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2. Sport practice and plantar pressure in children aged 10–18 years: evaluation using Namrol® Podoprint®

Author

C. Lopes, J. Neves Silva, E. Matos, S. Xavier Sousa, D. Gonçalves, N. Azevedo, L. Rodrigues, and G. Pacheco

Subjects
Medicine
Abstract

AbstractIntroduction The foot is key to sport [1] and is part of a set of mechanisms responsible for absorbing impacts, maintaining balance and distribution of forces. Therefore, special attention to the distribution of plantar pressure is necessary [2]. Baropodometry consists of the quantification of anteroposterior and lateral oscillations of the sole of the foot, while the individual remains under a pressure platform [3]. The goal of this investigation is to verify if there is an association between students' sports practice and their distribution of plantar pressure and to analyse whether there are differences regarding plantar pressure distribution between students who practice and those who do not practice a specific modality (volleyball, swimming or soccer).Material and methods The current research is a cross-sectional study carried out in a non- probabilistic sample comprising 499 students from Amares, Portugal aged 10–18 years (average age: 13.79 ± 2.50), 238 (47.7%) being males and 261 (52.3%) females. An informed consent was given to all participants and a questionnaire was used to ascertain whether individuals practiced physical exercise and, if so, what type of exercise they practiced. Finally, an evaluation of the plantar pressure distribution of the study participants was made using the Namrol® Podoprint® baropodometry platform. All data were analysed using descriptive and inferential statistics, which were performed using the Mann–Witney (U) test for association. Significance levels (denoted as α or alpha) of 0.05 and 0.01 have been considered for the presence of statistically significant association between the considered variables.Results There was no statistically significant association between sport practice and the presence of pressure changes in the plantar area of the students analysed. Regarding the students who practice volleyball, we found statistically significant differences in the right/left pressure distribution, with a predominance of pressure in the right foot (U = 12327.000; Z= − 1.968; p-value = .049).Discussion and conclusion This study verified that there is no statistically significant association between the practice of sport and the presence of changes in the plantar zone when comparing students who practice sports and those who do not. It was verified that the volleyball practitioners presented a predominance of plantar pressure in the right foot, in contrast with the non-practitioners, which showed an equal distribution of plantar pressure. In this sense, future studies comprising a larger sample of participants of different sports, namely volleyball, may help identify which technical movements may be contributing to these baropodometric imbalances. In addition, these studies are important to help develop strategies that counterbalance these differences in foot pressure of children, minimising the future appearance of postural changes and related problems.

Published
2021
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3. Chronic lymphocytic leukaemia/small lymphocytic lymphoma treatment with rituximab and high‐dose methylprednisolone, revisited

Author

Blanca Polo, Maria Joao Costa, Ana Vagos Mata, C. Lopes, João F. Lacerda, Daniela Alves, Eduardo Espada, and João Raposo

Subjects
Male, high‐dose methylprednisolone, Cancer Research, medicine.medical_specialty, Disease, Neutropenia, Methylprednisolone, Gastroenterology, rituximab, hemic and lymphatic diseases, Internal medicine, medicine, Humans, Radiology, Nuclear Medicine and imaging, auto‐immune haemolytic anaemia, Stage (cooking), Adverse effect, RC254-282, Research Articles, Aged, Retrospective Studies, Aged, 80 and over, Lymphocytic leukaemia, business.industry, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Clinical Cancer Research, medicine.disease, Leukemia, Lymphocytic, Chronic, B-Cell, Progression-Free Survival, Fludarabine, Oncology, Female, Rituximab, business, chronic lymphocytic leukaemia, Research Article, medicine.drug
Abstract

High‐dose methylprednisolone plus rituximab (R‐HDMP) is a useful treatment in chronic lymphocytic leukaemia/small lymphocytic lymphoma (CLL/SLL) patients unfit for chemo‐immunotherapy and has proven its utility on the treatment of CLL/SLL complicated by auto‐immune cytopenias. We performed a retrospective, single‐centre study, of CLL/SLL patients treated with R‐HDMP for 9 years. Thirty‐nine patients were included, median age at time of treatment was 77 years. Most patients had stage Rai III/IV and Binet C disease. Twenty‐eight patients had relapsed/refractory disease at time of treatment with a median of 1 previous line of therapy; 53.8% had prior exposure to fludarabine and 25% to rituximab. Grade 3–4 neutropenia and thrombocytopenia were recorded in 10.2% and 17.9% patients, respectively. While on treatment, 51.3% had documented infectious complications, but no other non‐haematological toxicities grades 3–4 were identified. Overall response rate was 64%. Median overall survival and progression‐free survival were 24 and 13 months, respectively. Twenty four patients relapsed and 16 received another line of treatment after R‐HDMP, with median time to next treatment of 13.5 months. Thirteen out of the 24 patients improved performance status and were subsequently considered fit for chemo‐immunotherapy. R‐HDMP is a valuable option for elderly and frail patients, with low risk of severe myelotoxicity and other severe adverse events. It was shown to work as a bridge to other lines of treatment, including chemo‐immunotherapy., High dose methylprednisolone plus rituximab (R‐HDMP) is a useful treatment in chronic lymphocytic leukaemia/small lymphocytic lymphoma patients unfit for chemo‐immunotherapy. We present a cohort of patients with median age of 77 years, most with stage Rai III/IV and Binet C disease. Overall response rate was 64% and median overall survival and progression‐free survival were 24 and 13 months, respectively, with an acceptable toxicity profile, highlighting R‐HDMP utility for elderly and frail patients.

Published
2021

4. Serum BDNF and cognitive dysfunction in SLE: findings from a cohort of 111 patients

Author

Fabiano Ferreira Abrantes, Fernanda C Lopes, Helena Alessi, Paula C Coube, Lilia Alves Maria, Orlando Graziani Povoas Barsottini, Cristiane Kayser, Karina Hoshino, Lívia Almeida Dutra, and Alexandre Wagner Silva de Souza

Subjects
medicine.medical_specialty, Systemic lupus erythematosus, medicine.diagnostic_test, business.industry, Brain-Derived Neurotrophic Factor, Lupus Vasculitis, Central Nervous System, Cognition, General Medicine, medicine.disease, Pathophysiology, Rheumatology, Cohort Studies, Neurotrophic factors, Internal medicine, Potential biomarkers, Cohort, medicine, Humans, Lupus Erythematosus, Systemic, Cognitive Dysfunction, Neuropsychological assessment, skin and connective tissue diseases, business
Abstract

The association between brain-derived neurotrophic factor (BDNF) and neuropsychiatric systemic lupus erythematosus (NPSLE) is controversial in the literature. Cognitive dysfunction (CD) is a common, underdiagnosed NPSLE manifestation, but its pathophysiology is unknown. Thus, we investigate serum BDNF as a potential biomarker of CD in a cohort of SLE patients.We included 63 SLE patients, 48 NPSLE, and 57 age- and gender-matched controls (CON). All participants underwent neuropsychological assessment. Data on cardiovascular comorbidities, SLE disease activity index (SLEDAI), and Systemic Lupus International Collaborating Clinics damage index (SLICC-DI) were compiled. Multiple regression analyses evaluated predictors of serum BDNF levels.Serum BDNF levels were lower in SLE and NPSLE patients than in CON (SLE 800.4 ± 502.7 vs. NPSLE 779.7 ± 426.3 vs. CON 1,345.5 ng/mL ± 438.4; p 0.001). In addition, hypertension (B: - 192.5, SE: 84.3, 95% CI: - 359.7 to - 25.3, p = 0.024) and SLICC-DI score (B: - 75.9, SE: 27.2, 95% CI: - 129.8 to - 22, p = 0.006) were predictors of serum BDNF levels in SLE. There was no relation between BDNF levels and CD.BDNF levels are lower in SLE patients than CON and inversely associated with hypertension and SLICC-DI scores. No association between BDNF levels and CD or NPSLE was observed in this cohort. These findings indicate that BDNF may be associated with overall burden in SLE rather than specific manifestations such as cognition impairment. Key Points • BDNF is associated with an overall burden in SLE rather than specific manifestations such as cognition dysfunction. • BDNF levels are reduced in patients with SLE, and higher SLICC-DI scores and hypertension are independent predictors of lower serum BDNF levels. • The cognitive dysfunction rate is elevated (46%) among Brazilian SLE patients.

Published
2021

5. Comparison of the Thermal Performance of Mineral Oil and Natural Ester for Safer Eco-Friendly Power Transformers A Numerical and Experimental Approach

Author

Carlos A. Sá, Elisabete M. Ferreira, Ricardo C. Lopes, Artur Costa, Ren Rede Eléctrica Nacional, S.A., Lisboa, Portugal, S.A. Portugal Efacec Energia Máquinas e Equipamentos Eléctricos, Sandra Couto, Diogo Sá, Mario J. Soares, Catarina Corte-Real, Pedro U. Lima, and Pedro Monteiro

Subjects
Waste management, Renewable Energy, Sustainability and the Environment, SAFER, Thermal, medicine, Energy Engineering and Power Technology, Environmental science, Electrical and Electronic Engineering, Mineral oil, Environmentally friendly, Natural (archaeology), medicine.drug
Abstract

At present, most of the worldwide transformer fleet uses mineral oil as insulation fluid. However, the use of natural ester is playing an increasing role as safer and eco-friendly alternative to mineral oil. From the utilities’ perspective, the change in the mineral oil paradigm can be approached by replacing their assets by new eco-friendly transformers or refurbishing their assets, substituting only the insulating fluid. To make an informed decision, guidelines indicating how a transformer designed for mineral oil would behave when operating with natural ester, are of paramount importance. In the present research, temperature rise tests were carried out in a 15MVA ODAF core-type power transformer, under different operating conditions. Tests were run for mineral oil as insulating fluid and subsequently repeated for natural ester. To gain further insights on experimental results, thermal modelling of the transformer under the same test conditions was carried out, using Thermal-Hydraulic Network Models and Computational Fluid Dynamics techniques. From the present work it was found that the relationship between the thermal behaviour of the transformer using natural ester or mineral oil is not simple as it depends on the operating conditions of the transformer and on the geometry of the windings.

Published
2021

6. Association between muscle strength, upper extremity fatigue resistance, work ability and upper extremity dysfunction in a sample of workers at a tertiary hospital

Author

T. M. Fifolato, Felipe de Souza Serenza, Natalia Claro da Silva, Karen A. Kawano Suzuki, E. R. C. Lopes, Marisa de Cássia Registro Fonseca, and Heloísa Correa Bueno Nardim

Subjects
Male, Muscle Strength Dynamometer, medicine.medical_specialty, Upper extremity, Sports medicine, Elbow, Chronic pain, Isometric exercise, Diseases of the musculoskeletal system, Tertiary Care Centers, 03 medical and health sciences, Grip strength, 0302 clinical medicine, Work capacity evaluation, Rheumatology, Activities of Daily Living, medicine, Humans, Orthopedics and Sports Medicine, Muscle Strength, Musculoskeletal Diseases, Muscle strength dynamometer, 030222 orthopedics, Hand Strength, business.industry, Middle Aged, medicine.disease, medicine.anatomical_structure, RC925-935, Orthopedic surgery, Physical therapy, Upper Extremity Dysfunction, Female, business, 030217 neurology & neurosurgery, Research Article
Abstract

Background Upper extremity musculoskeletal disorders negatively affect ability to perform activities of daily living, self-care and work. Therefore, outcome measurements that address muscle strength, fatigue resistance, functionality and work physical capacity must be defined to assess and plan specific actions to minimize them. Objective To investigate the association of upper extremity muscle strength with upper extremity fatigue resistance, work ability and upper extremity dysfunction in a sample of workers from a tertiary hospital. Methods Shoulder and elbow isokinetic strength were assessed by Biodex System 4™, isometric hand grip by JAMAR™, upper extremity fatigue resistance by Functional Impairment Test Hand and Neck/Shoulder/Arm (FIT-HaNSA), ability to work by the Work Ability Index and upper extremity dysfunction by the Quick-Disabilities of the Arm, Shoulder and Hand QuickDASH-Br questionnaire. The Nordic questionnaire and Numeric Pain Rating Scale (NPRS) were used for pain description. The associations were analysed by Spearman’s correlation coefficient (rho) (p Results Twenty-seven participants: 59.2% women; mean age 46 years old; 70.3% obese/overweight; 62.9% active with predominantly dynamic muscle contraction work. Besides predominance of good to moderate work ability (81.4%) and comorbidities (37%), all participants had symptoms of the upper extremities for at least 12 months, with a predominance of low-intensity in the shoulder (55.5%). In addition, 88.8% reported pain in other segments. Muscle strength of abduction (rho = 0.49), adduction (rho = 0.40), internal rotation (rho = 0.44) and hand grip (rho = 0.68) presented moderate correlation with FIT-HaNSA. Hand grip (rho = − 0.52) showed moderate correlation with upper extremity dysfunction. Conclusions The results of this preliminary study suggested the association of shoulder strength with fatigue resistance. Also, hand grip strength was associated with upper extremity dysfunction and fatigue resistance. No association was found with the Work Ability Index in this sample. So, it is suggested that hand grip and shoulder strength could be outcome measurements used for future interventions focused on upper extremity preventive exercises to improve strength and fatigue resistance of workers at risk for the development of musculoskeletal disorders. Other individual, psychosocial and organizational risk factors must also be considered as influences on upper extremity function.

Published
2021

7. Case reports of athletes affected by rhabdomyolysis: A systematic review

Author

Rodolfo de Alkmim Moreira Nunes, Juliana Brandão Pinto de Castro, Eduardo Borba Neves, Rodrigo Gomes de Souza Vale, Guilherme Henrique Mattos Dantas, and Gustavo C. Lopes

Subjects
myalgia, medicine.medical_specialty, Modalities, biology, business.industry, Athletes, Skeletal muscle, 030229 sport sciences, 030204 cardiovascular system & hematology, medicine.disease, biology.organism_classification, 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, Physical therapy, biology.protein, Medicine, Creatine kinase, medicine.symptom, business, Rhabdomyolysis, Social Sciences (miscellaneous)
Abstract

Objective To analyze intensity levels, modalities, types of physical activities, ambient temperature, and hydration levels during stimuli performed in training and competitionof studies that reported episodes of rhabdomyolysis in athletes. Method We conducted a systematic review following the PRISMA guidelines and registered on PROSPERO, as number CRD42020126107. MedLine (via PubMed), Cochrane, LILACS, SciELO, Web of Science, Scopus, CINAHL, SPORTDiscus, ScienceDirect, and PEDro databases were searched for case reports in which professional athletes, who had a technical team as support, were affected by rhabdomyolysis induced by the practice of physical activity. The descriptors and their synonyms “rhabdomyolysis”, “exercise”, and “athletes”, available in the Health Sciences Descriptors (DeCS) and Medical Subject Headings (MeSH), were used. Results After the screening process, 10 studies were includedand analyzed according to the CAse REport (CARE) guidelines.The sports of the case reports were soccer, football, swimming, wrestling, 24-hour cross-country skiing, and mixed martial arts (MMA).The age range of the athletes varied between 16 to 41 years old. The case reports described a total of 17 athletes (14 male and three female).The main aspects related to the diagnosis of rhabdomyolysis were ambient temperature, creatine kinase (CK) levels, the occurrence of renal impairment, and one or more signs of the classical triad (myalgia, dark urine, and muscle weakness). Conclusion It was observed difficulty in identifying concrete parameters to prevent and diagnose the rhabdomyolysis of premature form, however, controlling these variables may increase the chances of treatment success and decrease the risk of sequels.

