310 results on '"António Pires"'
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2. Transcatheter management of proximal stent migration in coarctation of the aorta
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Diogo Remi Oliveira Faim, Patrícia Vaz Silva, Andreia Francisco, and António Pires
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aortic arch ,coarctation of the aorta ,stent migration ,Medicine ,Pediatrics ,RJ1-570 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Proximal stent migration in setting of transcatheter management of coarctation of the aorta is a rare complication, which may require emergency surgery. Herein, we report a successful transcatheter management of proximal stent migration in a high surgical risk, a 14-year-old girl, which caused partial occlusion of both the descending aorta and the left subclavian artery.
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- 2022
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3. THE POTENTIAL OF VALUE ANALYSIS APPLICATION IN THE FURNITURE INDUSTRY - A CASE STUDY AT IKEA
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António Pires, Paulo Ávila, Goran Putnik, Leonilde Varela, Maria Manuela Cruz Cunha, and Rita Caldeira
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value analysis ,furniture industry ,functional analysis ,bookcase ,customer needs ,Management. Industrial management ,HD28-70 - Abstract
Value analysis methodology uses a structured and methodical job plan contemplating several steps to ensure success in its application. This paper intends to perspective the potential of value analysis application, namely in the furniture industry. To draw conclusions of this potential a case study was developed at an IKEA factory in Portugal. To characterize the customer needs in a clear language and to quantify the value of a product (a bookcase) produced in this factory, a value analysis study was developed. Functional analysis is the most known and distinctive phase of value analysis and is, nowadays, an autonomous tool. With this functional analysis, the authors intend to describe the functions that the product performs, to provide a better knowledge of the product, to evaluate the degree of satisfaction of the product through its functional performance and to facilitate the search for alternative solutions. The results obtained allowed us to reach some important conclusions about the application of value analysis in this type of industry and can be an initial step to promote the use of this tool in this kind of industry.
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- 2019
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4. Microstructural Characterization of Spheroidal Graphite Irons: A Study of the Effect of Preconditioning Treatment
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António Pires, Sónia Simões, Leander Michels, Emmanuelle Ott, Cathrine Hartung, and Carlos Silva Ribeiro
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preconditioning ,graphite ,microstructure ,microhardness ,electron backscattered diffraction ,Mining engineering. Metallurgy ,TN1-997 - Abstract
The effect of preconditioning treatments on the control and improvement of spheroidal graphite iron (SGI) microstructure was evaluated. In the melt, 0.15% of Zr-(Ca, Al) FeSi preconditioner was added into different conditions. Four samples were produced for this investigation: (1) in the first melt, there was no addition of a preconditioner for comparative purposes; (2) in the second melt, the preconditioner was added at the cold charge; (3) in the third melt, the preconditioner was added before the last cold charge; and (4) in the fourth melt, the preconditioner was added at tapping from the furnace. Microstructural characterization was conducted to understand the effect of the treatment on the SGI. Optical microscopy results show that preconditioning treatment increases graphite’s nodule density, ferrite content, and nodularity. Scanning electron microscopy (SEM), energy dispersive energy (EDS), and electron backscatter diffraction (EBSD) analysis were used to identify the types of microparticles present in the graphite nodules. Some complex microparticles were identified as AlMg2.5Si2.5N6, MgS, and CaS. The microstructural characteristics of the matrix, such as grain size, crystallographic orientation, and misorientation, were also evaluated by the EBSD. The addition of the preconditioning at tapping results in a higher ferrite fraction, smaller grain size, misorientation, and hardness values. This work suggests that the different preconditioning practice has a crucial effect on the microstructural characteristics of the SGI. This knowledge is vital, allowing the microstructure tailoring to enhance the mechanical properties of SGI to obtain the best performance of these materials.
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- 2022
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5. A rare case of isolated anomalous origin of the left pulmonar artery
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Lisete Lopes, Helena Andrade, and António Pires
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Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Published
- 2020
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6. How to develop a sustainable telemedicine service? A Pediatric Telecardiology Service 20 years on - an exploratory study
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Mélanie Raimundo Maia, Eduardo Castela, António Pires, and Luís Velez Lapão
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Case-study ,Implementation research ,Process evaluation ,Telemedicine service ,Telecardiology ,Pediatric care ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background Telemedicine services are promoting more access to healthcare. Portugal was an early adopter of telemedicine to overcome both its geological barriers and the shortage of healthcare professionals. The Pediatric Cardiology Service (PCS) at Coimbra University Hospital Centre (CHUC) has been using telemedicine to increase access and coverage since 1998. Their Pediatric Telecardiology Service has been daily connecting CHUC with 13 other Portuguese national hospitals, and regularly connecting with Portuguese-speaking African countries, through a teleconsultation platform. Methods This study aims at exploring the Pediatric Telecardiology Service’s evolution, through a comprehensive assessment of the PCS’s development, evolution and impact in public health, to better understand the critical factors for implementation and sustainability of telemedicine, in the context of healthcare services digitalization. A case study was performed, with cost-benefit, critical factors and organizational culture assessment. Finally, the Kingdon’s framework helped to understand the implementation and scale-up process and the role of policy-making. Results With the total of 32,685 out-patient teleconsultations, growing steadily from 1998 to 2016, the Pediatric Telecardiology Service has reached national and international recognition, being a pioneer and an active promotor of telemedicine. This telemedicine service has saved significant resources, about 1.1 million euros for the health system (e.g. in administrative and logistic costs) and approximately 419 euros per patient (considering an average of 1777 patients per year). PCS presents a dominant “Clan” culture. The Momentum’s critical factors for telemedicine service implementation enabled us to understand how barriers were overcome (e.g. political forces). Willingness, perseverance and teamwork, allied with partnership with key stakeholders, were the foundation for professionals’ engagement and service networking development. Its positive results, new regulations and the increasing support from the hospital board, set up a window of opportunity to establish a sustainable telemedicine service. Conclusion The Pediatric Telecardiology Service enables real-time communication and the sharing of clinical information, overcoming many barriers (from geographical ones to shortage of healthcare professionals), improving access to specialized care both in Portugal and Africa. Motivation and teamwork, and perseverance, were key for the Pediatric Telecardiology Service to tackle the window of opportunity which created conditions for sustainability.
