Publications by authors named "Ana Rocha"

264 Publications

Case Report: Intrapulmonary Arteriovenous Anastomoses in COVID-19-Related Pulmonary Vascular Changes: A New Player in the Arena?

Front Med (Lausanne) 2021 9;8:639152. Epub 2021 Feb 9.

Cardiothoracic and Vascular Division, Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.

Up to now, COVID-19-related vascular changes were mainly described as thrombo-embolic events. A handful of researchers reported another type of vascular abnormality referred to as "vascular thickening" or "vascular enlargement," without specifying whether the dilated vessels are arteries or veins nor providing a physiopathological hypothesis. Our observations indicate that the vascular dilatation occurs in the venous compartment, and underlying mechanisms might include increased blood flow due to inflammation and the activation of arteriovenous anastomoses.
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http://dx.doi.org/10.3389/fmed.2021.639152DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7900139PMC
February 2021

Dynamics of a Dual SARS-CoV-2 Lineage Co-Infection on a Prolonged Viral Shedding COVID-19 Case: Insights into Clinical Severity and Disease Duration.

Microorganisms 2021 Feb 2;9(2). Epub 2021 Feb 2.

CHUSJ-Centro Hospitalar Universitário S. João, 4200-319 Porto, Portugal.

A few molecularly proven severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cases of symptomatic reinfection are currently known worldwide, with a resolved first infection followed by a second infection after a 48 to 142-day intervening period. We report a multiple-component study of a clinically severe and prolonged viral shedding coronavirus disease 2019 (COVID-19) case in a 17-year-old Portuguese female. She had two hospitalizations, a total of 19 RT-PCR tests, mostly positive, and criteria for releasing from home isolation at the end of 97 days. The viral genome was sequenced in seven serial samples and in the diagnostic sample from her infected mother. A human genome-wide array (>900 K) was screened on the seven samples, and in vitro culture was conducted on isolates from three late samples. The patient had co-infection by two SARS-CoV-2 lineages, which were affiliated in distinct clades and diverging by six variants. The 20A lineage was absolute at the diagnosis (shared with the patient's mother), but nine days later, the 20B lineage had 3% frequency, and two months later, the 20B lineage had 100% frequency. The 900 K profiles confirmed the identity of the patient in the serial samples, and they allowed us to infer that she had polygenic risk scores for hospitalization and severe respiratory disease within the normal distributions for a Portuguese population cohort. The early-on dynamic co-infection may have contributed to the severity of COVID-19 in this otherwise healthy young patient, and to her prolonged SARS-CoV-2 shedding profile.
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http://dx.doi.org/10.3390/microorganisms9020300DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7912897PMC
February 2021

Long term mortality of patients with Parkinson's disease treated with deep brain stimulation in a reference center.

Clin Neurol Neurosurg 2021 Jan 12;202:106486. Epub 2021 Jan 12.

Faculty of Medicine, Porto University, Portugal; Neurosurgery Department, Centro Hospitalar Universitário De São João E.P.E., Porto, Portugal.

Introduction: Parkinson's disease (PD) is a common neurodegenerative disorder, with a higher risk of death than general population. Deep Brain Stimulation (DBS) has been used to treat PD for more than 2 decades, but few studies exist concerning mortality in this subset of patients. Our goal is to analyse mortality in PD patients treated with DBS in our centre.

Methods: retrospective evaluation of clinical files of patients with PD who underwent DBS surgery consecutively between October 2002 and May 2019.

Results: 346 patients were included in the analysis, 60 % male, with a mean age at disease onset of 48± 8 years (18-64), mean age at surgery of 60 ± 7 years (33-75), and mean disease duration until surgery of 14 ± 6 years (3-52). Mean follow-up after surgery was 7 ± 4 years (range 1-17). Overall mortality rate was 17.9 % and mean age at time of death was 71 ± 6 years. The main causes of death were pneumonia, dementia and acute myocardial infarction. In our series, male gender and disease duration until surgery were the only predictors of mortality in multivariate analysis.

Conclusion: Our study showed a long-term survival higher than previously described, and suggests that the treatment of patients with shorter disease evolution might have a survival benefit. The leading causes of death in PD patients treated with DBS seems unrelated to surgery, as the main causes of death are comparable to non-DBS patients.
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http://dx.doi.org/10.1016/j.clineuro.2021.106486DOI Listing
January 2021

Surgical Treatment Applied to Bilateral Vocal Fold Paralysis in Adults: Systematic Review.

J Voice 2021 Jan 16. Epub 2021 Jan 16.

State Center in Rehabilitation and Readaptation Dr. Henrique Santillo - CRER, Goiânia, Goiás State, Brazil.

Introduction: Bilateral vocal fold paralysis is a condition accounting for great mortality and significant worsening in patients' quality of life. Treatment applied to these patients seek balance among breathing, airway protection and voice quality.

Aim: Critically and systematically reviewing the current literature on the topic in order to set the best technique to restore breathing comfort, without the need of tracheostomy, in patients with bilateral vocal fold paralysis. Furthermore, it seeks the surgical type technique accounting for the best breathing rate and for the smallest changes in voice parameters.

Materials And Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses method methodology and population, interventions, comparatives, outcomes and study design criteria were used as systematic search in the biggest databases and in the grey literature. The following meshes were used for the search: surgical interventions, surgical treatment, bilateral vocal cord paralysis, bilateral vocal fold paralysis, tracheostomy, decannulation, voice, and dysphonia. The selected studies should have followed the randomized clinical-trial type or be longitudinal observational controlled prospective studies (cohort studies).

Results: In total, 3,548 articles were found. After duplicate studies were removed from the selection, the inclusion and exclusion criteria were applied and 06 articles were selected for qualitative analysis.

