopes
- Serviço de Gastrenterologia, Centro Hospitalar Universitário de São João, Porto, Portugal; Medical Faculty of the University of Porto, Porto, Portugal
| | - F Vilas-Boas
- Serviço de Gastrenterologia, Centro Hospitalar Universitário de São João, Porto, Portugal; Medical Faculty of the University of Porto, Porto, Portugal
| | - C Durães
- Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Porto, Portugal; Instituto de Patologia e Imunologia Molecular da Universidade do Porto (IPATIMUP), Porto, Portugal
| | - J Lopes
- Serviço de Anatomia Patológica, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - H Barroca
- Serviço de Anatomia Patológica, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - F Carneiro
- Medical Faculty of the University of Porto, Porto, Portugal; Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Porto, Portugal; Instituto de Patologia e Imunologia Molecular da Universidade do Porto (IPATIMUP), Porto, Portugal; Serviço de Anatomia Patológica, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - S A Melo
- Medical Faculty of the University of Porto, Porto, Portugal; Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Porto, Portugal; Instituto de Patologia e Imunologia Molecular da Universidade do Porto (IPATIMUP), Porto, Portugal
| | - G Macedo
- Serviço de Gastrenterologia, Centro Hospitalar Universitário de São João, Porto, Portugal; Medical Faculty of the University of Porto, Porto, Portugal.
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Tozzi A, Coelho R, Disler M, Lombardo F, Fedier A, Nunez Lopez M, Freuler F, Jacob F, Heinzelmann-Schwarz V. 1P Comprehensive assessment of gene mutations revealed overlapping responses for PARPi and chemotherapy in ovarian cancer cells. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.019] [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: 11/29/2022] Open
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Ferreira J, Parreira L, Farinha JM, Esteves AF, Coelho R, Pinheiro A, Mesquita D, Marinheiro R, Amador P, Lopes A, Caria R. Specialty-related asymmetries in treatment and outcomes of younger patients with atrial fibrillation. Europace 2022. [DOI: 10.1093/europace/euac053.180] [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
Funding Acknowledgements
Type of funding sources: None.
Background
Atrial fibrillation (AF) is the most common arrhythmia and one of the most frequent motives for presentation in the emergency department (ED). However, there are still significant inequalities concerning its treatment.
Purpose
We aimed to assess if management and outcomes of patients with AF differed according to the specialty to which they were referred at hospital discharge.
Methods
We conducted a retrospective single-centre analysis including adult patients admitted to the ED in 2016 with the International Classification of Diseases codes correspondent to AF. Patients older than 75 years and those whose electronic medical file was not accessible were excluded. Patient referral at discharge was not based on any pre-specified criteria but rather performed at the discretion of the physician in the ED.
We divided our sample into 3 groups according to whom the patients were referred at hospital discharge: A) patients referred to an electrophysiologist; B) patients referred to a general cardiologist; and C) those referred to a non-cardiologist (general practitioner or internist).
We assessed patient characteristics, delay to first appointment, treatment strategies as well as stroke and all-cause mortality at 3 years of follow-up.
Results
Of the 372 patients initially screened, 184 were excluded due to age over 75 and 85 patients due to inaccessible medical records, resulting in a final sample of 103 patients with a median age of 65 (58-71) years and median CHA2DS2-VASc of 2 (1-3).
At discharge from the index admission, one third of patients were referred to an electrophysiologist (group A), 41% to a general cardiologist (group B) and the remaining 26% to a non-cardiologist (group C). There were no significant differences in baseline characteristics or type of AF between the groups.
The delay from index hospital admission to the first appointment was superior in groups A and B compared with C (3 and 2 vs 0 months, p=0.050).
Patients referred to an electrophysiologist were more frequently started on a rhythm-control strategy compared with those referred to other physicians (71% vs 38% and 26%, p=0.004). Similarly, significantly more patients in group A underwent catheter ablation (47% vs 12% and 4%, p<0.001), around 2 years after the diagnosis (tendentially earlier than those in group B).
At 3 years follow-up, mortality was higher in group C compared with the other groups (15% vs 0 in group A and 2% in group B, p=0.019). Stroke rates did not differ between groups.
Conclusion
In this group of AF patients, referral to an electrophysiologist at discharge was associated with a higher rate of a rhythm-control strategy, including catheter ablation. In the long-term, those patients showed better survival. These results suggest that, in patients under 75 years, an earlier referral to an electrophysiologist might be beneficial.
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Affiliation(s)
- J Ferreira
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
| | - L Parreira
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
| | - JM Farinha
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
| | - AF Esteves
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
| | - R Coelho
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
| | - A Pinheiro
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
| | - D Mesquita
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
| | - R Marinheiro
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
| | - P Amador
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
| | - A Lopes
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
| | - R Caria
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
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5
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Parreira A, Carmo P, Marinheiro R, Mesquita D, Marques L, Mancelos S, Ferreira A, Goncalves A, Nunes S, Chmelevsky M, Ferreira J, Coelho R, Goncalves P, Marques H, Adragao P. Assessment of activation duration across the right ventricular outflow tract in patients with premature ventricular contractions using noninvasive electrocardiographic mapping: a validation study. Europace 2022. [DOI: 10.1093/europace/euac053.024] [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
Funding Acknowledgements
Type of funding sources: Private hospital(s). Main funding source(s): Learning Health
Introduction
Previous studies have reported that wavefront propagation speed across the right ventricular outflow tract (RVOT) can distinguish premature ventricular contractions (PVCs) with a RVOT origin from PVCs with a left ventricular outflow tract (LVOT) origin.
Aim
Validate the non-invasive electrocardiographic mapping (ECGI) for assessment of RVOT activation duration (AD) during PVCs and assess its value as a predictor of the origin of the PVCs.
Methods
We studied 18 consecutive patients, 8 males, median age 55 (35-63) years that underwent ablation of frequent (> 10.000 per 24 h) idiopathic PVCs with inferior axis, that had and an ECGI performed before ablation and the RVOT mapped in PVC. The ECGI was performed with the Amycard system, and invasive mapping was performed with the Carto or Ensite system. Isochronal activation maps of the RVOT in PVC were obtained with the activation direction method (ADM) of the ECGI, and with the Carto and Ensite systems. Total RVOT AD was measured as the time interval between the earliest and the latest activated region. Agreement between the two methods was performed using a Bland-Altman plot and linear regression . The cutoff value of AD to predict PVC origin was calculated with ROC curve.
Results
PVCs originated from the RVOT in 11 (61%) patients. The median (Q1-Q3) RVOT AD measured with ECGI was 54 (39-68) ms and with invasive map 57 (36-70) ms. The agreement between both methods was good with an R2 of 0.747, p<0.0001. Figure displays the Bland-Altman plot (panel A), the linear regression plot (panel B). and two examples of the ECGI isochronal map (panel C). The AD was significantly higher in PVCs from the RVOT vs LVOT, both with ECGI and Carto, respectively 62 (58-73) vs 37 (33-40) ms, p<0.0001 and 68 (60-75) vs 34 (30-40) ms, p<0.0001. The cutoff value of 43 ms for AD measured with ECGI, predicted the origin of the PVCs with a sensitivity and specificity of 100%.
Conclusions
We found good agreement between ECGI and Carto. The AD obtained with ECGI was accurate to predict the origin of the PVCs.
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Affiliation(s)
| | - P Carmo
- Hospital Luz, Lisbon, Portugal
| | | | - D Mesquita
- Hospital Center of Setubal, Setubal, Portugal
| | - L Marques
- Hospital Center of Setubal, Setubal, Portugal
| | | | | | - A Goncalves
- Hospital Center of Setubal, Setubal, Portugal
| | - S Nunes
- Hospital Luz, Lisbon, Portugal
| | - M Chmelevsky
- Almazov National Medical Research Center, St Petersburg, Russian Federation
| | - J Ferreira
- Hospital Center of Setubal, Setubal, Portugal
| | - R Coelho
- Hospital Center of Setubal, Setubal, Portugal
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Ferreira J, Fonseca M, Goncalves S, Farinha J, Esteves A, Pinheiro A, Coelho R, Costa C, Caria R. STEMI with mid-range ejection fraction: a group of intermediate risk not to be forgotten. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0803] [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: 11/14/2022] Open
Abstract
Abstract
Background
Reduced left ventricular ejection fraction (LVEF) <40% is an important negative prognostic factor in the setting of ST-elevation acute myocardial infarction (STEMI). On the other hand, data concerning mid-range LVEF (mrEF) post-STEMI are scarce. Consequently, recommendations regarding reassessment of LVEF or administration of neurohormonal medication in this group of patients (pts) are also lacking.
Purpose
To assess the current treatment and prognosis of STEMI with mrEF.
Methods
Retrospective study including all consecutive pts hospitalized for STEMI and submitted to primary percutaneous coronary intervention in a Cardiology centre in 2018. Pts were divided into 3 groups according to LVEF assessed before hospital discharge: preserved EF (pEF: LVEF ≥50%), mid-range EF (mrEF: LVEF 40–49%) and reduced EF (rEF: LVEF <40%). We analysed clinical characteristics, treatment, evolution of LVEF post-STEMI and clinical outcomes - death, myocardial infarction (MI) and hospitalization for heart failure (HF) – of the mrEF group and compared it with pEF.
Results
188 pts with a mean age of 61 years were admitted for STEMI in 2018. The majority (58%, n=109) had pEF; 29% (n=55) had mrEF and 13% (n=24) were in the rEF group. Pts in the mrEF group had similar baseline characteristics to the others. However, compared with pEF, culprit-lesion was more often located in left main or left anterior descending arteries (80% vs 35%, p<0.001) and NT-proBNP levels were higher in mrEF pts (2270 vs 881 pg/mL, p<0.001).
At discharge, all mrEF patients were medicated with a renin-angiotensin-aldosterone blocker and 91% with a beta-blocker.
After a median of 8 months, LVEF improved a mean of 4% (± 9%) in the mrEF group. However, in 12.5% LVEF worsened to <40% (vs 0 in the pEF group, p=0.006).
At a median follow-up of 2.6 years, there was an increase in mortality according to the EF group (pEF 4% vs mrEF 13% vs rEF 48%, log-rank: p<0.001 – fig. 1) with a hazard ratio (adjusted for age) of 3.75 (95% CI 1.1–12.8, p=0.035) for mrEF vs pEF. There was also a non-significant tendency to higher rates of the composite endpoint of MI and hospitalization for HF in the mrEF group vs pEF (8.2% vs 2.9%, p=0.213).
Conclusions
This study confirms previous reports of the worse prognosis of STEMI with mrEF and suggests the existence of a continuum of risk of adverse clinical outcomes according to LVEF. Therefore, this group of intermediate risk might also benefit from neurohormonal medication, which is only specifically recommended for rEF in current STEMI guidelines. It also highlights the importance of a closer follow-up (with reassessment of LVEF) of mrEF pts since a non negligeable proportion ultimately progress to rEF and may require additional medical treatment or even an implantable cardioverter defibrillator. Further research with larger samples is required to identify predictors of worsening LVEF and assess the impact of neurohormonal modulation in this population.