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- 2019
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7. Importância da monitorização ambulatória da pressão arterial no diagnóstico e prognóstico da hipertensão arterial em idade pediátrica
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Helena Andrade, António Pires, Natália Noronha, Maria Emanuel Amaral, Lisete Lopes, Paula Martins, António Marinho da Silva, and Eduardo Castela
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Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Resumo: Em idade pediátrica a prevalência da hipertensão arterial (HTA) tem aumentado progressivamente, sendo a obesidade uma das responsáveis. Apesar disso, a etiologia dominante nesta faixa etária é a patologia renal e/ou a cardiovascular. A monitorização ambulatória de pressão arterial (MAPA) é o método de eleição para o diagnóstico de HTA, especialmente em crianças com risco cardiovascular elevado. O seu uso está limitado a crianças a partir dos cinco anos. A seleção do tamanho da braçadeira é o ponto chave na obtenção de leituras corretas da tensão arterial (TA).O MAPA tem como principal indicação a confirmação do diagnóstico de HTA. Também permite diagnosticar hipertensão da bata branca (que pode representar um estádio intermédio entre a fase normotensa e a hipertensão), ou hipertensão mascarada, associada a progressão para hipertensão mantida e HVE. As crianças com HTA noturna isolada devem ser consideradas como portadoras de hipertensão mascarada. A carga tensional é definida como a percentagem de medições válidas acima do p95 para a idade, sexo e estatura, sendo que valores superiores a 25‐30% são patológicos e superiores a 50% são preditivos de hipertrofia ventricular esquerda (HVE). O MAPA correlaciona‐se com lesão de órgão alvo, nomeadamente com a HVE e a lesão renal. É útil na diferenciação da hipertensão secundária, já que estas crianças manifestam maiores cargas tensionais e menor dipping nocturno, e na confirmação da resposta à terapêutica.Assim, o MAPA permite o diagnóstico e a classificação da HTA, fornece informação prognóstica cardiovascular e identifica doentes com fenótipos intermédios de HTA. Abstract: The prevalence of high blood pressure (BP) at pediatric age has increased progressively, one of the causes of which is obesity. However, the dominant etiology in this age group is renal and/or cardiovascular pathology. Ambulatory blood pressure monitoring (ABPM) is the method of choice for the diagnosis of hypertension, especially in children at high cardiovascular risk. Its use is limited to children from five years of age. Choosing appropriate cuff size is key to obtaining correct blood pressure.The main indication for ABPM is to confirm the diagnosis of hypertension. It also allows the diagnosis of white coat hypertension (which may represent an intermediate stage between the normotensive phase and hypertension), or masked hypertension, associated with progression to sustained hypertension and left ventricular hypertrophy (LVH). Children with isolated nocturnal hypertension should be considered as having masked hypertension.BP load is defined as the percentage of valid measurements above the 95th percentile for age, gender, and height. Values above 25‐30% are pathological and those above 50% are predictive of LVH. ABPM correlates with target organ damage, particularly LVH and renal damage. It is useful in the differentiation of secondary hypertension, since these children show higher BP load and less nocturnal dipping, and confirmation of response to therapy. Thus ABPM allows the diagnosis and classification of hypertension, provides cardiovascular prognostic information and identifies patients with intermediate phenotypes of hypertension. Palavras‐chave: Idade pediátrica, Hipertensão arterial, Monitorização ambulatória de pressão arterial, Hipertensão da bata branca, Hipertensão mascarada, Lesão de órgão alvo, Keywords: Pediatric age, High blood pressure, Ambulatory blood pressure monitoring, White coat hypertension, Masked hypertension, Target organ damage
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- 2018
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8. Causa rara de disfunção ventricular esquerda em idade pediátrica
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Maria Emanuel Amaral, Pedro Epifânio, Natália Noronha, António Pires, Paula Martins, Vanda Azevedo, Eduardo Castela, and Manuel J. Antunes
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Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Resumo: A Origem Anómala da Artéria Coronária Esquerda da Artéria Pulmonar é uma cardiopatia congénita rara e uma causa de isquemia miocárdica em idade pediátrica. A maioria dos casos não diagnosticados morre no primeiro ano de vida, sendo necessária a formação de uma extensa rede de colaterais para permitir a sobrevivência. O diagnóstico não é linear exigindo elevada suspeição clínica. Os autores apresentam o caso de uma criança de oito anos de idade, de raça negra, assintomática, referenciada de Cabo Verde para esclarecimento de dilatação e disfunção do ventrículo esquerdo com fluxos turbulentos sistodiastólicos a nível do septo interventricular. Dos antecedentes destacava‐se quadro de insuficiência cardíaca diagnosticada aos três meses de idade, com avaliação posterior compatível com miocardiopatia dilatada. Teve melhoria clínica após início de terapêutica anticongestiva que mantinha na altura da admissão no nosso Centro. Ecocardiograficamente suspeitou‐se de Origem Anómala da Artéria Coronária Esquerda da Artéria Pulmonar, sendo este diagnóstico confirmado através de angiotomografia computorizada e cateterismo cardíaco. A doente foi submetida, com sucesso, a implantação direta da artéria coronária esquerda na aorta permitindo criar um sistema de perfusão coronário duplo. Este caso ilustra uma forma incomum de uma patologia rara que sobreviveu sem diagnóstico após o primeiro ano de vida. Reforça igualmente a importância da multimodalidade de imagem nestes casos. Abstract: Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery is a rare congenital heart disease and a cause of myocardial ischemia during childhood. Most undiagnosed cases die in the first year of life as an extensive collateral network is essential for survival. The diagnosis requires a high index of clinical suspicion. The authors present the case of an 8‐year‐old black asymptomatic child referred from Cape Verde Island in order to clarify left ventricular dilatation and dysfunction with systo‐diastolic turbulent flows observed at the interventricular septum. At the age of 3 months, she was diagnosed with heart failure, in the context of showing dilated cardiomyopathy. She was managed and clinically improved with anticongestive therapy, which she was still taking at the time of admission to our Center. The echocardiogram findings suggested Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery and the diagnosis was confirmed by computerized angiotomography and cardiac catheterization. The patient was successfully submitted to direct implantation of the left coronary artery into the aorta, allowing the creation of a double coronary perfusion system. This case illustrates an unusual presentation of a rare pathology that survived without a diagnosis after the first year of life. It also reinforces the importance of multimodality image screening in these cases. Palavras‐chave: ALCAPA, Síndrome de Bland‐White‐Garland, Anomalia das coronárias, Circulação colateral inter‐coronária, Cardiopatia congénita, Procedimento de Takeuchi, Keywords: ALCAPA, Bland‐White‐Garland Syndrome, Coronary anomalies, Inter‐coronarian collateral circulation, Congenital cardiopathy, Takeuchi procedure
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- 2019
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9. Células progenitoras endoteliais circulantes em crianças e adolescentes obesos
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António Pires, Paula Martins, Artur Paiva, Ana Margarida Pereira, Margarida Marques, Eduardo Castela, Cristina Sena, and Raquel Seiça
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Obesidade infantil ,Proteína C reativa ,Proteína quimiotática de monócitos-1 ,E-seleticna ,Dimetilarginina assimétrica ,Células progenitoras endoteliais ,Pediatrics ,RJ1-570 - Abstract
Resumo Objetivo Investigar a relação entre os números de células progenitoras endoteliais circulantes e a ativação endotelial em uma população pediátrica com obesidade. Métodos Estudo observacional e transversal, que incluiu 120 crianças e adolescentes com obesidade primária de ambos de sexos, entre seis e 17 anos, recrutados de nossa Clínica de Riscos Cardiovasculares. O grupo de controle contou com 41 crianças e adolescentes com índice de massa corporal normal. As variáveis analisadas foram: idade, sexo, índice de massa corporal, pressão arterial sistólica e diastólica, proteína C reativa de alta sensibilidade, perfil lipídico, leptina, adiponectina, resistência à insulina para avaliação do modelo de homeostase, proteína quimiotática de monócitos-1, E-seleticna, dimetilarginina assimétrica e números de células endoteliais progenitoras circulantes. Resultados A resistência à insulina foi correlacionada à dimetilarginina assimétrica (p = 0,340; p = 0,003), que foi diretamente correlacionada, porém de forma muita amena, à E-seleticna (ρ = 0,252; p = 0,046). Não constatamos que a proteína C reativa de alta sensibilidade estivesse correlacionada a marcadores de ativação endotelial. A pressão arterial sistólica foi diretamente correlacionada ao índice de massa corporal ρ = 0,471; p < 0,001) e à resistência à insulina para avaliação do modelo de homeostase (ρ = 0,230; p = 0,012) e inversamente correlacionada à adiponectina (ρ = −0,331; p < 0,001) e à lipoproteína de alta densidade-colesterol ρ = −0,319; p < 0,001). Os números de células progenitoras endoteliais circulantes foram diretamente correlacionados, porém de forma muito amena, ao índice de massa corporal (r = 0,211; p = 0,016), à leptina (ρ = 0,245; p = 0,006), aos níveis de triglicerídeos (r = 0,241; p = 0,031) e à E-seleticna ρ = 0,297; p = 0,004). Conclusão Os números de células progenitoras endoteliais circulantes são elevados em crianças e adolescentes obesos com comprovação de ativação endotelial. Isso sugere que, na infância, os mecanismos de reparação endotelial estão presentes no contexto da ativação endotelial.