Conclusions: The assessed surgical procedures showed good cost-benefit to treat bilateral vocal fold paralysis, either because they improved the breathing function in most patients and allowed decannulation in patients with tracheostomy, or because they accounted for small changes to both voice parameters or deglutition. However, none of the described techniques has shown respiratory and functional outcomes better than those recorded for the other ones. The decision on what surgery to perform still must be made based on the judgement of an experienced surgeon.
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http://dx.doi.org/10.1016/j.jvoice.2020.11.018DOI Listing
January 2021

Visceral Dissemination of Mucocutaneous Leishmaniasis in a Kidney Transplant Recipient.

Pathogens 2020 Dec 30;10(1). Epub 2020 Dec 30.

Kidney Transplant Department, Centro Hospitalar e Universitário de São João, Faculdade de Medicina da Universidade do Porto, 4200-319 Oporto, Portugal.

Intracellular protozoan of the genus , endemic in the Mediterranean basin, are the cause of cutaneous (CL), mucocutaneous (MCL), and visceral leishmaniasis (VL). A 75-year-old woman was admitted nine years after a second kidney transplant (KT), due to persistent pancytopenia and fever. She presented edema and erythema of the nose in the last two years and an exophytic nodular lesion located on the left arm, with areas of peripheral necrosis and central ulceration in the last 18 months. A bone marrow biopsy revealed features compatible with amastigotes, and polymerase chain reaction test (PCR) for was positive. Moreover, biopsy and PCR for of the cutaneous lesion on the patient's left arm and nose and PCR from peripheral blood were positive. Thus, a diagnosis of CL, MCL, and VL was made, and liposomal amphotericin B was initiated, but the patient had an unfavorable outcome and died. This is the first report of a KT recipient presenting with the entire spectrum of leishmaniasis. In Portugal, this infection is rare-so a high degree of clinical suspicion is required for its diagnosis, especially in endemic regions, as visceral leishmaniasis is a potentially life-threatening infection.
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http://dx.doi.org/10.3390/pathogens10010018DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7824171PMC
December 2020

Creatinine variation improves Zwolle score in selecting low-risk patients after ST-segment elevation myocardial infarction.

Coron Artery Dis 2020 Dec 23;Publish Ahead of Print. Epub 2020 Dec 23.

Cardiology Department, Hospital do Espírito Santo, Évora General Surgery Department, Hospital Professor Doutor Fernando Fonseca, Amadora CRIA/Cerebro-Cardiovascular Responsability Center, Hospital do Espírito Santo/University of Évora, Évora, Portugal.

Background: The Zwolle score is recommended to identify ST-segment elevation myocardial infarction (STEMI) patients with low-risk eligible for early discharge. Our aim was to ascertain if creatinine variation (Δ-sCr) would improve Zwolle score in the decision-making of early discharge after primary percutaneous coronary intervention (PCI).

Methods And Results: A total of 3296 patients with STEMI that underwent primary PCI were gathered from the Portuguese Registry on Acute Coronary Syndromes. A Modified-Zwolle score, including Δ-sCr, was created and compared with the original Zwolle score. Δ-sCr was also compared between low (Zwolle score ≤3) and non-low-risk patients (Zwolle score >3). The primary endpoint is 30-day mortality and the secondary endpoints are in-hospital mortality and complications. Thirty-day mortality was 1.5% in low-risk patients (35 patients) and 9.2% in non-low-risk patients (92 patients). The Modified-Zwolle score had a better performance than the original Zwolle score in all endpoints: 30-day mortality (area under curve 0.853 versus 0.810, P < 0.001), in-hospital mortality (0.889 versus 0.845, P < 0.001) and complications (0.728 versus 0.719, P = 0.037). Reclassification of patients lead to a net reclassification improvement of 6.8%. Additionally, both original Zwolle score low-risk patients and non-low-risk patients who had a Δ-sCr ≥0.3 mg/dl had higher 30-day mortality (low-risk: 1% versus 6.6%, P < 0.001; non-low-risk 4.4% versus 20.7%, P < 0.001), in-hospital mortality and complications.

Conclusion: Δ-sCr enhanced the performance of Zwolle score and was associated with higher 30-day mortality, in-hospital mortality and complications in low and non-low-risk patients. This data may assist the selection of low-risk patients who will safely benefit from early discharge after STEMI.
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http://dx.doi.org/10.1097/MCA.0000000000001002DOI Listing
December 2020

Optimization of the Effects of Different Temperatures and Compositions of Filmogenic Solution on Using Predictive Mathematical Models.

Foods 2020 Dec 23;10(1). Epub 2020 Dec 23.

Department of Agricultural Engineering, Federal University of Campina Grande, Campina Grande 58428-830, Brazil.

It is well known that intake of probiotic brings health benefits. Lactic bacteria with probiotic potential have aroused the interest of the industry in developing food products that incorporate such benefits. However, incorporating probiotic bacteria into food is a challenge for the industry, given the sensitivity of probiotic cultures to process conditions. Therefore, the objective of this study is to evaluate gelatin- and inulin-based filmogenic solutions as a potential vehicle for incorporating probiotics into food products and to model the fermentation kinetics. () growth in filmogenic solutions was analyzed under the influence of a variety gelatin concentrations (1.0-3.0%) and inulin concentrations (4.0-6.0%) and fermented under the effect of different temperatures (25-45 °C). A full 2 factorial plan with three replicates at the central point was used to optimize the process. The impacts of process conditions on cell development are fundamental to optimize the process and make it applicable by the industry. The present study showed that the optimal conditions for the development of probiotic cells in filmogenic solutions are a combination of 1.0% gelatin with 4.0% inulin and fermentation temperature of 45 °C. It was observed that the maximum cell growth occurred in an estimated time of about 4 h of fermentation. cell production and substrate consumption during the fermentation of the filmogenic solution were well simulated by a model proposed in this article, with coefficients of determination of 0.981 (cell growth) and 0.991 (substrate consumption).
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http://dx.doi.org/10.3390/foods10010025DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7824258PMC
December 2020

Cerebellar gangliocytoma as a cause of fluctuating hearing loss.

