Publications by authors named "Helena Andrade"

23 Publications

  • Page 1 of 1

Post-COVID-19 and the Portuguese national eye care system challenge.

J Optom 2020 Oct-Dec;13(4):257-261. Epub 2020 May 11.

Professional Association of Licensed Optometrists, Portugal.

The pandemic of the severe acute respiratory syndrome disease caused by the new coronavirus SARS-CoV-2 (COVID-19), had profound impact in many countries and their health care systems. Regarding Portugal, a suppression strategy with social distancing was adopted, attempting to break the transmission chains, bending the epidemy curve and reducing mortality. These measures seek to prevent an eventual National Health Service over-running, enforcing the suspension of all elective and non-urgent health care. Despite the success in so far, there is a consensus on the need to recover the previous level of health care provision and further enhance it. The Portuguese National Health Service, as a public, universal access, health care system funded by the State proved, in this context, its importance and relevance to the Portuguese population. However, long standing issues, such as the pre pandemic over long waiting lists for hospital ophthalmology attendance, whose determinants are fully identified but still unmet, emerge amplified from this pandemic. The lack of primary eye care in the National Health Service is a significant bottleneck, placing a huge stress on hospital-based care. An exclusive ophthalmologist's center care was over-runned before pandemic and will be even more so. The optometrist's exclusion from differentiated, multisectoral and multidisciplinary eye care teams remains the main hurdle to overcome and insure universal eye care in Portugal. National Health Service highlights the consequences of an overcome model. Universal eye care more than ever demands an evidence-based, integrated approach with primary eye care, in the community, on time and of proximity.
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http://dx.doi.org/10.1016/j.optom.2020.05.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7211682PMC
October 2020

A rare case of isolated anomalous origin of the left pulmonar artery.

Rev Port Cardiol 2020 Jun 16;39(6):353-355. Epub 2020 Jun 16.

Hospital Pediatrico de Coimbra, Serviço de Cardiologia Pediátrica, Coimbra, Portugal.

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http://dx.doi.org/10.1016/j.repc.2020.02.010DOI Listing
June 2020

Using a PCR-Based Method To Analyze and Model Large, Heterogeneous Populations of DNA.

Chembiochem 2020 04 7;21(8):1144-1149. Epub 2020 Jan 7.

B CUBE Center for Molecular Bioengineering, Technische Universität Dresden, Tatzberg 41, 01307, Dresden, Germany.

The study of populations of large size and high diversity is limited by the capability of collecting data. Moreover, for a pool of individuals, each associated with a unique characteristic feature, as the pool size grows, the possible interactions increase exponentially and quickly go beyond the limit of computation and experimental studies. Herein, the design of DNA libraries with various diversity is reported. By using a facile analytical method based on real-time PCR, the diversity of a pool of DNA can be evaluated to allow extraordinarily high heterogenicity (e.g., >1 trillion). It is demonstrated that these DNA libraries can be used to model heterogeneous populations; these libraries exhibit functions such as self-protection, suitability for biased expansion, and the possibility to evolve into amorphous structures. The method has shown the remarkable power of parallel computing with DNA, since it can resemble an analogue computer and be applied in selection-based biotechnology methods, such as DNA-encoded chemical libraries. As a chemical approach to solve problems traditionally for genetic and statistical analysis, the method provides a quick and cost-efficient evaluation of library diversity for intermediate steps through a selection process.
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http://dx.doi.org/10.1002/cbic.201900603DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7217214PMC
April 2020

Lessons learned from a prolonged norovirus GII.P16-GII.4 Sydney 2012 variant outbreak in a long-term care facility in Portugal, 2017.

Infect Control Hosp Epidemiol 2019 10 24;40(10):1164-1169. Epub 2019 Jul 24.

Department of Infectious Diseases, National Health Institute Doutor Ricardo Jorge, Instituto Nacional de Saúde, INSA, Lisbon, Portugal.

Objective: To investigate an outbreak of acute gastroenteritis caused by norovirus (NoV) in a long-term care facility (LTCF) in Portugal to describe and estimate its extent, and we implemented control measures.

Design: Outbreak investigation.

Methods: Probable cases were residents or staff members in the LTCF with at least 1 of the following symptoms: (1) diarrhea, (2) vomiting, (3) nausea, and/or (4) abdominal pain between October 31 and December 8, 2017. Confirmed cases were probable cases with positive NoV infection detected by real-time polymerase chain reaction (RT-PCR) and the same genotype in stool specimens.

