Publications by authors named "Jorge Ferreira"

260 Publications

Shotgun mass spectrometry-based lipid profiling identifies and distinguishes between chronic inflammatory diseases.

EBioMedicine 2021 Jul 23;70:103504. Epub 2021 Jul 23.

iNOVA4Health, CEDOC, NOVA Medical School, NMS, Universidade Nova de Lisboa, 1169-056 Lisboa, Portugal. Electronic address:

Background: Localized stress and cell death in chronic inflammatory diseases may release tissue-specific lipids into the circulation causing the blood plasma lipidome to reflect the type of inflammation. However, deep lipid profiles of major chronic inflammatory diseases have not been compared.

Methods: Plasma lipidomes of patients suffering from two etiologically distinct chronic inflammatory diseases, atherosclerosis-related vascular disease, including cardiovascular (CVD) and ischemic stroke (IS), and systemic lupus erythematosus (SLE), were screened by a top-down shotgun mass spectrometry-based analysis without liquid chromatographic separation and compared to each other and to age-matched controls. Lipid profiling of 596 lipids was performed on a cohort of 427 individuals. Machine learning classifiers based on the plasma lipidomes were used to distinguish the two chronic inflammatory diseases from each other and from the controls.

Findings: Analysis of the lipidomes enabled separation of the studied chronic inflammatory diseases from controls based on independent validation test set classification performance (CVD vs control - Sensitivity: 0.94, Specificity: 0.88; IS vs control - Sensitivity: 1.0, Specificity: 1.0; SLE vs control - Sensitivity: 1, Specificity: 0.93) and from each other (SLE vs CVD ‒ Sensitivity: 0.91, Specificity: 1; IS vs SLE - Sensitivity: 1, Specificity: 0.82). Preliminary linear discriminant analysis plots using all data clearly separated the clinical groups from each other and from the controls, and partially separated CVD severities, as classified into five clinical groups. Dysregulated lipids are partially but not fully counterbalanced by statin treatment.

Interpretation: Dysregulation of the plasma lipidome is characteristic of chronic inflammatory diseases. Lipid profiling accurately identifies the diseases and in the case of CVD also identifies sub-classes.

Funding: Full list of funding sources at the end of the manuscript.
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http://dx.doi.org/10.1016/j.ebiom.2021.103504DOI Listing
July 2021

Myocardial infarction in the COVID-19 pandemic - Reperfusion therapy revisited.

Authors:
Jorge Ferreira

Rev Port Cardiol (Engl Ed) 2021 07;40(7):473-474

Serviço de Cardiologia, CHLO, Hospital de Santa Cruz, Carnaxide, Portugal. Electronic address:

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http://dx.doi.org/10.1016/j.repce.2021.07.015DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8278190PMC
July 2021

Medication adherence to direct anticoagulants in patients with non-valvular atrial fibrillation - a real world analysis.

Rev Port Cardiol 2021 Jun 30. Epub 2021 Jun 30.

Serviço de Cardiologia, Hospital Santa Cruz, Centro Hospitalar Lisboa Ocidental, Carnaxide, Portugal.

Introduction And Objectives: Direct oral anticoagulants (DOACs) changed the landscape of atrial fibrillation (AF) treatment, but also brought new challenges in terms of accessibility and compliance. The purpose of this study was to assess adherence to DOACs, and predictors of adherence in a population of AF patients.

Methods: Single-center retrospective study including all patients with non-valvular AF treated with a DOAC and followed in outpatient general cardiology, whose first DOAC prescription was between 1 April 2016 to August 2018. The number of pharmacy refills from the day of first prescription to 31 August 2018 was counted (by means of an electronic prescription platform). Medication refill adherence (MRA) was calculated by dividing the total days of supply by the number of days under therapy. Non-compliance was defined as MRA <90%.