Clin Case Rep 2020 Dec 13;8(12):2923-2925. Epub 2020 Sep 13.

Servicio de Otorrinolaringología Hospital Universitario Puerta de Hierro Madrid Spain.

Cerebellar lesions could be a cause of fluctuating hearing loss, due to the increase of intracranial pressure by partially or complete blocking of the Foramen of Luschka. Patients with intracranial hypertension may present audio-vestibular symptoms. Fluctuating sensorineural hearing loss may be the manifestation of different inner ear disorders such as Meniere's disease (MD), immune-mediated inner ear disease (IMIED), otosyphilis, and labyrinthine fistula including semicircular canal dehiscence. A rare mechanism involved in the fluctuating hearing loss is the increase in cerebrospinal fluid (CSF) pressure, that may be caused by a cerebellar tumor. A 51-year-old female presented a 2-year history of left ear fluctuating hearing loss and tinnitus, with fluctuations among the day, and normal otoscopy. Several audiometries showed a left ear moderate sensorineural hearing loss in low frequencies (Figure 1). The patient underwent a cerebral magnetic resonance imaging (MRI) (Figure 2). She was treated with three courses of systemic steroids showing improvement of symptoms during the treatment. However, the symptoms always returned when corticotherapy was interrupted. The patient was given two intratympanic steroids cycles combined with hydrochlorothiazide/ amiloride hydrochloride. The cerebral MRI described a left cerebellar focal lesion diagnosed as a cerebellar gangliocytoma. After receiving the second intratympanic steroids, cycle combined with systemic ameride showed a significant improvement of audition. Between the several causes of fluctuating hearing loss, a cerebellar gangliocytoma is a very rare disease, which needs a high degree of suspicion and otorhinolaryngologists should be familiar with this entity since patients may present with audiological and vestibular symptoms.
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http://dx.doi.org/10.1002/ccr3.3158DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7752477PMC
December 2020

Clinical 3-D Gait Assessment of Patients With Polyneuropathy Associated With Hereditary Transthyretin Amyloidosis.

Front Neurol 2020 23;11:605282. Epub 2020 Nov 23.

INESC TEC, FEUP and LABIOMEP, University of Porto, Porto, Portugal.

Hereditary amyloidosis associated with transthyretin V30M (ATTRv V30M) is a rare and inherited multisystemic disease, with a variable presentation and a challenging diagnosis, follow-up and treatment. This condition entails a definitive and progressive motor impairment that compromises walking ability from near onset. The detection of the latter is key for the disease's diagnosis. The aim of this work is to perform quantitative 3-D gait analysis in ATTRv V30M patients, at different disease stages, and explore the potential of the obtained gait information for supporting early diagnosis and/or stage distinction during follow-up. Sixty-six subjects (25 healthy controls, 14 asymptomatic ATTRv V30M carriers, and 27 symptomatic patients) were included in this case-control study. All subjects were asked to walk back and forth for 2 min, in front of a Kinect v2 camera prepared for body motion tracking. We then used our own software to extract gait-related parameters from the camera's 3-D body data. For each parameter, the main subject groups and symptomatic patient subgroups were statistically compared. Most of the explored gait parameters can potentially be used to distinguish between the considered group pairs. Despite of statistically significant differences being found, most of them were undetected to the naked eye. Our Kinect camera-based system is easy to use in clinical settings and provides quantitative gait information that can be useful for supporting clinical assessment during ATTRv V30M onset detection and follow-up, as well as developing more objective and fine-grained rating scales to further support the clinical decisions.
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http://dx.doi.org/10.3389/fneur.2020.605282DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7719818PMC
November 2020

Multivariate and Multiscale Complexity of Long-Range Correlated Cardiovascular and Respiratory Variability Series.

Entropy (Basel) 2020 Mar 11;22(3). Epub 2020 Mar 11.

Department of Engineering, University of Palermo, Viale delle Scienze, Bldg. 9, 90128 Palermo, Italy.

Assessing the dynamical complexity of biological time series represents an important topic with potential applications ranging from the characterization of physiological states and pathological conditions to the calculation of diagnostic parameters. In particular, cardiovascular time series exhibit a variability produced by different physiological control mechanisms coupled with each other, which take into account several variables and operate across multiple time scales that result in the coexistence of short term dynamics and long-range correlations. The most widely employed technique to evaluate the dynamical complexity of a time series at different time scales, the so-called multiscale entropy (MSE), has been proven to be unsuitable in the presence of short multivariate time series to be analyzed at long time scales. This work aims at overcoming these issues via the introduction of a new method for the assessment of the multiscale complexity of multivariate time series. The method first exploits vector autoregressive fractionally integrated (VARFI) models to yield a linear parametric representation of vector stochastic processes characterized by short- and long-range correlations. Then, it provides an analytical formulation, within the theory of state-space models, of how the VARFI parameters change when the processes are observed across multiple time scales, which is finally exploited to derive MSE measures relevant to the overall multivariate process or to one constituent scalar process. The proposed approach is applied on cardiovascular and respiratory time series to assess the complexity of the heart period, systolic arterial pressure and respiration variability measured in a group of healthy subjects during conditions of postural and mental stress. Our results document that the proposed methodology can detect physiologically meaningful multiscale patterns of complexity documented previously, but can also capture significant variations in complexity which cannot be observed using standard methods that do not take into account long-range correlations.
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http://dx.doi.org/10.3390/e22030315DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7516773PMC
March 2020

Analysis of Long Period Gratings Inscribed by CO Laser Irradiation and Estimation of the Refractive Index Modulation.

Sensors (Basel) 2020 Nov 10;20(22). Epub 2020 Nov 10.

Department of Physics and I3N, University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal.