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- 2015
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10. Circulating endothelial progenitor cells in obese children and adolescents
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António Pires, Paula Martins, Artur Paiva, Ana Margarida Pereira, Margarida Marques, Eduardo Castela, Cristina Sena, and Raquel Seiça
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Pediatric obesity ,C‐reactive protein ,Monocyte chemoattractant protein‐1 ,E‐selectin ,Asymmetric dimethylarginine ,Endothelial progenitor cells ,Pediatrics ,RJ1-570 - Abstract
Objective: This study aimed to investigate the relationship between circulating endothelial progenitor cell count and endothelial activation in a pediatric population with obesity. Methods: Observational and transversal study, including 120 children and adolescents with primary obesity of both sexes, aged 6–17 years, who were recruited at this Cardiovascular Risk Clinic. The control group was made up of 41 children and adolescents with normal body mass index. The variables analyzed were: age, gender, body mass index, systolic and diastolic blood pressure, high‐sensitivity C‐reactive protein, lipid profile, leptin, adiponectin, homeostasis model assessment‐insulin resistance, monocyte chemoattractant protein‐1, E‐selectin, asymmetric dimethylarginine and circulating progenitor endothelial cell count. Results: Insulin resistance was correlated to asymmetric dimethylarginine (ρ = 0.340; p = 0.003), which was directly, but weakly correlated to E‐selectin (ρ = 0.252; p = 0.046). High sensitivity C‐reactive protein was not found to be correlated to markers of endothelial activation. Systolic blood pressure was directly correlated to body mass index (ρ = 0.471; p
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- 2015
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11. Abdominal pain of cardiovascular origin
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Pedro Epifânio, Maria Emanuel Amaral, Natália Noronha, Paula Martins, Dina Rodrigues, António Pires, and Eduardo Castela
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Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Infective endocarditis is a microbial infection of the endocardium and it is rare in the pediatric population. In children, congenital heart disease is one of the most important risk factors for developing infective endocarditis and can involve other structures in addition to cardiac valves. The prognosis is generally better than in other forms of endocarditis, although the average mortality rate in the pediatric population is 15-25%. Clinical manifestations can mimic other diseases such as meningitis and collagen-vascular disease or vasculitis. Therefore, a high degree of suspicion is required to make an early diagnosis. Gram-positive bacteria, specifically alpha-hemolytic streptococci, Staphylococcus aureus and coagulase-negative staphylococci, are the most commonly involved bacteria. Diagnosis is based on the modified Duke criteria, which rely mostly on clinical assessment, echocardiography and blood cultures. Antibacterial treatment should ideally be targeted. However, if no specific bacteria have been identified, patients should promptly be treated empirically with multiple drug regimens based on local resistance and the most common etiologies.The authors describe a case of a seven-year-old girl with classic clinical signs of endocarditis, with a clinical twist. Resumo: A endocardite infecciosa é uma infecção microbiana do endocárdio e é rara na população pediátrica. Nessa faixa etária, a doença cardíaca congénita é um dos fatores de risco mais importantes para o desenvolvimento de endocardite infecciosa, pode envolver outras estruturas para além das válvulas cardíacas. O prognóstico é geralmente melhor do que noutras formas de endocardite, embora a taxa média de mortalidade em população pediátrica seja em torno a de 15-25%. As manifestações clínicas podem mimetizar outras doenças, tais como meningite, vasculite ou doença vascular do colagénio, e, por conseguinte, é necessário um elevado grau de suspeita para fazer um diagnóstico precoce. Os microrganismos mais frequentemente implicados são as bactérias gram-positivas, especificamente os estreptococos alfa-hemolíticos, Staphylococcus aureus e estafilococos coagulase-negativos. O diagnóstico baseia-se nos critérios de Duke modificados, que dependem principalmente da avaliação clínica, da ecocardiografia e de hemoculturas. O tratamento antibacteriano deve ser orientado ao microrganismo em causa. No entanto, na ausência de organismos identificados, o tratamento empírico não deve ser adiado, devem-se usar diferentes combinações de antibióticos e ter em conta as resistências locais e etiologias mais frequentes. Os autores descrevem um caso de uma menina de sete anos com sinais clínicos clássicos de endocardite, com uma reviravolta clínica. Keywords: Infective endarteritis, Native aortic coarctation, Thromboembolic infarcts, Staphylococcus schleiferi, Palavras-chave: Endarterite infecciosa, Coartação da aorta nativa, Enfartes tromboembólicos, Staphylococcus schleiferi
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- 2018
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12. Insulin Resistance, Dyslipidemia and Cardiovascular Changes in a Group of Obese Children
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António Pires, Paula Martins, Ana Margarida Pereira, Patricia Vaz Silva, Joana Marinho, Margarida Marques, Eduardo Castela, Cristina Sena, and Raquel Seiça
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Obesidade Pediátrica ,Resistência à Insulina ,Dislipidemias ,Doenças Cardiovasculares ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Introduction: Obesity-related comorbidities are present in young obese children, providing a platform for early adult cardiovascular disorders. Objectives: To compare and correlate markers of adiposity to metabolic disturbances, vascular and cardiac morphology in a European pediatric obese cohort. Methods: We carried out an observational and transversal analysis in a cohort consisting of 121 obese children of both sexes, between the ages of 6 and 17 years. The control group consisted of 40 children with normal body mass index within the same age range. Markers of adiposity, plasma lipids and lipoproteins, homeostasis model assessment-insulin resistance, common carotid artery intima-media thickness and left ventricular diameters were analyzed. Results: There were statistically significant differences between the control and obese groups for the variables analyzed, all higher in the obese group, except for age, high-density lipoprotein cholesterol and adiponectin, higher in the control group. In the obese group, body mass index was directly correlated to left ventricular mass (r=0.542; p=0.001), the homeostasis model assessment-insulin resistance (r=0.378; p=
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- 2015
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13. PROPOSAL OF AN EMPIRICAL MODEL FOR SUPPLIERS SELECTION
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Paulo Ávila, Alzira Mota, Goran Putnik, Lino Costa, António Pires, João Bastos, and M.M. Cruz-Cunha
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Suppliers/partners selection model ,hierarchical structure criteria ,linear weighting methods ,Analytic Hierarchy Process ,Multi-Attribute Rating Technique ,Management. Industrial management ,HD28-70 - Abstract
The problem of selecting suppliers/partners is a crucial and important part in the process of decision making for companies that intend to perform competitively in their area of activity. The selection of supplier/partner is a time and resource-consuming task that involves data collection and a careful analysis of the factors that can positively or negatively influence the choice. Nevertheless it is a critical process that affects significantly the operational performance of each company. In this work, trough the literature review, there were identified five broad suppliers selection criteria: Quality, Financial, Synergies, Cost, and Production System. Within these criteria, it was also included five sub-criteria. Thereafter, a survey was elaborated and companies were contacted in order to answer which factors have more relevance in their decisions to choose the suppliers. Interpreted the results and processed the data, it was adopted a model of linear weighting to reflect the importance of each factor. The model has a hierarchical structure and can be applied with the Analytic Hierarchy Process (AHP) method or Simple Multi-Attribute Rating Technique (SMART). The result of the research undertaken by the authors is a reference model that represents a decision making support for the suppliers/partners selection process.