Funding Acknowledgement
Type of funding sources: None. Kaplan-Meier Survival Analysis
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Affiliation(s)
- J Ferreira
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
| | - M Fonseca
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
| | - S Goncalves
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
| | - J.M Farinha
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
| | - A.F Esteves
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
| | - A Pinheiro
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
| | - R Coelho
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
| | - C Costa
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
| | - R Caria
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
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7
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Esteves A, Parreira L, Fonseca M, Farinha J, Ferreira J, Pinheiro A, Coelho R, Mesquita D, Amador P, Lopes A, Fonseca N, Caria R. Aortic plaques in patients with atrial fibrillation: an often-forgotten risk factor for thromboembolism. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0429] [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: 11/14/2022] Open
Abstract
Abstract
Background
CHA2DS2-VASc risk score is the main determinant for maintaining anticoagulation after atrial fibrillation (AF) ablation, irrespective of the procedure outcome. The presence of aortic plaques is included in the score, but isn't regularly assessed previously to AF ablation. This way, risk factors for coronary artery disease (CAD) other than arterial hypertension and diabetes mellitus may influence stroke risk in patients with AF, albeit not being included in the CHA2DS2-VASc score.
Purpose
We sought to evaluate the prevalence of aortic plaques diagnosed during transesophageal echocardiography (TOE) in patients submitted to AF ablation and to assess its determinants and clinical impact on the CHA2DS2-VASc score.
Methods
Retrospective study of patients submitted to AF ablation that performed TOE prior to the procedure, with assessment of aortic plaques. CHA2DS2-VASc risk score was evaluated in the pre-ablation patient evaluation and reassessed after TOE. Demographic, clinical and echocardiographic data, including cardiovascular risk factors, were analyzed. We assessed AF recurrence rate, cerebrovascular events and death during follow-up.
Results
120 patients were submitted to TOE prior to AF ablation from November 2015 to December 2020, mean age 66.6 (±9.55) years, 48% male. In 30 (25%) patients aortic plaques were identified in TOE. Mean CHA2DS2-VASc was 2.2 (±1.47) in pre-ablation evaluation and 2.5 (±1.69) post-TOE, increasing in all patients with aortic plaques and prompting beginning of oral anticoagulation in 5 patients. AF was paroxysmal in 74% and persistent in 26% of patients, mean duration of 6.28 (±3.76) years. Arterial hypertension was present in 79 (66%) of patients, type 2 diabetes mellitus in 24 (20%) and dyslipidemia in 67 (56%). 17 (14%) patients had a prior stroke. During a mean follow-up of 30 (±18.3) months, 32 (27%) patients had AF recurrence and 10 (8%) were submitted to redo procedures. 107 (89%) patients remained under oral anticoagulation, stroke occurred in 1 patient and 2 patients died.
In univariate analysis, age, type 2 diabetes mellitus and dyslipidemia predicted an increase in CHA2DS2-VASc score after TOE (respectively, OR 1.113, 95% CI 1.041–1.190, p-value 0.002; OR 2.907, 95% CI 1.145–7.379, p-value 0.025; and OR 2.442, 95% CI 1.016–5.868, p-value 0.046).
In multivariate analysis, age is the only independent predictor of increased CHA2DS2-VASc score after TOE (OR 1.095, 95% CI 1.013–1.185, p-value 0.023). No risk factor for CAD was independently associated with the presence of aortic plaques (Table 1).
Conclusion
In this population, single CAD risk factors were not independent predictors of aortic plaques. If TOE had not been performed prior to AF ablation, 25% of patients would have had an underestimated CHA2DS2-VASc score and would be off anticoagulation after the procedure, unprotected from thromboembolic events.
Funding Acknowledgement
Type of funding sources: None. Table 1
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Affiliation(s)
- A.F Esteves
- Hospital Center of Setubal, Setubal, Portugal
| | - L Parreira
- Hospital Center of Setubal, Setubal, Portugal
| | - M Fonseca
- Hospital Center of Setubal, Setubal, Portugal
| | - J.M Farinha
- Hospital Center of Setubal, Setubal, Portugal
| | - J Ferreira
- Hospital Center of Setubal, Setubal, Portugal
| | - A Pinheiro
- Hospital Center of Setubal, Setubal, Portugal
| | - R Coelho
- Hospital Center of Setubal, Setubal, Portugal
| | - D Mesquita
- Hospital Center of Setubal, Setubal, Portugal
| | - P Amador
- Hospital Center of Setubal, Setubal, Portugal
| | - A Lopes
- Hospital Center of Setubal, Setubal, Portugal
| | - N Fonseca
- Hospital Center of Setubal, Setubal, Portugal
| | - R Caria
- Hospital Center of Setubal, Setubal, Portugal
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8
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Farinha J, Fonseca M, Parreira L, Esteves A, Pinheiro A, Ferreira J, Coelho R, Mesquita D, Marinheiro R, Amador P, Caria R. Left atrial stiffness measured by echocardiography is a stronger predictor of atrial fibrillation recurrence after radiofrequency catheter ablation than left atrial volume. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0510] [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: 11/14/2022] Open
Abstract
Abstract
Introduction
Left atrial volume (LAV) is an accepted predictor of atrial fibrillation (AF) recurrence after radiofrequency catheter ablation, stronger than AF duration.
Objective
The aim of this study was to assess the value of left atrial stiffness (LAS) index as a new parameter evaluated by echocardiography to the prediction of AF recurrence after radiofrequency catheter ablation.
Methods
We retrospectively studied consecutive patients with paroxysmal or persistent AF submitted to radiofrequency catheter ablation at our institution between 2017 and 2019. We used transthoracic echocardiography to measure the LAV indexed to body surface area and the LAS index, defined as the ratio between the mitral E/e' (obtained with pulsed Doppler at the tip of the mitral leaflets – E, and tissue Doppler imaging at the mitral annulus – e') and the left atrial strain during the reservoir phase (obtained by speckle tracking echocardiography) [LAS index = (E/e') / LA reservoir strain]. The left ventricular ejection fraction (LVEF) was also evaluated. Patients with poor quality echocardiographic images were excluded. We compared 2 groups of patients, according to the recurrence of AF after the blanking period. We analysed the clinical characteristics and echocardiographic findings. The effect of clinical and echocardiography parameters on AF recurrence was evaluated by univariate and multivariate Cox Regression analysis.
Results
We studied 33 patients, 27 with paroxysmal AF and 6 with persistent AF. Baseline patients' characteristics are presented in Table 1. During a mean follow-up time of 17.9±10.4 months, 7 patients (21%) had AF recurrence, and none died. Patients with AF recurrence had a higher LAS index. After adjusting for confounding variables, only LAS index and LAV were independently associated with AF recurrence (Table 2). Every one unit increase in LAS index was associated with an 11-fold increased risk of AF recurrence (HR 10.86, 95% CI 1.38–85.56; p=0.024), while every one unit increase in LAV index was only associated with a 6% increased risk of AF recurrence (HR 1.06, 95% CI 1.01–1.11, p=0.010).
Conclusion
LAS index evaluated by echocardiography was a much stronger predictor of AF recurrence after radiofrequency catheter ablation than left atrial volume.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- J.M Farinha
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
| | - M Fonseca
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
| | - L Parreira
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
| | - A.F Esteves
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
| | - A Pinheiro
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
| | - J Ferreira
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
| | - R Coelho
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
| | - D Mesquita
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
| | - R Marinheiro
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
| | - P Amador
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
| | - R Caria
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
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9
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Farinha JM, Parreira L, Esteves AF, Fonseca M, Pinheiro A, Ferreira J, Coelho R, Mesquita D, Marinheiro R, Amador P, Caria R. Patients with reflex syncope have a higher prevalence of atrial fibrillation than general population which is predicted by the type of the tilt table test response. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0325] [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: 11/13/2022] Open
Abstract
Abstract
Introduction
Reflex syncope is the result of an imbalance between the sympathetic and parasympathetic nervous system. The autonomic nervous system has been associated to some forms of atrial fibrillation (AF).
Objective
The aim of this study was to assess the prevalence of AF in patients with reflex syncope and a positive tilt table test and to identify the type of tilt test response in patients with AF in comparison to patients without AF.
Methods
We retrospectively studied consecutive patients that underwent a tilt table test at our institution between 2016 and 2019. We selected those patients with a positive test. Patients with an implanted pacemaker at the time of the tilt test and patients followed in a different institution were excluded. Previous diagnoses of AF episodes were assessed. We analysed the clinical characteristics and the tilt table test results according to previous history of AF.
Results
We studied 49 patients with a positive tilt test. Seven (14.3%) patients had previously diagnosed paroxysmal AF at the time of the tilt table test. Patients with AF were older, had more frequently hypertension, and the tilt test response was more frequently a vasodepressor than mixed or cardioinhibitory response (71.4% vs. 28.6%) (Table). In univariate analysis, age and hypertension were associated with AF, respectively, OR 1.08 (95% CI 1.01–1.17), p=0.034 and OR 10.80 (95% CI 1.19–98.36), p=0.035. A vasodepressor response was also associated with AF (OR 6.25, 95% CI 1.06–36.74, p=0.043).
Conclusions
Patients with reflex syncope and a positive tilt table test had a higher prevalence of AF than the general population. A vasodepressor response was associated with AF as were age and hypertension, demonstrating the possible impact of the autonomic nervous system and the multifactorial nature of AF.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- J M Farinha
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
| | - L Parreira
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
| | - A F Esteves
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
| | - M Fonseca
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
| | - A Pinheiro
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
| | - J Ferreira
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
| | - R Coelho
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
| | - D Mesquita
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
| | - R Marinheiro
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
| | - P Amador
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
| | - R Caria
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
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10
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Candjondjo A, Ferreira J, Esteves A, Farinha J, Fonseca M, Coelho R, Gama L, Sa C, Lopes A, Fernandes A, Perdigao A, Seixo F, Fonseca N, Santos R, Caria R. Predictors of patient and system delay for primary percutaneous coronary intervention. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1278] [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: 11/15/2022] Open
Abstract
Abstract
Background
The delay times of the patient and the system for primary percutaneous coronary intervention (p-PCI) have a determining impact on the prognosis of patients with acute myocardial infarction with ST segment elevation (STEMI).
Purpose
To identify the predictors of patient and system delay for p-PCI in the period of 2020 at a reference hospital for p-PCI.
Methods
Patients submitted to p-PCI in the period from March to September 2020 were included and compared with the same period in 2019. We analyzed the differences between the two groups regarding the patient's delay times, time from the onset of symptoms to the first medical contact (FCM) and the system (time from the first contact with the health system to p-ICP). Data collection of the patient's previous history, coronary intervention performed and post-PCI follow-up was performed using the electronic patient record. Univariate analysis and logistic regression models from multivariate analysis were used to determine the predictors of “patient delay” and “system delay” and adjusted for confounding factors. The analysis was performed with a significance level of 5%.
Results
We included in the study 255 patients who underwent p-PCI, of which 122 in the period from 2020 and 133 in the period from 2019. Regarding the characteristics of the population, there were no significant differences between the two periods. Regarding the patient's delay time, there were no statistically significant differences. The variable first medical contact with a non p-PCI center was the only variable associated with system delay>90 minutes in the multivariate analysis, OR (6.18: 95% CI, 1.91–20), p=0.002. There was a statistically significant association between the period of 2020 (pandemic period) and total ischemia time, but with a negative effect, dependent variable adjusted for confounding factors [adjusted OR: −0.10; 95% CI: −107.61 to −5.57; p=0.03].