Results: The outbreak was caused by NoV GII.P16-GII.4 Sydney 2012 variant and affected 146 people. The highest illness rates were observed in residents (97 of 335, 29%) and nurses (16 of 83, 19%). All 11 resident wards were affected. Data on cases and their working or living areas suggest that movement between wards facilitated the transmission of NoV, likely from person to person.

Conclusions: The delay in the identification of the causative agent, a lack of restrictions of resident and staff movement between wards, and ineffective initial deep-cleaning procedures resulted an outbreak that continued for >1 month. The outbreak ended only after implementation of strict control measures. Recommendations for controlling future NoV outbreaks in LTCFs include emphasizing the need to control resident's movements and to restrict visitors, timely and effective environmental cleaning and disinfection, leave of absence for ill staff, and encouraging effective hand hygiene.
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http://dx.doi.org/10.1017/ice.2019.201DOI Listing
October 2019

Management of Asymptomatic Wolff-Parkinson-White Pattern in Young Patients: Has Anything Changed?

Pediatr Cardiol 2019 Jun 8;40(5):892-900. Epub 2019 May 8.

Faculty of Medicine, University of Coimbra, Coimbra, Portugal.

The approach to pediatric asymptomatic Wolff-Parkinson-White (WPW) patients is controversial. The objective of this review is to update the last consensus of specialists of the Pediatric and Congenital Electrophysiology Society/Heart Rhythm Society on this subject in order to summarize the most recent evidence on the management of young patients with asymptomatic WPW pattern. A systematic review of the literature published between 2008 and 2018 was performed taking into account the protocol of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) in PubMed (including Cochrane), Embase, and Web of Science. Observational, experimental, and multicentric studies were included. Out of a total of 37 articles selected, 4 were considered eligible. Most studies considered a cutoff age of 8 or greater as recommended in the 2012 consensus. The identification of a shortest pre-excitatory RR interval (SPERRI) ≤ 250 ms seems to be the best predictor for risk stratification. The importance of routine isoprenaline use to improve the sensitivity of the electrophysiological study to identify patients at high risk of sudden death was consensual. Prophylactic ablative therapy has been indicated in asymptomatic children with an accessory pathway (AP) who have a low SPERRI and/or a low effective anterograde period of the AP and/or multiple APs. Despite the evidence found in the most recent studies, more studies are warranted in this setting.
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http://dx.doi.org/10.1007/s00246-019-02110-6DOI Listing
June 2019

Rare cause of cardiac failure in an infant.

Cardiol Young 2019 May 2;29(5):711-713. Epub 2019 May 2.

Paediatric Cardiology Department, Paediatric Hospital, Coimbra,Portugal.

Congenital stenosis of the pulmonary veins is a rare condition whose outcome is guarded despite the available treatment options. We report a case of a 6-month-old infant with significant stenosis of all four pulmonary veins.
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http://dx.doi.org/10.1017/S1047951119000428DOI Listing
May 2019

Second generation DNA-encoded dynamic combinatorial chemical libraries.

Chem Commun (Camb) 2019 Mar;55(26):3753-3756

B CUBE Center for Molecular Bioengineering, Technische Universität Dresden, Germany.

We present a DNA-encoded chemical library, which allows dynamic selection followed by ligation of the encoding strands. As a chemical approach to mimic the genetic recombination process of adaptive immunity, the technology led to an enhanced enrichment factor and signal-to-noise ratio compared to static libraries.
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http://dx.doi.org/10.1039/c9cc01429bDOI Listing
March 2019

Specificity from nonspecific interaction: regulation of tumor necrosis factor-α activity by DNA.

J Biol Chem 2019 04 27;294(16):6397-6404. Epub 2019 Feb 27.

From the B CUBE Center for Molecular Bioengineering, Technische Universität Dresden, 01307 Dresden, Germany

As anionic biopolymers, oligonucleotides can have biological functions independent from their roles as the medium for the storage and flow of genetic information. In this paper, we investigated the interaction between DNA and the pro-inflammatory cytokine tumor necrosis factor-α (TNFα). Although various forms of DNA bind to TNFα with low μm dissociation constants, the interaction stabilizes the trimeric form of TNFα and enhances its cytotoxic effect. Based on this mechanism, a photoswitchable TNFα (TNFα-2-nitroveratryloxycarbonyl) has been designed whose sensitivity to DNA-mediated up-regulation of TNFα activity can be tuned by light irradiation. The mechanism described in this study represents a general model to understand the involvement of nonspecific interactions among biomolecules in regulating their biological functions. Because the interaction is not DNA sequence-specific, the resulting effect should be considered for oligonucleotide-based therapeutics in general.
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http://dx.doi.org/10.1074/jbc.RA119.007586DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6484132PMC
April 2019

Peptidyl prolyl / isomerase activity on the cell surface correlates with extracellular matrix development.