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- 2015
14. Pro-inflammatory triggers in childhood obesity: Correlation between leptin, adiponectin and high-sensitivity C-reactive protein in a group of obese Portuguese children
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António Pires, Paula Martins, Ana Margarida Pereira, Joana Marinho, Patrícia Vaz Silva, Margarida Marques, Eduardo Castela, Cristina Sena, and Raquel Seiça
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Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Introduction: Pediatric obesity is increasingly prevalent in the Portuguese population. Adipocyte dysfunction results in the expression of pro-inflammatory mediators that are responsible for the low-grade inflammatory process that characterizes obesity. Objectives: The aim of this study was to investigate the relationship between markers of adiposity, inflammation and adipokines in a Portuguese obese pediatric population. Methods: One hundred and twenty children of both sexes, aged 6–17 years, were included in this study. The control group consisted of 41 healthy normal-weight children. The variables analyzed were age, gender, body mass index, waist circumference, fat mass percentage, high-sensitivity C-reactive protein (hs-CRP), leptin and adiponectin. Results: There were significant differences between controls and obese children for all parameters analyzed. In the obese group, after controlling for age and gender, hs-CRP (p=0.041), adiponectin (p=0.019) and leptin (p
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- 2014
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15. O SUJEITO SIMULADOR NA AVALIAÇÃO PSICOLÓGICA FORENSE
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Francisco Valente Gonçalves, António Pires, and Ângela Vila-Real
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Law in general. Comparative and uniform law. Jurisprudence ,K1-7720 - Abstract
A simulação é um dos comportamentos mais esperados e observados durante uma avaliação psicológica em contexto forense. A perspetiva teórica dos profissionais condiciona o seu foco clínico e métodos a aplicar. Contudo uma visão rígida poderá condicionar uma recolha de maior qualidade sobre o sujeito avaliado. Procurou-se analisar a literatura referente a dois conceitos associados ao comportamento de simulação, o conceito de impostor, referido pela teoria psicanalítica, e o conceito malingering, fundamentado por uma perspetiva cognitivo-comportamental. Assim, realizou-se uma revisão dos pressupostos considerados numa avaliação psicológica em âmbito forense, da noção de inimputabilidade no sistema jurídico português e dos conceitos impostor e malingering. O objetivo é o de juntar esforços e promover a interação dos profissionais de psicologia forense, ainda que, com quadros teóricos de referência distintos. Será a articulação de mais saberes que proporcionará uma compreensão de maior qualidade sobre os fenómenos em que o sujeito simulador está circunscrito? As conclusões sugerem a necessidade de olhar e analisar o sujeito através de diferentes perspetivas a fim de melhor categorizar e compreender os traços de comportamento associados ao comportamento de simulação e ao funcionamento psíquico do sujeito simulador. Palavras-chave: Avaliação psicológica forense, simulação, malingering.
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- 2017
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16. Rare forms of pediatric congenital right ventricular fistulae
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Natália Noronha, Pedro Pires Epifânio, Paula Martins, António Pires, António Marinho, and Eduardo Castela
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Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Published
- 2018
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17. Infant heart tumour
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Pedro Epifânio, Maria Emanuel Amaral, Natália Noronha, Andreia Francisco, Dina Rodrigues, António Pires, and Eduardo Castela
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Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Published
- 2018
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18. Endocardite infecciosa como primeira manifestação de cardiopatia congénita de apresentação tardia
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Patrícia Vaz Silva, Joana Castro Marinho, Paula Martins, Isabel Santos, António Pires, Graça Sousa, and Eduardo Castela
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Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Resumo: O diagnóstico de cardiopatia congénita é estabelecido habitualmente em idade precoce, logo, a endocardite infecciosa é uma forma de apresentação rara desta patologia.Descreve-se um caso clínico de um adolescente com febre intermitente com uma semana de evolução e perda ponderal não quantificada. A observação detetou um sopro holossistólico rude e um sopro diastólico, associados a um frémito na região precordial. Analiticamente, apresentava sinais sugestivos de um processo infeccioso ativo. A investigação etiológica revelou a presença de uma comunicação interventricular perimembranosa restritiva, bicuspidia aórtica com regurgitação aórtica e vegetações a nível da válvula mitral e aórtica. Perante o diagnóstico de endocardite mitroaórtica, iniciou antibioterapia endovenosa associada a terapêutica anticongestiva. Após melhoria clínica inicial, desenvolveu quadro de insuficiência cardíaca congestiva. Repetiu o ecocardiograma, que mostrou abcesso paravalvular aórtico e mitral extenso. A antibioterapia foi substituída e a terapêutica anticongestiva foi intensificada. Foi posteriormente submetido a cirurgia cardíaca. A evolução tem sido favorável, mantendo-se assintomático sob terapêutica anticongestiva. Abstract: A diagnosis of congenital heart disease is usually established at an early age, so infective endocarditis is a rare form of presentation.The authors describe the case of a male adolescent with a week-long history of intermittent fever and unquantified weight loss. Physical examination detected pansystolic and diastolic murmurs, and an associated precordial thrill. Laboratory tests showed evidence of an active infection. Etiological investigation revealed a perimembranous ventricular septal defect, aortic regurgitation, and aortic and mitral valve vegetations. A diagnosis of mitral-aortic infective endocarditis was made and he was started on intravenous antibiotics and anticongestive therapy. After initial clinical improvement, he developed symptoms and signs of congestive heart failure. Repeat echocardiography showed an extensive mitral-aortic paravalvular abscess. The antibiotics were changed and anticongestive therapy was intensified, and he subsequently underwent surgery. The outcome has been generally favorable, and at present he is asymptomatic under anticongestive therapy. Palavras-chave: Endocardite infecciosa, Comunicação interventricular, Staphylococcus aureus, Key words: Infective endocarditis, Ventricular septal defect, Staphylococcus aureus
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- 2013
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19. Reply to the Letter to the Editor 'High-sensitivity C-reactive protein in obese children: Too complex a marker to use?'
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António Pires
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Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Published
- 2015
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20. Obesidade: Paradigma da Disfunção Endotelial em Idade Pediátrica
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António Pires, Eduardo Castela, Cristina Sena, and Raquel Seiça
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Criança ,Endotélio Vascular ,Obesidade Pediátrica ,Tecido Adiposo. ,Medicine ,Medicine (General) ,R5-920 - Abstract
Introdução: A obesidade é considerada pela Organização Mundial de Saúde como uma epidemia global sendo considerada um factor de risco cardiovascular independente. Material e Métodos: Estima-se que cerca de 10% da população pediátrica mundial apresente excesso de peso ou obesidade e que cerca de 40% sejam obesas na vida adulta. A obesidade caracteriza-se por um processo pró-inflamatório crónico que resulta na lesão do endotélio. O resultante desequilíbrio na produção de mediadores que normalmente regulam a homeostasia vascular, particularmente a biodisponibilidade do óxido nítrico, favorece um ambiente pró-aterosclerótico propício ao desenvolvimento da doença cardiovascular. Resultados: Estudos anátomo-patológicos em crianças com excesso de peso ou obesidade evidenciam lesões do endotélio que se traduzem nos precursores da lesão aterosclerótica. Discussão: A disfunção endotelial é a manifestação mais precoce da lesão aterosclerótica. Estas alterações evidenciam-se precocemente em crianças obesas, contribuindo para a doença cardiovascular no adulto. Conclusão: As repercussões clínicas destas alterações raramente se manifestam em idade pediátrica, sendo detectadas apenas através de biomarcadores, alterações morfológicas dos vasos ou modificações do tónus arterial periférico.