Conclusion
In this study, the patient's admission to a non p-PCI centers was identified as the only predictor of longer delay until p-PCI (system delay). However, these results should serve as a contribution to decision making in order to mitigate risks, regardless of any associated catastrophe and eventually alert the population not to neglect the symptoms suspected of acute myocardial infarction.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
| | - J Ferreira
- Hospital Center of Setubal, Setubal, Portugal
| | - A Esteves
- Hospital Center of Setubal, Setubal, Portugal
| | - J Farinha
- Hospital Center of Setubal, Setubal, Portugal
| | - M Fonseca
- Hospital Center of Setubal, Setubal, Portugal
| | - R Coelho
- Hospital Center of Setubal, Setubal, Portugal
| | - L Gama
- Unidade local de Saúde do Litoral Alentejano, EPE, Alentejo, Portugal
| | - C Sa
- Centro Hospitalar Barreiro/Montijo, EPE / Hospital Nossa Senhora do Rosário, Setúbal, Portugal
| | - A Lopes
- Hospital Center of Setubal, Setubal, Portugal
| | - A Fernandes
- Hospital Center of Setubal, Setubal, Portugal
| | - A Perdigao
- Hospital Center of Setubal, Setubal, Portugal
| | - F Seixo
- Hospital Center of Setubal, Setubal, Portugal
| | - N Fonseca
- Hospital Center of Setubal, Setubal, Portugal
| | - R Santos
- Hospital Center of Setubal, Setubal, Portugal
| | - R Caria
- Hospital Center of Setubal, Setubal, Portugal
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11
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Esteves AF, Parreira L, Fonseca M, Farinha JM, Pinheiro A, Ferreira J, Coelho R, Mesquita D, Amador P, Fonseca N, Santos R, Seixo F, Costa C, Caria R. Rapid atrial fibrillation increases cardiac biomarkers: decision to perform coronary angiography based on novel high-sensitivity Troponin I peak. Europace 2021. [DOI: 10.1093/europace/euab116.299] [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
Funding Acknowledgements
Type of funding sources: None.
Background
Since January 2018 the availability of high sensitivity Troponin I (hsTnI) has improved ischemia diagnosis. In patients with rapid atrial fibrillation (AF), the decision to undergo coronary angiography is usually due to elevated cardiac biomarkers. However, evidence to support the rentability of this approach is sparse.
Purpose
Evaluate if hsTnI in patients with rapid AF and elevated cardiac biomarkers has a good discriminative power to predict a positive coronary angiography.
Methods
We retrospectively studied consecutive patients admitted to the emergency department (ED) between January 2018 and December 2019 with rapid AF that underwent coronary angiography and had multiple hsTnI values obtained. We analysed risk factors, initial and peak hsTnI, time from ED admission to peak hsTnI and ST-T segment abnormalities (ST depression and/or T wave inversion). We evaluated the presence of significant coronary artery stenosis with the need of revascularization at coronary angiography. Univariable and multivariable analysis was performed to obtain the Odds Ratio (OR, 95% CI, p-value) for significant coronary artery disease (CAD).
Receiver operator characteristics (ROC) curve and area under the curve (AUC) were obtained to determine the discriminative power of peak hsTnI as predictor of a positive coronary angiography. Optimal cut-point value was obtained (Youden index) and patients were divided according to this value.
Results
From 1407 patients admitted to the ED with rapid AF, 30 patients, 60% male, median age 74 (IQR 61.25-80.75) years, were submitted to coronary angiography. Significant coronary artery stenosis was present in 17 (57%) patients.
Age, ST-T segment abnormalities and peak hsTnI were predictors of significant CAD, respectively 1.203, 1.064-1.361, 0.003; 25.00, 3.522-177.477, 0.001; and 1.000, 1.000-1.001, 0.015.
Optimal cut-point value for predicting the presence of significant coronary artery stenosis at coronary angiography was a peak hsTnI of 359 pg/mL (AUC 0.869, p-value 0.001, 95% CI 0.742-0.995). The two groups with hsTnI < 359 and hsTnI >359 differed in age and ST-T segment abnormalities (see Table).
After adjustment, peak hsTnI >359 pg/mL was the only independent predictor of significant CAD (23.894, 1.310-435.669, 0.032).
Conclusion
In this group of patients with rapid AF, peak hsTnI >359 pg/mL was the only independent predictor of significant coronary artery disease. Therefore, those patients should undergo coronary angiography. Abstract Figure.
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Affiliation(s)
- AF Esteves
- Hospital Center of Setubal, Setubal, Portugal
| | - L Parreira
- Hospital Center of Setubal, Setubal, Portugal
| | - M Fonseca
- Hospital Center of Setubal, Setubal, Portugal
| | - JM Farinha
- Hospital Center of Setubal, Setubal, Portugal
| | - A Pinheiro
- Hospital Center of Setubal, Setubal, Portugal
| | - J Ferreira
- Hospital Center of Setubal, Setubal, Portugal
| | - R Coelho
- Hospital Center of Setubal, Setubal, Portugal
| | - D Mesquita
- Hospital Center of Setubal, Setubal, Portugal
| | - P Amador
- Hospital Center of Setubal, Setubal, Portugal
| | - N Fonseca
- Hospital Center of Setubal, Setubal, Portugal
| | - R Santos
- Hospital Center of Setubal, Setubal, Portugal
| | - F Seixo
- Hospital Center of Setubal, Setubal, Portugal
| | - C Costa
- Hospital Center of Setubal, Setubal, Portugal
| | - R Caria
- Hospital Center of Setubal, Setubal, Portugal
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12
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Esteves AF, Parreira L, Mesquita D, Fonseca M, Farinha JM, Pinheiro A, Ferreira J, Coelho R, Amador P, Lopes A, Fonseca N, Caria R. Optimal percentage of biventricular pacing to obtain CRT response: how high is high enough. Europace 2021. [DOI: 10.1093/europace/euab116.460] [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
Funding Acknowledgements
Type of funding sources: None.
Background
The greatest benefit with cardiac resynchronization therapy (CRT) is achieved when biventricular pacing (BivP) percentage (%) is close to 100%. However, in some patients that goal can be challenging to obtain.
Purpose
Determine whether a lower BivP% could lead to similar CRT response and events, as compared with patients with BivP% >98%.
Methods
Patients with CRT followed up in a remote-monitoring network were retrospectively analyzed. BivP% was assessed and response to CRT was defined as an absolute increase in left ventricle ejection fraction (LVEF) >5% or a relative increase in LVEF >15%.
Low BivP% was defined as <98%. Clinical, echocardiographic data and all-cause death during follow-up were evaluated. ROC curve and AUC were obtained to determine the discriminative power of BivP% as predictor of CRT response. Optimal cut-point value was obtained and patients were divided according to this value. Kaplan-Meyer survival function was used to compare survival in the different groups and the Log-rank test was used for comparison between the groups.
Results
88 patients, 76% male, median age 73.5 (IQR 65.75-79.25) years were included. A CRT-D was implanted in 69%. Etiology was ischemic in 44%. 93% were under beta-blockers. Median LVEF before CRT was 27% (IQR 20.25-32).
44 patients (50%) had low BivP% (median 91%, IQR 96-99), 55% due to atrial fibrillation and 52% due to frequent premature ventricular complexes. After optimization of medical therapy, device programming and/or interventional procedures, we obtained a BivP >98% in 26 out of the 44 patients (59%). However, in 18 patients (20%) BivP% was <98% (median 95, IQR 92.25-96). 66% patients were CRT responders. Median follow-up was 36 (IQR 23.75-84) months. During follow-up, all-cause mortality was 27% (24 patients).
Optimal cut-point value for predicting CRT response was 91% BivP% (AUC 0.644, p-value 0.047, 95% CI 0.496-0.792). The characteristics of the two groups didn’t differ significantly (Table).
Survival was significantly higher in patients with BivP% >91% (Log-rank 3.667, p-value 0.050) – Figure.
Conclusion
In this population, BivP% >91% was sufficient to achieve CRT-response and was associated with a better survival. BivP% <91%(n = 4)BivP% >91%(n = 84)p-valueAge in years, median (IQR)72.50 (70.50-73.75)74.00 (65.00-80.00)0.666CRT-D, n (%)3 (75.0)58 (69.0)0.999Ischemic cardiopathy, n (%)3 (75.0)35 (41.7)0.311LVEF before CRT, median (IQR)27 (19-39)27 (20-32)0.795Beta-blockers, n (%)4 (100.0)78 (95.1)0.999Abstract Figure.
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Affiliation(s)
- AF Esteves
- Hospital Center of Setubal, Setubal, Portugal
| | - L Parreira
- Hospital Center of Setubal, Setubal, Portugal
| | - D Mesquita
- Hospital Center of Setubal, Setubal, Portugal
| | - M Fonseca
- Hospital Center of Setubal, Setubal, Portugal
| | - JM Farinha
- Hospital Center of Setubal, Setubal, Portugal
| | - A Pinheiro
- Hospital Center of Setubal, Setubal, Portugal
| | - J Ferreira
- Hospital Center of Setubal, Setubal, Portugal
| | - R Coelho
- Hospital Center of Setubal, Setubal, Portugal
| | - P Amador
- Hospital Center of Setubal, Setubal, Portugal
| | - A Lopes
- Hospital Center of Setubal, Setubal, Portugal
| | - N Fonseca
- Hospital Center of Setubal, Setubal, Portugal
| | - R Caria
- Hospital Center of Setubal, Setubal, Portugal
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13
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Ferreira J, Fonseca M, Costa C, Farinha JM, Esteves AF, Pinheiro A, Coelho R, Silvestre I, Caria R. Clinical impact of transoesophageal echocardiography in acute brain ischaemia: who should we select? Eur J Prev Cardiol 2021. [DOI: 10.1093/eurjpc/zwab061.138] [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: 11/13/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Stroke is a prevalent disease and is still the leading cause of death in Portugal. Transoesophageal echocardiography (TOE) is a sensitive test often performed to detect embolic sources. However, since its most common findings such as patent foramen ovale (PFO) and atheroma plaques do not necessarily mandate a change in treatment, there is still debate over its clinical impact in the context of brain ischaemia (BI) and which patients (pts) should be submitted to it.
Purpose
To assess the clinical impact of TOE following BI and to identify clinical and diagnostic testing results that could help predict which pts benefit from it.
Methods
A retrospective study was conducted including all pts submitted to TOE in our hospital after acute BI in 2018 and 2019. Clinical and testing data (brain, vascular and cardiac imaging and 24h-Holter monitoring) was analysed and compared between 2 groups: the pts who had findings in TOE compatible with a source of embolism which resulted in a change in treatment ("relevant TOE" group) vs all other pts who had no such findings or whose findings did not result in change in treatment ("others"). Predictors of relevant TOE were also analysed.
Results
Of the 87 pts (mean age of 57 and maximum of 83) included in the study, 51 (59%) had findings compatible with a potential source of embolism in TOE, PFO being the most common (n = 42). In only half of them did these findings result in a change in treatment (the relevant TOE group: n = 25; 29% of the overall population).
Age and other baseline characteristics did not significantly differ between groups. Pts with a relevant TOE presented more often with visual-field defects (32% vs 10%, p = 0.020) and were more likely to have visible acute lesions on brain imaging (96% vs 76%, p = 0.032) compared with the others. There was also a borderline significant association between the presence of infarct in the territory of the superior cerebellar artery and a relevant TOE (p = 0.054). On the contrary, the presence of significant lesions in extracranial arteries was negatively associated with a relevant TOE (p = 0.016).
Considering the whole population, there were no transthoracic echocardiography (TTE) predictors of a relevant TOE but when analysing only younger patients (age < 50), the presence of any abnormality in TTE became associated with a relevant TOE (OR 8.5, CI 1.1-63.9; p = 0.044). We found no predictors of relevant TOE in 24h-Holter results.
Conclusions
TOE commonly identified potential sources of brain embolism, which proved relevant in half the cases. In the impossibility of submitting all BI patients to TOE, this study suggests that brain and vascular imaging rather than age or other baseline characteristics may be useful in predicting a relevant result. Moreover, TTE does not seem to be an adequate screening method to select patients for TOE, except possibly in younger patients. Studies with larger samples are needed to confirm these results.