Commun Biol 2019 11;2:58. Epub 2019 Feb 11.

B CUBE Center for Molecular Bioengineering, Technische Universität Dresden, Dresden, 01307, Germany.

Interactions with the extracellular matrix (ECM) dictate cell fates. However, the complexity of dense ECM network and cell-surface molecules prevent the study of their dynamic interaction at the molecular level on living cells. Here, we focus on peptidyl prolyl isomerases (PPIases) to dissect prolyl isomerization from other dynamic events. We reveal the contribution of PPIase on the mechanical properties of various ECM materials and on the dynamic cell-ECM interaction. To avoid complications associated with the existing spectroscopy-based methods such as light scattering, an assay was developed for detecting PPIase activity on living cell surface. This assay allows us to correlate PPIase activity with ECM development, and with the physiological and pathological states of the cells, including the functional properties of cancer cells and immune effector cells.
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http://dx.doi.org/10.1038/s42003-019-0315-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6370856PMC
April 2020

Importance of ambulatory blood pressure monitoring in the diagnosis and prognosis of pediatric hypertension.

Rev Port Cardiol 2018 09 2;37(9):783-789. Epub 2018 Jun 2.

Serviço de Cardiologia Pediátrica, Hospital Pediátrico de Coimbra, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.

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.
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http://dx.doi.org/10.1016/j.repc.2017.09.026DOI Listing
September 2018

Estimating treatment coverage for people with substance use disorders: an analysis of data from the World Mental Health Surveys.

World Psychiatry 2017 Oct;16(3):299-307

Colegio Mayor de Cundinamarca University, Bogota, Colombia.

Substance use is a major cause of disability globally. This has been recognized in the recent United Nations Sustainable Development Goals (SDGs), in which treatment coverage for substance use disorders is identified as one of the indicators. There have been no estimates of this treatment coverage cross-nationally, making it difficult to know what is the baseline for that SDG target. Here we report data from the World Health Organization (WHO)'s World Mental Health Surveys (WMHS), based on representative community household surveys in 26 countries. We assessed the 12-month prevalence of substance use disorders (alcohol or drug abuse/dependence); the proportion of people with these disorders who were aware that they needed treatment and who wished to receive care; the proportion of those seeking care who received it; and the proportion of such treatment that met minimal standards for treatment quality ("minimally adequate treatment"). Among the 70,880 participants, 2.6% met 12-month criteria for substance use disorders; the prevalence was higher in upper-middle income (3.3%) than in high-income (2.6%) and low/lower-middle income (2.0%) countries. Overall, 39.1% of those with 12-month substance use disorders recognized a treatment need; this recognition was more common in high-income (43.1%) than in upper-middle (35.6%) and low/lower-middle income (31.5%) countries. Among those who recognized treatment need, 61.3% made at least one visit to a service provider, and 29.5% of the latter received minimally adequate treatment exposure (35.3% in high, 20.3% in upper-middle, and 8.6% in low/lower-middle income countries). Overall, only 7.1% of those with past-year substance use disorders received minimally adequate treatment: 10.3% in high income, 4.3% in upper-middle income and 1.0% in low/lower-middle income countries. These data suggest that only a small minority of people with substance use disorders receive even minimally adequate treatment. At least three barriers are involved: awareness/perceived treatment need, accessing treatment once a need is recognized, and compliance (on the part of both provider and client) to obtain adequate treatment. Various factors are likely to be involved in each of these three barriers, all of which need to be addressed to improve treatment coverage of substance use disorders. These data provide a baseline for the global monitoring of progress of treatment coverage for these disorders as an indicator within the SDGs.
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http://dx.doi.org/10.1002/wps.20457DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5608813PMC
October 2017

[The Museu da Saúde in Portugal: a physical space, a virtual space].