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- 2015
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21. Total anomalous pulmonary venous return
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Pedro Epifânio, Maria Emanuel Amaral, Ângela Moreira, Dina Rodrigues, António Pires, and Eduardo Castela
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Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Published
- 2016
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22. Tumor cardíaco em criança assintomática: um diagnóstico acidental
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Carolina Cordinhã, Ângela Pereira, Patrícia Vaz Silva, Teresa Dionísio, Paula Martins, Graça Sousa, Isabel Santos, António Pires, Lúcia Ribeiro, and Eduardo Castela
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Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Resumo: Os tumores cardíacos são uma entidade rara em idades pediátricas, com uma incidência variável entre 0,001% e 0,003%. Sendo habitualmente benignos, os rabdomiomas e os fibromas são os tipos histológicos mais frequentes. A clínica é inespecífica e dependente das dimensões e localização do tumor.Descreve-se o caso de uma criança de quatro anos previamente saudável e assintomática, observada em contexto de infecção respiratória, tendo-se identificado cardiomegália na teleradiografia torácica. A ecocardiografia transtorácica revelou uma massa volumosa e heterogénea no ventrículo esquerdo, sem causar obstrução da câmara de saída ou disfunção valvular. A ressonância magnética foi sugestiva de fibroma. Procedeu-se a terapêutica cirúrgica, com excisão completa que confirmou fibroma mantendo-se assintomática. Abstract: Cardiac tumors in the pediatric population are rare, their incidence range between 0.001% and 0.003%. They are mostly benign, rhabdomyomas the most common type, followed by fibromas. The clinical features are being usually nonspecific and depend on the size and location of the tumor within the heart.We report the case of a previously healthy four-year-old boy referred for flu-like symptoms. A respiratory infection was suspected and a chest X-ray showed an increased cardiothoracic index. An echocardiogram revealed a single large heterogeneous mass in the left ventricle emerging from the lateral wall. Despite its size, the mass did not obstruct the left ventricular outflow tract or affect mitral valve function. Cardiac magnetic resonance imaging showed a large mass whose imaging features were suggestive of a fibroma. He became symptomatic during follow-up and was referred for surgical excision of the mass. Histological study confirmed a fibroma. At present the patient remains asymptomatic. Palavras-chave: Tumores cardíacos, Pediatria, Ressonância magnética cardíaca, Fibroma, Keywords: Cardiac tumors, Pediatric, Cardiac magnetic resonance imaging, Fibroma
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- 2011
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23. Sopro cardíaco pediátrico: estudo de série de casos
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Rita Oliveira, Luís Martins, Helena Andrade, António Pires, and Eduardo Castela
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Sopro Cardiaco ,Pediatria ,Medicine (General) ,R5-920 - Abstract
Introdução: Em cerca de metade da população pediátrica é detectado um sopro cardíaco (SC) em algum momento da sua vida. Os SC constituem uma causa frequente de referenciação a Consulta de Pediatria e/ou Cardiologia Pediátrica, pelo que se torna importante o conhecimento dos sinais de alarme evocadores de cardiopatia na avaliação de uma criança com SC. Objectivo: Estudo da população referenciada a Consulta de Cardiologia Pediátrica entre Janeiro e Março de 2012 com o diagnóstico de SC. Material e Métodos: Estudo de uma série de casos de crianças referenciadas por SC. Foram analisados dados, avaliando variáveis demográficas, anamnésicos, sinais clínicos e resultado dos exames complementares, nomeadamente ecocardiografia transtorácica e electrocardiograma. Resultados: No período em análise, realizaram-se um total de 743 primeiras consultas de Cardiologia Pediátrica, das quais em 197 (26,5%) o motivo de referenciação foi SC. Das crianças avaliadas, 51,3% pertenciam ao sexo masculino e a maioria (cerca de 70%) tinha idade inferior a 2 anos. Na quase totalidade das crianças o SC apresentava características de sopro inocente e o restante exame objectivo não apresentava alterações de relevo. Em cerca de 1/3 dos casos foi detectada alteração na avaliação ecocardiográfica. Do cruzamento entre as diferentes variáveis em análise destaca-se uma relação estatisticamente significativa entre auscultação de sopro não inocente, alterações ao exame objectivo e ecocardiografia patológica. Verificou-se também uma associação positiva e com significância estatística entre o grupo etário inferior a 1 ano e os achados ecocardiográficos. Discussão: O SC em idade pediátrica é um motivo frequente de referenciação a Consulta da especialidade. Na sua maioria, o SC em pediatria é uma condição benigna e as características clínicas parecem suficientes para diferenciação de uma condição potencialmente patológica. Tal como descrito em estudos anteriores, alterações ao exame físico e idade inferior a 2 anos são sinais de alarme que requerem avaliação mais detalhada.
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- 2013
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24. Physiological variables and estimates of heat exchange in sheep kept at thermoneutral and thermal stress temperatures
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Silva, Ricardo de Sousa, Furtado, Dermeval Araújo, Ribeiro, Neila Lidiany, Neto, José Pinheiro Lopes, Rodrigues, Raimundo Calixto Martins, Oliveira, Airton Gonçalves de, Silva, José Antônio Pires da Costa, Silva, Maycon Rodrigues da, Mascarenhas, Nágela Maria Henrique, Marques, Jordânio Inácio, and Morais, Fabiana Tereza Leal de
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- 2024
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25. Erdafitinib versus pembrolizumab in pretreated patients with advanced or metastatic urothelial cancer with select FGFR alterations: cohort 2 of the randomized phase III THOR trial
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Bastick, Patricia, Sewak, Sanjeev, Tran, Ben, Pichler, Martin, Shariat, Shahrokh, Rottey, Sylvie, Schatteman, Peter, Schrijvers, Dirk, Verschaeve, Vincent, Vulsteke, Christof, Barros Leite Ferreira, Luiza Aleixo, de Santana Gomes Andrea Juliana, Pereira, Junior, Joao Antonio, Azevedo, Sergio, Bastos, Diogo, Borges, Giuliano, Dettino, Aldo, Antonio, Pires Luis, Luz, Murilo, Martins, Suelen, Mota, Jose Mauricio, Toledo, Joseane, Eigl, Bernhard, Finch, Daygen, Gingerich, Joel, Dong, Haiying, Huang, Jian, Jin, Jie, Pan, Hongming, Sun, Zhongquan, Tian, Ye, Wan, Ben, Wu, Bin, Xu, Ting, Xue, Wei, Zhou, Fangjian, Barthelemy, Philippe, Borchiellini, Delphine, Calcagno, Fabien, Carnot, Aurelien, Cornillon, Pierre, Delva, Remy, Emambux, Sheik, Houede, Nadine, Laguerre, Brigitte, Lauridant, Géraldine, Loriot, Yohann, Mahammedi, Hakim, Maillet, Denis, Pouessel, Damien, Roubaud, Guilhem, Schlurmann-Constans, Friederike, Tosi, Diego, Zanetta, Sylvie, Banek, Severine, Feyerabend, Susan, Kramer, Mario, Niegisch, Guenther, Nuhn, Philipp, Schnabel, Marco, Wuelfing, Christian, Baka, Sofia, Bamias, Aristotelis, Fountzilas, George, Kalofonos, Harabolos, Karalis, Konstantinos, Kotsakis, Athanasios, Timotheadou, Eleni, Landherr, Laszlo, Mangel, Laszlo, Pe’er, Avivit, Levratovsky, Meital, Basso, Umberto, Battelli, Nicola, Cavo, Alessia, De Giorgi, Ugo, Doni, Laura, Galli, Luca, Gigante, Maria Olga, Guadalupi, Valentina, Maio, Michele, Milesi, Laura, Nolè, Franco, Scagliotti, Giorgio, Tortora, Giampaolo, Fukasawa, Satoshi, Harabayashi, Toru, Kamiya, Naoto, Kawahara, Takashi, Kawakita, Mutsushi, Matsubara, Nobunaki, Matsumoto, Kazumasa, Nishimura, Kazuo, Rikiya, Taoka, Shimizu, Nobuaki, Tagaki, Toshio, Kang, Taek Won, Kim, Jwa Hoon, Kim, SeHyun, Lee, Hyo Jin, Lee, Yun-Gyoo, Rha, Sun Young, Seo, Ho Kyung, Los, Maartje, Zurawski, Bogdan, Cortes, Paulo, Faustino, Catia, Vau, Nuno Sineiro, da Luz, Ricardo, Atduev, Vagif, Kirtbaya, Dmitry, Kopyltsov, Evgeny, Lykov, Aleksandr, Marat, Urmantsev, Orlov, Sergey, Penkov, Konstantin, Pirmagomedov, Albert, Semenov, Andrey, Varlamov, Sergey, Anguera, Georgia, Domenech, Montserrat, Girones, Regina, Gonzalez del Alba, Aranzazu, Milagro, Nuria Lainez, Luque, Raquel, Ortega, Esther Martínez, Mellado, Begoña, Méndez Vidal, María Jose, Fernandez, Esteban Nogales, Valderrama, Begoña Perez, Marín, Alvaro Pinto, Santander, Carmen, Huang, Yi-Hsiu, Su, Wen-Pin, Wu, Hung-Chan, Wu, WenJeng, Yu, Kai-Jie, Bilici, Ahmet, Goker, Erdem, Gumus, Mahmut, Karaoglu, Aziz, Kefeli, Umut, Köse, Fatih, Ozguroglu, Mustafa, Tural, Deniz, Turk, Haci, Yalcin, Suayib, Bondarenko, Igor, Khareba, Gennadii, Kidik, Yana, Lychkovskyy, Oleksandr, Sakalo, Valerii, Shevnia, Serghii, Stakhovskyy, Eduard, Bahl, Amit, Crabb, Simon, Powles, Thomas, Sankey, Peter, Sarwar, Mohammad, Benedetto, Pasquale, Burgess, Earle, Dawson, Nancy, Doshi, Gurjyot, Fleming, Mark, Maly, Joseph, Parikh, Mamta, Waterhouse, David, Siefker-Radtke, A.O., Matsubara, N., Park, S.H., Huddart, R.A., Burgess, E.F., Özgüroğlu, M., Valderrama, B.P., Laguerre, B., Basso, U., Triantos, S., Akapame, S., Kean, Y., Deprince, K., Mukhopadhyay, S., and Loriot, Y.