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Affiliation(s)
- J Ferreira
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
| | - M Fonseca
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
| | - C Costa
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
| | - JM Farinha
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
| | - AF Esteves
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
| | - A Pinheiro
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
| | - R Coelho
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
| | - I Silvestre
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
| | - R Caria
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
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14
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Cheong SL, Yau SL, Silva G, Coelho R. Unusual cutaneous manifestations and congenital hearing loss in a patient with GJB2 (F142L) mutation. Clin Exp Dermatol 2021; 46:1338-1340. [PMID: 33914937 DOI: 10.1111/ced.14719] [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] [Accepted: 04/26/2021] [Indexed: 11/29/2022]
Affiliation(s)
- S L Cheong
- Department of Dermatology, Centro Hospitalar Conde de São Januário, Macau, Macau SAR, China
| | - S L Yau
- Department of Dermatology, Centro Hospitalar Conde de São Januário, Macau, Macau SAR, China
| | - G Silva
- Department of Dermatology, Centro Hospitalar Conde de São Januário, Macau, Macau SAR, China
| | - R Coelho
- Department of Dermatology, Centro Hospitalar Conde de São Januário, Macau, Macau SAR, China
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15
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Ferreira J, Fonseca M, Farinha JM, Esteves AF, Pinheiro A, Coelho R, Goncalves S, Costa C, Caria R. Acute coronary syndrome in COVID-19 times: could it be business as usual? European Heart Journal. Acute Cardiovascular Care 2021. [PMCID: PMC8135328 DOI: 10.1093/ehjacc/zuab020.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Funding Acknowledgements Type of funding sources: None. Background In an attempt to cope with the COVID-19 pandemic, several measures of social distancing and reorganization of health care systems have been adopted. In Portugal, these included suspending elective clinical activity and a temporary national lockdown. Data from multiple centres, including central hospitals in Portugal, has shown a reduction in hospital admissions for acute coronary syndrome (ACS) during the COVID-19 outbreak. Fear of going to the hospital and physical inactivity have been pointed as possible explanations. Purpose to assess the impact of this pandemic and the measures taken against it on the pattern of admissions and treatment of patients with ACS in a district hospital. Methods A single-centre retrospective study was conducted in the Cardiology Department of a Portuguese district hospital, capable of performing 24h percutaneous coronary intervention. We analyzed the admissions for ACS during the peak of the first COVID-19 outbreak in Portugal (16th of March to 3rd of May 2020, coinciding with the suspension of elective activity) and compared it with two control periods: one immediately preceding the study period (27th of January to 15th of March - 2020 control) and one exactly one year before (16th of March to 3rd of May 2019 - 2019 control). Results During the 7 weeks of the first COVID-19 outbreak, 46 patients were hospitalized for ACS in our department, while 54 had been admitted during the 2020 control period and 40 in the 2019 control period, with a mean of 7 admissions/week (vs 8 and 6, respectively; p > 0.05). There were no significant differences between the study group and both controls regarding basal characteristics. Their presentation did not differ: the majority of patients (57%) was admitted for ST-elevation myocardial infarction and median time from symptom onset to admission to the emergency room was 3 hours, with 4% of patients presenting in Killip class ≥III (p > 0.05 for all). We also found no significant differences in the treatment administered nor in the outcomes (96% submitted to coronary angiography, median length of hospitalization of 4 days and in-hospital mortality rate of 2%, p > 0.05 for all). Conclusions Our study suggests that the reduction in admissions for ACS during the COVID-19 outbreak is not universal. Additionally, severity at presentation, treatment administered and outcomes did not seem to differ. The relatively low prevalence of COVID-19 in our hospital"s region might be the cause, since people might fear and refrain less from going to the hospital. Larger studies with other centres in low-prevalence regions are needed to confirm this hypothesis.
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Affiliation(s)
- J Ferreira
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
| | - M Fonseca
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
| | - JM Farinha
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
| | - AF Esteves
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
| | - A Pinheiro
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
| | - R Coelho
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
| | - S Goncalves
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
| | - C Costa
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
| | - R Caria
- Hospital Center of Setubal, Cardiology, Setubal, Portugal
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16
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Romanelli M, Coelho R, Coster D, Ferreira J, Fleury L, Henderson S, Hollocombe J, Imbeaux F, Jonsson T, Kogan L, Meneghini O, Merle A, Pinches SD, Sauter O, Tardini G, Yadykin D, Smith S, Strand P, WPCD Team. Code Integration, Data Verification, and Models Validation Using the ITER Integrated Modeling and Analysis System (IMAS) in EUROfusion. Fusion Science and Technology 2020. [DOI: 10.1080/15361055.2020.1819751] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- M. Romanelli
- UKAEA, Culham Science Centre, Abingdon, OX143DB, United Kingdom
| | - R. Coelho
- ISFN, Instituto Superior Técnico, Lisbon, Portugal
| | - D. Coster
- Max-Planck Institute for Plasma Physics, Garching, Germany
| | - J. Ferreira
- ISFN, Instituto Superior Técnico, Lisbon, Portugal
| | - L. Fleury
- CEA, IRFM, Saint-Paul-lez-Durance, France 13067
| | - S. Henderson
- UKAEA, Culham Science Centre, Abingdon, OX143DB, United Kingdom
| | - J. Hollocombe
- UKAEA, Culham Science Centre, Abingdon, OX143DB, United Kingdom
| | - F. Imbeaux
- CEA, IRFM, Saint-Paul-lez-Durance, France 13067
| | - T. Jonsson
- Royal Institute of Technology, Stockholm, Sweden
| | - L. Kogan
- UKAEA, Culham Science Centre, Abingdon, OX143DB, United Kingdom
| | | | - A. Merle
- Ecole Polytechnique Fédérale de Lausanne (EPFL), Swiss Plasma Center (SPC), CH-1015, Lausanne, Switzerland
| | - S. D. Pinches
- ITER Organization, 13067 St Paul-lez-Durance Cedex, France
| | - O. Sauter
- Ecole Polytechnique Fédérale de Lausanne (EPFL), Swiss Plasma Center (SPC), CH-1015, Lausanne, Switzerland
| | - G. Tardini
- Max-Planck Institute for Plasma Physics, Garching, Germany
| | - D. Yadykin
- SEE, Chalmers University of Technology, Gothenburg, Sweden
| | - S. Smith
- General Atomics, San Diego, California
| | - P. Strand
- SEE, Chalmers University of Technology, Gothenburg, Sweden
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17
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Huang YL, Liang CY, Ritz D, Coelho R, Septiadi D, Estermann M, Rimmer N, Vlajnic T, David L, Rothen-Rutishauser B, Jacob F, Heinzelmann-Schwarz V. Integrin α2-collagen interaction promotes ovarian cancer metastasis. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- Y.-L Huang
- Universitätsspital Basel, Department of Biomedicine
| | - C.-Y Liang
- Universitätsspital Basel, Department of Biomedicine
| | - D Ritz
- Universität Basel, Biozentrum
| | - R Coelho
- University of Porto, Institute of Molecular Pathology and Immunology of the University of Porto
| | - D Septiadi
- University of Fribourg, Adolphe Merkle Institute
| | - M Estermann
- University of Fribourg, Adolphe Merkle Institute
| | - N Rimmer
- Universitätsspital Basel, Department of Biomedicine
| | - T Vlajnic
- Universitätsspital Basel, Institute of Pathology
| | - L David
- University of Porto, Institute of Molecular Pathology and Immunology of the University of Porto
| | | | - F Jacob
- Universitätsspital Basel, Department of Biomedicine
| | - V Heinzelmann-Schwarz
- Universitätsspital Basel, Department of Biomedicine
- Universitätsspital Basel, Gynecological Cancer Center
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18
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Cerejeira A, Cunha S, Coelho R, Macedo G, Barkoudah E, Azevedo F, Lisboa C. Perianal warts as a risk marker for anal high-risk-human papillomavirus (HPV) detection and HPV-associated diseases. J Eur Acad Dermatol Venereol 2020; 34:2613-2619. [PMID: 32713086 DOI: 10.1111/jdv.16834] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Accepted: 07/09/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND Genital warts are the most common sexually transmitted infection (STI) and are caused by human papillomavirus (HPV). Persistent anal infection by oncogenic genotypes of HPV is a determinant for anal cancer. Currently, anal cancer screening is not widely implemented. OBJECTIVES Our aim is to evaluate the role of perianal warts as a risk marker for anal high-risk (HR) HPV detection and anal dysplasia. METHODS In this observational, retrospective, cohort study of attendees of a STI outpatient clinic between January 2010 and June 2018, all human immunodeficiency virus (HIV)-positive men who have sex with men (MSM) who performed anal cytology, anal HPV DNA detection and anoscopy were included. A comparison was made between patients with and without perianal warts. Primary endpoint: proportion of patients with an abnormal anal cytology. Secondary endpoints: proportion of patients with (i) anal HR-HPV detection; (ii) anal HPV 16 detection; (iii) abnormal anal biopsy; and (iv) anal high-grade squamous intraepithelial lesion (HSIL). RESULTS Seventy-eight individuals were included: 39 with perianal warts and 39 without perianal warts. Subjects with perianal warts more frequently had an abnormal anal cytology (71.8% vs. 38.5%; P = 0.003). This group also had a higher rate of anal HPV 16 detection (38.5% vs. 12.8%; P = 0.01). No differences were detected in the proportion of patients with anal HR-HPV detection, with an abnormal anal biopsy or with anal HSIL. Perianal warts was an independent risk factor for an abnormal anal cytology (OR: 7.2) and for anal HPV 16 detection (OR: 6.7). CONCLUSION Given the high risk of anal cancer in HIV-positive MSM, effective screening strategies are greatly needed. This study suggests that the presence of perianal warts is a suitable risk marker for anal HPV 16 detection and anal dysplasia.