Long period gratings (LPGs) inscribed in single mode fibers (SMFs) using CO laser irradiation were modelled numerically using the coupled mode method. The model considers the specifications of the inscription technique, such as the shape of the refractive index modulation that mimics the circularly symmetric point-to-point laser irradiation profile. A simple expression for predicting the resonant wavelength was obtained assuming a two-mode coupling model. However, to explain the spectra of the experimental LPGs, it was necessary to assume a reasonably high refractive index change and a multimode coupling model. Furthermore, using the developed model and a genetic algorithm to fit experimental resonances to simulated ones, we were able to estimate the maximum refractive index change, obtaining a value of 2.2 × 10, confirming the high refractive index change. The proposed model also predicts a second order resonance for this high value of refractive index change that was confirmed experimentally. Hence, with this model, we found some significant differences in the LPGs behavior when compared with conventional ones, namely, the emergence of coupling between different cladding modes and the competition of first and second order resonances which change the LPG transmission spectrum.
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http://dx.doi.org/10.3390/s20226409DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7697559PMC
November 2020

Inter- and intrarater reliability of unidigital and bidigital vaginal palpation to evaluation of maximal voluntary contraction of pelvic floor muscles considering risk factors and dysfunctions.

Neurourol Urodyn 2021 01 5;40(1):348-357. Epub 2020 Nov 5.

Department of Physical Therapy, Women's Health Research Laboratory, São Carlos, São Paulo, Brazil.

Aims: To evaluate inter- and intrarater reliability of unidigital and bidigital vaginal palpation of pelvic floor muscle (PFM) maximal voluntary contraction (MVC) according to PFM risk factors and dysfunctions.

Methods: A total of 187 women were recruited and evaluated by two examiners. Both performed the evaluation of MVC with unidigital and bidigital palpation, graded by Modified Oxford Scale. After 7-10 days, one examiner repeated the assessment. To analyze reliability by Cohen's linear Kappa (κw), participants were allocated into different groups according to: body mass index (BMI), menopause, parity, type of delivery and PFM dysfunctions, as pelvic organ prolapse (POP), constipation, urgency, urgency urinary incontinence, pelvic pain, and stress urinary incontinence.

Results: Inter-rater reliability of unidigital palpation was considered fair (κw = 0.21-0.40) to moderate (κw = 0.41-0.60) according to BMI, postmenopausal status, parity, type of delivery, and PFM dysfunctions. Inter-rater reliability of bidigital palpation varied from none (κw = 0.00-0.20) to moderate for all risk factors and PFM dysfunctions. Intra-rater reliability of unidigital palpation was considered fair only for women with POP (κw = 0.37) and moderate to substantial (κw = 0.61-0.80) to all other variables. Intra-rater reliability of bidigital palpation ranged from moderate to almost perfect (κw = 0.81-1.00).

Conclusions: When performing vaginal palpation, physiotherapists must consider the way that is performing the evaluation, as some PFM risk factors and dysfunctions could influence the inter- and intrarater reliability of unidigital and bidigital palpation.
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http://dx.doi.org/10.1002/nau.24566DOI Listing
January 2021

Finding the guilty pill.

Age Ageing 2021 Feb;50(2):596

Department of Internal Medicine, Centro Hospitalar Tâmega e Sousa, Penafiel, Portugal.

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http://dx.doi.org/10.1093/ageing/afaa215DOI Listing
February 2021

Growth Performance After Agouti-Signaling Protein 1 () Overexpression in Transgenic Zebrafish.

Zebrafish 2020 Dec 28;17(6):373-381. Epub 2020 Oct 28.

Department of Fish Physiology and Biotechnology, Instituto de Acuicultura de Torre de la Sal, Consejo Superior de Investigaciones Científicas (IATS-CSIC), Castellon, Spain.

The melanocortin system is a key structure in the regulation of energy balance. Overexpression of inverse agonists, agouti-signaling protein (ASIP), and agouti-related protein (AGRP) results in increased food intake, linear growth, and body weight. ASIP regulates dorsal-ventral pigment polarity through melanocortin 1 receptor (MC1R) and overexpression induces obesity in mice by binding to central MC4R. overexpression in transgenic zebrafish (-Tg) enhances growth, yet experiments show fish overexpressing do not develop obesity even under severe feeding regimes. -Tg fish do not need to eat more to grow larger and faster; thus, increased food efficiency can be observed. In addition, -Tg fish reared at high density are able to grow far more than wild-type (WT) fish reared at low density, although -Tg fish seem to be more sensitive to crowding stress than WT fish, thus making the melanocortin system a target for sustainable aquaculture, especially as the U.S. Food and Drug Association has recently approved transgenic fish trading.
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http://dx.doi.org/10.1089/zeb.2020.1932DOI Listing
December 2020

anti-trypanosomal potential of kaurane and pimarane semi-synthetic derivatives.

Nat Prod Res 2020 Oct 23:1-10. Epub 2020 Oct 23.

Núcleo de Pesquisas em Ciências Exatas e Tecnológicas, Universidade de Franca, Franca, SP, Brazil.

As part of the search for anti-trypanosomal agents, this work presents the production of sixteen derivatives. All of them were obtained from two natural diterpenes, one with kaurane skeleton (-kaurenoic acid) and other with a pimarane skeleton (-pimaradienoic acid). Then, the eighteen compounds were assayed against epimastigote form of , with the derivatives showing increase of activity in relation to their precursors. Moreover, the most active derivative presented an IC <12.5 µM (estimated 0.8 µM), lower than Benznidazole (IC = 9.8 µM), used as control. The esterification of acid diterpenes showed to be an interesting way in the search for anti-trypanosomal agents.
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http://dx.doi.org/10.1080/14786419.2020.1837824DOI Listing
October 2020

De Winter pattern: An ST-elevation myocardial infarction equivalent.

Rev Port Cardiol 2020 Sep 9. Epub 2020 Sep 9.

Serviço de Cardiologia, Hospital do Espírito Santo, Évora, Portugal.

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http://dx.doi.org/10.1016/j.repc.2019.09.020DOI Listing
September 2020

Study aging by fibroblasts metabolome.