Published
2021

8. An overview of the level of dietary support in the gut microbiota at different stages of life: A systematic review

Author

Luciane Pires, Gustavo C. Lopes, Bernardo A. Petriz, Alessandra da Rocha Pinheiro Mulder, Filipe M. Ribeiro, Octavio L. Franco, and Dahan da Cunha Nascimento

Subjects
0301 basic medicine, Gerontology, 030109 nutrition & dietetics, Nutrition and Dietetics, biology, business.industry, Endocrinology, Diabetes and Metabolism, MEDLINE, Psychological intervention, 030209 endocrinology & metabolism, Context (language use), Evidence-based medicine, Gut flora, biology.organism_classification, Gut microbiome, Diet, Gastrointestinal Microbiome, 03 medical and health sciences, 0302 clinical medicine, Intervention (counseling), Humans, Medicine, Microbiome, business, Life Style
Abstract

Summary Background & aims The gut microbiome is an essential factor for the health of the host. Several factors may alter the gut's microbiota composition, including genetic factors, lifestyle, aging, and dietary intervention. This process can be an essential element in the prevention and treatment of diseases associated with microbiome dysfunction through appropriate dietary interventions. Based on this context, a systematic review was carried out in order to assess the effect of dietary intervention on the profile of the gut microbiota throughout different stages of life. Methods The systematic review was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA), with the eligibility criteria following the principle of PICOS. The literature search was carried out in 2019 throughout PubMed/MEDLINE, Scopus, and Science Direct. Thus, 1237 studies were selected, and 40 articles were included by criteria. Results According to the level of evidence of Centre for Evidence-Based Medicine (OCEBM), 21 studies reached the level of evidence B1, 15 articles were classified with B2, and four articles with B3. No dietary intervention was applied at all stages of life, nor with similar proportions of intervention. No dietary intervention was applied at all stages of life, nor with similar proportions of intervention. On the other hand, dietary interventions alter the intestinal microbiota in different pathological realities. Conclusions Different dietary interventions change the microbiome composition at all stages of life in healthy and pathological individuals. However, more clinical studies are needed to identify the specifics of each stage in response to interventions.

Published
2021

9. Monocytic and granulocytic myeloid-derived suppressor cell plasticity and differentiation are organ-specific

Author

Mikayla C. Lopes, Nicholas A. DaSilva, Benjamin A. Rabinowitz, Jillian Gardell, Steven C. Katz, David C. Rowley, and Prajna Guha

Subjects
0301 basic medicine, Cancer Research, Adoptive cell transfer, Tumor microenvironment, Cancer, Biology, medicine.disease, Metastasis, law.invention, 03 medical and health sciences, 030104 developmental biology, 0302 clinical medicine, Immunity, law, Cell culture, 030220 oncology & carcinogenesis, Genetics, medicine, Myeloid-derived Suppressor Cell, Cancer research, Suppressor, Molecular Biology
Abstract

Myeloid-derived suppressor cells (MDSCs) are a heterogeneous population of immature myeloid cells that proliferate in the setting of cancer and have potent immunosuppressive functions hindering anti-tumor immunity. Here we establish that the immunologic landscape and tumor microenvironments (TME) vary between different organs which discretely shape MDSC repertoires. We found that pSTAT3 signaling exerts a dominant effect on MDSC programming in liver metastasis (LM). In contrast, in lung metastasis (LuM), MDSC programming is driven mainly by pSTAT5. Adoptive transfer of LM-MDSC into LuM resulted in a shift from pSTAT3 signaling to pSTAT5, in association with an overall shift toward lung MDSC programming. A shift from more immunosuppressive M-MDSC to G-MDSC, along with enhanced differentiation of MDSCs into pro-inflammatory M1 macrophages in LuM, indicated that MDSC plasticity and differentiation patterns are environmentally dependent. Using mass spectroscopy, we confirmed that LM-MDSCs showed enhanced expression of key proliferation pathway markers. This confirmed that liver-specific MDSC programing was comprehensive but reversible, implying that therapeutic targeting of LM-MDSC could prime the TME in a favorable manner. Our data suggest that MDSC programming in response to malignancy is highly dependent on organ-specific conditions and is modifiable.

Published
2020

10. A C. elegans model for neurodegeneration in Cockayne syndrome

Author

Björn Schumacher, Katarzyna Bozek, Amanda F C Lopes, Aleksandra Trifunovic, Marija Herholz, Matthias Rieckher, Trifunovic, Aleksandra [0000-0002-5472-3517], Schumacher, Björn [0000-0001-6097-5238], and Apollo - University of Cambridge Repository

Subjects
DNA Repair, DNA repair, DNA damage, AcademicSubjects/SCI00010, Context (language use), Biology, Mitochondrion, Genome Integrity, Repair and Replication, medicine.disease_cause, Cockayne syndrome, 03 medical and health sciences, 0302 clinical medicine, Genetics, medicine, Animals, Caenorhabditis elegans, Cockayne Syndrome, Poly-ADP-Ribose Binding Proteins, 030304 developmental biology, 0303 health sciences, Mutation, Neurodegeneration, medicine.disease, biology.organism_classification, Cell biology, Mitochondria, Disease Models, Animal, DNA Repair Enzymes, 030217 neurology & neurosurgery, DNA Damage
Abstract

Cockayne syndrome (CS) is a congenital syndrome characterized by growth and mental retardation, and premature ageing. The complexity of CS and mammalian models warrants simpler metazoan models that display CS-like phenotypes that could be studied in the context of a live organism. Here, we provide a characterization of neuronal and mitochondrial aberrations caused by a mutation in the csb-1 gene in Caenorhabditis elegans. We report a progressive neurodegeneration in adult animals that is enhanced upon UV-induced DNA damage. The csb-1 mutants show dysfunctional hyperfused mitochondria that degrade upon DNA damage, resulting in diminished respiratory activity. Our data support the role of endogenous DNA damage as a driving factor of CS-related neuropathology and underline the role of mitochondrial dysfunction in the disease.

Published
2020

11. Validade de construto do Functional Impairment Test-Hand and Neck/Shoulder and Arm (FIT-HANSA) para trabalhadores com queixas no membro superior de um hospital terciário

Author

Marisa de Cássia Registro Fonseca, Lívia Nahas Pinola, Natalia Claro da Silva, Flávia Pessoni Faleiros Macêdo Ricci, T. M. Fifolato, Karen Ayumi Kawano Suzuki, and E. R. C. Lopes

Subjects
Ability to work, medicine.medical_specialty, Functional impairment, business.industry, Elbow, Construct validity, General Medicine, Physical strength, Fatigue resistance, medicine.anatomical_structure, Muscle strength, medicine, Physical therapy, Upper limb, business
Abstract

O Functional Impairment Test-Hand and Neck/Shoulder/Arm (FIT-HaNSA) é um instrumento que avalia a resistência à fadiga e o desempenho do membro superior por meio de funções motoras grossas comumente utilizadas no dia a dia. Objetivo: Analisar a validade de construto do FIT-HaNSA em trabalhadores com sintomas no membro superior, por meio da correlação entre a resistência à fadiga do segmento com os escores de força muscular do ombro, cotovelo e mão, com a capacidade para o trabalho (ICT) e com a disfunção do membro superior (QUICK DASH-Br). Métodos: Trinta e nove trabalhadores de um hospital terciário com idade média de 42,9 anos (DP13,29) foram recrutados. Os instrumentos de medida Isocinético Biodex System 4 Pro™, dinamômetro de preensão palmar JAMAR®, QuickDASH-Br e ICT foram aplicados e correlacionados com o FIT-HaNSA. O Coeficiente de Correlação de Pearson (r) foi utilizado para quantificar a associação entre os instrumentos. Resultados: O FIT-HaNSA apresentou de fraca a moderada correlação entre a força muscular do ombro, cotovelo e mão (r= 0,18 – 0,58), porém significativas para ombro e mão. A associação entre o FIT-HaNSA com o QuickDASH-Br e ICT se mostraram fracas (r= -0,38 e 0,21). Conclusão: Nosso estudo forneceu evidências preliminares com relação às relações esperadas e validade do FIT-HaNSA como instrumento de medida para a avaliação da fadiga e desconforto em trabalhadores com queixas no membro superior.

Published
2020

12. Impact of markers of endothelial injury and hypercoagulability on systemic lupus erythematosus

Author

L C Vieira Alves, P Madureira de Pádua, F Freire Campos Nunes, W Batista Cicarini, C de Mello Gomes Loures, T M Pinto Dabés Guimarães, R C Figueiredo Duarte, C Lopes Santoro Neiva, R Vargas Consoli, V de Paulo Coelho Peixoto de Toledo, K Silvestre Ferreira, M. das Graças Carvalho, E Afonso Reis, and C Coelho Moreira

Subjects
Adult, Male, Thrombomodulin, Clinical manifestation, 030204 cardiovascular system & hematology, Severity of Illness Index, Thrombin generation, Thromboplastin, Fibrin Fibrinogen Degradation Products, Disease activity, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, immune system diseases, D-dimer, Humans, Lupus Erythematosus, Systemic, Thrombophilia, Medicine, skin and connective tissue diseases, business.industry, Middle Aged, Cross-Sectional Studies, Case-Control Studies, 030220 oncology & carcinogenesis, Immunology, Female, Endothelium, Vascular, business, Biomarkers
Abstract

We have explored the relationship between possible hemostatic changes and clinical manifestation of the systemic lupus erythematosus (SLE) as a function of greater or lesser disease activity according to Systemic Lupus Erythematosus Disease Activity Index-2000 (SLEDAI-2K) criteria. Endothelial injury and hypercoagulability were investigated in patients with SLE by measuring thrombomodulin (TM), D-dimer (DDi) and thrombin generation (TG) potential. A total of 90 participants were distributed into three groups: 1) women with SLE presenting with low disease activity (laSLE) (SLEDAI-2K ≤ 4), 2) women with SLE presenting with moderate to high disease activity (mhaSLE) (SLEDAI-2K > 4), and 3) a control group comprising healthy women. Levels of TM and DDi were higher both in the laSLE and mhaSLE groups compared to controls and in mhaSLE compared to the laSLE group. With respect to TG assay, lagtime and endogen thrombin potential, low concentrations of tissue factor provided the best results for discrimination among groups. Analysis of these data allow us to conclude that TM, DDi and TG are potentially useful markers for discriminating patients with very active from those with lower active disease. Higher SLE activity may cause endothelial injury, resulting in higher TG and consequently a hypercoagulability state underlying the picture of thrombosis common in this inflammatory disease.

Published
2020

13. Red wine consumption mitigates the cognitive impairments in low-density lipoprotein receptor knockout (LDLr−/−) mice

Author

Rui Daniel Prediger, Eduardo Luiz Gasnhar Moreira, Gabriela Cristina de Paula, Daiane Fátima Engel, Cláudia P. Figueiredo, Samantha C. Lopes, Andreza Fabro de Bem, and Jade de Oliveira

Subjects
Male, 0301 basic medicine, medicine.medical_specialty, Hypercholesterolemia, Medicine (miscellaneous), Hippocampus, Wine, Familial hypercholesterolemia, Motor Activity, Cholesterol, Dietary, Mice, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Animals, Cognitive Dysfunction, Effects of sleep deprivation on cognitive performance, Receptor, Liver Diseases, Alcoholic, Mice, Knockout, 030109 nutrition & dietetics, Nutrition and Dietetics, Behavior, Animal, business.industry, General Neuroscience, Brain, food and beverages, Cognition, General Medicine, medicine.disease, Mice, Inbred C57BL, Disease Models, Animal, Endocrinology, Receptors, LDL, LDL receptor, business, 030217 neurology & neurosurgery, Lipoprotein
Abstract

Although the benefits of moderate intake of red wine in decreasing incidence of cardiovascular diseases associated to hypercholesterolemia are well recognized, there are still widespread misconceptions about its effects on the hypercholesterolemia-related cognitive impairments. Herein we investigated the putative benefits of regular red wine consumption on cognitive performance of low-density lipoprotein receptor knockout (LDLr-/-) mice, an animal model of familial hypercholesterolemia, which display cognitive impairments since early ages. The red wine was diluted into the drinking water to a final concentration of 6% ethanol and was available for 60 days for LDLr-/- mice fed a normal or high-cholesterol diet. The results indicated that moderate red wine consumption did not alter locomotor parameters and liver toxicity. Across multiple cognitive tasks evaluating spatial learning/reference memory and recognition/identification memory, hypercholesterolemic mice drinking red wine performed significantly better than water group, regardless of diet. Additionally, immunofluorescence assays indicated a reduction of astrocyte activation and lectin stain in the hippocampus of LDLr-/- mice under consumption of red wine. These findings demonstrate that the moderate consumption of red wine attenuates short- and long-term memory decline associated with hypercholesterolemia in mice and suggest that it could be through a neurovascular action.

Published
2020

14. Impacts of protein supplementation during late gestation of beef cows on maternal skeletal muscle and liver tissues metabolism

Author

P. D. Teixeira, A. S. Trece, Marcio de Souza Duarte, L. R. Santos, Mateus Pies Gionbelli, Thaís C Costa, R. C. Lopes, T.R.S. Gionbelli, and Cláudia Batista Sampaio

Subjects
Male, 040301 veterinary sciences, Biology, SF1-1100, 0403 veterinary science, chemistry.chemical_compound, Animal science, Pregnancy, medicine, Animals, Muscle, Skeletal, tissue mobilization, chemistry.chemical_classification, amino acids, Fetus, Methionine, 0402 animal and dairy science, Fatty acid, Skeletal muscle, 04 agricultural and veterinary sciences, Metabolism, Animal Feed, 040201 dairy & animal science, Animal culture, Diet, Amino acid, fetal programming, gluconeogenesis, medicine.anatomical_structure, Liver, chemistry, Gluconeogenesis, Dietary Supplements, Gestation, Cattle, Female, Animal Science and Zoology, maternal nutrition
Abstract

Since nutritional requirements are increased at the end of gestation to meet the demands of the pregnant uterus, pregnant beef cows are susceptible to mobilization of body reserves (mainly fat and amino acids (AAs)) and to alter the metabolism of nutrients in the liver and muscle to support such demands. The objective of this study was to evaluate the effect of CP supplementation on maternal nutrient metabolism in the late gestation of beef cows grazing a low-quality pasture. Forty-three pregnant Nellore cows gestating male fetuses (average age = 6 years; average weight = 544 kg) at 193 ± 30 (mean ± SD) days (d) of gestation were divided into eight groups (experimental units, with four to five cows each). Treatments were (1) control (CON, n = 4): pasture-based (PB) diet without CP supplementation and (2) supplemented (SUP, n = 4): PB diet daily supplemented with 2 g/kg of BW of a 43.5% CP supplement. Liver and skeletal muscle biopsies were performed at 265 days of gestation and samples were collected for mRNA expression. On day 280 of gestation, blood samples were collected to assess plasma levels of AA. The CON-fed cows tended to have greater (P = 0.057) total circulating AA than SUP-fed cows. The circulating glycogenic AA was greater (P = 0.035) in CON than in SUP cows. CON cows was greater for histidine (P = 0.015), methionine (P = 0.007) and alanine (P = 0.036) than SUP cows. The CON- and SUP-fed showed no differences for gluconeogenesis, fatty acid transport and signaling axis markers in the liver. The mRNA expression of markers for skeletal muscle synthesis, p7056k (P = 0.060) and GSK3B (P = 0.096), tended to be greater in cows from CON than SUP group. No differences were found for mRNA expression of markers for skeletal muscle degradation. We conclude that CP supplementation to CP-restricted late-pregnant beef cows reduces the maternal tissue mobilization and changes the profile of plasma circulating AA and the mRNA expression of markers for the synthesis of skeletal muscle tissue.

Published
2020

15. Slow pathway region as the exit site of parahisian premature ventricular contractions: Why choose safety over the earliest activation?