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Affiliation(s)
- A Cerejeira
- Department of Dermatology and Venereology, Centro Hospitalar Universitário de São João, EPE Porto, Porto, Portugal
| | - S Cunha
- Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - R Coelho
- Department of Gastroenterology, Centro Hospitalar Universitário de São João EPE, Porto, Portugal
| | - G Macedo
- Department of Gastroenterology, Centro Hospitalar Universitário de São João EPE, Porto, Portugal
| | - E Barkoudah
- Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA
| | - F Azevedo
- Department of Dermatology and Venereology, Centro Hospitalar Universitário de São João, EPE Porto, Porto, Portugal
| | - C Lisboa
- Department of Dermatology and Venereology, Centro Hospitalar Universitário de São João, EPE Porto, Porto, Portugal.,Microbiology Service, Department of Pathology and CINTESIS, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
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19
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Bellomo C, Alonso D, Coelho R, Iglesias A, Periolo N, Martínez V. A newborn infected by Andes virus suggests novel routes of hantavirus transmission: a case report. Clin Microbiol Infect 2020; 26:130-131. [DOI: 10.1016/j.cmi.2019.09.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 09/09/2019] [Accepted: 09/11/2019] [Indexed: 11/24/2022]
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20
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Oliveira L, Descalço A, Silva A, Coelho R, Martins Â, Ferreira R. Which central apnea index must support further investigation? 5-years at a paediatric sleep laboratory. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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21
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Coelho R, Descalço A, Paixão E, Martins Â, Silva A, Oliveira L, Ferreira R. Reliability of QuePedS in the screening of pediatric sleep disordered breathing. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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22
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Magro F, Lopes S, Silva M, Coelho R, Portela F, Branquinho D, Correia L, Fernandes S, Cravo M, Caldeira P, Sousa HT, Patita M, Lago P, Ramos J, Afonso J, Redondo I, Machado P, Cornillie F, Lopes J, Carneiro F. Low Golimumab Trough Levels at Week 6 Are Associated With Poor Clinical, Endoscopic and Histological Outcomes in Ulcerative Colitis Patients: Pharmacokinetic and Pharmacodynamic Sub-analysis of the Evolution Study. J Crohns Colitis 2019; 13:1387-1393. [PMID: 30989180 DOI: 10.1093/ecco-jcc/jjz071] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS Golimumab has an established exposure-response relationship in patients with ulcerative colitis [UC]. However, the association of serum golimumab trough levels [TL] with objective markers of disease activity, such as endoscopic and histological activity scores and concentrations of biomarkers, remains less understood. This report describes the relationship of serum golimumab TL at the end of the induction period [Week 6] with clinical, endoscopic, histological, and biomarker parameters. METHODS This was an open-label, uncontrolled, prospective and interventional study. Moderate to severely active UC patients naïve to biologic therapy were treated with golimumab. Serum golimumab TL and faecal calprotectin levels were measured at baseline [Week 0 of induction] and Week 6. RESULTS A total of 34 patients completed the induction phase [Week 6] and were included in this analysis. Overall, 47.1% and 14.7% of patients achieved clinical response and remission with significantly higher serum golimumab TL in patients with early response or remission [3.7 μg/mL vs 1.3 μg/mL, p = 0.0013; and 3.1 μg/mL vs 1.7 μg/mL, p = 0.0164, respectively]. In addition, golimumab TL were significantly higher in patients achieving histological remission [4.2 μg/mL vs 1.7 μg/mL, p = 0.0049]. Week 6 golimumab TL were inversely correlated with the total Mayo score [rs = -0.546; p = 0.0008], the Mayo endoscopic subscore [rs = -0.381; p = 0.0262], the Geboes histological activity score [rs = -0.464; p = 0.0057], and faecal calprotectin levels [rs = -0.497; p = 0.0044]. CONCLUSIONS A higher early exposure to golimumab is associated with a better objective response in active UC patients and appears to drive the outcome at Week 6.
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Affiliation(s)
- F Magro
- Centro Hospitalar São João, Departamento de Gastrenterologia, Porto, Portugal.,Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - S Lopes
- Centro Hospitalar São João, Departamento de Gastrenterologia, Porto, Portugal
| | - M Silva
- Centro Hospitalar São João, Departamento de Gastrenterologia, Porto, Portugal
| | - R Coelho
- Centro Hospitalar São João, Departamento de Gastrenterologia, Porto, Portugal
| | - F Portela
- Centro Hospitalar Universitário de Coimbra, Departamento de Gastrenterologia, Coimbra, Portugal
| | - D Branquinho
- Centro Hospitalar Universitário de Coimbra, Departamento de Gastrenterologia, Coimbra, Portugal
| | - L Correia
- Centro Hospitalar Lisboa Norte, Departamento de Gastrenterologia, Lisboa, Portugal
| | - S Fernandes
- Centro Hospitalar Lisboa Norte, Departamento de Gastrenterologia, Lisboa, Portugal
| | - M Cravo
- Hospital Beatriz Ângelo, Departamento de Gastrenterologia, Loures, Portugal
| | - P Caldeira
- Centro Hospitalar Universitário do Algarve, Departamento de Ciências Biomédicas e Medicina, Universidade do Algarve, Algarve Biomedical Centre, Universidade do Algarve, Faro, Portugal
| | - H T Sousa
- Centro Hospitalar Universitário do Algarve, Departamento de Ciências Biomédicas e Medicina, Universidade do Algarve, Algarve Biomedical Centre, Universidade do Algarve, Faro, Portugal
| | - M Patita
- Hospital Garcia de Orta, Departamento de Gastrenterologia, Almada, Portugal
| | - P Lago
- Centro Hospitalar do Porto, Departamento de Gastrenterologia, Porto, Portugal
| | - J Ramos
- Centro Hospitalar Lisboa Central, Departamento de Gastrenterologia, Lisboa, Portugal
| | - J Afonso
- Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - I Redondo
- MSD Portugal, Medical Affairs, Paço de Arcos, Portugal
| | - P Machado
- MSD Portugal, Medical Affairs, Paço de Arcos, Portugal
| | | | - J Lopes
- Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - F Carneiro
- Faculdade de Medicina, Universidade do Porto, Porto, Portugal.,Instituto de Patologia e Imunologia Molecular da Universidade do Porto [Ipatimup], i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
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23
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Coelho M, Coelho R. O5 The Needs of Health Literacy on Sexuality and Affections in Adolescence - a systematic review. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz098.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M Coelho
- University Hospital- North Lisbon Center, Lisbon, PORTUGAL
| | - R Coelho
- Family Health Unit of São João da Talha, ACES Loures-Odivelas, Sacavém, PORTUGAL
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24
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Brás JP, Pinto S, Almeida MI, Prata J, von Doellinger O, Coelho R, Barbosa MA, Santos SG. Peripheral Biomarkers of Inflammation in Depression: Evidence from Animal Models and Clinical Studies. Methods Mol Biol 2019; 2011:467-492. [PMID: 31273717 DOI: 10.1007/978-1-4939-9554-7_28] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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] [Indexed: 06/09/2023]
Abstract
Depression is a highly prevalent psychiatric condition, with over 300 million sufferers, and is an important comorbidity for other conditions, like cardiovascular disorders or diabetes. Therapy is largely based on psychotherapy and/or pharmacological intervention, particularly aimed at altering neurotransmitter levels in the central nervous system, but inadequate response to treatment remains a significant clinical problem. Herein, evidence supporting a molecular link between inflammation and depression will be discussed, particularly the increased prevalence of depression in chronic inflammatory diseases and the evidence on the use of anti-inflammatory drugs to treat depression. Moreover, the potential for the levels of peripheral inflammatory molecules to act as depression biomarkers, in the diagnosis and monitoring of depression will be examined, considering clinical- and animal model-based evidence.
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Affiliation(s)
- J P Brás
- i3S-Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal
- INEB-Instituto de Engenharia Biomédica, University of Porto, Porto, Portugal
- ICBAS-Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, Portugal
| | - S Pinto
- i3S-Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal
- FMUP-Faculty of Medicine, University of Porto, Porto, Portugal
- Department of Clinical Neurosciences and Mental Health, Centro Hospitalar Universitário São João, Porto, Portugal
| | - M I Almeida
- i3S-Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal
- INEB-Instituto de Engenharia Biomédica, University of Porto, Porto, Portugal
| | - J Prata
- i3S-Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal
- FMUP-Faculty of Medicine, University of Porto, Porto, Portugal
- Department of Psychiatry and Mental Health, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - O von Doellinger
- i3S-Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal
- FMUP-Faculty of Medicine, University of Porto, Porto, Portugal
- Department of Psychiatry and Mental Health, Centro Hospitalar do Tâmega e Sousa, Penafiel, Portugal
| | - R Coelho
- i3S-Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal
- FMUP-Faculty of Medicine, University of Porto, Porto, Portugal
- Department of Clinical Neurosciences and Mental Health, Centro Hospitalar Universitário São João, Porto, Portugal
| | - M A Barbosa
- i3S-Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal
- INEB-Instituto de Engenharia Biomédica, University of Porto, Porto, Portugal
- ICBAS-Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, Portugal
| | - S G Santos
- i3S-Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal.
- INEB-Instituto de Engenharia Biomédica, University of Porto, Porto, Portugal.
- ICBAS-Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, Portugal.
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25
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Prata J, Machado AS, von Doellinger O, Almeida MI, Barbosa MA, Coelho R, Santos SG. The Contribution of Inflammation to Autism Spectrum Disorders: Recent Clinical Evidence. Methods Mol Biol 2019; 2011:493-510. [PMID: 31273718 DOI: 10.1007/978-1-4939-9554-7_29] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [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] [Indexed: 06/09/2023]
Abstract
Autism comprises a complex and heterogeneous spectrum of neurodevelopmental disorders, usually termed autism spectrum disorders (ASD). It is more prevalent in males than females, and genetic and environmental factors are believed to account in similar percentages to the development of ASD. In recent years, the contribution of inflammation and inflammatory mediators to disease aetiology and perpetuation has been the object of intense research. In this chapter, inflammatory aspects that contribute to ASD are discussed, including abnormal microglia activation and polarization phenotypes, increased systemic levels of pro-inflammatory mediators, and altered patterns of immune cell response to activation stimuli. Also, inflammation in the context of gut microbiome and the impact of inflammation on gender prevalence of ASD are considered. Finally, treatment impact on inflammatory parameters and the potential for use of anti-inflammatory drugs, alone or in combination with antipsychotics, to manage ASD are examined.
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Affiliation(s)
- J Prata
- i3S-Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal
- FMUP-Faculty of Medicine, University of Porto, Porto, Portugal
- Department of Psychiatry and Mental Health, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - A S Machado
- i3S-Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal
- FMUP-Faculty of Medicine, University of Porto, Porto, Portugal
- Department of Clinical Neurosciences and Mental Health, Centro Hospitalar UniversitÃrio São João, Porto, Portugal
| | - O von Doellinger
- i3S-Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal
- FMUP-Faculty of Medicine, University of Porto, Porto, Portugal
- Department of Psychiatry and Mental Health, Centro Hospitalar do Tâmega e Sousa, Penafiel, Portugal
| | - M I Almeida
- i3S-Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal
- INEB-Instituto de Engenharia Biomédica, University of Porto, Porto, Portugal
| | - M A Barbosa
- i3S-Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal
- INEB-Instituto de Engenharia Biomédica, University of Porto, Porto, Portugal
- ICBAS-Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, Portugal
| | - R Coelho
- i3S-Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal
- FMUP-Faculty of Medicine, University of Porto, Porto, Portugal
- Department of Clinical Neurosciences and Mental Health, Centro Hospitalar UniversitÃrio São João, Porto, Portugal
| | - S G Santos
- i3S-Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal.
- INEB-Instituto de Engenharia Biomédica, University of Porto, Porto, Portugal.
- ICBAS-Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, Portugal.