Results: A total of 264 patients (120 men, mean age 74 [PLEASE INSERT SYMBOL] 12 years) met the inclusion criteria. The median CHA2DS2VASC score was 3 (interquartile range (IQR) 2-5) and the median HAS-BLED was 1 (IQR 1-2). Rivaroxaban, apixaban, dabigatran and edoxaban were prescribed in 45%, 41%, 24% and 13% of patients, respectively. Throughout the study, 51 patients (19%) used at least two DOACs. Patients were under DOAC for a median period of 439 days (IQR 269-638), during which the included population adhered to therapy 90% of the time (IQR 75-100%). Half of the patients (51%) were classified as non-compliant; therapy duration (adjusted odds ratio (OR) 1.06 per month, 95% confidence interval (CI) 1.03-1.08, p<0.001), taking DOACs with b.i.d. (adjusted OR 1.73, 95%CI 1.08-2.75, p=0.022), and higher medication copayments (adjusted OR 2.13, 95%CI 1.28-3.45, p=0.003) were independent predictors of non-compliance.

Conclusion: Half of the patients (51%) were classified as non-compliant (medication refill adherence < 90%). Therapy duration, DOACs with b.i.d. posology and higher medication copayments were independent predictors of non-compliance, which might be targets to improve patient adherence.
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http://dx.doi.org/10.1016/j.repc.2020.10.017DOI Listing
June 2021

Spanish Asthma Management Guidelines (GEMA) VERSION 5.1. Highlights and Controversies.

Arch Bronconeumol 2021 May 26. Epub 2021 May 26.

Sociedad Española de Inmunología Clínica-Alergología y Asma Pediátrica (SEICAP), Hospital Católico Universitario Casa de Salud, Valencia, España.

In this fifth phase of development, the contents of the Spanish Asthma Management Guidelines (GEMA), which include versions 5.0 and 5.1, have undergone a thorough review. The aim here is to set the main changes in context. These could be summarized as follows: DIAGNOSIS: new FE cut-off and severity classification based on treatment needed to maintain control; INTERMITTENT ASTHMA: a more restrictive concept and treatment extended to include a glucocorticoid/adrenergic combination as needed; MILD ASTHMA: glucocorticoid/adrenergic therapy as needed as an alternative in case of low therapeutic adherence to conventional fixed-dose steroids; SEVERE ASTHMA: readjustment of phenotypes, incorporation of triple therapy in a single inhaler, and criteria for selection of a biologic in severe uncontrolled asthma; OTHERS: specific scoring in childhood asthma, incorporation of certain organizational aspects (care circuits, asthma units, telemedicine), new sections on COVID-19 and nasal polyposis.
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http://dx.doi.org/10.1016/j.arbres.2021.05.010DOI Listing
May 2021

Starch and protein recovery from brewer's spent grain using hydrothermal pretreatment and their conversion to edible filamentous fungi - A brewery biorefinery concept.

Bioresour Technol 2021 Oct 13;337:125409. Epub 2021 Jun 13.

Swedish Centre for Resource Recovery, University of Borås, 50190 Borås, Sweden.

This study aimed at recovering a highly concentrated starch and protein stream from the brewer's spent grain (BSG). The effect of pretreatment temperature and retention time on the solubilization of starch and protein; and the generation of fermentation inhibitors were studied. Then, the application of recovered streams for fungal cultivation was evaluated using different edible fungi Aspergillus oryzae, Neurospora intermedia, and Rhizopus delemar. The hydrothermal pretreatment resulted in the highest solubilized starch concentration, 43 g/L, corresponding to 83% solubilization of initial BSG starch content. The highest protein concentration was 27 g/L (48% solubilization of initial BSG protein content). Cultivation with Neurospora intermedia on the recovered streams from the two best pretreatment conditions, 140 ℃ for 4 h and 180 ℃ for 30 min, resulted in pure fungal biomass with the highest protein content 59.62% and 50.42% w/w, respectively. Finally, a brewery biorefinery was proposed for the valorization of BSG.
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http://dx.doi.org/10.1016/j.biortech.2021.125409DOI Listing
October 2021

FeNO testing in severe asthma: A clinical argument or an access constraint?

Pulmonology 2021 Jun 14. Epub 2021 Jun 14.

Pneumology Unit, Hospitais da Universidade de Coimbra, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Centre of Pneumology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal. Electronic address:

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http://dx.doi.org/10.1016/j.pulmoe.2021.05.002DOI Listing
June 2021

Production of polyhydroxyalkanoates (PHAs) by using food waste acidogenic fermentation-derived volatile fatty acids.