Hist Cienc Saude Manguinhos 2015 Dec;22 Suppl:1749-63

Insa, Lisboa, Portugal,

Museu da Saúde (Museum of Health) in Portugal, based on the dual concept of a multifaceted physical space and a virtual space, is preparing an inventory of its archive. So far, it has studied five of its collections in greater depth: tuberculosis, urology, psychology, medicine, and malaria. In this article, these collections are presented, and the specificities of developing museological activities within a national laboratory, Instituto Nacional de Saúde Doutor Ricardo Jorge, are also discussed, highlighting the issues of the store rooms and exhibition spaces, the inventory process, and the communication activities, with a view to overcoming the challenges inherent to operating in a non-museological space.
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http://dx.doi.org/10.1590/S0104-59702015000500012DOI Listing
December 2015

The number of reduced alignments between two DNA sequences.

BMC Bioinformatics 2014 Apr 1;15:94. Epub 2014 Apr 1.

Departamento de Análise Matemática, Facultade de Matemáticas, Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain.

Background: In this study we consider DNA sequences as mathematical strings. Total and reduced alignments between two DNA sequences have been considered in the literature to measure their similarity. Results for explicit representations of some alignments have been already obtained.

Results: We present exact, explicit and computable formulas for the number of different possible alignments between two DNA sequences and a new formula for a class of reduced alignments.

Conclusions: A unified approach for a wide class of alignments between two DNA sequences has been provided. The formula is computable and, if complemented by software development, will provide a deeper insight into the theory of sequence alignment and give rise to new comparison methods.

Ams Subject Classification: Primary 92B05, 33C20, secondary 39A14, 65Q30.
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http://dx.doi.org/10.1186/1471-2105-15-94DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3977907PMC
April 2014

Guidance for clinical and public health laboratories testing for influenza virus antiviral drug susceptibility in Europe.

J Clin Virol 2013 05 31;57(1):5-12. Epub 2013 Jan 31.

National Influenza Centre, Influenza and Respiratory Viruses Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain.

Two classes of antiviral drugs are licensed in Europe for treatment and prophylaxis of influenza; the M2 ion-channel blockers amantadine and rimantadine acting against type A influenza viruses only and the neuraminidase enzyme inhibitors zanamivir and oseltamivir acting against type A and type B influenza viruses. This guidance document was developed for but not limited to the European Union (EU) and other European Economic Area (EEA) countries on how and when to test for influenza virus antiviral drug susceptibility. It is aimed at clinical and influenza surveillance laboratories carrying out antiviral drug susceptibility testing on influenza viruses from patients suspected of harbouring viruses with reduced susceptibility or for the monitoring of the emergence of such among circulating viruses, respectively. Therefore, the guidance should not be read as a directive or an algorithm for treatment. Monitoring for emergence of influenza viruses with reduced drug susceptibility in hospitalized cases is crucial for decision making on possible changes to antiviral treatment. Therefore, it is important to test for antiviral susceptibility in certain patient groups, such as patients treated with influenza antiviral drugs. It is also important to determine the frequency of viruses with natural (not related to drug use) reduced susceptibility among community and hospitalized cases, as this knowledge is essential for making empirical antiviral treatment decisions. Furthermore, testing of specimens from community influenza patients is needed to determine the frequency of viruses with reduced susceptibility and good viral fitness that are readily transmissible, as they may become dominant among circulating viruses. Phenotypic neuraminidase enzyme inhibition assays are recommended to determine the level of inhibition of the neuraminidase enzyme by antiviral drugs as a measure of drug susceptibility of the virus. Genotypic assays are recommended to identify amino acid substitutions in the neuraminidase and M2 ion-channel proteins that have been associated with reduced antiviral susceptibility previously. By 2012 all circulating seasonal influenza A(H1N1)pdm09 and A(H3N2) viruses were naturally resistant to the M2 ion-channel blockers, so priority should be given to testing for neuraminidase inhibitor susceptibility.
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http://dx.doi.org/10.1016/j.jcv.2013.01.009DOI Listing
May 2013

[Emery-Dreifuss muscular dystrophy: case report].

Rev Port Cardiol 2012 Mar;31(3):241-5

Serviço de Cardiologia, Hospitais da Universidade de Coimbra, Coimbra, Portugal.