Author

C Lopes, Leonor Parreira, Rita Marinheiro, Pedro Amador, José Farinha, and Rui Caria

Subjects
Exit site, medicine.medical_specialty, medicine.diagnostic_test, business.industry, Left bundle branch block, Slow pathway, Radiofrequency ablation, medicine.medical_treatment, Treatment outcome, Catheter ablation, medicine.disease, law.invention, law, Physiology (medical), Internal medicine, Heart rate, Cardiology, Medicine, Cardiology and Cardiovascular Medicine, business, Electrocardiography
Published
2019

16. Light-driven oxygen evolution from water oxidation with immobilised TiO2 engineered for high performance

Author

Pedro B. Tavares, Joaquim L. Faria, Lifeng Liu, Zhipeng Yu, Joana C. Lopes, Cláudia G. Silva, and Maria J. Sampaio

Subjects
Anatase, Multidisciplinary, Materials science, Aqueous solution, Science, Oxygen evolution, chemistry.chemical_element, Oxygen, Article, law.invention, Adsorption, Engineering, Chemical engineering, chemistry, law, Specific surface area, Photocatalysis, Medicine, Calcination
Abstract

Calcination treatments in the range of 500–900 °C of TiO2 synthesised by the sol–gel resulted in materials with variable physicochemical (i.e., optical, specific surface area, crystallite size and crystalline phase) and morphological properties. The photocatalytic performance of the prepared materials was evaluated in the oxygen evolution reaction (OER) following UV-LED irradiation of aqueous solutions containing iron ions as sacrificial electron acceptors. The highest activity for water oxidation was obtained with the photocatalyst thermally treated at 700 °C (TiO2-700). Photocatalysts with larger anatase to rutile ratio of the crystalline phases and higher surface density of oxygen vacancies (defects) displayed the best performance in OER. The oxygen defects at the photocatalyst surface have proven to be responsible for the enhanced photoactivity, acting as important active adsorption sites for water oxidation. Seeking technological application, water oxidation was accomplished by immobilising the photocatalyst with the highest OER rate measured under the established batch conditions (TiO2-700). Experiments operating under continuous mode revealed a remarkable efficiency for oxygen production, exceeding 12% of the apparent quantum efficiency (AQE) at 384 nm (UV-LED system) compared to the batch operation mode.

Published
2021

17. 55 Continuous spinal anesthesia for open cholecystectomy: customized anaesthetic management in a challenging patient

Author

M Correia, C Lopes, and D Zuzarte

Subjects
Surgical team, business.industry, Sedation, Tuohy needle, Context (language use), Dysphagia, Sufentanil, Anesthesia, medicine, Intraoperative Period, medicine.symptom, business, Contraindication, medicine.drug
Abstract

Background and Aims Continuous spinal anesthesia (CSA) provides fast onset titratable neuroaxial block. In the context of upper abdominal surgery on patients with acute respiratory disease offers minimization of respiratory complications and ensures adequate anaesthetic conditions. We aim to present a CSA for open cholecystectomy in a patient with multiple neurological deficits and acute pneumonia. Methods 60 years-old woman, 40 kg, 152 cm. Past history of rickets having severe skeletal deformation; hypertension; status post cerebellar tumor resection with multiple sequelae: loss of visual and auditory acuity, dysphagia, dysphonia, respiratory insufficiency and ventriculoperitoneal shunt. Admitted for urgent open cholecystectomy having alongside acute pneumonia with pleural effusion. Laboratory tests and current medication posed no contraindication to spinal anesthesia. Spinal catheter 20G was introduced through 18G tuohy needle at L3-L4 level. On supine position the adequate block level was achieved using bed tilting and sequential doses of hyperbaric bupivacaine (total of 10 mg) and sufentanil (total of 10 mcg). During the 1h procedure there was no need for sedation. The spinal catheter was removed on the operatory room (OR) after a morphine 100 mcg administration. Neither respiratory nor regional anesthesia complications were reported on the postoperative period. Results Although a CSA in this patient was a challenge we considered that the benefits exceeded the risks and surpassed limitations of other techniques. The anaesthetic plan was sustained by careful communication with the patient and strict collaboration of the surgical team. Conclusions CSA allowed a safe and effective management during the intraoperative period and optimized the postoperative recovery.

Published
2021

18. 208 Distal nerve blocks for upper limb surgery: high quality, low volumes

Author

M Chedas, D Zuzarte, and C Lopes

Subjects
medicine.medical_specialty, Right forearm, business.industry, Local anesthetic, medicine.drug_class, Surgery, Upper limb surgery, Plastic surgery, Axillary block, Anesthetic, Medicine, Airway, business, Radial nerve, medicine.drug
Abstract

Background and Aims Through this clinical case we aim to raise awareness of the existence of highly effective peripheral nerve blocks that allow to minimize the volume of local anesthetic, thus reducing the associated complications. Methods A 20 year-old ASA I man was admitted for urgent reconstructive plastic surgery after left hand flexor tendon injury and right forearm extensor digitorium injury. To offer anesthesia of the whole hand, we decided to perform a left axillary block. The right-limb wound was expected to be superficial and thus manageable under subcutaneous anesthetic infiltration. When initiating the intervention on the right wound it was obvious that subcutaneous anesthesia was insufficient as the injury was deeper than predicted. Faced with the fact that we had almost reached the toxic dose and that we were avoiding approaching the airway, we decided to perform an ultrasound guided distal-arm radial block, as the involved structures depended on radial sensory innervation. Results A total amount of 3 ml of local anesthetic was used. The patient experienced complete anesthesia of the radial nerve territory, and surgery was successfully achieved. No complications were reported Conclusions This approach reminds us that that, similar to the distal-arm radial block, there are numerous distal blocks that can be performed. While allowing a volume sparing technique, these blocks are both easy and safe to perform, offering high quality anesthesia and analgesia.

Published
2021

19. Neurotranscriptomic changes associated with chick-directed parental care in adult non-reproductive Japanese quail

Author

Patricia C. Lopes and Robert de Bruijn

Subjects
Male, 0301 basic medicine, Offspring, Science, media_common.quotation_subject, Hypothalamus, Physiology, Coturnix, Biology, Article, Neglect, 03 medical and health sciences, 0302 clinical medicine, biology.animal, medicine, Animals, Maternal Behavior, Social Behavior, Neurotensin, Urocortins, media_common, Urocortin, Multidisciplinary, Behavior, Animal, Aggression, Gene Expression Profiling, Reproduction, Brain, Chromosome Mapping, Functional genomics, Genomics, Quail, Stria terminalis, 030104 developmental biology, Social behaviour, Medicine, Female, medicine.symptom, Transcriptome, Paternal care, 030217 neurology & neurosurgery
Abstract

For many species, parental care critically affects offspring survival. But what drives animals to display parental behaviours towards young? In mammals, pregnancy-induced physiological transformations seem key in preparing the neural circuits that lead towards attraction (and reduced-aggression) to young. Beyond mammalian maternal behaviour, knowledge of the neural mechanisms that underlie young-directed parental care is severely lacking. We took advantage of a domesticated bird species, the Japanese quail, for which parental behaviour towards chicks can be induced in virgin non-reproductive adults through a sensitization procedure, a process that is not effective in all animals. We used the variation in parental responses to study neural transcriptomic changes associated with the sensitization procedure itself and with the outcome of the procedure (i.e., presence of parental behaviours). We found differences in gene expression in the hypothalamus and bed nucleus of the stria terminalis, but not the nucleus taeniae. Two genes identified are of particular interest. One is neurotensin, previously only demonstrated to be causally associated with maternal care in mammals. The other one is urocortin 3, causally demonstrated to affect young-directed neglect and aggression in mammals. Because our studies were conducted in animals that were reproductively quiescent, our results reflect core neural changes that may be associated with avian young-directed care independently of extensive hormonal stimulation. Our work opens new avenues of research into understanding the neural basis of parental care in non-placental species.

Published
2021

20. Regional Delivery of Anti-PD-1 Agent for Colorectal Liver Metastases Improves Therapeutic Index and Anti-Tumor Activity

Author

Steven C. Katz, Louis F. Chai, Kyle O’Connell, John C. Hardaway, Mikayla C. Lopes, Kara R. Heatherton, Benjamin A. Rabinowitz, David Benjamin Jaroch, Prajna Guha, Chandra C. Ghosh, and Bryan Cox

Subjects
0301 basic medicine, PD-L1, medicine.medical_specialty, Colorectal cancer, Immunology, Gastroenterology, Article, 03 medical and health sciences, 0302 clinical medicine, Therapeutic index, In vivo, Internal medicine, Drug Discovery, PD-1, medicine, Pharmacology (medical), Adverse effect, Pharmacology, Antitumor activity, biology, business.industry, regional delivery, medicine.disease, myeloid-derived suppressor cells, bioluminescence, systemic delivery, liver metastasis, 030104 developmental biology, Infectious Diseases, Apoptosis, 030220 oncology & carcinogenesis, Myeloid-derived Suppressor Cell, biology.protein, Medicine, business
Abstract

Metastatic liver tumors have presented challenges with the use of checkpoint inhibitors (CPIs), with only limited success. We hypothesize that regional delivery (RD) of CPIs can improve activity in the liver and minimize systemic exposure, thereby reducing immune-related adverse events (irAE). Using a murine model of colorectal cancer liver metastases (LM), we confirmed high levels of PD-L1 expression on the tumor cells and liver myeloid-derived suppressor cells (L-MDSC). In vivo, we detected improved LM response at 3 mg/kg on PTD7 via portal vein (PV) regional delivery as compared to 3 mg/kg via tail vein (TV) systemic delivery (p = 0.04). The minimal effective dose at PTD7 was 5 mg/kg (p = 0.01) via TV and 0.3 mg/kg (p = 0.02) via PV. We detected 6.7-fold lower circulating CPI antibody levels in the serum using the 0.3 mg/kg PV treatment compared to the 5 mg/kg TV cohort (p &lt, 0.001) without increased liver toxicity. Additionally, 3 mg/kg PV treatment resulted in increased tumor cell apoptotic signaling compared to 5 mg/kg TV (p &lt, 0.05). Therefore, RD of an anti-PD-1 CPI therapy for CRCLM may improve the therapeutic index by reducing the total dose required and limiting the systemic exposure. These advantages could expand CPI indications for liver tumors.

Published
2021

21. Controlled creation and annihilation of isolated robust emergent magnetic monopole like charged vertices in square artificial spin ice

Author

Ranveer Singh, Yoshikata Nakajima, Neha Chauhan, Neeti Keswani, Ricardo J. C. Lopes, Pintu Das, D. Sakthi Kumar, Afranio R. Pereira, and Tapobrata Som

Subjects
Physics, Nanoscale materials, Multidisciplinary, Field (physics), Condensed matter physics, Science, Magnetic monopole, Charge (physics), 02 engineering and technology, Electron, 021001 nanoscience & nanotechnology, 01 natural sciences, Electric charge, Article, Magnetic field, Spin ice, Magnetic properties and materials, 0103 physical sciences, Medicine, 010306 general physics, 0210 nano-technology, Excitation
Abstract

Magnetic analogue of an isolated free electric charge, i.e., a magnet with a single north or south pole, is a long sought-after particle which remains elusive so far. In magnetically frustrated pyrochlore solids, a classical analogue of monopole was observed as a result of excitation of spin ice vertices. Direct visualization of such excitations were proposed and later confirmed in analogous artificial spin ice (ASI) systems of square as well as Kagome geometries. However, such magnetically charged vertices are randomly created as they are thermally driven and are always associated with corresponding equal and opposite emergent charges, often termed as monopole–antimonopole pairs, connected by observable strings. Here, we demonstrate a controlled stabilisation of a robust isolated emergent monopole-like magnetically charged vertices in individual square ASI systems by application of an external magnetic field. The excitation conserves the magnetic charge without the involvement of a corresponding excitation of opposite charge. Well supported by Monte Carlo simulations our experimental results enable, in absence of a true elemental magnetic monopole, creation of electron vortices and studying electrodynamics in presence of a monopole-like field in a solid state environment.

Published
2021

22. Ventricular Arrhythmias in Patients with Obstructive Sleep Apnea

Author

Leonor Parreira, Andreia Fernandes, Pedro Amador, Dinis Mesquita, C Lopes, Marta Fonseca, Tatiana Duarte, Rui Caria, José Farinha, and Rita Marinheiro

Subjects
medicine.medical_specialty, medicine.medical_treatment, Comorbidity, 030204 cardiovascular system & hematology, Ventricular tachycardia, premature ventricular contractions, Article, sudden cardiac death, Sudden cardiac death, 03 medical and health sciences, 0302 clinical medicine, stomatognathic system, Internal medicine, Medicine, Humans, In patient, Continuous positive airway pressure, cardiovascular diseases, Sleep Apnea, Obstructive, Continuous Positive Airway Pressure, business.industry, Incidence, ventricular arrhythmias, Arrhythmias, Cardiac, General Medicine, medicine.disease, Obstructive sleep apnea, nervous system diseases, respiratory tract diseases, Cardiovascular Diseases, Cardiology, cardiovascular system, High incidence, ventricular tachycardia, Cardiology and Cardiovascular Medicine, business, 030217 neurology & neurosurgery
Abstract

Obstructive Sleep Apnea (OSA) is a prevalent condition thought to increase in the future. Being mostly undiagnosed, the most serious complications are cardiovascular diseases, among which are arrhythmias. Controversy remains as to whether OSA is a primary etiologic factor for ventricular arrhythmias, because of the high incidence of cardiovascular comorbidities in OSA patients. However, there is mostly a strong evidence of a relation between OSA and ventricular arrhythmias. A few mechanisms have been proposed to be responsible for this association and some electrocardiographic changes have also been demonstrated to be more frequent in OSA patients. Treatment of OSA with Continuous Positive Airway Pressure (CPAP) has the potential to reduce arrhythmias and confer a mortality benefit.

Published
2019

23. Echocardiographic but not clinical response to CRT is an independent predictor of a better survival free from arrhythmic events

Author

A Goncalves, Rui Caria, Pedro Amador, Marta Fonseca, Rita Marinheiro, Ana Cristina Esteves, D Valbom Mesquita, C Lopes, D Chambel, José Farinha, and Leonor Parreira

Subjects
medicine.medical_specialty, Ejection fraction, business.industry, medicine.medical_treatment, Diastole, Cardiac resynchronization therapy, Independent predictor, medicine.disease, New York Heart Association Classification, Sustained ventricular tachycardia, Physiology (medical), Internal medicine, Primary prevention, Heart failure, medicine, Cardiology, cardiovascular diseases, Cardiology and Cardiovascular Medicine, business
Abstract

Funding Acknowledgements Type of funding sources: None. Background Cardiac resynchronization therapy (CRT) is of proven benefit in heart failure patients, improving mortality and reducing hospital admissions. There is however uncertainty if the arrhythmic risk is reduced in responders. Purpose We aimed to assess if patients with a CRT implanted for primary prevention had less arrhythmic episodes if they responded to this therapy and if echocardiographic and clinical responses to CRT differ regarding the occurrence of ventricular arrhythmias. Methods We prospectively enrolled patients that underwent CRT implant for primary prevention according to ESC guidelines. Patients were classified as responders if they fulfilled one of four criteria (echocardiographic or clinical) at six months after implant: a 5% absolute improvement in LV ejection fraction (LVEF), a 15% improvement in LVEF, a 15% decrease in LV end-diastolic volume or a decrease in NYHA class. During follow-up with device interrogation, arrhythmic ventricular events (AVE) were classified as appropriate ICD therapies or sustained ventricular tachycardia either occurring in ICD monitoring zones or undetected by the device due to a slower rare, but clinically documented. All patients were further classified according to type of pacing, biventricular or LV only. Demographic characteristics of patients were also assessed. Results We enrolled 73 patients, 58 (79.5%) male, median age of 72 (65-77) years. Median LVEF was 28 (22-35) % (p = 0.95 between groups), ischemic etiology in 36 (46.6%, p = 1.00). The two groups with and without AVE did not differ significantly regarding clinical, echocardiographic, and electrocardiographic characteristics (table). CRT echocardiographic response criteria were met by 50 (68.5%) of patients and clinical criteria by 53 (72.6%) patients. AVE occurred in 15 (20.5%) patients. In univariate regression analysis, echocardiographic response was associated with reduced AVE (OR 0,14; p = 0,005). Clinical response to CRT was not associated with AVE (p = 0.07). LV only pacing was associated with a higher probability of AVE (OR 5.1; p = 0.038). In Cox regression multivariate analysis, response to CRT was the only independent predictor of better survival free from AVE (HR 0.28;CI 95%, p = 0.044) and LV only pacing was not associated with more episodes of ventricular arrhythmias (p = 0.17). Conclusions: Echocardiographic, but not clinical response to CRT therapy, is the only independent predictor of a higher survival free from arrhythmic events. In spite controversies regarding the arrhythmogenic role of LV pacing, this was not associated with higher ventricular arrhythmic events. Abstract Figure.