Curr Mol Med 2020 Aug 31. Epub 2020 Aug 31.

iBiMED -Institute of Biomedicine, Department of Medical Sciences, University of Aveiro, Aveiro. Portugal.

Aging is a complex multifactorial process that although universal is not fully understood. It is known that the impact of aging on health is influenced by multiple factors, such as sex, race, income, and education, and that age-related dis-eases are strongly associated to the way people get old. The knowledge of biological aging and its comparison to the chronological age is a paramount contributor to predict the metabolic decline and the onset of age-related diseases. As aging processes observed in whole human organism are somehow the reflexion of what happens in each cell type, it is possible to study aging process using cell lines, such as fibroblasts. Metabolomics analysis of cell lines, namely fibroblasts, gives inputs to personalized or integrative medicine; in fact cell metabolomics is an emerging field that addresses fundamental biological and metabolic questions using modern "omic" techniques as FTIR, NMR or MS. This paper revises the relevance of using fibroblasts as cell models to study the metabolome of aging.
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http://dx.doi.org/10.2174/1566524020999200831120852DOI Listing
August 2020

Therapeutic effects of açaí seed extract on hepatic steatosis in high-fat diet-induced obesity in male mice: a comparative effect with rosuvastatin.

J Pharm Pharmacol 2020 Dec 27;72(12):1921-1932. Epub 2020 Aug 27.

Department of Pharmacology, Institute of Biology, Rio de Janeiro State University, Rio de Janeiro, Brazil.

Objectives: Obesity is considered a risk factor for the development of non-alcoholic fatty liver disease (NAFLD). The hydroalcoholic extract obtained from the açai seed (ASE), rich in proanthocyanidins, has been shown a potential body weight regulator with antioxidant properties. This study aimed to investigate the therapeutic effect of ASE in obesity-associated NAFLD and compare it with Rosuvastatin.

Methods: Male C57BL/6 mice received a high-fat diet or standard diet for 12 weeks. The treatments with ASE (300 mg/kg per day) or rosuvastatin (20 mg/kg per day) began in the eighth week until the 12th week.

Key Findings: Our data show that the treatments with ASE and rosuvastatin reduced body weight and hyperglycaemia, improved lipid profile and attenuated hepatic steatosis in HFD mice. ASE and Rosuvastatin reduced HMGCoA-Reductase and SREBP-1C and increased ABGC8 and pAMPK expressions in the liver. Additionally, ASE, but not Rosuvastatin, reduced NPC1L1 and increased ABCG5 and PPAR-α expressions. ASE and rosuvastatin increased SIRT-1 expression and antioxidant defence, although only ASE was able to decrease the oxidative damage in hepatic tissue.

Conclusions: The therapeutic effect of ASE was similar to that of rosuvastatin in reducing dyslipidemia and hepatic steatosis but was better in reducing oxidative damage and hyperglycaemia.
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http://dx.doi.org/10.1111/jphp.13356DOI Listing
December 2020

H3K27me3 expression and methylation status in histological variants of malignant peripheral nerve sheath tumours.

J Pathol 2020 10 1;252(2):151-164. Epub 2020 Sep 1.

Research Department of Pathology, University College London, London, UK.

Diagnosing MPNST can be challenging, but genetic alterations recently identified in polycomb repressive complex 2 (PRC2) core component genes, EED and SUZ12, resulting in global loss of the histone 3 lysine 27 trimethylation (H3K27me3) epigenetic mark, represent drivers of malignancy and a valuable diagnostic tool. However, the reported loss of H3K27me3 expression ranges from 35% to 84%. We show that advances in molecular pathology now allow many MPNST mimics to be classified confidently. We confirm that MPNSTs harbouring mutations in PRC2 core components are associated with loss of H3K27me3 expression; whole-genome doubling was detected in 68%, and SSTR2 was amplified in 32% of MPNSTs. We demonstrate that loss of H3K27me3 expression occurs overall in 38% of MPNSTs, but is lost in 76% of histologically classical cases, whereas loss was detected in only 23% cases with heterologous elements and 14% where the diagnosis could not be provided on morphology alone. H3K27me3 loss is rarely seen in other high-grade sarcomas and was not found to be associated with an inferior outcome in MPNST. We show that DNA methylation profiling distinguishes MPNST from its histological mimics, was unrelated to anatomical site, and formed two main clusters, MeGroups 4 and 5. MeGroup 4 represents classical MPNSTs lacking H3K27me3 expression in the majority of cases, whereas MeGroup 5 comprises MPNSTs exhibiting non-classical histology and expressing H3K27me3 and cluster with undifferentiated sarcomas. The two MeGroups are distinguished by differentially methylated PRC2-associated genes, the majority of which are hypermethylated in the promoter regions in MeGroup 4, indicating that the PRC2 target genes are not expressed in these tumours. The methylation profiles of MPNSTs with retention of H3K27me3 in MeGroups 4 and 5 are independent of mutations in PRC2 core components and the driver(s) in these groups remain to be identified. Our results open new avenues of investigation. © 2020 The Authors. The Journal of Pathology published by John Wiley & Sons, Ltd. on behalf of The Pathological Society of Great Britain and Ireland.
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http://dx.doi.org/10.1002/path.5507DOI Listing
October 2020

Imaging evaluation of nonobstetric conditions during pregnancy: what every radiologist should know.

Radiol Bras 2020 May-Jun;53(3):185-194

Instituto Hermes Pardini, Belo Horizonte, MG, Brazil.