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Coelho R, Ricardo S, Theodorakis I, Jacob F, David L, Amaral A. PO-247 Mesothelin regulates invasion and peritoneal metastization of ovarian cancer. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.763] [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: 11/04/2022] Open
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Millington G, Collins A, Lovell C, Leslie T, Yong A, Morgan J, Ajithkumar T, Andrews M, Rushbook S, Coelho R, Catten S, Lee K, Skellett A, Affleck A, Exton L, Mohd Mustapa M, Levell N, McHenry P, Gibbon K, Buckley D, Leslie T, Mallon E, Wakelin S, Ungureanu S, Hunasehally R, Cork M, Johnston G, Chiang N, Natkunarajah J, Worsnop F, Duarte Williamson C, Donnelly J, Towers K, Saunders C, Adbi Salad A, Brain A. British Association of Dermatologists’ guidelines for the investigation and management of generalized pruritus in adults without an underlying dermatosis, 2018. Br J Dermatol 2018; 178:34-60. [DOI: 10.1111/bjd.16117] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2017] [Indexed: 12/20/2022]
Affiliation(s)
- G.W.M. Millington
- Dermatology Department Norfolk and Norwich University Hospital Colney Lane Norwich NR4 7UY U.K
| | - A. Collins
- Haematology Department Norfolk and Norwich University Hospital Colney Lane Norwich NR4 7UY U.K
| | - C.R. Lovell
- Dermatology Department Royal United Hospital Combe Park Bath BA1 3NG U.K
| | - T.A. Leslie
- Dermatology Department Royal Free Hospital Pond Street London NW3 2QGU.K
| | - A.S.W. Yong
- Dermatology Department Norfolk and Norwich University Hospital Colney Lane Norwich NR4 7UY U.K
| | - J.D. Morgan
- General Practitioner Chet Valley Medical Practice 40–48 George Lane London NR14 6QH U.K
| | - T. Ajithkumar
- Oncology Department Addenbrooke's Hospital Hills Road Cambridge CB2 2QQ U.K
| | - M.J. Andrews
- Nephrology Department Norfolk and Norwich University Hospital Colney Lane Norwich NR4 7UY U.K
| | - S.M. Rushbook
- Hepatology Unit Norfolk and Norwich University Hospital Colney Lane Norwich NR4 7UY U.K
| | - R.R. Coelho
- Dermatology Department St George's Hospital Blackshaw Road London SW17 0QT U.K
| | - S.J. Catten
- Dermatology Department Norfolk and Norwich University Hospital Colney Lane Norwich NR4 7UY U.K
| | - K.Y.C. Lee
- Dermatology Department Norfolk and Norwich University Hospital Colney Lane Norwich NR4 7UY U.K
| | - A.M. Skellett
- Dermatology Department Norfolk and Norwich University Hospital Colney Lane Norwich NR4 7UY U.K
| | - A.G. Affleck
- Dermatology Department Ninewells Hospital Dundee DD1 9SY U.K
| | - L.S. Exton
- British Association of Dermatologists Willan House 4 Fitzroy Square London W1T 5HQ U.K
| | - M.F. Mohd Mustapa
- British Association of Dermatologists Willan House 4 Fitzroy Square London W1T 5HQ U.K
| | - N.J. Levell
- Dermatology Department Norfolk and Norwich University Hospital Colney Lane Norwich NR4 7UY U.K
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Millington G, Collins A, Lovell C, Leslie T, Yong A, Morgan J, Ajithkumar T, Andrews M, Rushbook S, Coelho R, Catten S, Lee K, Skellett A, Affleck A, Exton L, Mohd Mustapa M, Levell N. 2018 年英国皮肤科医师协会有关在无基础皮肤病的成年患者中检查和管理全身瘙痒的指南. Br J Dermatol 2018. [DOI: 10.1111/bjd.16193] [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: 11/27/2022]
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Millington G, Collins A, Lovell C, Leslie T, Yong A, Morgan J, Ajithkumar T, Andrews M, Rushbook S, Coelho R, Catten S, Lee K, Skellett A, Affleck A, Exton L, Mohd Mustapa M, Levell N. British Association of Dermatologists’ guidelines for the investigation and management of generalized pruritus in adults without an underlying dermatosis, 2018. Br J Dermatol 2018. [DOI: 10.1111/bjd.16186] [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: 11/26/2022]
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Paul G, Aranha M, Fogliato F, Lorenzini F, Coelho R, Von Linsingen R, Stunitz L. O-13 Venous Priapism with More than 36 Hours of Evolution - Description of Management and Outcome of 05 Cases Treated in the State of Paraná – Brazil. J Sex Med 2017. [DOI: 10.1016/j.jsxm.2017.10.022] [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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Margalha Miranda A, Loureiro H, Ferreira S, Coelho R, Anacleto V. An older people's disease in a child – a case report of obstructive sleep apnea and arterial hypertension treated by continuous positive airway pressure. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Coelho R, Descalço A, Paixão E, Oliveira L, Silva A, Martins Â, Ferreira R. Obstructive sleep apnea syndrome and facial dysmorphisms in paediatric age. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Guillemaut C, Drewelow P, Matthews G, Kukushkin A, Pitts R, Abreu P, Brezinsek S, Brix M, Carman P, Coelho R, Devaux S, Flanagan J, Giroud C, Harting D, Lowry C, Maggi C, Militello F, Perez Von Thun C, Solano E, Widdowson A, Wiesen S, Wischmeier M, Wood D. Main chamber wall plasma loads in JET-ITER-like wall at high radiated fraction. Nuclear Materials and Energy 2017. [DOI: 10.1016/j.nme.2017.02.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Bustamante N, Patino A, Von Eckartsberg A, Coelho R, Suarez S, Arbelaez C. A Qualitative Approach to Evaluating the Global Barriers of International
Emergency Medicine Development. Ann Glob Health 2017. [DOI: 10.1016/j.aogh.2017.03.285] [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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Pinto SA, Coelho R, Silva A. Depression and multiple sclerosis–pathophysiological links: From biology to treatment. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
IntroductionDepressive disorders (DD) are the second cause of disability worldwide. DD affect predominantly working age individuals, recurring in 75% of cases. DD pathophysiology is intricate and multi-factorial. Several inflammatory diseases have been linked to mood disorders. Amidst these conditions is multiple sclerosis (MS), a chronic inflammatory disease of the central nervous system, characterized by frequent exacerbations and progressive functional loss.ObjectiveTo review the current knowledge on DD and MS as comorbidities and the underlying pathophysiologic mechanisms.MethodsWe performed a bibliographic search in Pubmed–publications released in the last 5 years, written in English, Portuguese and Spanish, containing the keywords depression, inflammatory disorders, multiple sclerosis.ResultsThe inflammatory hypothesis of depression provides a strong foundation to explain its close link with multiple sclerosis. The incidence and prevalence of DD is significantly higher in MS, especially in men. Functional imaging studies have shown that depressive symptoms are closely linked to the extension of inflammatory lesions, especially on the frontal and parietal regions, with particular emphasis to those affecting the grey matter. On the one hand, the clinical course and response to treatment of MS may be hindered by DD; on the other hand, the evolution of MS lesions leads to fluctuations in mood, with significant improvement of DD with successful MS treatment, independently of physical improvement.ConclusionsThere appears to be a biological link between DD and MS, with a bidirectional interference in the clinical course, prognosis and treatment response. Thus, both conditions must be correctly identified and treated.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Coelho R, Äkäslompolo S, Dinklage A, Kus A, Reimer R, Sundén E, Conroy S, Blanco E, Conway G, Hacquin S, Heuraux S, Lechte C, Silva FD, Sirinelli A, ITM-TF C. Synthetic Diagnostics in the European Union Integrated Tokamak Modelling Simulation Platform. Fusion Science and Technology 2017. [DOI: 10.13182/fst12-473] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- R. Coelho
- Associação EURATOM0IST, Instituto de Plasmas e Fusão Nuclear, Instituto Superior Técnico Universidade Técnica de Lisboa, P-1049-001 Lisboa, Portugal
| | - S. Äkäslompolo
- Aalto University, Euratom-Tekes Association, P.O. Box 14100, FI-00076 AALTO, Finland
| | - A. Dinklage
- Max-Planck-Institut für Plasma physik, EURATOM-Association, Wendelsteinstr. 1, Greifswald, Germany
| | - A. Kus
- Max-Planck-Institut für Plasma physik, EURATOM-Association, Wendelsteinstr. 1, Greifswald, Germany
| | - R. Reimer
- Max-Planck-Institut für Plasma physik, EURATOM-Association, Wendelsteinstr. 1, Greifswald, Germany
| | - E. Sundén
- Uppsala University, VR-Euratom Association, Box 516, 751 20 Uppsala, Sweden
| | - S. Conroy
- Uppsala University, VR-Euratom Association, Box 516, 751 20 Uppsala, Sweden
| | - E. Blanco
- Asociación EURATOM-CIEMAT para Fusión, CIEMAT, Madrid, Spain Association
| | - G. Conway
- Max-Planck-Institut für Plasma physik, EURATOM-IPP Association, Garching, Germany
| | - S. Hacquin
- CEA, IRFM, F-13108 Saint-Paul-lez-Durance, France
| | - S. Heuraux
- Université de Lorraine, IJL, UMR 7198, BP 70239, Vandoeuvre, F-54506 Cedex, France
| | - C. Lechte
- Institute for Plasma Research, University of Stuttgart, 70569 Stuttgart, Germany
| | - F. Da Silva
- Associação EURATOM0IST, Instituto de Plasmas e Fusão Nuclear, Instituto Superior Técnico Universidade Técnica de Lisboa, P-1049-001 Lisboa, Portugal
| | - A. Sirinelli
- CEA, IRFM, F-13108 Saint-Paul-lez-Durance, France
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Rodrigues-Pinto E, Pereira P, Coelho R, Andrade P, Ribeiro A, Lopes S, Moutinho-Ribeiro P, Macedo G. Outcome and risk factors assessment for adverse events in advanced esophageal cancer patients after self-expanding metal stents placement. Dis Esophagus 2017; 30:1-6. [PMID: 27629280 DOI: 10.1111/dote.12467] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Self-expanding metal stents (SEMS) are the treatment of choice for advanced esophageal cancers. Literature is scarce on risk factors predictors for adverse events after SEMS placement. Assess risk factors for adverse events after SEMS placement in advanced esophageal cancer and evaluate survival after SEMS placement. Cross-sectional study of patients with advanced esophageal cancer referred for SEMS placement, during a period of 3 years. Ninety-seven patients with advanced esophageal cancer placed SEMS. Adverse events were more common when tumors were located at the level of the distal esophagus/cardia (47% vs 23%, P = 0.011, OR 3.1), with statistical significance being kept in the multivariate analysis (OR 3.1, P = 0.018). Time until adverse events was lower in the tumors located at the level of the distal esophagus/cardia (P = 0.036). Survival was higher in patients who placed SEMS with curative intent (327 days [126-528] vs. 119 days [91-147], P = 0.002) and in patients submitted subsequently to surgery compared with those who did just chemo/radiotherapy or who did not do further treatment (563 days [378-748] vs. 154 days [133-175] vs. 46 days [20-72], P < 0.001). Subsequent treatment kept statistical significance in the multivariate analysis (HR 3.4, P < 0.001). SEMS allow palliation of dysphagia in advanced esophageal cancer and are associated with an increased out-of-hospital survival, as long as there are conditions for further treatments. Tumors located at the level of the distal esophagus/cardia are associated with a greater number of adverse events, which also occur earlier.