Published
2021

24. MO365URINARY BIOMARKERS AND POOR OUTCOMES IN PATIENTS WITH COVID-19 ADMITTED TO A REFERENCE HOSPITAL IN NORTHEAST BRAZIL

Author

G. B. Da Silva Junior, E. De Francesco Daher, M. M. P. Dantas, Sandra Mara Brasileiro Mota, N. C. Lopes, Gdayllon Cavalcante Meneses, Geraldo Bezerra, A. M. C. Martins, L. A. L. Lima, Polianna Lemos Moura Moreira Albuquerque, and I. C. J. Bandeira

Subjects
Transplantation, Creatinine, medicine.medical_specialty, business.industry, Urinary system, AKI. Clinical. Epidemiology and outcome, Urine, medicine.disease, Log-rank test, chemistry.chemical_compound, Mini Orals (sorted by session), chemistry, Nephrology, Internal medicine, Medicine, Risk factor, business, Prospective cohort study, AcademicSubjects/MED00340, Survival analysis, Kidney disease
Abstract

Background and Aims Kidney biomarkers improve early and specific AKI detection and also poor outcomes in different clinical contexts. Kidney disease is an important risk factor for poor outcomes in COVID-19. The aim of this study was to evaluate association of early levels of kidney biomarkers with poor outcomes in hospitalized patients with COVID-19. Method This is a prospective study conducted at the Instituto Dr. Jose Frota Hospital, an important public reference hospital for COVID-19 in northeast Brazil. Medical records with clinical, epidemiologic, laboratory and outcomes were collected. The urinary NGAL, KIM-1, MCP-1 and nephrin were the kidney biomarkers quantified at hospital admission. ELISA assays were used for analysis and biomarkers urinary concentrations were adjusted for urinary creatinine. Data were expressed as mean± standard deviation or median. Results A total of 69 patients collected urine and were included in this study. Male gender was predominant (65%) and mean age was 56±19 years. Regarding outcomes, the group had 62% of death, 92% of ICU admission and 65% of invasive respiratory support in ICU. Urinary NGAL and MCP-1 were significantly elevated in patients that needed invasive respiratory support in comparison with non-invasive support: uNGAL (median=104 [IQR=74-153] vs 71 [31-79] ng/mg-Cr, p=0.013), and uMCP-1 (3055 [1127-5008] vs 1315 [574-2127] pg/mg-Cr, p=0.027). Urinary nephrin and KIM-1 was also elevated, however with no statistical significance. Moreover, all urinary biomarkers were higher in ICU admission group and death group, but with p>0.05. In ROC curve analysis for prediction of invasive respiratory support, uNGAL had AUC=0.696 (0.565-0.827),p=0.012 and cut-off=78 ng/mg-Cr; uMCP-1 had AUC=0.676 (0.539-0.813), p=0.023 and cut-off=1354 pg/mg-Cr. In survival analysis, patients with uNGAL >78 ng/mg-Cr had worse prognosis and died more quickly (19 vs 48 days, log-rank test; p=0.01). In patients with uMCP-1 >1354 pg/mg-Cr, they also died more quickly, but with no significance (25 vs 48 days, log-rank test; p=0.08). Conclusion Urinary biomarkers NGAL and MCP-1 quantified at hospital admission were associated with poor outcomes, mostly with needed of invasive respiratory support in ICU. Prediction cut-off values for invasive respiratory support was useful to determine the survival prognosis.

Published
2021

25. The Transition From Undernutrition to Overnutrition Under Adverse Environments and Poverty: The Risk for Chronic Diseases

Author

Paola Caroline L. Leocádio, Synara C. Lopes, Ronaldo P. Dias, Jacqueline I. Alvarez-Leite, Richard L. Guerrant, João O. Malva, and Reinaldo B. Oriá

Subjects
intestinal microbiota, Opinion, obesity, Nutrition and Dietetics, Coronavirus disease 2019 (COVID-19), Poverty, Nutrition. Foods and food supply, poverty, business.industry, Endocrinology, Diabetes and Metabolism, COVID-19, malnutrition, dysbiosis, medicine.disease, Obesity, Malnutrition, Overnutrition, Environmental health, medicine, TX341-641, diet, business, Dysbiosis, Nutrition, Food Science
Published
2021

27. Exercise Attenuates Sickness Behavior And Protects Against Dopaminergic Impairment Induced By Neuroinflammation

Author

Samantha C. Lopes, Rui Daniel Prediger, Staats A, Martins RdP, Ana Elisa Speck, Alves ACdB, Alexandra Latini, Scheffer DdL, Aderbal S. Aguiar, and Hiago Murilo Melo

Subjects
medicine.medical_specialty, business.industry, Dopaminergic, Anhedonia, Physical exercise, Anorexia, Endocrinology, Neurochemical, Dopamine, Internal medicine, Medicine, medicine.symptom, business, Neuroinflammation, Sickness behavior, medicine.drug
Abstract

Neuroinflammation affects dopamine metabolism and produces a set of symptoms known as sickness behavior, including fever, anhedonia, anorexia, weight loss, decreased sociability and mobility, and cognitive impairment. Motor and cognitive impairments related to sickness behavior are associated with dopamine (DA) metabolism imbalance in the prefrontal cortex. Lipopolysaccharide (LPS) administration induces neuroinflammation and causes sickness behavior in mice, while physical exercise has anti-inflammatory properties and may attenuate sickness behavior and DA impairment. We investigated the effect of exercise on DA levels and sickness behavior induced by LPS in mice. Adult Swiss male mice (8–10 weeks, 47.1 ± 0.7 g, n=495) performed six weeks of voluntary exercise in free-running wheels (RW group) or had the blocked wheel in their cages (sedentary, SED group). After six weeks of exercise, both groups received an intraperitoneal injection (i.p.) of either saline (SAL) or LPS (0.33 mg/kg, i.p.). All animals were submitted to behavioral tests for sickness behavior assessment (fatigue, locomotion, anhedonia, and social interaction). Neuroinflammation markers and DA metabolism were assessed in the prefrontal cortex. LPS administration provoked anorexia, body weight loss, impaired motor function, social withdrawal, and anhedonia. This sickness behavior was accompanied by reduced cortical DA metabolism and its metabolite, 3,4-dihydroxyphenylacetic acid (DOPAC). Neuroinflammation was confirmed through increased levels of the proinflammatory cytokines IL-1β and IL-6. Inflammation was also confirmed in the blood by an increased content of IL-1β. Physical exercise intervention prevented animals from neurochemical, biochemical, and behavioral alterations. These findings provide new evidence of physical exercise’s potential as an environmental approach to treating neuroinflammatory conditions.

Published
2021

28. Adhering to a Mediterranean diet in a Mediterranean country: an excess cost for families?

Author

C Lopes, Sara Simões Pereira Rodrigues, Ricardo Mendes Alves, Julian Perelman, Faculdade de Ciências da Nutrição e Alimentação, and Faculdade de Medicina

Subjects
Mediterranean climate, education.field_of_study, Nutrition and Dietetics, Mediterranean diet, business.industry, Population, Food prices, Health sciences, Medical and Health sciences, Physical activity, Ciências médicas e da saúde, Medicine (miscellaneous), Food group, Evaluated data, Income level, Medical and Health sciences, Medicine, Ciências da Saúde, Ciências médicas e da saúde, business, education, Demography
Abstract

Background: Adherence to the Mediterranean diet has been decreasing in southern Europe, which could be linked to several cultural or educational factors. Our aim is to evaluate the extent to which economic aspects may also play a role, exploring the relationship between food prices in Portugal and adherence to the Mediterranean diet. Methods: We evaluated data from the Portuguese National Food, Nutrition, and Physical Activity Survey (IAN-AF 2015-2016) (n=3,591). Diet expenditures were estimated by attributing a retail price to each food group and the diet was transposed into the Mediterranean Diet Score used in the literature. Prices were gathered from five supermarket chains (65% of the Portuguese market share). Linear regression models were used to assess the association between different adherence levels to the MD levels and dietary costs. Results: Greater adherence to the MD was associated with a 21.2% (p< 0.05) rise in total dietary cost, which accounts for more 0.59€ in mean daily costs when compared with low adherence. High adherence individuals (vs. low adherence) had higher absolute mean daily costs with fish (0.62€/+285.8%; p< 0.05), fruits (0.26€/+115.8%; p< 0.05), and vegetables (0.10€/+100.9%; p< 0.05). The analysis stratified by education and income level showed significantly higher mean daily diet cost only amongst higher income groups. Conclusions: Our findings suggest that greater adherence to the MD was positively and significantly associated with higher total dietary cost. Policies to improve populations diet should take into consideration the cost of healthy foods, especially for large low- and middle-income families.

Published
2021

29. Musculoskeletal Complaints and Their Associations with Health and Work-Related Factors: A Cross-Sectional Study in a Beverage Company

Author

Vinicius Restani Castro, Leonardo D. S. Mauad, Marisa de Cássia Registro Fonseca, Lisandra Vanessa Martins, and E. R. C. Lopes

Subjects
Musculoskeletal pain, Cross-sectional study, business.industry, Medicine, Cognition, business, Work related, Psychosocial, Clinical psychology
Abstract

Introduction: Work-related Musculoskeletal Disorders include the musculoskeletal clinical conditions related to work. This study aimed to describe the prevalence of musculoskeletal pain and discomfort and to analyze the association of individual, physical/biomechanical, psychosocial, cognitive and organizational risk factors in a beverage company.

Published
2021

30. Brain transcriptomic changes in Japanese quail reveal roles for neurotensin and urocortin 3 in avian parental care

Author

Patricia C. Lopes and Robert de Bruijn

Subjects
Urocortin, Genetics, Offspring, Aggression, media_common.quotation_subject, Biology, Affect (psychology), Quail, Neglect, medicine.anatomical_structure, biology.animal, medicine, medicine.symptom, Paternal care, Sensitization, media_common
Abstract

For many species, parental care critically affects offspring survival. But what drives animals to display parental behaviours towards young? In mammals, pregnancy-induced physiological transformations seem key in preparing the neural circuits that lead towards attraction (and reduced-aggression) to young. Beyond mammalian maternal behaviour, knowledge of the neural mechanisms that underlie parental care is severely lacking. We took advantage of a domesticated bird species, the Japanese quail, for which parental behaviour towards chicks can be induced through a sensitization procedure, a process that is not effective in all animals. We used the variation in parental responses to study neural transcriptomic changes associated with the sensitization procedure itself and with the outcome of the procedure (i.e., presence of parental behaviours). Out of the brain regions studied, we found that most differences in gene expression were located in the hypothalamus. Two genes identified are of particular interest, as no role in avian parental care was known for those genes. One is neurotensin, previously only demonstrated to be causally associated with maternal care in mammals. The other one is urocortin 3, causally demonstrated to affect young-directed neglect and aggression in mammals. Our work opens new avenues of research into understanding the neural basis of parental care in non-placental species.

Published
2020

31. Antioxidants Improve Oxaliplatin-Induced Peripheral Neuropathy in Tumor-Bearing Mice Model: Role of Spinal Cord Oxidative Stress and Inflammation

Author

Marina Delgobo, Samantha C. Lopes, Raquel Nascimento das Neves, Alfeu Zanotto-Filho, Rosângela Mayer Gonçalves, José Cláudio Fonseca Moreira, Juliano Ferreira, Fernando Spiller, Sérgio José Macedo-Júnior, Débora Denardin Lückemeyer, Vitória Wibbelt dos Santos, Jonathan Paulo Agnes, Daniel Pens Gelain, Rui Daniel Prediger, Carolina Saibro Girardi, and Marcella de Amorim Ferreira

Subjects
Male, medicine.medical_treatment, Inflammation, Antineoplastic Agents, Pharmacology, medicine.disease_cause, Antioxidants, 03 medical and health sciences, Mice, 0302 clinical medicine, 030202 anesthesiology, Neoplasms, medicine, Animals, Neuroinflammation, chemistry.chemical_classification, Mice, Knockout, Reactive oxygen species, business.industry, Vitamin E, Peripheral Nervous System Diseases, medicine.disease, Mice, Inbred C57BL, Oxaliplatin, Toll-Like Receptor 4, Disease Models, Animal, Oxidative Stress, Anesthesiology and Pain Medicine, Peripheral neuropathy, Allodynia, Neurology, chemistry, Spinal Cord, Hyperalgesia, Neuroinflammatory Diseases, TLR4, Neurology (clinical), medicine.symptom, business, 030217 neurology & neurosurgery, Oxidative stress
Abstract

Chemotherapy-Induced Peripheral Neuropathy (CIPN) is a common, difficult-to-treat, and dose-limiting side effect associated with Oxaliplatin (OXA) treatment. In this study, we evaluated the effect of three antioxidants - namely N-acetylcysteine, α-lipoic acid and vitamin E – upon nociceptive parameters and antitumor efficacy of OXA in a tumor-bearing Swiss mice model. Oral treatment with antioxidants inhibited both mechanical and cold allodynia when concomitantly administrated with OXA (preventive protocol), as well as in animals with previously established CIPN (therapeutic protocol). OXA increased Reactive Oxygen Species (ROS) production and lipoperoxidation, and augmented the content of pro-inflammatory cytokines (IL-1β and TNF-α) and expression of the astrocytic marker Gfap mRNA in the spinal cord. Antioxidants decreased ROS production and lipoperoxidation, and abolished neuroinflammation in OXA-treated animals. Toll-like receptor 4 (Tlr4) and inflammasome enzyme caspase-1/11 knockout mice treated with OXA showed reduced levels of pro-inflammatory cytokines (but not oxidative stress) in the spinal cord, which were associated with resistance to OXA-induced mechanical allodynia. Lastly, antioxidants affected neither antitumor activity nor hematological toxicity of OXA in vivo. The herein presented results are provocative for further evaluation of antioxidants in clinical management of chemotherapy-induced peripheral neuropathy. Perspective This study reports preventive and therapeutic efficacy of orally administrated antioxidants (N-acetylcysteine, α-lipoic-acid and Vitamin-E) in alleviating oxaliplatin-induced peripheral neuropathy in tumor-bearing mice. Antioxidants’ anti-nociceptive effects are associated with inhibition of ROS-dependent neuroinflammation, and occur at no detriment of OXA antitumor activity, therefore indicating a translational potential of these compounds.