In recent decades, there has been a significant increase in the number of imaging examinations performed on pregnant patients. That increase has occurred across the various modalities, including ultrasound, computed tomography, and magnetic resonance imaging. However, little is known about the risks that these examinations generate for the mother and fetus, related to the use of ionizing radiation or the use of contrast media. When pregnant patients are submitted to imaging studies, the principles of protection established by the International Commission on Radiological Protection should always be respected, to avoid injury to the pregnant woman and the fetus. The potential deleterious effects on the fetus must be weighed against the damage caused by not performing an examination that is clearly indicated, given that a delayed or missed diagnosis can be even more harmful to the health of the mother and of the fetus itself. The purpose of this review article is to address concerns regarding the safety of imaging methods used during pregnancy, as well as to identify typical clinical situations that require decisions to be made about the indication and optimal planning of imaging examinations.
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http://dx.doi.org/10.1590/0100-3984.2019.0059DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7302893PMC
June 2020

Guidance on diagnosis, prevention and treatment of thromboembolic complications in COVID-19: a position paper of the Brazilian Society of Thrombosis and Hemostasis and the Thrombosis and Hemostasis Committee of the Brazilian Association of Hematology, Hemotherapy and Cellular Therapy.

Hematol Transfus Cell Ther 2020 Oct - Dec;42(4):300-308. Epub 2020 Jun 13.

Hospital Sírio-libanês, São Paulo, SP, Brazil; Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (Incor FMUSP), São Paulo, SP, Brazil.

Hemostatic abnormalities and thrombotic risk associated with coronavirus disease 2019 (COVID-19) are among the most discussed topics in the management of this disease. The aim of this position paper is to provide the opinion of Brazilian experts on the thromboprophylaxis and management of thrombotic events in patients with suspected COVID-19, in the sphere of healthcare in Brazil. To do so, the Brazilian Society of Thrombosis and Hemostasis (BSTH) and the Thrombosis and Hemostasis Committee of the Brazilian Association of Hematology, Hemotherapy and Cellular Therapy (ABHH) have constituted a panel of experts to carefully review and discuss the available evidence about this topic. The data discussed in this document was reviewed by May 9, 2020. Recommendations and suggestions reflect the opinion of the panel and should be reviewed periodically as new evidence emerges.
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http://dx.doi.org/10.1016/j.htct.2020.06.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7293502PMC
June 2020

Nonalcoholic fatty liver disease in women with polycystic ovary syndrome: associated factors and noninvasive fibrosis staging in a single Brazilian center.

Arch Endocrinol Metab 2020 May-Jun;64(3):235-242

Pós-Graduação em Ciências Aplicadas à Saúde do Adulto, Universidade Federal de Minas Gerais , Belo Horizonte , MG , Brasil.

Objective: Polycystic ovary syndrome (PCOS) is a recognized risk factor for nonalcoholic fatty liver disease (NAFLD). The aims of this study were to investigate the prevalence and factors associated with NAFLD in women with PCOS and evaluate noninvasive indices of hepatic fibrosis in patients with PCOS and NAFLD.

Subjects And Methods: Patients with PCOS (n = 87) and women without PCOS (n = 40; controls) were included. NAFLD was diagnosed by abdominal ultrasonography after exclusion of alcohol consumption and viral or autoimmune liver disease. Anthropometric, clinical and metabolic variables, homeostasis model assessment of insulin resistance (HOMA-IR) index, lipid accumulation product (LAP), FIB-4 index, NAFLD score, and transient elastography (TE; FibroScan) were obtained in subsets of patients with PCOS and NAFLD.

Results: A total of 87 patients with PCOS were included (mean age: 34.4 ± 5.7 years, mean body mass index [BMI]: 34.7 ± 4.7 kg/m 2 ). NAFLD was present in 67 (77.0%) patients with PCOS versus 21 of 40 (52.5%) controls (p = 0.005). Women with PCOS and liver steatosis, compared with their NAFLD-free counterparts, had higher values of BMI, waist circumference, triglycerides, total cholesterol, alanine and aspartate aminotransferases, and γ-glutamyltransferase, along with higher frequencies of obesity, metabolic syndrome, and insulin resistance. NAFLD was independently associated with waist circumference, serum triglycerides, and alanine aminotransferase levels. The FIB-4 index was not compatible with advanced fibrosis in any of the evaluated patients, while NAFLD score and TE were compatible with advanced liver fibrosis in 1 of 26 (3.8%) and 3 of 25 (12%) patients, respectively.

Conclusion: Women with PCOS had a high risk of NAFLD, and a combination of both was associated with central obesity, dyslipidemia, insulin resistance, and metabolic syndrome. Noninvasive methods suggested low rates of severe hepatic fibrosis in Brazilian women with PCOS. Arch Endocrinol Metab. 2020;64(3):235-42.
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http://dx.doi.org/10.20945/2359-3997000000242DOI Listing
June 2020

Anxiolytic and antioxidant effects of Mart. (açaí) seed extract in adult rat offspring submitted to periodic maternal separation.

Appl Physiol Nutr Metab 2020 Nov 9;45(11):1277-1286. Epub 2020 Jun 9.

Department of Pharmacology, Institute of Biology, Rio de Janeiro State University, Rio de Janeiro, RJ 20551-030, Brazil.

Many studies suggest a protective role of phenolic compounds in mood disorders. We aimed to assess the effect of (açaí) seed extract (ASE) on anxiety induced by periodic maternal separation (PMS) in adult male rats. Animals were divided into 6 groups: control, ASE, fluoxetine (FLU), PMS, PMS+ASE, and PMS+FLU. For PMS, pups were separated daily from the dam for 3 h between postnatal day (PN) 2 and PN21. ASE (200 mg·kg·day) and FLU (10 mg·kg·day) were administered by gavage for 34 days after stress induction, starting at PN76. At PN106 and PN108, the rats were submitted to open field (OF) and forced swim tests, respectively. At PN110, the rats were sacrificed by decapitation. ASE increased time spent in the center area in the OF test, glucocorticoid receptors in the hypothalamus, tropomyosin receptor kinase B (TRKB) levels in the hippocampus, and nitrite levels and antioxidant activity in the brain stem (PMS+ASE group compared with PMS group). ASE also reduced plasma corticotropin-releasing hormone levels, adrenal norepinephrine levels, and oxidative damage in the brain stem in adult male offspring submitted to PMS. In conclusion, ASE treatment has an anti-anxiety effect in rats submitted to PMS by reducing hypothalamic-pituitary-adrenal axis reactivity and increasing the nitric oxide (NO)-brain-derived neurotrophic factor (BDNF)-TRKB pathway and antioxidant defense in the central nervous system. ASE has anti-anxiety and antioxidant effects in early-life stress. ASE reduces hypothalamic-pituitary-adrenal axis reactivity. The anxiolytic effect of ASE may involve activation of the NO-BDNF-TRKB pathway in the central nervous system.
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http://dx.doi.org/10.1139/apnm-2020-0099DOI Listing
November 2020

Effects of Short Term Metformin Treatment on Brown Adipose Tissue Activity and Plasma Irisin Levels in Women with Polycystic Ovary Syndrome: A Randomized Controlled Trial.