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Affiliation(s)
- E Rodrigues-Pinto
- Department of Gastroenterology, Centro Hospitalar São João, Porto, Portugal
| | - P Pereira
- Department of Gastroenterology, Centro Hospitalar São João, Porto, Portugal
| | - R Coelho
- Department of Gastroenterology, Centro Hospitalar São João, Porto, Portugal
| | - P Andrade
- Department of Gastroenterology, Centro Hospitalar São João, Porto, Portugal
| | - A Ribeiro
- Department of Gastroenterology, Centro Hospitalar São João, Porto, Portugal
| | - S Lopes
- Department of Gastroenterology, Centro Hospitalar São João, Porto, Portugal
| | - P Moutinho-Ribeiro
- Department of Gastroenterology, Centro Hospitalar São João, Porto, Portugal
| | - G Macedo
- Department of Gastroenterology, Centro Hospitalar São João, Porto, Portugal
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Macedo L, Antonino de Souza Junior J, Coelho R, Fonseca F, Firmino A, Silva M, Fragoso R, Albuquerque E, Silva M, de Almeida Engler J, Terra W, Grossi-de-Sa M. Knocking down chitin synthase 2 by RNAi is lethal to the cotton boll weevil. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.biori.2017.04.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Peixoto A, Pinto ER, Silva M, Coelho R, Santos-Antunes J, Andrade P, Gaspar R, Nunes A, Lopes S, Macedo G. Azathioprine-induced acute pancreatitis in inflammatory bowel disease : natural history and severity spectrum. Acta Gastroenterol Belg 2017; 80:87-88. [PMID: 29364109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Reyes Cortes S, Alper B, Alves D, Baruzzo M, Bernardo J, Buratti P, Coelho R, Challis C, Chapman I, Hawkes N, Hender TC, Hobirk J, Joffrin E. MHD marking using the MSE polarimeter optics in ILW JET plasmas. Rev Sci Instrum 2016; 87:11E556. [PMID: 27910694 DOI: 10.1063/1.4962244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
In this communication we propose a novel diagnostic technique, which uses the collection optics of the JET Motional Stark Effect (MSE) diagnostic, to perform polarimetry marking of observed MHD in high temperature plasma regimes. To introduce the technique, first we will present measurements of the coherence between MSE polarimeter, electron cyclotron emission, and Mirnov coil signals aiming to show the feasibility of the method. The next step consists of measuring the amplitude fluctuation of the raw MSE polarimeter signals, for each MSE channel, following carefully the MHD frequency on Mirnov coil data spectrograms. A variety of experimental examples in JET ITER-Like Wall (ILW) plasmas are presented, providing an adequate picture and interpretation for the MSE optics polarimeter technique.
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Affiliation(s)
- S Reyes Cortes
- IPFN, Instituto Superior Técnico, Universidade de Lisboa, 1049-001 Lisboa, Portugal
| | - B Alper
- CCFE, Culham Science Centre, Abingdon OX14 3DB, United Kingdom
| | - D Alves
- European Organization for Nuclear Research, CERN, F-01631CERN Cedex, France
| | - M Baruzzo
- Conzorsio RFX, Corso Stati Uniti 4, 35127 Padova, Italy
| | - J Bernardo
- IPFN, Instituto Superior Técnico, Universidade de Lisboa, 1049-001 Lisboa, Portugal
| | - P Buratti
- ENEA C. R. Frascati, Via E. Fermi 45, Frascati, Italy
| | - R Coelho
- IPFN, Instituto Superior Técnico, Universidade de Lisboa, 1049-001 Lisboa, Portugal
| | - C Challis
- CCFE, Culham Science Centre, Abingdon OX14 3DB, United Kingdom
| | - I Chapman
- CCFE, Culham Science Centre, Abingdon OX14 3DB, United Kingdom
| | - N Hawkes
- CCFE, Culham Science Centre, Abingdon OX14 3DB, United Kingdom
| | - T C Hender
- CCFE, Culham Science Centre, Abingdon OX14 3DB, United Kingdom
| | - J Hobirk
- Max-Planck-Institute fur Plasmaphysik, Euratom Association, 85748 Garching bei Munchen, Germany
| | - E Joffrin
- IRFM-CEA, Centre de Cadarache, 13108 Saint-Paul-lez-Durance, France
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Affiliation(s)
- J Dobson
- Department of Dermatology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, U.K..
| | - C Ondhia
- Department of Dermatology, St Mary's Hospital, Imperial College Healthcare NHS Trust, Praed St, London, W2 1NY, U.K
| | - A-M Skellett
- Department of Dermatology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, U.K
| | - R Coelho
- Department of Dermatology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, U.K
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Coelho R, Matejcik S, McCarthy P, Suchkov EP, Zaitsev FS, Team EUI, Team ASDEXU. Evaluation of Epsilon-Net Calculated Equilibrium Reconstruction Error Bars in the European Integrated Modeling Platform. Fusion Science and Technology 2016. [DOI: 10.13182/fst15-177] [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] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- R Coelho
- Universidade de Lisboa, Instituto Superior Técnico, Instituto de Plasmas e Fusão Nuclear, 1049-001 Lisboa, Portugal
| | - S Matejcik
- Comenius University, Department of Experimental Physics, EUROfusion CU, Bratislava, Slovakia
| | - P McCarthy
- University College Cork, Department of Physics, Cork, Ireland
| | - E. P Suchkov
- Russian Academy of Science, Scientific Research Institute of System Development, Moscow, Russia
- Moscow State University, Department of Computational Mathematics and Cybernetics, Moscow, Russia
- FUSION Advanced Research Group, s.r.o., Bratislava, Slovakia
| | - F. S Zaitsev
- Comenius University, Department of Experimental Physics, EUROfusion CU, Bratislava, Slovakia
- Russian Academy of Science, Scientific Research Institute of System Development, Moscow, Russia
- Moscow State University, Department of Computational Mathematics and Cybernetics, Moscow, Russia
- FUSION Advanced Research Group, s.r.o., Bratislava, Slovakia
| | | | - ASDEX Upgrad Team
- Universidade de Lisboa, Instituto Superior Técnico, Instituto de Plasmas e Fusão Nuclear, 1049-001 Lisboa, Portugal
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Coelho R, Rodrigues-Pinto E, Cardoso H, Santos-Antunes J, Marques M, Horta e Vale A, Malheiro L, Macedo G. Severe metabolic acidosis: the presenting sign of an enterovesical fistula. Int J Colorectal Dis 2016; 31:785-6. [PMID: 26105744 DOI: 10.1007/s00384-015-2287-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/13/2015] [Indexed: 02/04/2023]
Affiliation(s)
- R Coelho
- Gastroenterology Department, Faculty of Medicine, Centro Hospitalar São João, Porto, Portugal.
| | - E Rodrigues-Pinto
- Gastroenterology Department, Faculty of Medicine, Centro Hospitalar São João, Porto, Portugal
| | - H Cardoso
- Gastroenterology Department, Faculty of Medicine, Centro Hospitalar São João, Porto, Portugal
| | - J Santos-Antunes
- Gastroenterology Department, Faculty of Medicine, Centro Hospitalar São João, Porto, Portugal
| | - M Marques
- Gastroenterology Department, Faculty of Medicine, Centro Hospitalar São João, Porto, Portugal
| | - A Horta e Vale
- Gastroenterology Department, Faculty of Medicine, Centro Hospitalar São João, Porto, Portugal
| | - L Malheiro
- Surgery Department, Faculty of Medicine, Centro Hospitalar São João, Porto, Portugal
| | - G Macedo
- Gastroenterology Department, Faculty of Medicine, Centro Hospitalar São João, Porto, Portugal
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Domingo A, Coelho R, Cortes E, Garcia-Cortes B, Mas F, Mejuto J, Miller P, Ramos-Cartelle A, Santos MN, Yokawa K. Is the tiger shark Galeocerdo cuvier a coastal species? Expanding its distribution range in the Atlantic Ocean using at-sea observer data. J Fish Biol 2016; 88:1223-1228. [PMID: 26817438 DOI: 10.1111/jfb.12887] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Revised: 08/27/2015] [Accepted: 11/21/2015] [Indexed: 06/05/2023]
Abstract
The occurrence of tiger shark Galeocerdo cuvier in the Atlantic Ocean was assessed using at-sea observer data from multiple pelagic longline fisheries. Geographic positions of 2764 G. cuvier recorded between 1992 and 2013 and covering a wide area of the Atlantic Ocean were compared with the currently accepted distribution ranges of the species. Most records fell outside those ranges in both the Southern and Northern Hemispheres, which strongly suggests that the distribution range of G. cuvier in the open ocean is considerably larger than previously described.
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Affiliation(s)
- A Domingo
- Dirección Nacional de Recursos Acuáticos (DINARA), Laboratorio de Recursos Pelágicos (LaRPe), Constituyente, 1497, Montevideo, Uruguay
| | - R Coelho
- Portuguese Institute for the Ocean and Atmosphere (IPMA, I.P.), Avenida 5 de Outubro s/n, 8700-305, Olhão, Portugal
| | - E Cortes
- National Oceanographic and Atmospheric Administration, National Marine Fisheries Service, Southeast Fisheries Science Center, Panama City Laboratory, Panama City, FL, 32408, U.S.A
| | - B Garcia-Cortes
- Instituto Español de Oceanografía, P. O. Box 130, 15080, A Coruña, España
| | - F Mas
- Dirección Nacional de Recursos Acuáticos (DINARA), Laboratorio de Recursos Pelágicos (LaRPe), Constituyente, 1497, Montevideo, Uruguay
- Centro de Investigación y Conservación Marina (CICMAR), Av. Giannattasio Km. 30, El Pinar, Uruguay
| | - J Mejuto
- Instituto Español de Oceanografía, P. O. Box 130, 15080, A Coruña, España
| | - P Miller
- Dirección Nacional de Recursos Acuáticos (DINARA), Laboratorio de Recursos Pelágicos (LaRPe), Constituyente, 1497, Montevideo, Uruguay
- Centro de Investigación y Conservación Marina (CICMAR), Av. Giannattasio Km. 30, El Pinar, Uruguay
| | - A Ramos-Cartelle
- Instituto Español de Oceanografía, P. O. Box 130, 15080, A Coruña, España
| | - M N Santos
- Portuguese Institute for the Ocean and Atmosphere (IPMA, I.P.), Avenida 5 de Outubro s/n, 8700-305, Olhão, Portugal
| | - K Yokawa
- National Research Institute of Far Seas Fisheries, 5-7-1 Orido, Shimizu-ku, Shizuoka-City, Shizuoka, 424 8633, Japan
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Cunha GR, Asevedo E, Mansur RB, Zugman A, Pan PM, Gadelha A, Belangero SI, Rizzo LB, Coelho R, Stertz L, Cogo-Moreira H, Grassi-Oliveira R, Teixeira AL, Kauer-Sant'Anna M, Mari JJ, Miguel EC, Bressan RA, Brietzke E. Inflammation, neurotrophism and oxidative stress and childhood psychopathology in a large community sample. Acta Psychiatr Scand 2016; 133:122-132. [PMID: 26139469 DOI: 10.1111/acps.12453] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/11/2015] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To investigate the association between peripheral biomarkers and child psychopathology in a large community sample. METHOD A total of 625 aged 6- to 13-year old subjects were recruited from a community school-based study. Psychopathology was assessed using the Child Behaviour Checklist (CBCL). Psychiatric diagnosis was evaluated using the Development and Well-Being Assessment. The following biomarkers were examined in peripheral blood: brain-derived neurotrophic factor, cytokines (IL-2, IL-4, IL-6, IL-10, IL-17, IFN-g, and TNF-α), chemokines (eotaxin/CCL11, IP-10, MCP-1), cytokine receptors (sTNFR1 and sTNFR2), and the oxidative stress marker TBARS. RESULTS We found significant associations between sTNFR2, eotaxin/CCL11 and CBCL total score, as well as with specific dimensions of psychopathology. There were different patterns of association between these biomarkers and psychological and behavioural symptoms in children with and without a mental disorder. TBARS, IL-6 and MCP-1 were more specific to some clusters of symptoms in children with a psychiatric diagnosis. CONCLUSION Our data support the potential use of biomarkers, especially those involved in immune-inflammatory pathways, in investigating neurodevelopmental psychopathology. Their association with different dimensions of symptoms might be of useful when analyzing illness severity and clusters of symptoms within specific disorders.