Published
2020

32. Frequent premature ventricular contractions. Association of burden and complexity with prognosis according to the presence of structural heart disease

Author

Rui Caria, Artur Lopes, Leonor Parreira, Dinis Mesquita, Marta Fonseca, D Chambel, José Farinha, Pedro Amador, Rita Marinheiro, C Lopes, and Jose Venancio

Subjects
Male, medicine.medical_specialty, Heart Diseases, Heart disease, 030204 cardiovascular system & hematology, premature ventricular contractions, Ventricular tachycardia, Sudden death, Ventricular contraction, 03 medical and health sciences, 0302 clinical medicine, Physiology (medical), Internal medicine, Humans, Medicine, 030212 general & internal medicine, Aged, Retrospective Studies, business.industry, Incidence (epidemiology), Hazard ratio, Original Articles, General Medicine, Middle Aged, Prognosis, medicine.disease, structural heart disease, Ventricular Premature Complexes, PVC complexity, Quartile, Heart failure, Electrocardiography, Ambulatory, idiopathic, Original Article, PVC burden, Female, Cardiology and Cardiovascular Medicine, business
Abstract

Introduction Premature ventricular contractions (PVC) have been associated with mortality and heart failure (HF) regardless the presence of structural heart disease (SHD). The aim of this study was assessing the impact of burden and complexity of PVCs on prognosis, according to presence of SHD. Methods 312 patients were retrospectively evaluated out of 1967 consecutive patients referred for 24‐hr Holter at a single hospital, with a PVC count >1% of total beats. Two groups with and without SHD. PVC burden (PVC%), presence of complex forms, incidence of all‐cause death, combined outcomes of all‐cause death and cardiovascular hospitalizations, HF death and HF hospitalizations and, sudden death (SD) or hospitalizations due to ventricular arrhythmias (VA)were assessed. Results Premature ventricular contraction burden was 2.7 (IQR: 1.6–6.7). SHD patients had more polymorphic PVCs, 77% versus 65%, p = .022, triplets and episodes of non‐sustained ventricular tachycardia (NSVT): 44% versus 27%, p = .002; 30% versus 12%, p

Published
2020

33. We Are Not Alone in Trying to Be Alone

Author

Patricia C. Lopes

Subjects
disease transmission, medicine.medical_specialty, Ecology, Coronavirus disease 2019 (COVID-19), parasite avoidance, lcsh:Evolution, COVID-19, disgust avoidance, Biology, sickness behavior, social behavior, lcsh:QH540-549.5, lcsh:QH359-425, medicine, lcsh:Ecology, Intensive care medicine, Disease transmission, Ecology, Evolution, Behavior and Systematics, Sickness behavior
Published
2020

34. P518Inappropriate shocks in atrial fibrillation patients: are they really deleterious?

Author

C Lopes, Leonor Parreira, Rui Caria, Joaquim J. Ferreira, Pedro Amador, Dinis Mesquita, Rita Marinheiro, Marta Fonseca, Ana Cristina Esteves, and José Farinha

Subjects
medicine.medical_specialty, business.industry, Physiology (medical), Internal medicine, medicine, Cardiology, Atrial fibrillation, Cardiology and Cardiovascular Medicine, medicine.disease, business
Abstract

Introduction Data suggest inappropriate defibrillator shocks are associated with a higher risk of all-cause mortality, particularly those delivered for atrial fibrillation (AF). However, the impact of inappropriate shocks has not been studied specifically in a population with AF. Aims to determine if AF-triggered inappropriate shocks are associated with long- term mortality in patients with AF and defibrillators implanted for primary prevention. Methods Retrospective single-center study. We analyzed all patients with defibrillators implanted for primary prevention in whom AF was diagnosed until the end of 2017. The cause of inappropriate shocks was evaluated by analysis of the stored intracardiac electrogram. Basal characteristics, cardiovascular risk factors, left ventricle ejection fraction, heart failure etiology (ischemic and non-ischemic), kidney function (creatinine) and medication were evaluated. Death was assessed during the follow-up. Results We studied 177 patients [median age 66 years (IQR 59-71); 82% male], with defibrillators and AF. AF was diagnosed before defibrillator implantation in 131 patients (74%) and after the implantation in the remaining 46 (26%). Inappropriate shocks occurred in 31 patients and 24 (14%) were caused by AF with rapid ventricular response: 13 patients with previously diagnosed AF and 11 with new-onset AF. During a median follow-up of 65 (IQR: 36-104) months, 74 patients died. Multivariate Cox-regression analysis demonstrated inappropriate shocks caused by AF were not independently related with death (adjusted HR 0.53; CI 0.23-1.23, p = 0.14). Kaplan-Meier survival curve demonstrated patients with AF-triggered inappropriate shocks had a better survival comparing to those with AF but without inappropriate shocks (logrank, p = 0.03) (figure). Conclusions In this group of AF patients, inappropriate shocks caused by AF did not increase the risk of death. Instead, these patients had a better survival comparing to those with AF but no shocks, probably due to a re-evaluation of the patient´s status and subsequent closer medical monitoring, strictly control of symptoms and optimization of drug treatment. These results demonstrate that inappropriate shocks are probably not deleterious per si through a direct mechanism. Abstract Figure. Kaplan-Meier survival curve

Published
2020

35. P1393Prolonged atrial electrical conduction as a predictor of atrial fibrillation after atrioventricular nodal reentrant tachycardia ablation

Author

C Lopes, Dinis Mesquita, Marta Fonseca, B Santos, Leonor Parreira, Rita Marinheiro, Pedro Amador, José Farinha, J. Venancio, C Duarte, Joaquim J. Ferreira, Ana Cristina Esteves, and Rui Caria

Subjects
Tachycardia, medicine.medical_specialty, Atrium (architecture), business.industry, medicine.medical_treatment, Atrial fibrillation, Cardiac Ablation, Ablation, medicine.disease, Bundle of His, medicine.anatomical_structure, Physiology (medical), Internal medicine, Cardiology, Medicine, medicine.symptom, Cardiology and Cardiovascular Medicine, business, NODAL, Coronary sinus
Abstract

BACKGROUND Patients (pts) with atrioventricular nodal reentrant tachycardia (AVNRT) have a higher incidence of atrial fibrillation (AF) during follow-up. Conventional risk factors can play a role in AF development, however atrial electrical conduction properties may be implicated in AF pathogenesis. AIMS to evaluate atrial conduction times and assess its effect on AF development during follow-up. METHODS We studied AVNRT pts who performed EPS and catheter ablation of the slow pathway between 2013 and 2016 in a single center. Pts with AF or valvular disease were excluded. We evaluated duration of symptoms due to AVNRT, conventional risk factors for AF (age, gender, obesity, hypertension, diabetes and structural heart disease (SHD)), left atrium (LA) enlargement and electrophysiologic study (EPS) time intervals related with atrial electrical conduction properties. We measured the time interval between: (1) the beginning of the P wave on the ECG to the A deflection in His-bundle electrogram (P-AHis); (2) the beginning of the P wave to the mid-distal coronary sinus (CS) atrial electrogram (P-CS) and (3) the beginning of the P wave to the H deflection in His-bundle electrogram (P-HHis). RESULTS Fifty-two pts were evaluated during a median follow-up of 63 months (IQR 51-69): 22% male, median age 55 years (IQR 42-67). AF occurred in 9 patients (17%) (39 cases per 1000 person-years). Patients with AF were older (67 vs 53 years, p= 0.005) and had more frequently LA enlargement (33% vs 7%, p= 0.024) but they did not differ in hypertension, obesity, diabetes, SHD and duration of symptoms. EPS measured intervals P-AHis and P-HHis interval were not different between the groups (26.0 vs 22.8 ms, p = 0.89 and 151 vs 106 ms, p= 0.56, respectively) but P-CS were prolonged in patients with AF (70 vs 55 ms, p = 0.02) (figure 1). Univariate logistic analysis for AF is presented in table 1. There was no interaction between P-CS and LA enlargement (p = 0.87). In multiavariate analysis, only P-CS was independently associated with AF (table). CONCLUSIONS In this group of patients with AVNRT, P-CS, but not other atrial conduction intervals, was independently associated with AF development. The possible role of LA electrical conduction impairment in AVNRT pts for AF development needs further studies. Univariate and multivariate analysis Univariate analysis Multivariate analysis OR 95% CI p-value OR 95% CI p-value Age (years) 1.10 1.02-1.19 0.016 1.10 1.00-1.21 0.051 LA enlargement 7.00 1.10-44.71 0.040 3.42 0.41-28.03 0.255 P-CS 1.07 1.021.14 0.013 1.06 1.01-1.12 0.044 OR Odds ratio. CI: confidence interval Abstract Figure. Box-plot for the studied intervals

Published
2020

36. Multiple-level cervical spine trauma in children: Case report and literature review

Author

Wallan R. Mendes, A.J.F. da Silva, and Fabrício A. C. Lopes

Subjects
musculoskeletal diseases, medicine.medical_specialty, medicine.medical_treatment, Arthrodesis, lcsh:Surgery, Case Report, Critical Care and Intensive Care Medicine, Trauma, 03 medical and health sciences, 0302 clinical medicine, Burst fracture, medicine, Orthopedics and Sports Medicine, Corpectomy, Children, 030222 orthopedics, Neck pain, Spinal cord, medicine.diagnostic_test, business.industry, 030208 emergency & critical care medicine, Magnetic resonance imaging, lcsh:RD1-811, medicine.disease, musculoskeletal system, Surgery, medicine.anatomical_structure, Fracture, Emergency Medicine, Ligament, Cervical collar, medicine.symptom, business
Abstract

Spinal trauma is rare in children, but when it occurs, trauma of the cervical spine corresponds to 60%–80% of all cases. The most common causes of pediatric cervical spine injuries are automobile accidents, sports activities, and leisure-related accidents. Herein we report a surgically-treated case of cervical spine trauma with fractures of multiple vertebrae. A 12-year-old female victim of a high fall (from a tree) was admitted to the emergency room with neck pain and weakness in all the limbs. On examination, she was conscious, breathing spontaneously, with grade-4 tetraparesis, and preserved sphincter control. Cervical spine computed tomography (CT) revealed a burst fracture of the C4 body with retropulsion into the spinal cord and fractures of the C5 body and posterior elements of C2, C3, and C4. Cervical spine magnetic resonance imaging (MRI) revealed a hypersignal of the spinal cord from C3 to C6 in T2, indicating contusion. Because no signs of posterior spine instability (ligament lesions) were noted on MRI, we decided to perform a C3–C5 anterior arthrodesis with C4 corpectomy and autologous (iliac) graft placement. The patient had a good postoperative evolution. Furthermore, the patient had no motor deficit, but due to the other fractures in the spine, we chose to keep the cervical collar for 3 months and followed-up on an outpatient basis. Although spinal trauma is less frequent in children than in adults, children can have severe cervical spine injuries (multiple fractures with spinal contusion), and then surgery plays a key role in stabilizing the spine and decompressing the spinal cord to avoid sequelae.

Published
2020

37. Baseline corticosterone is associated with parental care in virgin Japanese quail (Coturnix japonica)

Author

Faith Holloway, Edena Khoshaba, Patricia C. Lopes, Robert de Bruijn, and Jessica Wright-Lichter

Subjects
Male, Hypothalamo-Hypophyseal System, animal structures, Pituitary Function Tests, Physiology, Coturnix, Dexamethasone, Nesting Behavior, 03 medical and health sciences, Behavioral Neuroscience, chemistry.chemical_compound, Random Allocation, 0302 clinical medicine, Endocrinology, Corticosterone, biology.animal, medicine, Animals, Sexual Maturation, Sensitization, Morning, biology, Reproductive success, Behavior, Animal, Endocrine and Autonomic Systems, business.industry, Coturnix japonica, Reproduction, biology.organism_classification, Quail, 030227 psychiatry, medicine.anatomical_structure, chemistry, Animals, Newborn, Female, business, Paternal care, 030217 neurology & neurosurgery, medicine.drug
Abstract

Glucocorticoids (GCs) are thought to impact reproductive success, and ultimately fitness. In this study we focus specifically on the relationship between GCs and parental care. Captive bred Japanese quail (Coturnix japonica) do not show spontaneous parental care behavior, however this behavior can be induced through a sensitization procedure. We investigated how the GC status of Japanese quail relates to parental care in animals of both sexes exposed or not to a chick sensitization treatment. To assess GC status, we obtained baseline plasma and feather cort samples, and used the HPA-axis function test to assess stress responsiveness by examining the response to a standardized stressor as well as negative feedback efficacy through dexamethasone injection. Next, birds were either exposed to chicks overnight in a small enclosure (sensitization treatment) or were enclosed but not exposed to chicks (control). The following morning, adult behaviors were filmed in the presence of a fresh set of chicks for 20 min. A final serum GC sample was obtained to assess if exposure to novel chicks was perceived as stressful. In control animals, baseline GCs were associated with increased total parental care duration and decreased latency to first parental care event. Interestingly, the opposite relationship was found in the sensitization group. Finally, exposure to novel chicks was not associated with an increase in corticosterone in either group. Overall it appears that baseline GCs are correlated with parental care in captive bred Japanese quail, and that the relationship changes direction depending on whether or not sensitization has occurred.

Published
2020

38. Extracellular Vesicles Derived from Induced Pluripotent Stem Cells Promote Renoprotection in Acute Kidney Injury Model

Author

Gustavo M C Lopes, Rafael Soares Lindoso, Renata Skovronova, Adalberto Vieyra, Giovane G Tortelote, Jarlene A Lopes, Camila Wendt, Benedetta Bussolati, Marta Tapparo, Kildare Rocha de Miranda, Tais Hanae Kasai-Brunswick, Federica Collino, Douglas B Almeida, Afd Pharmacology, and Pharmacology

Subjects
Male, kidney, Induced Pluripotent Stem Cells, Adipose tissue, Regenerative medicine, Article, Cell therapy, 03 medical and health sciences, 0302 clinical medicine, AKI, ROS, extracellular vesicles, iPSC, mitochondria, medicine, Animals, Humans, Rats, Wistar, Induced pluripotent stem cell, lcsh:QH301-705.5, 030304 developmental biology, 0303 health sciences, Kidney, Chemistry, Mesenchymal stem cell, Acute kidney injury, General Medicine, Acute Kidney Injury, medicine.disease, 3. Good health, Cell biology, Rats, medicine.anatomical_structure, lcsh:Biology (General), 030220 oncology & carcinogenesis, Stem cell, Reactive Oxygen Species
Abstract

Induced pluripotent stem cells (iPSC) have been the focus of several studies due to their wide range of application, including in cellular therapy. The use of iPSC in regenerative medicine is limited by their tumorigenic potential. Extracellular vesicles (EV) derived from stem cells have been shown to support renal recovery after injury. However, no investigation has explored the potential of iPSC-EV in the treatment of kidney diseases. To evaluate this potential, we submitted renal tubule cells to hypoxia-reoxygenation injury, and we analyzed cell death rate and changes in functional mitochondria mass. An in vivo model of ischemia-reperfusion injury was used to evaluate morphological and functional alterations. Gene array profile was applied to investigate the mechanism involved in iPSC-EV effects. In addition, EV derived from adipose mesenchymal cells (ASC-EV) were also used to compare the potential of iPSC-EV in support of tissue recovery. The results showed that iPSC-EV were capable of reducing cell death and inflammatory response with similar efficacy than ASC-EV. Moreover, iPSC-EV protected functional mitochondria and regulated several genes associated with oxidative stress. Taken together, these results show that iPSC can be an alternative source of EV in the treatment of different aspects of kidney disease.