Horm Metab Res 2020 Oct 4;52(10):718-723. Epub 2020 May 4.

Department of Obstetrics and Gynecology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.

Polycystic ovary syndrome (PCOS) is a chronic dysfunction associated with obesity and metabolic disorders that can be ameliorated by treatment with metformin. Brown adipose tissue (BAT) has been recently identified in adult humans, and irisin is a myokine that induces BAT formation. The aim of this randomized controlled trial was to evaluate whether a short term treatment with metformin alters BAT activity and plasma irisin levels in women with PCOS. The participants were randomly assigned to receive metformin (1500 mg/day, n=21) or placebo (n=24) during 60 days. BAT activity was assessed by F-FDG positron emission tomography-computed tomography (PET-CT) and plasma irisin levels were measured by enzyme immunoassay. The groups were similar in age, body measures, metabolic profile and PCOS phenotypes. BAT activity did not change significantly in the women treated with metformin (median Δ SUV=-0.06 g/ml, interquartile interval -2.81 to 0.24 g/ml, p=0.484, Wilcoxon's test) or placebo (median Δ SUV=0.98 g/ml, interquartile interval -2.94 to 4.60 g/ml, p=0.386). In addition, plasma irisin levels remained unchanged in the groups treated with metformin (median Δ=-98 ng/ml, interquartile interval -366 to 60 ng/ml, p=0.310) and placebo (median Δ=28 ng/ml, interquartile interval -1260 to 215 ng/ml, p=0.650). These results suggest that in PCOS women BAT activity and plasma irisin levels may not change after a brief treatment with metformin.
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http://dx.doi.org/10.1055/a-1157-0615DOI Listing
October 2020

Fever, nausea and vomiting, and CSF pleocytosis must be meningoencephalitis, right? No, think again!

Clin Neurol Neurosurg 2020 07 20;194:105813. Epub 2020 Mar 20.

Department of Neurology, Centro Hospitalar Universitário de São João E.P.E., Porto, Portugal; Department of Clinical Neurosciences and Mental Health, Faculdade de Medicina da Universidade do Porto, Portugal.

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http://dx.doi.org/10.1016/j.clineuro.2020.105813DOI Listing
July 2020

Neurophysiological Correlates of the Near-Miss Effect in Gambling.

J Gambl Stud 2020 Jun;36(2):653-668

Laboratory of Neuropsychophysiology, Faculty of Psychology and Educational Sciences, University of Porto, Rua Alfredo Allen, 4200-135, Porto, Portugal.

The near-miss effect in gambling refers to a losing situation that is (or perceived to be) close to a win by the gambler. This effect is one of the many cognitive distortions that can occur during gambling games. The main objective of the present study was to analyze the electrophysiological correlates of the near-miss effect via an event-related potential (ERP) study examining four distinct gambling outcomes: win, full miss, near-miss before the payline, and near-miss after the payline. This study comprised 23 healthy voluntary participants (10 women) with ages ranging between 19 and 34 years (M = 22.5; SD = 3.65). All participants completed the South Oaks Gambling Screen and played a computerized slot machine, programed to induce the near-miss effect and specifically designed for an ERP study. By splitting the near-miss effect in two subtypes (before and after the payline), increased feedback-related negativity (FRN) was found for the near-misses after the payline in comparison to losses and also to near-misses before the payline. Results also indicated an increased P300 amplitude for the near-misses before the payline compared both with losses and with near-misses after the payline. The results suggest that both FRN and P300 present different sensitivities to near-miss subtypes, suggesting a payline effect that is not demonstrated when the data of near-misses before and after the payline are analyzed together. This is the first study to analyze the effect of the near-miss subtype in an ERP study and confirms the findings of previous behavioral studies.
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http://dx.doi.org/10.1007/s10899-020-09937-2DOI Listing
June 2020

Moyamoya Syndrome after Radiation Therapy: a Clinical Report.

Eur J Case Rep Intern Med 2019 2;6(12):001337. Epub 2019 Dec 2.

Clinical Neurosciences and Mental Health Department, Faculty of Medicine of the University of Porto, Portugal.

Moyamoya syndrome (MMS) is a rare, chronic and progressive vasculopathy with a characteristic angiographic pattern and well-recognized predisposing conditions, such as cranial therapeutic radiation. We report the case of a 36-year-old Caucasian female with a history of craniopharyngioma treated with whole-brain radiotherapy 20 years previously. She was admitted to the emergency department with disorientation and imperceptible speech lasting for 1 hour. Upon examination, she had slight motor aphasia, without sensory or motor deficits. However, the neurological deficits worsened on standing position. The computed tomography (CT) angiogram and transcranial Doppler ultrasonography revealed occlusion of the distal portion of the left internal carotid artery (ICA). Mechanical thrombectomy was attempted without success. Head CT was repeated, revealing left periventricular acute ischaemic stroke. The cerebral angiography showed total occlusion of the left ICA with an exuberant network of transdural collateral vessels, confirming MMS. The patient completed a functional rehabilitation program with progressive improvement of deficits and maintained a multidisciplinary follow-up. MMS is a serious late complication from cranial radiation therapy and a well-described risk factor for ischaemic stroke in younger patients. Therefore, early detection and prompt treatment are mandatory, as the consequences can be disastrous, such as cognitive and neurologic decline due to repeated strokes.