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- 2024
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26. Blood biochemical, hormonal, and hematological responses of native sheep submitted to different environmental conditions
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Rodrigues, Raimundo Calixto Martins, Furtado, Dermeval Araújo, Ribeiro, Neila Lidiany, de Sousa Silva, Ricardo, da Costa Silva, José Antônio Pires, da Silva, Maycon Rodrigues, Mascarenhas, Nágela Maria Henrique, Cavalcanti, Cácio Ribeiro, Ayres, Gypson Dutra Junqueira, Dornelas, Karoline Carvalho, Lima, Patricia Rodriguesde, and de Figueiredo, Caio Franklin Vieira
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- 2023
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27. Thermal stress index for native sheep
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Mascarenhas, Nágela Maria Henrique, Furtado, Dermeval Araújo, Fonsêca, Vinicius de França Carvalho, de Souza, Bonifácio Benício, de Oliveira, Airton Gonçalves, Leal Morais, Fabiana Teresinha, Silva, Ricardo de Sousa, Silva, Maycon Rodrigues da, Batista, Luanna Figueiredo, Dornelas, Karoline Carvalho, Bezerra, Carlos Vailan de Castro, and Costa Silva, José Antonio Pires da
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- 2023
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28. Berry syndrome: a rare cause of cardiac failure in the early neonatal period
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João Dias, Joana Marinho, Dina Rodrigues, and António Pires
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Heart Failure ,Infant, Newborn ,Humans ,General Medicine ,Mandibulofacial Dysostosis - Published
- 2024
29. METROLOGICAL CONCEPTS AND APPLICATIONS OF 3D OPTICAL SCANNING
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Yamanaka, Douglas Mamoru, primary, Castanho, Manuel António Pires, additional, and Yoshida, Olga Satomi, additional
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- 2024
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30. Dimensional assessment of rolling mill roll using form measurement instrument
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Yamanaka, Douglas Mamoru, primary and Castanho, Manuel António Pires, additional
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- 2024
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31. Framework for a risk assessment model to apply in Virtual / Collaborative Enterprises.
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Paulo ávila 0001, Alzira Mota, João Bastos, Leonel Patrício, António Pires, Hélio Castro, Maria Manuela Cruz-Cunha, and Leonilde Varela
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- 2020
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32. Congenital heart defects and preterm birth: Outcomes from a referral center
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Andreia Palma, Sofia Morais, Patrícia V. Silva, and António Pires
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Cardiology and Cardiovascular Medicine - Published
- 2023
33. Doença de Kawasaki: Preditores de Resistência à Imunoglobulina Intravenosa e Complicações Cardíacas
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Diogo Faim, Cláudio Henriques, Ana Brett, Andreia Francisco, Fernanda Rodrigues, and António Pires
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Doença de Kawasaki/complicações ,Síndrome de Linfonodos Mucocutâneos/complicações ,Resistência à Medicamentos ,Doenças da Artéria Coronariana ,Imunoglobulina ,Criança ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Resumo Fundamento: A doença de Kawasaki (DK) é a principal causa de cardiopatia adquirida em idade pediátrica nos países desenvolvidos. Objetivos: Identificar fatores preditores de resistência à imunoglobulina intravenosa (IGIV), calcular a eficácia dos modelos preditores japoneses e caracterizar as complicações cardíacas. Métodos: Análise retrospectiva dos casos de DK entre janeiro de 2006 e julho de 2018 em um hospital pediátrico português. Foram construídas curvas ROC para encontrar fatores preditores de resistência e utilizada regressão logística multivariada para elaborar o modelo preditor. O nível de significância utilizado foi de 5%. Resultados: Foram incluídos 48 pacientes com mediana de idade de 36 meses. Verificou-se resistência à IGIV em 21%. Ocorreram alterações ecocardiográficas em 46%, com envolvimento coronário em 25%. Como variáveis preditoras de resistência, a proteína C-reativa (PC-R) apresentou uma AUC ROC = 0,789, ponto de corte = 15,1 mg/dL, sensibilidade (S) = 77,8% e especificidade (E) = 78,9%. A velocidade de sedimentação (VS) apresentou uma AUC ROC = 0,781, ponto de corte = 90,5 mm/h, S = 66,7% e E = 85,7%. O modelo com as duas variáveis apresentou valor p = 0,042 e AUC ROC = 0,790. O modelo Kobayashi apresentou S = 63,6% e E = 77,3%; Egami, S = 66,7% e E = 73,1%; e Sano, S = 28,6% e E = 94,1%. Conclusão: A PC-R e a VS são variáveis independentes que mostraram tendência preditora de resistência à IGIV com pontos de corte ótimos de 15,1 mg/dL e 90,5 mm/h, respectivamente. Cerca de metade dos pacientes teve algum tipo de envolvimento cardíaco. Os modelos japoneses não têm utilidade nessa população. (Arq Bras Cardiol. 2021; 116(3):485-491)
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34. Towards integration of data-driven agronomic experiments with data provenance
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Cruz, Sérgio Manuel Serra da and Nascimento, José Antonio Pires do
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- 2019
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35. Dimensional metrology of image fusion: a computer vision approach
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Yamanaka, Douglas Mamoru, primary and Castanho, Manuel António Pires, additional
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- 2023
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36. METROLOGIA DIMENSIONAL DA FUSÃO E DA SEGMENTAÇÃO DE IMAGENS
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Yamanaka, Douglas Mamoru, primary and Castanho, Manuel António Pires, additional
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- 2020
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37. Incidental finding in a newborn with respiratory distress
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Natália Noronha, Pedro Pires Epifânio, Patrícia Vaz Silva, António Pires, António Marinho, and Eduardo Castela
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Medicine - Full Text
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38. SisGExp: Rethinking Long-Tail Agronomic Experiments
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Manuel Serra da Cruz, Sergio, do Nascimento, José Antonio Pires, Hutchison, David, Series editor, Kanade, Takeo, Series editor, Kittler, Josef, Series editor, Kleinberg, Jon M., Series editor, Mattern, Friedemann, Series editor, Mitchell, John C., Series editor, Naor, Moni, Series editor, Pandu Rangan, C., Series editor, Steffen, Bernhard, Series editor, Terzopoulos, Demetri, Series editor, Tygar, Doug, Series editor, Weikum, Gerhard, Series editor, Mattoso, Marta, editor, and Glavic, Boris, editor
- Published
- 2016
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39. Cardiac tumours in children: a single-centre experience and literature review
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Diogo Faim, Andreia Francisco, and António Pires
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Pediatrics, Perinatology and Child Health ,General Medicine ,Cardiology and Cardiovascular Medicine - Abstract
Cardiac tumours are extremely rare in children. Although more than 90% are benign, children can develop obstructive or embolisation derived symptoms, arrhythmias, constitutional symptoms, cardiac tamponade, or even sudden death. Although the majority are asymptomatic, and some spontaneously regress, appropriate follow-up is needed on a case-by-case basis, as patients may develop late symptoms. Definitive diagnosis is only possible through histological analysis; however, it is possible to infer tumour type with a high grade of certainty based on imaging features, particularly cardiac magnetic resonance. Surgical resection is advocated for those causing symptoms, obstruction, cardiac dysfunction, and high risk of embolisation. The aim of this review is to present the state of the art related to cardiac tumours in the paediatric population, in the context of our own experience.