Published
2020

39. Safety of hospital discharge before return of bowel function after elective colorectal surgery

Author

J Chapman, S, Blanco-Colino, R, Pérez-Ajates, S, O Anabitarte Bautista, Hodson, J, C Glasbey, J, Pata, F, Pellino, G, Sgrò, A, Soares, A, T van Elst, S Van Straten, Nepogodiev, D, Borakati, A, F Bath, M, H Yasin, I, Mclean, K, Arthur, T, Kovacevic, M, Delibegovic, S, Karamanliev, M, Swamad, M, Žebrák, R, Paramasivam, R, Martensen, A, M Larsen, H, Rädeker, L, E Frey, P, Kechagias, A, Venara, A, Duchalais, E, Ioannidis, A, Pasquali, S, Simioni, A, Farina, V, Podda, M, Lorenzon, L, Schaeff, V, Otto, A, Jakubauskas, M, R van Elst, T, Chu, M, Pvb, Fagan, I Wells, C, A Alagoa João, Juloski, J, Y El Kasmy El Kasmi, Espin-Basany, E, Clerc, D, Ciubotaru, C, Popescu, S, Yanishev, A, Lee, S, B Ozkan, B, A Yagız Sen, K Aktas, M, E Baki, B, Yüksek, B, Kamarajah, S, A Khaw, R, Mills, E, Goodson, R, Thakral, N, D Ablett, A, Adra, M, Kwek, I, M Khan, S, Quinn, P, R Manley, L, Badran, A, Ramjeeawon, A, Campbell, A, L Tan, H, S Rye, D, Rajaraman, N, G Norman, J, Vutipongsatorn, K, Solomou, G, Akhbari, M, Ali, A, Murray, V, M Baker, D, D Brandao, B, Stainer, B, Thavayogan, R, Jones, D, O Onafowokan, O, Gharooni, A, Dabab, N, Carlton-Carew, S, Kungwengwe, G, Gabriel, M, Sewart, E, C Shortland, T, Lawday, S, Pockney, P, Dawson, A, D Brumfitt, C, Stewart, P, B, Ng, K Luong, J, Ivanov, V, Borisova, A, Neykov, V, Kunčarová, K, Kološová, B, Antonova, T, Farkašová, M, L Harbjerg, J, Brandsborg, S, Brinck, S, D Kjaer, M, Mark-Christensen, A, P Unbehaun, K, Dalsgaard, P, D Lycke, K, Lenaoures, P, Brigand, C, Dumange, E, Gout, M, Moehwald, C, Prem, M, Alhalabi, O, Sliwinski, S, Krupp, J, Gablenz, E, Schmitzer, L, Kopp, A, Steinle, J, Gsenger, J, J Pohl, L, Riccardi, M, M Christodoulou, I, Konstantinidis, M, Machairas, N, Zoikas, A, Balalis, D, K Manatakis, D, L Aguilera, M, Marano, L, Fleres, F, Lovisetto, F, Sasia, D, Segalini, E, Pata, G, Lucchi, A, Sagnotta, A, Campagnaro, T, Petrelli, F, Gallo, G, Papandrea, M, Testa, V, Sinibaldi, G, F Di Candido, Colombo, F, Perrone, G, Aresu, S, Biancafarina, A, Canonico, G, Pagnanelli, M, Curletti, G, Bini, R, A de Manzoni Garberini, Impellizzeri, H, Cillara, N, Tutino, R, Picciariello, A, Coletta, D, Savino, G, Ferrara, F, Tamini, N, Talamo, G, Parini, D, Giamundo, P, A Lo Conte, Pagano, G, Ripetti, V, Pesce, A, Menduni, N, Giudicissi, R, Goldin, E, Rega, D, Belli, A, Andriola, V, Gordini, L, Foppa, C, Piccolo, G, Birindelli, A, Ferrari, C, Ballarini, Z, Tirelli, F, Milone, M, M De Rosa, S Pipitone Federico, N, Molteni, B, L Tilocca, P, Sancini, G, N Piozzi, G, Lauretta, A, Poillucci, G, Mulas, S, Simcikas, D, Portelli, L, Jwm van Wijnbergen, L Dinger, T, Sfh Ten Doesschate, Ashm van Dalen, D van den Bos, D, Hansmann, M, J Medina Feliz, Z Kuiper, S, Abdulrahman, Z, R Pruijssers, S, Farik, S, M Elliott, B, P Geneta, V, Wilton, S, Kandelaki, H, L Peng, S, Campbell, S, K Lim, Y, S Yassaie, S, Murray, M, Haran, C, Tan, J, Castro, J, Laranjeira, A, Catarino, S, Neves-Marques, C, G Correia, J, N Vieira, B, C Quintela, A, L Serra, M, Maciel, J, Cunha, M, J Aparício, D, Neves, J, Azevedo, J, Romano, M, Eiró, F, Romano, J, Monteiro, C, Claro, M, R Almeida, M, Peyroteo, M, D Machado, N, Capote, H, Ferreira, M, Sousa, X, Devesa, H, Cavadas, D, Guerreiro, I, Costa, M, Rosete, M, Salman, M, English, C, Mohammed, N, Litvin, A, V Ćuk, V, Mészárosová, K, Jaich, R, H De Lima, Brooks, S, Marx, M, M Nshalati Salvation, J García Cardo, Mora-Guzmán, I, J Sancho Muriel, U de Andres Olabarria, Muriel, P, C Jimenez Viñas, Alconchel, F, O Esteban Sinovas, C Fairén Oro, M López Otero, S Figueroa Jiménez, O Claramonte Bellmunt, J Martínez Caballero, Rubio-Pérez, I, M Aguilar-Martínez, M, J Segura-Sampedro, J, C Olmedo Moreno, D Negre Parra, M Estévez Diz, A, Martín-Balbuena, R, C Bustamante Recuenco, E Licardie Bolaños, R, Fernández, P, A Díaz Padillo, Forero-Torres, A, I Alberdi San Román, H Salvador Rosés, M Merayo Álvarez, P Villarejo Campos, C Lopes Moreira, C, P Uriol Peralta, M Serrano Navidad, Ripollés-Melchor, J, Garcea, A, H Gómez Facundo, P Troncoso Pereira, V Pérez Guarinos, C, Blaser, B, Piazza, G, Gagliardi, B, Serin, H, S Yurdaor, S, Arslan, E, Kopac, O, Uyanik, A, B Ozmen, B, Tiftik, E, Aksoy, B, Yalcinkaya, A, Ozoglu, F, D Kocer, M, Bilicen, G, N Cinar, E, Uslu, Ö, Kaya, Y, Demirci, K, Wong, J, Mmh, Farhan-Alanie, Suresh, G, Asif, A, J Finch, B, Bhahirathan, Y, Herron, J, Z Yi Tew, Obukofe, R, Russell, C, Suchett-Kay, I, Netke, T, Williams, L, Kisiel, A, Y Liu, F, Claireaux, H, James, P, Mondal, A, Kalderon, R, H Nadama, H, Al-Saraff, Z, Jph, Tam, Powell-Chandler, A, Wood, F, Rebecca, Gorgievska, Ragavoodoo, A, Thakrar, C, Rojoa, D, Palmer, C, Davidson, K, Giacci, L, Hale, J, W Gan, F, Makin-Taylor, R, Y Hey, C, Toh, C, M Findlay, J, Griffiths, N, Ganesananthan, S, Jasionowska, S, Poustie, M, Wong, C, Turner, T, Pyc, W, Sloper, W, Warner, C, Coey, J, Mason, D, Sait, S, Kowal, M, Owen, M, Saiyed, A, Ashworth, I, Akbari, K, Curran, M, Martin, P, Parker, D, Kwok, K, Lye, C, Ghaly, M, Sammour, T, Lewis, D, Mundasad, R, Wilkes, A, Ctercteko, G, Maslyankov, S, Dimov, R, Iliev, S, Dimitrov, D, Marek, F, Örhalmi, J, Skalický, P, Skalický, T, Chrz, K, Christensen, P, Worsøe, J, S Kristensen, E, J Emmertsen, K, S Loeve, U, L Mihaljevic, A, Herrle, F, M Konstantinidis, K, Korkolis, D, Karanikas, I, Vincenti, L, Anania, G, Borghi, F, Agresta, F, Maretto, I, Parisi, A, Bucci, L, G De Palma, Guglielmi, A, Cucinotta, E, F La Torre, Cianchi, F, Guerrieri, M, Trompetto, M, Persiani, R, Micheletto, G, Delrio, P, Cantafio, S, Ronconi, M, Pag, Bisagni, M De Prizio, Franceschi, A, Galleano, R, Cavallini, M, Brescia, A, D'Ambra, L, Benevento, A, Niolu, P, Calgaro, M, Colangelo, E, Grottola, T, F Altomare, D, Puleo, S, Salamone, G, Pietrabissa, A, Poggioli, G, Erdas, E, Ottonello, R, Tonini, V, Selvaggi, F, Sammarco, G, Ceccarelli, G, C De Nisco, Surgo, D, Taglietti, L, Ozolins, A, Sivinš, A, Poskus, T, Psaila, J, A Bemelman, W, J Graat, L, Langenhoff, B, Bpl, Wijnhoven, Ahw van de Ven, Poelman, M, Lps, Stassen, Slooter, G, Yiz, Acherman, Hoff, C, F Gerhards, M, Mwj, Stommel, J Hazebroek, E, Aaw van Geloven, A Schasfoort, R, L van Leeuwen, B, B Tuynman, J, Mwa van Tilburg, G Boerma, E, Sharma, P, Jenkins, B, P Bissett, I, Herd, A, Gordon, A, Vernon, D, Omundsen, M, J, Ly, Reddy, A, Bonnet, G, Harmston, C, Morales, M, Francisco, V, Costa, S, Manso, A, Amorim, E, Pereira, J, Cardoso, J, Ourô, S, Caratão, M, Nascimento, C, B Ribeiro da Silva, Taranu, V, Dias, R, Mendes, J, Allen, M, Silva, A, Carlos, S, Barbosa, E, Carneiro, C, Ramos, L, Lencastre, L, Martins, R, Silva-Vaz, P, F Ridgway, P, A McNamara, D, Cahill, R, Hogan, A, Larkin, J, R O'Connell, P, Negoi, I, Abelevich, A, M Ćuk, V, Vician, M, Ede, C, Sardiwalla, I, Mulira, S, Montwedi, D, Oyomno, M, Sabia, D, V Portugal Porras, Vigorita, V, G Sanz Ortega, García, J, A Espí Macías, F Blanco Antona, A Luján Mompeán, J, S Salvans Ruiz, Villarejo-Campos, P, M Romero Simó, Sánchez-Guillén, L, M Jiménez-Gómez, L, A Sánchez López, Golda, T, D Julià Bergkvist, Nevado, C, F Noguera Aguilar, J, B Ricardo Felipe, Septiem, J, A Rodríguez Sánchez, Cañete-Gómez, J, I Ruiz Montesinos, Millán-Scheiding, M, Prieto-Nieto, I, Frasson, M, D García Olmo, Hübner, M, Petermann, D, O Sauvain, M, Ozben, V, E Geçim, I, Disçi, E, Rencuzogullari, A, Kurt, A, Bisgin, T, Pehlivan, M, Isik, A, Onur, E, Leventoglu, S, C Haksal, M, S Erturk, M, Keskin, M, Guner, A, S Tutcu Sahin, S Ozbalci, G, Pergel, A, Albayrak, D, Bruce, D, Fearnhead, N, Arthur, J, Harron, M, Beattie, G, Titu, L, Saunders, M, Phillips, J, Dindyal, S, Cresswell, B, Gercek, Y, Lee, J, Linn, T, Faulkner, G, Lockwood, S, Rees, J, Charalabopoulos, A, Campbell, B, Kontovounisios, C, Amarnath, T, Johnson, M, Epanomeritakis, E, Vigs, S, Nastro, P, Gilliam, A, Smolarek, S, Wilson, T, Orbell, J, Mcintyre, R, Agarwal, T, Hainsworth, P, Patel, P, Vijay, J, Liu, B, P Dhruva Rao, Roxburgh, C, Vipond, M, Youssef, H, Thorn, C, Schizas, A, Denley, S, Bowley, D, Das, K, Cuming, T, Saha, A, Chung, L, Pitt, J, Davis, P, Jones, O, Taylor, M, Bhargava, A, Haji, A, Watson, N, Bloom, I, Singh, B, Norwood, M, Gurjar, S, Stylianides, N, Mirza, S, Evans, M, Williams, G, Patil, P, Hernon, J, Finch, G, Green, S, Chapple, K, Fafemi, O, Warusavitarne, J, Samee, A, Carden, C, Ong, L, Verma, K, Joseph, A, Rawat, N, Pinkney, T, Oke, O, Glen, P, Maxwell-Armstrong, C, Oliphant, R, Garner, J, J Moug, S, Middleton, S, N Lund, J, J Smart, N, Osborn, G, Moore, T, Raymond, T, H Knowles, C, S Hany, T, Clarke, R, Khera, G, Brady, R, Sellahewa, C, Mason, C, Torrance, A, Lasithiotakis, K, Knight, J, Pullybank, A, Ainsworth, P, Reid, F, Ramwell, A, Maslekar, S, George, R, Skull, A, Holtham, S, Muhammad, K, Lal, R, Varcada, M, M Smith, F, Howlader, M, Defriend, D, Kirk, S, Richards, T, Evans, C, M Borg, C, Telford, K, Sarfraz, N, Busby, K, Hollingshead, J, Speake, D, Pawa, N, West, D, Chadwick, M, Komolafe, O, Richardson, S, Thornton, M, Goede, A, Osborne, C, Bandyopadhyay, D, Foong, J, J Lee, Y, Liebenberg, P, Mijalkov, D, Wells, A, Bull, N, Ajmera, A, Warburton, T, Morgan, S, Mahmoud, A, Schachtel, M, Mikhail, B, Fomin, I, Mekaeil, B, Taylor, N, Stevenson, C, Drane, A, Pahalawatta, U, T Lai, L, Debiasio, A, Hjs, Jun, Hengpoonthana, R, M Mendis, D, M Robb, P, J Lee, H, Aab, Wyche, T Davis, L, Chrimes, A, Agarwal, A, Zhao, J, Williams, S, Jmsn, Jayalath, Khor, S, Muddasani, T, Childs, S, Ridgway, S, Nda, Blefari, Tam, H, Puchalski, N, Ngai, C, Mackenzie, J, Johnson, N, Holmes, M, Zuzek, R, Saluja, T, Gould, T, K Goh, Y, Selvaraj, T, Z Beh, Y, N Dudi-Venkata, N, Horne, D, L Borrow, J, Campbell, C, Cousins, G, Jackson, L, Maheepala, K, Zhao, S, Holden, E, Tutt, L, Thompson, B, Collins, H, Louie, F, Buckland, B, Smith, D, Chong, C, H Chua, T, Nayak, C, Redmond, J, R Tan, R, Gramlick, M, S Teh, J, Y Ng, S, Britten-Jones, P, R Mohd Rosli, Hdv, Pham, Jegathees, T, Smcj, Coulter-Nile, P Gosselink, M, L Wang, Y, Maciaszek, M, S Chrapko, P, Nair, A, Thirugnanasundralingam, V, 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Subjects
operative, Male, postoperative discharge, Postoperative Complications, 0302 clinical medicine, Colostomy, CRITERIA, Prospective Studies, Bowel function, Colectomy, IMAGINE, stoma, intestines, Proctectomy, Ileostomy, digestive, oral, and skin physiology, patient discharge, colorectal surgery, hospital discharge, bowel function, RECOVERY, Middle Aged, adult, colostomy, elective surgical procedures, female, follow-up studies, humans, ileostomy, ileus, male, middle aged, multivariate analysis, patient readmission, patient safety, postoperative complications, prospective studies, recovery of function, colectomy, proctectomy, Patient Discharge, Colorectal surgery, ileus - - discharge - bowel function - elective - colorectal surgery, Elective Surgical Procedures, 030220 oncology & carcinogenesis, Female, 030211 gastroenterology & hepatology, Patient Safety, Cohort study, safety, Adult, medicine.medical_specialty, Ileus, Patient Readmission, defecation, 03 medical and health sciences, medicine, Hospital discharge, Humans, colorectal surgery, colorectal resection, Colorectal resection, defecation, postoperative complications, colorectal surgery, intestines, patient discharge, patient readmission, safety, surgical procedures, operative, colorectal resection, ileus, business.industry, Recovery of Function, Odds ratio, medicine.disease, digestive system diseases, surgical procedures, Surgery, Multivariate Analysis, Defecation, business, Follow-Up Studies
Abstract