Learning Points: Moyamoya syndrome should be considered in younger patients presenting with acute neurologic deficits, particularly those treated with cranial radiotherapy.The treatment of acute stroke in patients with moyamoya syndrome should include intravenous hydration and avoidance of hypotension.The benefit of antiplatelet agents is limited and equivocal for patients with moyamoya syndrome and oral anticoagulants are not recommended for long-term treatment.
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http://dx.doi.org/10.12890/2019_001337DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6936925PMC
December 2019

"Comparative intra- and inter-rater reliability of maximal voluntary contraction with unidigital and bidigital vaginal palpation and construct validity with Peritron manometer".

Neurourol Urodyn 2020 02 24;39(2):721-731. Epub 2019 Dec 24.

Women's Health Research Laboratory, Physical Therapy Department, Federal University of São Carlos, São Carlos, São Paulo, Brazil.

Aims: Evaluate the intra- and inter-rater reliability of maximal voluntary contraction (MVC) of pelvic floor muscle (PFM) assessment by unidigital and bidigital vaginal palpation. As a secondary aim, evaluate the construct validity of vaginal palpation and a manometer.

Methods: A total of 120 women were recruited and allocated into three groups according to age (group 1 [G1]: 18-35; G2: 36-59; G3: ≥60 years). Examiner A conducted an interview and examiners B and C performed evaluations of PFM function using both unidigital and bidigital vaginal palpation. Seven to 10 days later, examiner B repeated both types of vaginal palpation and measured the MVC pressure with a Peritron. Reliability was analyzed using Cohen's linear weighted Kappa (κ ). The construct validity was calculated using the Spearman's correlation (r ).

Results: Intra-rater reliability of unidigital and bidigital palpation was κ  = 0.75 and κ  = 0.58 in G1, κ  = 0.59 and κ  = 0.73 in G2, and κ  = 0.79 and κ  = 0.86 in G3, respectively. Inter-rater reliability of unidigital and bidigital palpation was κ  = 0.52 and κ  = 0.48 in G1, κ  = 0.47 and κ  = 0.52 in G2, and κ  = 0.50 and κ  = 0.64 in G3, respectively. Spearman's correlation coefficients were significant at r  = 0.79 and r  = 0.80 for unidigital and bidigital vaginal palpation, respectively.

Conclusions: Unidigital or bidigital vaginal palpation were indicated to evaluate G1 and G2 but bidigital palpation was more reliable in G3 when two examiners performed the evaluation. For the assessment conducted by one examiner, unidigital palpation was more reliable in G1 while bidigital palpation was more reliable in G2 and G3. Both unidigital and bidigital palpation have high measures of validity.
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http://dx.doi.org/10.1002/nau.24263DOI Listing
February 2020

Prognostic yield of imaging before and after recanalization treatments in ischemic stroke.

Acta Neurol Scand 2020 Mar 11;141(3):226-235. Epub 2020 Jan 11.

Department of Neurology and Stroke Unit, Faculty of Medicine of University of Porto, Centro Hospitalar Universitário São João, Porto, Portugal.

Objectives: The scores to predict outcome in ischemic stroke were validated prior to the approval of modern revascularization treatments. We evaluated the accuracy of pre and post-treatment models in a recent recanalization therapy cohort and whether radiological and ultrasound findings could improve their accuracy.

Material & Methods: We included 375 anterior circulation ischemic stroke patients treated with intravenous thrombolysis or thrombectomy during 2017 and 2018. We collected demographic, clinical, and imaging data. We built pre and post-treatment logistic regression models to predict independence (modified Rankin Scale 0-2) at 3 months. The models included the Alberta Stroke Program Early CT Score (ASPECTS), infarct volume (ABC/2 method), and the Thrombolysis in Brain Ischemia (TIBI) ultrasonographic grade of recanalization. We compared areas under the receiver operating characteristic curve (AUC).

Results: Our preintervention model, combining neurological deficit severity, age, and admission glycemia, was not improved by the inclusion of ASPECTS (AUC 0.80 vs 0.79, P = .28). Early neurological recovery at 24-hour significantly increased prognostic performance (AUC = 0.85, P < .01), which did not change by adding final infarct volume or the persistence of arterial occlusion of the affected territory (AUC = 0.86 and 0.85, P > .05).

Conclusions: Models that combine simple variables such as neurological deficit severity, age, and admission glycemia were the most useful for predicting functional outcome in ischemic stroke patients submitted to revascularization treatments. Pre and post-treatment imaging findings did not enhance prognostic accuracy when compared to the patient's clinical improvement.
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http://dx.doi.org/10.1111/ane.13208DOI Listing
March 2020

Development and characterization of blends formulated with banana peel and banana pulp for the production of blends powders rich in antioxidant properties.

J Food Sci Technol 2019 Dec 2;56(12):5289-5297. Epub 2019 Aug 2.

1Programa de Pós-Graduação em Engenharia Agrícola, UFCG, Campina Grande, PB Brazil.

The food product industry is increasingly looking for foods with nutritional properties that can provide health benefits. Additionally, a challenge for the food industry is the use of all raw materials. For these reasons, banana peel that is a raw material from Banana () fruit emerges as potential for new food product development. Here, we developed powder blends using a lyophilization process for the preparation of flour to potential use in cookies, bread, and pasta products. Three formulations were designed; the main difference in the formulations was the use of banana peel concentration. Our results showed that blends produced with banana peel presented physical-chemical properties considered suitable for use in food industry. Moreover, the evaluated morphological parameters reveal the properties of the powders. The blends formulated with banana peel have more antioxidant properties, showing that the banana peel may be an attractive option to generate powders with high antioxidant properties.
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http://dx.doi.org/10.1007/s13197-019-03999-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6838270PMC
December 2019