Emery-Dreifuss muscular dystrophy type 1 (EDMD1) is a familial disease with X-Linked recessive transmission, caused by a mutation in a nuclear envelope protein, emerin. Clinical manifestations usually occur in adolescence and include contractures, muscle atrophy and weakness, and cardiac conduction disturbances. We describe the case of a young male, aged 16, with first-degree atrioventricular (AV) block and limited extension of both forearms. He had elevated CK, and cardiac monitoring showed severe conduction tissue disease, with significant sinus pauses, chronotropic incompetence and periods of AV dissociation during exercise. Immunohistochemical staining using an emerin antibody showed absence of the protein in a fragment of muscle tissue and genetic study identified a mutation associated with EDMD1. Study of his brother, aged 21, also established a diagnosis of EDMD1. Both individuals received a permanent pacemaker but musculoskeletal manifestations at that time did not warrant any other intervention: Screening for certain genetic diseases, including muscular dystrophies, is mandatory following identification of conduction abnormalities in young people.
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http://dx.doi.org/10.1016/j.repc.2012.01.006DOI Listing
March 2012

High blood pressure in the pediatric age group.

Rev Port Cardiol 2010 Mar;29(3):413-32

Cardiologia Pediátrica, Serviço de Cardiologia dos Hospitais da Universidade de Coimbra, Coimbra, Portugal.

The definition of hypertension (HT) in the pediatric age group is based on the normal distribution of blood pressure (BP) in healthy children. Normal BP is defined as being below the 90th percentile for gender, age and height, and hypertension as equal to or higher than the 95th percentile on at least three separate occasions. If the values are above the 90th percentile but below the 95th percentile, the child should be considered prehypertensive. Ambulatory BP monitoring is useful in the assessment of BP levels in the young. P values in children and adolescents have creased in the last decade, in parallel with increases in body mass index, and HT now has a prevalence of 2-5%. Obesity in childhood and adolescence is one of the main predictors of HT in adulthood, but it is also associated with other cardiovascular risk factors such as dyslipidemia, abnormal glucose metabolism, insulin resistance, inflammation and impaired vascular function. Left ventricular hypertrophy is the most prominent evidence of target organ damage caused by hypertension in children and adolescents. The goal for antihypertensive treatment is to reduce BP below the 95th percentile. Weight control, with regular physical activity and dietary changes, is the primary therapy for obesity-related hypertension. Weight loss decreases not only BP but also other cardiovascular risk factors. The indications for use of antihypertensive drugs are: symptomatic hypertension, secondary hypertension, established hypertensive target organ damage, stage 2 hypertension and failure of nonpharmacologic measures.
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March 2010

Antiviral drug profile of seasonal influenza viruses circulating in Portugal from 2004/2005 to 2008/2009 winter seasons.

Antiviral Res 2010 May 18;86(2):128-36. Epub 2010 Jan 18.

National Reference Laboratory for Antimicrobial Resistance, Research and Development Unit, Department of Infectious Diseases, National Institute of Health, Av. Padre Cruz, Lisbon, Portugal.

A research project on antiviral drug resistance of influenza viruses circulating in Portugal has been carried out since 2007. Here, the first results obtained regarding the evaluation of susceptibility to amantadine and oseltamivir are presented. Information about antiviral prescription and exposure was available through the National Influenza Surveillance Programme. Amantadine susceptibility was evaluated by pyrosequencing for known resistance markers on 178 influenza A strains from 2004/2005 to 2006/2007. Susceptibility to oseltamivir was evaluated by 50% inhibitory concentration determination on 340 virus strains from 2004/2005 to 2008/2009, 134 of which were further analyzed by sequencing of the neuraminidase gene. This study revealed that influenza antiviral drugs were rarely prescribed at national level. Resistance to amantadine was observed on only A(H3N2) strain isolated during 2005/2006 and on 38 (74.5%) of the 51 A(H3N2) strains from 2006/2007, all carrying the mutation S31N in their M2 sequence. Oseltamivir resistance was observed in 6 (20.7%) of the 29 A(H1N1) strains from 2007/2008 and in all strains from 2008/2009, which exhibited extremely high IC(50) values and carrying the mutation H275Y in their neuraminidase sequence. The national data generated and analyzed in this study may contribute to increase the knowledge on influenza antiviral drug resistance which is a problem of global concern.
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http://dx.doi.org/10.1016/j.antiviral.2010.01.002DOI Listing
May 2010

Aortic deformities: not all are aneurysms.

Rev Port Cardiol 2009 Oct;28(10):1177-9

Unidade de Cardiologia Pediátrica, Serviço de Cardiologia dos Hospitais da Universidade de Coimbra, Coimbra, Portugal.

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October 2009

Transcatheter closure of a fenestration in intracardiac Fontan circulation.

Rev Port Cardiol 2008 Dec;27(12):1591-5

Unidade de Cardiologia Pediátrica dos Hospitals da Universidade de Coimbra, Coimbra, Portugal.