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Affiliation(s)
- G R Cunha
- National Institute of Developmental Psychiatry (INPD), São Paulo, Brazil.,Program for Recognition and Intervention in Individuals in At-Risk Mental State (PRISMA), Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil.,Department of Psychiatry, Interdisciplinary Laboratory of Clinical Neurosciences (LINC), Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - E Asevedo
- National Institute of Developmental Psychiatry (INPD), São Paulo, Brazil.,Program for Recognition and Intervention in Individuals in At-Risk Mental State (PRISMA), Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil.,Department of Psychiatry, Interdisciplinary Laboratory of Clinical Neurosciences (LINC), Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - R B Mansur
- National Institute of Developmental Psychiatry (INPD), São Paulo, Brazil.,Program for Recognition and Intervention in Individuals in At-Risk Mental State (PRISMA), Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - A Zugman
- National Institute of Developmental Psychiatry (INPD), São Paulo, Brazil.,Program for Recognition and Intervention in Individuals in At-Risk Mental State (PRISMA), Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil.,Department of Psychiatry, Interdisciplinary Laboratory of Clinical Neurosciences (LINC), Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - P M Pan
- National Institute of Developmental Psychiatry (INPD), São Paulo, Brazil.,Program for Recognition and Intervention in Individuals in At-Risk Mental State (PRISMA), Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil.,Department of Psychiatry, Interdisciplinary Laboratory of Clinical Neurosciences (LINC), Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - A Gadelha
- National Institute of Developmental Psychiatry (INPD), São Paulo, Brazil.,Program for Recognition and Intervention in Individuals in At-Risk Mental State (PRISMA), Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil.,Department of Psychiatry, Interdisciplinary Laboratory of Clinical Neurosciences (LINC), Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - S I Belangero
- National Institute of Developmental Psychiatry (INPD), São Paulo, Brazil.,Department of Psychiatry, Interdisciplinary Laboratory of Clinical Neurosciences (LINC), Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - L B Rizzo
- Department of Psychiatry, Interdisciplinary Laboratory of Clinical Neurosciences (LINC), Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - R Coelho
- Post-Graduation Program in Psychology, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.,Developmental Cognitive Neuroscience Research Group (GNCD), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - L Stertz
- Molecular Psychiatry Unit and National Science and Technology Institute for Translational Medicine (INCT-TM), Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.,Department of Psychiatry and Behavioral Sciences, UT Center for Molecular Psychiatry, University of Texas Health Science Center, Houston, TX, USA
| | - H Cogo-Moreira
- Department of Psychiatry, Interdisciplinary Laboratory of Clinical Neurosciences (LINC), Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - R Grassi-Oliveira
- National Institute of Developmental Psychiatry (INPD), São Paulo, Brazil.,Post-Graduation Program in Psychology, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.,Developmental Cognitive Neuroscience Research Group (GNCD), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - A L Teixeira
- Translational Psychoneuroimmunology Group, Federal University of Minas Gerais (UFMG), Belo Horizonte
| | - M Kauer-Sant'Anna
- Molecular Psychiatry Unit and National Science and Technology Institute for Translational Medicine (INCT-TM), Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - J J Mari
- National Institute of Developmental Psychiatry (INPD), São Paulo, Brazil.,Program for Recognition and Intervention in Individuals in At-Risk Mental State (PRISMA), Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil.,Department of Psychiatry, Interdisciplinary Laboratory of Clinical Neurosciences (LINC), Federal University of São Paulo (UNIFESP), São Paulo, Brazil.,Laboratory of Molecular Psychiatry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - E C Miguel
- National Institute of Developmental Psychiatry (INPD), São Paulo, Brazil.,Laboratory of Molecular Psychiatry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.,Department of Psychiatry, Faculty of Medicine, University of São Paulo (USP), São Paulo, Brazil
| | - R A Bressan
- National Institute of Developmental Psychiatry (INPD), São Paulo, Brazil.,Program for Recognition and Intervention in Individuals in At-Risk Mental State (PRISMA), Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil.,Department of Psychiatry, Interdisciplinary Laboratory of Clinical Neurosciences (LINC), Federal University of São Paulo (UNIFESP), São Paulo, Brazil.,Laboratory of Molecular Psychiatry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - E Brietzke
- National Institute of Developmental Psychiatry (INPD), São Paulo, Brazil.,Program for Recognition and Intervention in Individuals in At-Risk Mental State (PRISMA), Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil.,Department of Psychiatry, Interdisciplinary Laboratory of Clinical Neurosciences (LINC), Federal University of São Paulo (UNIFESP), São Paulo, Brazil
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Bates A, Samavedi S, Kumar A, Mouraviev V, Rocco B, Coelho R, Palmer K, Patel V. Salvage robot assisted radical prostatectomy: A propensity matched study of perioperative, oncological and functional outcomes. European Journal of Surgical Oncology (EJSO) 2015; 41:1540-6. [DOI: 10.1016/j.ejso.2015.06.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Revised: 05/10/2015] [Accepted: 06/04/2015] [Indexed: 11/16/2022]
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Kumar A, Samavedi S, Bates A, Coelho R, Rocco B, Marquinez J, Jenson C, Palmer K, Patel V. V36 Use of intra-operative indocyanine green and Firefly® technology to visualize the “landmark artery” for nerve sparing robot assisted radical prostatectomy. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/s1569-9056(15)61120-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Lau E, Freitas P, Costa J, Batista R, Máximo V, Coelho R, Matos-Lima L, Eloy C, Carvalho D. Loss of mitochondrial SDHB expression: what is its role in diffuse thyroid lipomatosis? Horm Metab Res 2015; 47:165-7. [PMID: 25679879 DOI: 10.1055/s-0034-1398559] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Diffuse lipomatosis of the thyroid gland is a very rare disease, characterized by extensive infiltration of thyroid parenchyma by mature adipose tissue, usually not accompanied by amyloid fibrils deposition. The pathophysiology of adipose tissue infiltration in the thyroid gland remains unknown. We report a clinical case of a diffuse thyroid lipomatosis, whose immunohistochemical study of succinate dehydrogenase - subunit B (SDHB) revealed loss of expression of this protein in the follicular or adipose cells. We detected the presence of a recently described SDHB gene large deletion. Loss of mitochondrial SDHB expression may have a key role in understanding the pathophysiology of thyrolipomatosis, by regulating status of lipid metabolism.
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Affiliation(s)
- E Lau
- Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar São João (CHSJ), Faculty of Medicine, University of Porto, Porto, Portugal
| | - P Freitas
- Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar São João (CHSJ), Faculty of Medicine, University of Porto, Porto, Portugal
| | - J Costa
- Department of Pathology, (CHSJ), Faculty of Medicine, University of Porto, Porto, Portugal
| | - R Batista
- Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), Faculty of Medicine, University of Porto, Porto, Portugal
| | - V Máximo
- Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), Faculty of Medicine, University of Porto, Porto, Portugal
| | - R Coelho
- Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), Faculty of Medicine, University of Porto, Porto, Portugal
| | - L Matos-Lima
- Department of General Surgery, CHSJ, Faculty of Medicine, University of Porto, Porto, Portugal
| | - C Eloy
- Department of Pathology, (CHSJ), Faculty of Medicine, University of Porto, Porto, Portugal
| | - D Carvalho
- Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar São João (CHSJ), Faculty of Medicine, University of Porto, Porto, Portugal
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Henriques RB, Malaquias A, Nedzelskiy IS, Silva C, Coelho R, Figueiredo H, Fernandes H. Radial profile measurements of plasma pressure-like fluctuations with the heavy ion beam diagnostic on the tokamak ISTTOK. Rev Sci Instrum 2014; 85:11D848. [PMID: 25430261 DOI: 10.1063/1.4891045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The Heavy Ion Beam Diagnostic (HIBD) on the tokamak ISTTOK (Instituto Superior Técnico TOKamak) has been modified, in terms of signal conditioning, to measure the local fluctuations of the neσ1,2(Te) product (plasma density times the effective ionization cross-section) along the tokamak minor diameter, in 12 sample volumes in the range of -0.7a < r < 0.7a, with a maximum delay time of 1 μs. The corresponding signals show high correlation with the magnetic Mirnov coils in the characteristic MHD frequency range of ISTTOK plasmas and enable the identification of tearing modes. This paper describes the HIBD signal conditioning system and presents a preliminary analysis of the radial profile measurements of local neσ1,2(Te) fluctuations.
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Affiliation(s)
- R B Henriques
- Instituto de Plasmas e Fusão Nuclear, Instituto Superior Técnico, Universidade de Lisboa, 1049-001 Lisboa, Portugal
| | - A Malaquias
- Instituto de Plasmas e Fusão Nuclear, Instituto Superior Técnico, Universidade de Lisboa, 1049-001 Lisboa, Portugal
| | - I S Nedzelskiy
- Instituto de Plasmas e Fusão Nuclear, Instituto Superior Técnico, Universidade de Lisboa, 1049-001 Lisboa, Portugal
| | - C Silva
- Instituto de Plasmas e Fusão Nuclear, Instituto Superior Técnico, Universidade de Lisboa, 1049-001 Lisboa, Portugal
| | - R Coelho
- Instituto de Plasmas e Fusão Nuclear, Instituto Superior Técnico, Universidade de Lisboa, 1049-001 Lisboa, Portugal
| | - H Figueiredo
- Instituto de Plasmas e Fusão Nuclear, Instituto Superior Técnico, Universidade de Lisboa, 1049-001 Lisboa, Portugal
| | - H Fernandes
- Instituto de Plasmas e Fusão Nuclear, Instituto Superior Técnico, Universidade de Lisboa, 1049-001 Lisboa, Portugal
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Nazareth N, Magro F, Silva J, Duro M, Gracio D, Coelho R, Appelberg R, Macedo G, Sarmento A. Infliximab therapy increases the frequency of circulating CD16(+) monocytes and modifies macrophage cytokine response to bacterial infection. Clin Exp Immunol 2014; 177:703-11. [PMID: 24816497 DOI: 10.1111/cei.12375] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2014] [Indexed: 12/30/2022] Open
Abstract
Crohn's disease (CD) has been correlated with altered macrophage response to microorganisms. Considering the efficacy of infliximab treatment on CD remission, we investigated infliximab effects on circulating monocyte subsets and on macrophage cytokine response to bacteria. Human peripheral blood monocyte-derived macrophages were obtained from CD patients, treated or not with infliximab. Macrophages were infected with Escherichia coli, Enterococcus faecalis, Mycobacterium avium subsp. paratuberculosis (MAP) or M. avium subsp avium, and cytokine levels [tumour necrosis factor (TNF) and interleukin (IL)-10] were evaluated at different time-points. To evaluate infliximab-dependent effects on monocyte subsets, we studied CD14 and CD16 expression by peripheral blood monocytes before and after different infliximab administrations. We also investigated TNF secretion by macrophages obtained from CD16(+) and CD16(-) monocytes and the frequency of TNF(+) cells among CD16(+) and CD16(-) monocyte-derived macrophages from CD patients. Infliximab treatment resulted in elevated TNF and IL-10 macrophage response to bacteria. An infliximab-dependent increase in the frequency of circulating CD16(+) monocytes (particularly the CD14(++) CD16(+) subset) was also observed (before infliximab: 4·65 ± 0·58%; after three administrations: 10·68 ± 2·23%). In response to MAP infection, macrophages obtained from CD16(+) monocytes were higher TNF producers and CD16(+) macrophages from infliximab-treated CD patients showed increased frequency of TNF(+) cells. In conclusion, infliximab treatment increased the TNF production of CD macrophages in response to bacteria, which seemed to depend upon enrichment of CD16(+) circulating monocytes, particularly of the CD14(++) CD16(+) subset. Infliximab treatment of CD patients also resulted in increased macrophage IL-10 production in response to bacteria, suggesting an infliximab-induced shift to M2 macrophages.
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Affiliation(s)
- N Nazareth
- CEBIMED - Biomedicine Research Center, Health Sciences Faculty, University Fernando Pessoa, Porto, Portugal
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