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- 2022
40. Radiographic study on the tibial insertion of the posterior cruciate ligament
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Gali, Julio Cesar, Esquerdo, Paulo, Almagro, Marco Antonio Pires, and da Silva, Phelipe Augusto Cintra
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- 2015
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41. Estudo radiográfico da inserção tibial do ligamento cruzado posterior
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Gali, Julio Cesar, Esquerdo, Paulo, Almagro, Marco Antonio Pires, and Silva, Phelipe Augusto Cintra da
- Published
- 2015
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42. Importance of anatomically locating the infrapatellar branch of the saphenous nerve in reconstructing the anterior cruciate ligament using flexor tendons
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Gali, Julio Cesar, Resina, André França, Pedro, Gabriel, Neto, Ildefonso Angelo Mora, Almagro, Marco Antonio Pires, da Silva, Phelipe Augusto Cintra, and Caetano, Edie Benedito
- Published
- 2014
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43. Importância da localização anatômica do ramo infrapatelar do nervo safeno na reconstrução do ligamento cruzado anterior com tendões flexores
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Gali, Julio Cesar, Resina, André França, Pedro, Gabriel, Neto, Ildefonso Angelo Mora, Almagro, Marco Antonio Pires, da Silva, Phelipe Augusto Cintra, and Caetano, Edie Benedito
- Published
- 2014
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44. Time-resolved luminescence studies of Eu3+ in soda-lime silicate glasses
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Ruivo, Andreia, Muralha, Vânia S.F., Águas, Hugo, de Matos, António Pires, and Laia, César A.T.
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- 2014
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45. Punção Trans Túnel Intra-Atrial Guiada por Imagem Multimodal e Sistema de Mapeamento 3-D com Integração de TC em Doente com Flutter Atrial Pós Cirurgia de Senning
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Patrícia Viana da Silva, Pedro Sousa, António Pires, and Andreia Palma
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Flutter atrial ,medicine.medical_specialty ,Ablação por cateter ,Transposição das Grandes Artérias ,medicine.medical_treatment ,Catheter ablation ,Punctures ,Imagem ,Catheter manipulation ,Internal medicine ,medicine ,Diseases of the circulatory (Cardiovascular) system ,Humans ,Atrium (heart) ,business.industry ,Arrhythmias, Cardiac ,Transeptal Puncture ,medicine.disease ,Arterial Switch Operation ,medicine.anatomical_structure ,Atrial Flutter ,Great arteries ,RC666-701 ,Cirurgia de Senning ,Image ,Catheter Ablation ,Cardiology ,Senning Procedure ,Tomography, X-Ray Computed ,Cardiology and Cardiovascular Medicine ,business ,Punção transeptal ,Atrial flutter ,Senning Surgery - Abstract
The complex post-surgical anatomy after the Senning procedure presents several challenges for catheter ablation. Transbaffle approach allows access to the pulmonary venous atrium and better catheter manipulation. However, this modified transseptal puncture can be challenging to perform. The authors present the case of a 29-year-old woman who underwent a Senning procedure for dextro-transposition of the great arteries. The patient had recurrent episodes of atrial flutter despite adequate antiarrhythmic therapy and was referred for catheter ablation. […] Transbaffle Puncture Using Multimodality [...]
- Published
- 2021
46. Cardiovascular manifestations of Hutchinson–Gilford progeria syndrome
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Andreia Palma, Patrícia V. Silva, and António Pires
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congenital, hereditary, and neonatal diseases and abnormalities ,integumentary system ,Pediatrics, Perinatology and Child Health ,nutritional and metabolic diseases ,General Medicine ,Cardiology and Cardiovascular Medicine - Abstract
Cardiovascular complications are the most frequent cause of death in patients with the Hutchinson–Gilford progeria syndrome. However, due to its rarity, studying the course of cardiac abnormalities has been a challenge. The cardiovascular phenotype helps to provide greater insight into the natural history of these abnormalities.
- Published
- 2022
47. Off-label use of a vena caval filter in the SVC in an adolescent with upper deep vein thrombosis
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João Dias, Joana Marinho, Patrícia Vaz Silva, Sofia Simões, Sónia Silva, and António Pires
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Pediatrics, Perinatology and Child Health ,General Medicine ,Cardiology and Cardiovascular Medicine - Abstract
Vena caval filters remain as a useful tool in patients with deep vein thrombosis and contraindications to anticoagulation. Although they are rarely used in paediatric patients, they have been shown to be safe and effective when used in the inferior vena cava. In this case report, we describe the off-label use of a retrievable vena caval filter in the superior vena cava in an adolescent with acute lymphoblastic leukaemia with extensive thrombosis of the right upper neck veins as a means to reduce the risk of pulmonary embolism.
- Published
- 2022
48. Cardiotoxicity Associated With Pediatric Hodgkin Lymphoma Treatment
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João Mendes, Andreia Francisco, and António Pires
- Abstract
Introduction: Cardiotoxicity is one of the possible consequences of treating Hodgkin's lymphoma. This assumes a very important role in the patients outcomes since, increasingly, theyhave a higher survival rate, better quality of life and inherently longer survival. This is due to the improvement in the treatment of this pathology.Material and methods: Clinical information was collected from 103 patients about their age at diagnosis, sex, cardiovascular risk factors, anthracycline dose to which they were subjected and the use of mediastinal radiotherapy.According to this information, echocardiograms of these patients were analysed at five different times. Results: We obtained lower TAPSE values for females and for higher doses. Inverse relationships were also observed between the TAPSE value measured 6 months after treatment. The LV systolic function 5 years after treatment was inversed relationed with the age of the patients. Discussion: It was observed that there may be a relationship between the TAPSE 3 values and the anthracycline dose to which the patient was submitted, and we found lower TAPSE values in the group with the highest dose, in this case of 220 mg/m2.Conclusion: The incidence of cardiotoxicity after treatment for Hodgkin's lymphoma was 8% in the studied population.One of the conclusions we can take from this study is that it appears that cardiac toxic cardiac toxicity begins to reflect on right heart function in a chronic phase, more than 2 years after treatment.Other conclusions we can draw are that younger age, female sex and higher cumulative dose could be risk factors for cardiotoxicity due to anthracyclines.