Ileus is common after colorectal surgery and is associated with an increased risk of postoperative complications. Identifying features of normal bowel recovery and the appropriateness for hospital discharge is challenging. This study explored the safety of hospital discharge before the return of bowel function.A prospective, multicentre cohort study was undertaken across an international collaborative network. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The main outcome of interest was readmission to hospital within 30 days of surgery. The impact of discharge timing according to the return of bowel function was explored using multivariable regression analysis. Other outcomes were postoperative complications within 30 days of surgery, measured using the Clavien-Dindo classification system.A total of 3288 patients were included in the analysis, of whom 301 (9·2 per cent) were discharged before the return of bowel function. The median duration of hospital stay for patients discharged before and after return of bowel function was 5 (i.q.r. 4-7) and 7 (6-8) days respectively (P 0·001). There were no significant differences in rates of readmission between these groups (6·6 versus 8·0 per cent; P = 0·499), and this remained the case after multivariable adjustment for baseline differences (odds ratio 0·90, 95 per cent c.i. 0·55 to 1·46; P = 0·659). Rates of postoperative complications were also similar in those discharged before versus after return of bowel function (minor: 34·7 versus 39·5 per cent; major 3·3 versus 3·4 per cent; P = 0·110).Discharge before return of bowel function after elective colorectal surgery appears to be safe in appropriately selected patients.El íleo es frecuente tras la cirugía colorrectal y se asocia con un aumento del riesgo de las complicaciones postoperatorias. Identificar las características de una recuperación normal del tránsito y la idoneidad para el alta hospitalaria es una tarea difícil. Este estudio examinó la seguridad del alta hospitalaria antes del restablecimiento de la función intestinal. MÉTODOS: Se llevó a cabo un estudio de cohortes prospectivo y multicéntrico a través de una red de colaboración internacional. Se incluyeron pacientes adultos sometidos a resección electiva colorrectal entre enero y abril 2018. El objetivo principal fue el reingreso hospitalario durante los 30 primeros días tras la intervención. Se utilizó un análisis de regresión multivariable para evaluar el impacto del momento del alta en función del restablecimiento de la función intestinal. El objetivo secundario fue las complicaciones postoperatorias en los primeros 30 días después de la cirugía, valoradas mediante el sistema de clasificación de Clavien-Dindo.Se incluyeron en el análisis 3.288 pacientes, de los cuales 301 (9,2%) fueron dados de alta antes del restablecimiento de la función intestinal. La mediana de la estancia hospitalaria de los pacientes dados de alta antes y después del restablecimiento de la función intestinal fue 5 (rango intercuartílico: 4-7) y 7 (6-8) días, respectivamente (P 0,001). No hubo diferencias significativas en las tasas de reingreso entre estos grupos (6,6% versus 8,0%; P = 0,499), y este resultado se mantuvo en el análisis multivariable tras el ajuste por diferencias basales (razón de opotunidades, odds ratio, OR 0,90; i.c. del 95% 0,55-1,46, P = 0,659). Las tasas de complicaciones postoperarorias fueron similares en aquellos dados de alta antes o después del restablecimiento de la función intestinal (complicaciones menores: 34,7% versus 39,5%; complicaciones mayores 3,3% versus 3,4%; P = 0,110). CONCLUSIÓN: Dar de alta antes del restablecimiento de la función intestinal tras cirugía colorrectal electiva parece ser seguro en pacientes debidamente seleccionados.

Published
2020

40. Obsessive–Compulsive Personality Symptoms Predict Poorer Response to Gamma Ventral Capsulotomy for Intractable OCD

Author

Maria Eugênia Copetti, Antonio C. Lopes, Guaraci Requena, Isaac N. S. Johnson, Benjamin D. Greenberg, Georg Noren, Nicole C. R. McLaughlin, Roseli G. Shavitt, Eurípedes C. Miguel, Marcelo C. Batistuzzo, and Marcelo Q. Hoexter

Subjects
Treatment response, Internal capsule, lcsh:RC435-571, medicine.medical_treatment, Obsessive Compulsive Personality, media_common.quotation_subject, gamma ventral capsulotomy, 03 medical and health sciences, 0302 clinical medicine, obsessive–compulsive disorder, lcsh:Psychiatry, medicine, Personality, personality disorders, Obsessive-compulsive disorder (OCD), functional neurosurgery, media_common, Psychiatry, business.industry, Brief Research Report, medicine.disease, Personality disorders, Obsessive–compulsive personality disorder, 030227 psychiatry, Psychiatry and Mental health, Capsulotomy, business, obsessive–compulsive personality disorder, 030217 neurology & neurosurgery, Clinical psychology
Abstract

Gamma ventral capsulotomy (GVC) is a radiosurgical procedure which aims to create lesions in the ventral part of the anterior limb of the internal capsule (ALIC). It has been used as a treatment option for patients with intractable obsessive-compulsive disorder (OCD) who do not respond to several first-line treatments attempts. However, changes in personality disorder symptoms after GVC have not been investigated. The aims of this study are to investigate changes in personality disorder symptoms after GVC and to search for baseline personality disorder symptoms that may predict clinical response to GVC. Fourteen treatment-intractable OCD patients who underwent GVC completed the Structured Clinical Interview for DSM-IV Personality Disorders (SCID-II) at baseline and one year after the procedure. Wilcoxon signed-rank test was performed to investigate personality disorder symptom changes before and after surgery. Linear regression models were utilized to predict treatment response, using baseline personality disorder symptoms as independent variables. We did not observe any quantitative changes in personality disorder symptoms after GVC, compared with baseline. Higher severity of obsessive-compulsive personality disorder symptoms at baseline was correlated with worse treatment response after GVC for OCD (β = -0.085, t-value = -2.52, p-value = 0.027). These findings advocate for the safety of the GVC procedure in this specific population of intractable OCD patients, in terms of personality disorder symptom changes. They also highlight the importance of taking into account the severity of obsessive-compulsive personality disorder symptoms when GVC is indicated for intractable OCD patients.

Published
2020
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41. Burden of disease associated with dietary exposure to carcinogenic aflatoxins in Portugal using human biomonitoring approach

Author

Carla Martins, M. De Boevre, Carla Nunes, S. De Saeger, Ana Goios, Ricardo Assunção, Arnau Vidal, C Lopes, Duarte Torres, Paula Alvito, and Faculdade de Ciências da Nutrição e Alimentação

Subjects
Adult, Male, Aflatoxin, Population, Burden of Disease, Food Contamination, Urine, Young Adult, Aflatoxins, Environmental health, Biomonitoring, Humans, Medicine, Toxicologia, education, Carcinogen, Biomarkers of Exposure, education.field_of_study, Portugal, business.industry, Health sciences, Medical and Health sciences, Ciências médicas e da saúde, Outbreak, Middle Aged, Diet, Segurança Alimentar, Population Surveillance, Human Biomonitoring, Medical and Health sciences, Female, Ciências da Saúde, Ciências médicas e da saúde, Avaliação do Risco, business, Risk assessment, Biomarkers, Food Science, Food contaminant
Abstract

Human biomonitoring is an important tool to assess human exposure to chemicals, contributing to describe trends of exposure over time and to identify population groups that could be under risk. Aflatoxins are genotoxic and carcinogenic food contaminants causing hepatocellular carcinoma, the third leading cause of cancer deaths worldwide. In Portugal, scarce data are available regarding exposure to aflatoxins and no previous study used human biomonitoring data to comprehensively characterize the associated burden of disease. 24 h urine and first-morning urine paired samples were collected by 94 participants and were analyzed by liquid chromatography–tandem mass spectrometry for the quantitative determination of aflatoxins (B1, B2, G1, G2 and M1). Deterministic and probabilistic models were developed to assess the Portuguese exposure to aflatoxins and to estimate the health impact of this exposure, estimating the attributed Disability-Adjusted Life Years (DALYs). Aflatoxins were detected in a maximum of 13% (AFB1), 16% (AFB2), 1% (AFG1), 2% (AFG2) and 19% (AFM1) of the urine samples. Data obtained through the probabilistic approach revealed an estimated mean probable daily intake of 13.43 ng/kg body weight per day resulting in 0.13 extra cases of hepatocellular carcinoma, corresponding to mean annual DALYs of 172.8 for the Portuguese population (10 291 027 inhabitants). The present study generated for the first time and within a human biomonitoring study, reliable and crucial data to characterize the burden associated to the exposure to aflatoxins of the Portuguese population. The obtained results constitute an imperative support to risk managers in the establishment of preventive policy measures that contribute to ensure public health protection. Highlights: Portuguese population is exposed to aflatoxins, carcinogenic toxins to humans; Human biomonitoring studies contribute to an accurate estimation of the burden; Exposure to aflatoxins of Portuguese population results in 172.8 Disability-Adjusted Life Years. Thanks are due to FCT/MCTES for the financial support to (UIDP/50017/2020+UIDB/50017/2020), through national funds (Portugal). This research was also supported by MYTOX-SOUTH, Ghent University Global Minds programme (https://mytoxsouth.org) (Belgium). The EEA Grants Program, Public Health Initiatives (PT06 − 000088SI3) funded the IAN-AF national survey (Portugal). info:eu-repo/semantics/publishedVersion

Published
2020

42. Será a implantação de desfibrilhador menos útil nos doentes com cardiopatia não isquémica?

Author

Marta Fonseca, C Lopes, José Farinha, Leonor Parreira, Tatiana Duarte, Rui Caria, Pedro Amador, Catarina Sá, and Rita Marinheiro

Subjects
Gynecology, lcsh:Diseases of the circulatory (Cardiovascular) system, 03 medical and health sciences, medicine.medical_specialty, 0302 clinical medicine, lcsh:RC666-701, business.industry, Medicine, 030212 general & internal medicine, 030204 cardiovascular system & hematology, Cardiology and Cardiovascular Medicine, business
Abstract

Resumo: Introdução e objetivo: O benefício do desfibrilhador implantável está bem demonstrado nos doentes com cardiopatia isquémica. No entanto, a evidência deste benefício é menos robusta em doentes com cardiopatia não isquémica. Pretendeu‐se determinar se os doentes com cardiopatia não isquémica apresentavam a mesma incidência de choque apropriado e mortalidade total, comparativamente àqueles com cardiopatia isquémica. Métodos: Estudo retrospetivo, em que foram analisados todos os doentes com cardioversor‐desfibrilhador implantável ou terapia de ressincronização cardíaca com desfibrilhador, implantados para prevenção primária, entre 2004 a 2014, num único centro. A população foi dividida em dois grupos: doentes com cardiopatia isquémica e doentes com cardiopatia não isquémica. O endpoint primário combinado foi choque apropriado e morte por qualquer causa. Resultados: Foram estudados 281 doentes, dos quais 187 (66%) apresentavam cardiopatia isquémica. Os doentes com cardiopatia isquémica eram mais velhos, mais frequentemente do género masculino e com maior prevalência de fatores de risco cardiovasculares. O follow‐up médio foi de 55±42 meses. Trinta e quatro doentes (18%) com cardiopatia isquémica e 20 doentes (21%) com cardiopatia não isquémica tiveram um choque apropriado (p=0,64). Oitenta e nove doentes (47%) com cardiopatia isquémica e 36 (38%) com cardiopatia não isquémica morreram durante o follow‐up (p=0,19). A curva de Kaplan‐Meier demonstra que a probabilidade de choque ou morte ao longo do tempo é semelhante nos dois grupos (logrank, p=0.14). Conclusão: Na população estudada, não existiram diferenças na probabilidade de choque apropriado ou na mortalidade total nos doentes com cardiopatia não isquémica comparativamente aqueles com cardiopatia isquémica. Abstract: Introduction and Objective: The benefits of implanted defibrillators in patients with ischemic heart disease (IHD) are well known. However, the evidence is less robust in patients with non‐ischemic heart disease (non‐IHD). We aimed to determine whether patients with non‐IHD have a similar incidence of appropriate shocks and all‐cause mortality compared to those with IHD. Methods: In a retrospective single‐center study we analyzed all patients with implantable cardioverter‐defibrillators or cardiac resynchronization therapy‐defibrillators implanted for primary prevention between 2004 and 2014. The population was divided into two groups: patients with IHD and patients with non‐IHD. The composite endpoint was appropriate shock and all‐cause mortality. Results: Two hundred and eighty‐one patients were studied, of whom 187 (66%) had IHD. Patients with IHD were older, more frequently male and with more cardiovascular risk factors. Mean follow‐up was 55±42 months. Thirty‐four patients (18%) with IHD and 20 patients (21%) with non‐IHD had an appropriate shock (p=0.64). Eighty‐nine patients (47%) with IHD and 36 (38%) with non‐IHD died during follow‐up (p=0.19). The rate of shocks or death over time was similar in patients with IHD and non‐IHD according to Kaplan‐Meier survival curve analysis (log‐rank p=0.10). Conclusion: In this population, there were no differences in appropriate shocks or all‐cause mortality in the two groups. Palavras‐chave: Cardioversor desfibrilhador implantável, Cardiopatia não isquémica, Cardiopatia isquémica, Choque apropriado, Morte, Keywords: Implantable defibrillator, Non‐ischemic heart disease, Ischemic heart disease, Appropriate shock, Death

Published
2018

43. Discordance between human sperm quality and telomere length following differential gradient separation/swim-up

Author

Eduardo Rocha, Maria João Pinho, Rosália Sá, Soraia Pinto, Carolina Almeida, Alberto Barros, A. C. Lopes, Mário Sousa, and Pedro Oliveira

Subjects
Adult, Male, Reproductive Techniques, Assisted, medicine.medical_treatment, Separation (statistics), Biology, Logistic regression, Male infertility, Andrology, Human fertilization, Gamete Biology, Genetics, medicine, Centrifugation, Density Gradient, Humans, Genetics (clinical), Assisted reproductive technology, Sperm Count, Obstetrics and Gynecology, Telomere Homeostasis, General Medicine, Middle Aged, Telomere, medicine.disease, Sperm, Spermatozoa, Real-time polymerase chain reaction, Reproductive Medicine, Sperm Motility, Population study, Developmental Biology
Abstract

BACKGROUND: Strong evidence has suggested an important role of telomeres in meiosis, fertilization, and embryo development. PURPOSE: To determine if sperm telomere length (STL) in sperm purified by differential gradient centrifugation followed by swim-up (selected STL) is correlated with sperm quality and clinical outcomes. METHODS: Relative selected STL was assessed by quantitative polymerase chain reaction (Q-PCR) in 78 consecutive assisted reproductive technology (ART) treatments during 2017. Statistical analyses were performed in the totality of patients, and in normozoospermic and non-normozoospermic patients. These included correlations between selected STL and sperm quality parameters, embryological parameters (multivariable linear regression), and clinical parameters (multivariable logistic regression). RESULTS: No significant correlations were found between selected STL and sperm quality in the total population. However, selected STL was significantly correlated with total sperm count (r = 0.361; P = 0.039) and sperm DNA fragmentation-post-acrosomal region pattern (r = − 0.464; P = 0.030) in normozoospermic patients. No relation was observed between selected STL and clinical outcomes in any clinical group. CONCLUSIONS: As the correlations observed in normozoospermic patients were not representative of the whole heterogeneous population, differences in the sperm characteristics of the study population may lead to discrepant results when evaluating the association of STL with sperm quality. Since the total population selected STL was not related with sperm quality and with clinical outcomes, results do not support the use of selected STL measurement to evaluate the reproductive potential of the male patient or to predict the success rates of ART treatments. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s10815-020-01897-1) contains supplementary material, which is available to authorized users.