We present a case of tricuspid atresia and the treatment that was used in a child now aged 12. The malformation was corrected at the age of five through intracardiac Fontan circulation. Later, the child developed a right-to-left shunt due to dehiscence in the intra-atrial conduit, causing significant desaturation. This was treated by transcatheter closure with a 10 mm Amplatzer device at 8 years of age. Currently the child is asymptomatic with no residual shunts, and the position of the device is normal. The percutaneous closure of Fontan fenestrations using the Amplatzer device is a therapeutic approach that provides good results. It results in normal oxygen saturation and has low morbidity. The technique is simple, available to most cardiac catheterization laboratories, safe, and offers a reasonable cost-benefit ratio. In addition, the design of the device is suitable for this type of defect.
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December 2008

Patent ductus arteriosus--neonatal intensive care unit registry.

Rev Port Cardiol 2008 Jul-Aug;27(7-8):877-85

Serviço de Neonatologia e Unidade de Cardiologia Pediátrica dos Hospitals da Universidade de Coimbra, Coimbra, Portugal.

Objectives: This study took place at the Neonatal Intensive Care Unit (NICU) of the Dr Daniel de Matos Maternity Hospital and evaluated the incidence of patent ductus arteriosus (PDA), the clinical evolution of the newborns affected, the treatment prescribed, and associated morbidity and mortality.

Methods: We carried out a retrospective medical chart review of newborns admitted to the NICU between January 2001 and December 2005.

Results: PDA was found in 69 newborns. Median gestational age (GA) was 28 weeks and birth weight (BW) 1100 grams. The diagnosis of PDA was established, on average, between the fifth and sixth day of life. Of the 53 newborns with criteria for closure, 49 had indomethacin therapy, with a success rate of 88%; surgical ligation was subsequently necessary in six of these. Thirty-eight newborns presented associated comorbidities, and eight died.

Conclusions: The results obtained in this study are in agreement with the literature. In cases with GA of less than 30 weeks and/or BW below 1500g, the need for treatment for PDA closure is greater than in cases with higher GA/BW, and a more aggressive approach is required, with presymptomatic prolonged indomethacin. The results obtained in this work led us to conclude that echocardiography should be performed to screen for PDA in all newborns of less than 30 weeks or with BW below 1500g. We intend in the near future to answer a question that emerged from this study: will earlier diagnosis lead to improved outcomes?
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March 2009

Amplatzer implantation after displacement of the first device.

Rev Port Cardiol 2008 Feb;27(2):281-2

Unidade de Cardiologia Pediátrica dos Hospitais da Universidade de Coimbra, Coimbra, Portuga.

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February 2008

High genetic diversity of measles virus, World Health Organization European Region, 2005-2006.

Emerg Infect Dis 2008 Jan;14(1):107-14

World Health Organization (WHO) Regional Reference Laboratory for Measles and Rubella, Laboratoire National de Santé-Immunology 20A, rue Auguste Lumiere, Luxembourg, Luxembourg.

During 2005-2006, nine measles virus (MV) genotypes were identified throughout the World Health Organization European Region. All major epidemics were associated with genotypes D4, D6, and B3. Other genotypes (B2, D5, D8, D9, G2, and H1) were only found in limited numbers of cases after importation from other continents. The genetic diversity of endemic D6 strains was low; genotypes C2 and D7, circulating in Europe until recent years, were no longer identified. The transmission chains of several indigenous MV strains may thus have been interrupted by enhanced vaccination. However, multiple importations from Africa and Asia and virus introduction into highly mobile and unvaccinated communities caused a massive spread of D4 and B3 strains throughout much of the region. Thus, despite the reduction of endemic MV circulation, importation of MV from other continents caused prolonged circulation and large outbreaks after their introduction into unvaccinated and highly mobile communities.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2600148PMC
http://dx.doi.org/10.3201/eid1401.070778DOI Listing
January 2008

[Echovirus type 13 meningitis: admissions to a paediatric ward at a Lisbon hospital].

Acta Med Port 2004 Jul-Aug;17(4):299-302. Epub 2004 Aug 31.

Serviço de Pediatria. Hospital Fernando Fonseca, Amadora.

Infections by echovirus 13 are rare. In our country, it had not been previously reported any infection of this sort until 2000, when eleven echovirus 13 meningitis were observed in the Department of Pediatrics of the Hospital Fernando Fonseca. In England and Spain outbreaks of echovirus 13 meningitis during 2000 was also reported. Based on these facts the authors make an epidemiological analyses of their series.
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March 2006