- Published
- 2022
49. Production of high‐quality SARS‐CoV‐2 antigens: Impact of bioprocess and storage on glycosylation, biophysical attributes, and ELISA serologic tests performance
- Author
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Paula Mastoso, Marcos F. Q. Sousa, M. A. A. Thomaz, Patrícia Gomes-Alves, Carlos Gonçalves, Nádia Duarte, Tiago M. Bandeiras, Marie-Louise Bergman, Lígia S. Nobre, António Pires, Ana M. G. Silva, Micael C. Freitas, S. M. Mendes, Jocelyne Demengeot, Rute P. Eleutério, Lindsay Kosack, Onome Akpogheneta, Paula M. Alves, Ana Lemos, Rute Castro, Júlia Costa, João J. Clemente, Ricardo Gomes, Sandra M. Monteiro, and Filipe Pinto
- Subjects
0106 biological sciences ,0301 basic medicine ,Glycosylation ,Protein Conformation ,Spike ,medicine.disease_cause ,01 natural sciences ,Applied Microbiology and Biotechnology ,SARS‐CoV‐2 ,RBD ,Serology ,chemistry.chemical_compound ,Freezing ,serologic assay ,thermal stability during storage ,Antigens, Viral ,Coronavirus ,education.field_of_study ,Protein Stability ,Articles ,Recombinant Proteins ,Cold Temperature ,Biochemistry ,Spike Glycoprotein, Coronavirus ,ELISA ,Spike (software development) ,Biotechnology ,Population ,Enzyme-Linked Immunosorbent Assay ,Bioengineering ,Biology ,Article ,Virus ,03 medical and health sciences ,Immune system ,Antigen ,COVID‐19 ,010608 biotechnology ,medicine ,Humans ,Serologic Tests ,Bioprocess ,education ,SARS-CoV-2 ,bioprocess ,Virology ,HEK293 Cells ,030104 developmental biology ,chemistry ,Cell culture ,production and purification - Abstract
Serological assays are valuable tools to study SARS‐CoV‐2 spread and, importantly, to identify individuals that were already infected and would be potentially immune to a virus reinfection. SARS‐CoV‐2 Spike protein and its receptor binding domain (RBD) are the antigens with higher potential to develop SARS‐CoV‐2 serological assays. Moreover, structural studies of these antigens are key to understand the molecular basis for Spike interaction with angiotensin converting enzyme 2 receptor, hopefully enabling the development of COVID‐19 therapeutics. Thus, it is urgent that significant amounts of this protein became available at the highest quality. In this study, we produced Spike and RBD in two human derived cell hosts: HEK293‐E6 and Expi293F™. We evaluated the impact of different and scalable bioprocessing approaches on Spike and RBD production yields and, more importantly, on these antigens' quality attributes. Using negative and positive sera collected from human donors, we show an excellent performance of the produced antigens, assessed in serologic enzyme‐linked immunosorbent assay (ELISA) tests, as denoted by the high specificity and sensitivity of the test. We show robust Spike productions with final yields of approx. 2 mg/L of culture that were maintained independently of the production scale or cell culture strategy. To the best of our knowledge, the final yield of 90 mg/L of culture obtained for RBD production, was the highest reported to date. An in‐depth characterization of SARS‐CoV‐2 Spike and RBD proteins was performed, namely the antigen's oligomeric state, glycosylation profiles, and thermal stability during storage. The correlation of these quality attributes with ELISA performance show equivalent reactivity to SARS‐CoV‐2 positive serum, for all Spike and RBD produced, and for all storage conditions tested. Overall, we provide straightforward protocols to produce high‐quality SARS‐CoV‐2 Spike and RBD antigens, that can be easily adapted to both academic and industrial settings; and integrate, for the first time, studies on the impact of bioprocess with an in‐depth characterization of these proteins, correlating antigen's glycosylation and biophysical attributes to performance of COVID‐19 serologic tests., Spike and RBD were produced in human derived cells hosts. Shake flasks, stirred tank and wave bioreactors were compared. The impact of these different scalable bioprocessing approaches on Spike and RBD production yields and quality attributes was evaluated. An in‐depth characterization of SARS‐CoV‐2 Spike and RBD proteins was performed, namely the antigen s oligomeric state, glycosylation profiles and thermal stability during storage. The correlation of these quality attributes with ELISA performance is discussed.
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- 2021
50. Kawasaki Disease: Predictors of Resistance to Intravenous Immunoglobulin and Cardiac Complications
- Author
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Diogo Faim, Ana Maria Oliveira Brett, António Pires, Fernanda Rodrigues, Cláudio Henriques, and Andreia Francisco
- Subjects
Resistência à Medicamentos ,medicine.medical_specialty ,Heart Diseases ,Mucocutaneous Lymph Node Syndrome/complications ,Drug Resistance ,Criança ,Coronary Artery Disease ,Mucocutaneous Lymph Node Syndrome ,030204 cardiovascular system & hematology ,Síndrome de Linfonodos Mucocutâneos/complicações ,Kawasaki Disease/complications ,03 medical and health sciences ,0302 clinical medicine ,Immunoglobulin ,Diseases of the circulatory (Cardiovascular) system ,Humans ,Medicine ,Child ,Gynecology ,business.industry ,Imunoglobulina ,Artigo Original ,Doenças da Artéria Coronariana ,Immunoglobulins, Intravenous ,Heart ,medicine.disease ,RC666-701 ,Doença de Kawasaki/complicações ,Original Article ,Kawasaki disease ,Cardiology and Cardiovascular Medicine ,business - Abstract
Resumo Fundamento A doença de Kawasaki (DK) é a principal causa de cardiopatia adquirida em idade pediátrica nos países desenvolvidos. Objetivos Identificar fatores preditores de resistência à imunoglobulina intravenosa (IGIV), calcular a eficácia dos modelos preditores japoneses e caracterizar as complicações cardíacas. Métodos Análise retrospectiva dos casos de DK entre janeiro de 2006 e julho de 2018 em um hospital pediátrico português. Foram construídas curvas ROC para encontrar fatores preditores de resistência e utilizada regressão logística multivariada para elaborar o modelo preditor. O nível de significância utilizado foi de 5%. Resultados Foram incluídos 48 pacientes com mediana de idade de 36 meses. Verificou-se resistência à IGIV em 21%. Ocorreram alterações ecocardiográficas em 46%, com envolvimento coronário em 25%. Como variáveis preditoras de resistência, a proteína C-reativa (PC-R) apresentou uma AUC ROC = 0,789, ponto de corte = 15,1 mg/dL, sensibilidade (S) = 77,8% e especificidade (E) = 78,9%. A velocidade de sedimentação (VS) apresentou uma AUC ROC = 0,781, ponto de corte = 90,5 mm/h, S = 66,7% e E = 85,7%. O modelo com as duas variáveis apresentou valor p = 0,042 e AUC ROC = 0,790. O modelo Kobayashi apresentou S = 63,6% e E = 77,3%; Egami, S = 66,7% e E = 73,1%; e Sano, S = 28,6% e E = 94,1%. Conclusão A PC-R e a VS são variáveis independentes que mostraram tendência preditora de resistência à IGIV com pontos de corte ótimos de 15,1 mg/dL e 90,5 mm/h, respectivamente. Cerca de metade dos pacientes teve algum tipo de envolvimento cardíaco. Os modelos japoneses não têm utilidade nessa população. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0) Abstract Background Kawasaki disease (KD) is the leading cause of acquired cardiac disease in children, in developed countries. Objectives To identify predictive factors for resistance to intravenous immunoglobulin (IVIG), calculate the effectiveness of Japanese predictive models and characterize cardiac complications. Methods Retrospective analysis of KD cases admitted in a Portuguese paediatric hospital between january 2006 and july 2018. ROC curves were used to determine predictive factors for resistance and the multivariate logistic regression analysis was used to develop the predictive model. A significance level of 5% was used. Results 48 patients with a median age of 36 months were included. The IVIG resistance was 21%. Echocardiographic anomalies were noted in 46%, with coronary involvement in 25% of the sample population. As predictive variable of resistance, the C-reactive protein (CRP) presented an AUC ROC = 0.789, optimal cut-off value 15.1 mg/dL, sensitivity (Sn) 77.8% and specificity (Sp) 78.9%. The erythrocyte sedimentation rate (ESR) presented an AUC ROC = 0.781, optimal cut-off value 90.5 mm/h, Sn 66.7% and Sp 85.7%. The model with the two variables showed p = 0.042 and AUC ROC = 0.790. Predictive strength of Japanese models were: Kobayashi (Sn 63.6%, Sp 77.3%), Egami (Sn 66.7%, Sp 73.1%), Sano (Sn 28.6%, Sp 94.1%). Conclusion CRP and ESR are independent variables that were related to IVIG resistance, with optimal cut-off points of 15.1 mg/dL and 90.5 mm/h, respectively. About half of the patients had some form of cardiac involvement. The Japanese models appeared to be inadequate in our population. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0)
- Published
- 2021
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