Published
2019

44. LDL Receptor Deficiency Does not Alter Brain Amyloid-β Levels but Causes an Exacerbation of Apoptosis

Author

Camila Tiefensee Ribeiro, Eslen Delanogare, Samantha C. Lopes, Daiane Fátima Engel, Eduardo Luiz Gasnhar Moreira, Daniel Pens Gelain, Nelson H. Gabilan, Jade de Oliveira, Helen M. Melo, Andreza Fabro de Bem, José Cláudio Fonseca Moreira, Rui Daniel Prediger, Gabriela Cristina de Paula, and Sergio T. Ferreira

Subjects
0301 basic medicine, Male, medicine.medical_specialty, Aging, Hippocampus, Gene Expression, Prefrontal Cortex, Caspase 3, Apoptosis, Familial hypercholesterolemia, 03 medical and health sciences, chemistry.chemical_compound, Amyloid beta-Protein Precursor, Mice, 0302 clinical medicine, Internal medicine, Gene expression, medicine, Animals, Receptor, Prefrontal cortex, Maze Learning, Brain Chemistry, Mice, Knockout, General Neuroscience, nutritional and metabolic diseases, General Medicine, medicine.disease, Mice, Inbred C57BL, Psychiatry and Mental health, Clinical Psychology, 030104 developmental biology, Endocrinology, Cholesterol, chemistry, Receptors, LDL, Low-density lipoprotein, LDL receptor, lipids (amino acids, peptides, and proteins), Geriatrics and Gerontology, 030217 neurology & neurosurgery
Abstract

Familial hypercholesterolemia (FH) is a genetic disorder caused by dysfunction of low density lipoprotein receptors (LDLr), resulting in elevated plasma cholesterol levels. FH patients frequently exhibit cognitive impairment, a finding recapitulated in LDLr deficient mice (LDLr-/-), an animal model of FH. In addition, LDLr-/- mice are more vulnerable to the deleterious memory impact of amyloid-β (Aβ), a peptide linked to Alzheimer's disease. Here, we investigated whether the expression of proteins involved in Aβ metabolism are altered in the brains of adult or middle-aged LDLr-/- mice. After spatial memory assessment, Aβ levels and gene expression of LDLr related-protein 1, proteins involved in Aβ synthesis, and apoptosis-related proteins were evaluated in prefrontal cortex and hippocampus. Moreover, the location and cell-specificity of apoptosis signals were evaluated. LDLr-/- mice presented memory impairment, which was more severe in middle-aged animals. Memory deficit in LDLr-/- mice was not associated with altered expression of proteins involved in Aβ processing or changes in Aβ levels in either hippocampus or prefrontal cortex. We further found that the expression of Bcl-2 was reduced while the expression of Bax was increased in both prefrontal cortex and hippocampus in 3- and 14-month-old LDLr-/-mice Finally, LDLr-/- mice presented increased immunoreactivity for activated caspase-3 in the prefrontal cortex and hippocampus. The activation of caspase 3 was predominantly associated with neurons in LDLr-/- mice. Cognitive impairment in LDLr-/- mice is thus accompanied by an exacerbation of neuronal apoptosis in brain regions related to memory formation, but not by changes in Aβ processing or levels.

Published
2019

45. Role of toll-like receptor 4 and sex in 6-hydroxydopamine–induced behavioral impairments and neurodegeneration in mice

Author

Juciano Gasparotto, Fernando Spiller, Lucas A. S. Santos, Daniel Pens Gelain, Pedro Ozorio Brum, Daniel Oppermann Peixoto, Alfeu Zanotto-Filho, Rui Daniel Prediger, Cibele Martins Pinho, Rosângela Mayer Gonçalves, José Cláudio Fonseca Moreira, Jade de Oliveira, Camila Tiefensee-Ribeiro, Samantha C. Lopes, Jonathan Paulo Agnes, and Nauana Somensi

Subjects
medicine.medical_specialty, Parkinson's disease, Mice, Transgenic, Substantia nigra, Striatum, Hydroxydopamines, Cellular and Molecular Neuroscience, Sex Factors, Internal medicine, medicine, Animals, Denervation, Hydroxydopamine, Pars compacta, business.industry, Dopaminergic, Neurodegeneration, Brain, Neurodegenerative Diseases, Parkinson Disease, Cell Biology, medicine.disease, Mice, Inbred C57BL, Toll-Like Receptor 4, Disease Models, Animal, Endocrinology, nervous system, Nerve Degeneration, Female, Microglia, business
Abstract

Parkinson's disease (PD) is a neurodegenerative disease characterized by progressive loss of the nigrostriatal dopaminergic neurons that are associated with motor alterations and non-motor manifestations (such as depression). Neuroinflammation is a process with a critical role in the pathogenesis of PD. In this regard, toll-like receptor 4 (TLR4) is a central mediator of immune response in PD. Moreover, there are gender-related differences in the incidence, prevalence, and clinical features of PD. Therefore, we aimed to elucidate the role of TLR4 in the sex-dependent response to dopaminergic denervation induced by 6-hydroxydopamine (6-OHDA) in mice. Female and male adult wildtype (WT) and TLR4 knockout (TLR4-/-) mice were administered with unilateral injection of 6-OHDA in the dorsal striatum, and non-motor and motor impairments were evaluated for 30 days, followed by biochemistry analysis in the substantia nigra pars compacta (SNc), dorsal striatum, and dorsoventral cortex. Early non-motor impairments (i.e., depressive-like behavior and spatial learning deficits) induced by 6-OHDA were observed in the male WT mice but not in male TLR4-/- or female mice. Motor alterations were observed after administration of 6-OHDA in both strains, and the lack of TLR4 was also related to motor commitment. Moreover, ablation of TLR4 prevented 6-OHDA-induced dopaminergic denervation and microgliosis in the SNc, selectively in female mice. These results reinforced the existence of sex-biased alterations in PD and indicated TLR4 as a promising therapeutic target for the motor and non-motor symptoms of PD, which will help counteract the neuroinflammatory and neurodegenerative processes.

Published
2021

46. Transpalatine Route for the Correction of Transsphenoidal Encephalocele in a Child: A Case Report and Literature Review

Author

Fabrício A. C. Lopes and Aldo José F. da Silva

Subjects
medicine.medical_specialty, Neural tube defect, business.industry, lcsh:R, lcsh:Surgery, Sphenoid bone, lcsh:Medicine, lcsh:RD1-811, medicine.disease, Surgery, Encephalocele, transpalatine, transsphenoidal, medicine, Neurology (clinical), Favorable outcome, Presentation (obstetrics), business, Surgical treatment, encephalocele, meningoceles
Abstract

Introduction Transsphenoidal encephalocele is a rare neural tube defect characterized by the herniation of meninges and eventually of parts of the brain through a bony defect in the sphenoid bone. The clinical presentation is variable, and surgical treatment is controversial. Case Report This report describes the case of an 8-month-old female child diagnosed with transsphenoidal encephalocele. The child presented with obstruction of the upper airways and was fed via a nasogastric tube but did not present changes in the hypothalamic-pituitary-axis. The patient underwent surgery with the transsphenoidal–transpalatine route, with an excellent outcome and without fistulas or infections. Conclusions Although transsphenoidal encephalocele is a rare congenital anomaly, the transsphenoidal–transpalatine route for the correction of this type of encephalocele is a safe option and produces a favorable outcome in pediatric patients.

Published
2017

47. Cystic nephroma in pediatrics

Author

Débora Dorneles Cunha de Queiroz Turíbio, Raiane S. Oliveira, Jeovana Pinheiro Fernandes de Souza, Isadora C. Lopes, Thais M. Cruz, Fabio Medeiros de Azevedo, Ana Clara Dantas, and Leonardo Moura Ferreira de Souza

Subjects
Male, Pediatrics, medicine.medical_specialty, business.industry, Cystic nephroma, medicine.disease, Nephrectomy, Kidney Neoplasms, Child, Preschool, Pediatrics, Perinatology and Child Health, medicine, Humans, Child, Tomography, X-Ray Computed, business, Ultrasonography
Abstract

El nefroma quístico es un tumor renal benigno raro, de etiología incierta. En niños puede manifestarse como una masa abdominal palpable, hematuria e infecciones urinarias recurrentes. Exámenes de imagen como ultrasonografía y tomografía computadorizada ayudan en el diagnóstico, sin embargo, la confirmación se realiza mediante el estudio anatomopatológico. El tratamiento es quirúrgico, pudiendo ser nefrectomía parcial o total, con buen diagnóstico.Objetivo: Describir un caso raro de nefroma quístico pediátrico, sus manifestaciones clínicas, aspectos radiológicos e histopatológicos, así como tratamiento y su evolución.Caso Clínico: Preescolar, sexo masculino, con historia clínica de infecciones urinarias de repetición en el primer año de vida. A los 2 años y 8 meses, presentó nodulación en hipocondrio derecho con dolor local a la palpación, asociado a molestias disúricas y hematuria. La ecografía mostró un riñón derecho aumentado de volumen por formación quística multiseptada. La tomografía computadorizada demostró formación expansiva quística multioculada en el riñón derecho. A los 2 años y 10 meses, realizó nefrectomía parcial derecha para exéresis y estudio anatomopatológico, compatible con nefroma quístico. Evolucionó con regresión de la hematuria y de los episodios recurrentes de infecciones urinarias, manteniendo función renal preservada. Actualmente, con 4 años y 6 meses, asintomático.Conclusiones: El nefroma quístico es una entidad rara, en general de buen pronóstico. La asociación de hallazgos clínicos, imágenes radiológicas y estudio anatomopatológico son fundamentales para el establecimiento diagnóstico y mejor definición de la conducta terapéutica.

Published
2021

48. Cabazitaxel as 3rd-4th line of treatment in castration-resistant metastatic prostate cancer - assessment of the impact of prior treatments on survival outcomes

Author

M. Baptista Freitas, Joceara Reis, M. J. Costa, S. Meireles, I.C. Nogueira Costa, I. Augusto, A. Valente, M.J. Ribeiro, and C. Lopes De Almeida

Subjects
Oncology, medicine.medical_specialty, Prostate cancer, business.industry, Cabazitaxel, Urology, Internal medicine, Medicine, Line (text file), Castration resistant, business, medicine.disease, medicine.drug
Published
2021

49. Vessel centerline reconstruction from non-isocentric and non-orthogonal paired monoplane angiographic images

Author

Pedro A. Lemos, Augusto C. Lopes, Guillermo J. Tearney, Elazer R. Edelman, Caroline C. O’Brien, Lynn Bailey, Mie Kunio, Massachusetts Institute of Technology. Institute for Medical Engineering & Science, Kunio, Mie, O'Brien, Caroline C., Lopes Jr, Augusto Celso de Araujo, and Edelman, Elazer R

Subjects
Databases, Factual, Sus scrofa, Coronary Artery Disease, Iterative reconstruction, 030204 cardiovascular system & hematology, Coronary Angiography, Article, Imaging phantom, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, Percutaneous Coronary Intervention, 0302 clinical medicine, Predictive Value of Tests, In vivo, medicine, Animals, Humans, Radiology, Nuclear Medicine and imaging, Cardiac imaging, Retrospective Studies, Cardiac cycle, Phantoms, Imaging, business.industry, Reproducibility of Results, Isocenter, Reconstruction algorithm, Coronary Vessels, Coronary arteries, medicine.anatomical_structure, Radiographic Image Interpretation, Computer-Assisted, Stents, Cardiology and Cardiovascular Medicine, business, Algorithms, Biomedical engineering
Abstract

Purpose Three-dimensional reconstruction of a vessel centerline from paired planar coronary angiographic images is critical to reconstruct the complex three-dimensional structure of the coronary artery lumen and the relative positioning of implanted devices. In this study, a new vessel centerline reconstruction method that can utilize non-isocentric and non-orthogonal pairs of angiographic images was developed and tested. Methods Our new method was developed in in vitro phantom models of bifurcated coronary artery with and without stent, and then tested in in vivo swine models (twelve coronary arteries). This method was also validated using data from six patients. Results Our new method demonstrated high accuracy (root mean square error = 0.27 mm or 0.76 pixel), and high reproducibility across a broad imaging angle (20°–130°) and between different cardiac cycles in vitro and in vivo. Use of this method demonstrated that the vessel centerline in the stented segment did not deform significantly over a cardiac cycle in vivo. In addition, the total movement of the isocenter in each image could be accurately estimated in vitro and in vivo. The performance of this new method for patient data was similar to that for in vitro phantom models and in vivo animal models. Conclusions We developed a vessel centerline reconstruction method for non-isocentric and non-orthogonal angiographic images. It demonstrated high accuracy and good reproducibility in vitro, in vivo, and in clinical setting, suggesting that our new method is clinically applicable despite the small sample size of clinical data. Keywords Coronary angiography Image reconstruction Reconstruction algorithm Stereoscopic theory, National Institutes of Health (U.S.) (R01 GM49039), Honjo International Scholarship Foundation

Published
2017

50. Burden of disease attributable to exposure to aflatoxins in Portugal using Human biomonitoring data

Author

Arnau Vidal, Duarte Torres, Paula Alvito, S. De Saeger, C Lopes, M. De Boevre, Carla Martins, Ricardo Assunção, Ana Goios, Carla Nunes, and Faculdade de Ciências da Nutrição e Alimentação

Subjects
Burden of disease, Aflatoxin, business.industry, Environmental health, Health sciences, Medical and Health sciences, Biomonitoring, Ciências médicas e da saúde, Medical and Health sciences, Public Health, Environmental and Occupational Health, Medicine, Ciências da Saúde, Ciências médicas e da saúde, business
Abstract

Human biomonitoring (HBM) is recognized as an important tool to assess the Human exposure to chemicals, contributing to describe trends and patterns of exposure over time and to identify population groups that could be under risk. Natural chemicals as mycotoxins, fungi metabolites that produce toxic effects in humans, are important compounds that could be found in foods usually consumed worldwide in a daily basis. Mycotoxins as aflatoxins (AFTs) are genotoxic, carcinogenic and immunosuppressive compounds. Hepatocellular carcinoma (HCC) is one of their main health toxic effects and is the third leading cause of cancer deaths worldwide. In Portugal, scarce data are available regarding exposure to AFTs and none previous study used HBM data to characterize comprehensively the burden associated to this exposure. In the scope of the National Food, Nutrition, and Physical Activity Survey of the Portuguese General Population (2015-2016), 24h-urine samples from 94 participants were analyzed by liquid chromatography-mass spectrometry (LC-MS/MS) for the simultaneous determination of AFTs (B1, B2, G1, G2, M1). A model was developed to estimate the health impact of the exposure of Portuguese population to aflatoxins, estimating the number of cases of HCC and DALYs attributed to AFTs exposure. AFTs were detected in 12.8% (AFB1), 16.0% (AFB2) and 19.1% (AFM1) of the 24h-urine samples. The estimated number of extra cases of HCC attributed to this exposure ranged from 17 to 65 cases/year; the associated DALYs for the Portuguese population ranged from 284 to 1802 years. The present study generated, for the first time and within a HBM study, reliable data regarding the exposure of the Portuguese population to AFTs. These data were crucial to characterize the health impact associated to AFTs exposure and to support risk managers to establish preventive policy measures that contribute to ensure the public health protection. Key messages Portuguese population is exposed to aflatoxins, chemical food contaminants that may be harmful (carcinogenic, immunotoxic, mutagenic, teratogenic, hepatotoxic) to humans. Human biomonitoring studies provide realistic data on internal exposure at individual level, contributing to a more accurate estimation of the burden derived from this exposure.

Published
2019

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