Bioengineered 2021 Dec;12(1):2480-2498

Swedish Centre for Resource Recovery, University of Borås, Sweden.

High production costs still hamper fast expansion of commercial production of polyhydroxyalkanoates (PHAs). This problem is greatly related to the cultivation medium which accounts for up to 50% of the whole process costs. The aim of this research work was to evaluate the potential of using volatile fatty acids (VFAs), derived from acidogenic fermentation of food waste, as inexpensive carbon sources for the production of PHAs through bacterial cultivation. could assimilate glucose, acetic acid, butyric acid, and caproic acid as single carbon sources in synthetic medium with maximum PHAs production yields of 9-11%, on a cell dry weight basis. Single carbon sources were then replaced by a mixture of synthetic VFAs and by a VFAs-rich stream from the acidogenic fermentation of food waste. After 72 h of cultivation, the VFAs were almost fully consumed by the bacterium in both media and PHAs production yields of 9-10%, on cell dry weight basis, were obtained. The usage of VFAs mixture was found to be beneficial for the bacterial growth that tackled the inhibition of propionic acid, iso-butyric acid, and valeric acid when these volatile fatty acids were used as single carbon sources. The extracted PHAs were revealed to be polyhydroxybutyrate (PHB) by characterization methods of Fourier-transform infrared spectroscopy (FTIR) and differential scanning calorimetry (DSC). The obtained results proved the possibility of using VFAs from acidogenic fermentation of food waste as a cheap substrate to reduce the cost of PHAs production.
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http://dx.doi.org/10.1080/21655979.2021.1935524DOI Listing
December 2021

Myocardial infarction in the COVID-19 pandemic - Reperfusion therapy revisited.

Authors:
Jorge Ferreira

Rev Port Cardiol 2021 07 5;40(7):473-474. Epub 2021 Jun 5.

Serviço de Cardiologia, CHLO, Hospital de Santa Cruz, Carnaxide, Portugal. Electronic address:

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http://dx.doi.org/10.1016/j.repc.2021.05.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8179662PMC
July 2021

[Palliative rehabilitation interventions in palliative care: a scoping review].

Prof Inferm 2021 Jan-Mar;74(1):55-63

RN., Ph.D., Coordinating Professor, Health Sciences Research Unit, Nursing School of Coimbra, Portugal.

Background: Palliative rehabilitation is defined as the process of helping a person with a progressive, commonly advanced, and/or incurable disease reach their physical, psychological, and social potential consistent with physiological and environmental limitations and life preferences. However, the evidence on this subject is dispersed in the literature.

Objective: To examine and map interventions of palliative rehabilitation, implemented and evaluated in palliative care.

Methodology: A scoping review, using the Joanna Briggs Institute's guideline, was conducted. Multiple databases were searched: CINAHL Complete; PubMed; Scopus; SciELO; Cochrane Central Register of Controlled Trials; PEDro, as well as grey literature for studies that focus on qualified healthcare professionals caring for patients 18 years of age or older, working in palliative care, that focus on the concepts of palliative rehabilitation interventions.

Results: Of the 314 studies retrieved, two were included in this review. Both were conducted with physiotherapists, and none mentioned nursing rehabilitation. One of the studies implemented and evaluated an intervention of exclusively physical domain and another of physical and emotional domain. The interventions still differ in the number of treatments which ranged from 4 to 7 sessions. Both studies were implemented in oncological and non-oncological patients.

Conclusion: Further research is needed to explore the rehabilitation strategies used by healthcare professionals working in palliative care that help patients. Moreover, since nurses are often the healthcare professionals who are in closest proximity to, and who spend the most time with, the patient, which rehabilitation interventions do these professionals should be focus of intervention.
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http://dx.doi.org/10.7429/pi.2021.741055DOI Listing
June 2021

High-Resolution Analysis of Centrosome Behavior During Mitosis.

Methods Mol Biol 2021 ;2329:179-194

Instituto de Investigação e Inovação em Saúde (i3S), Porto, Portugal.

Cell division requires a dynamic reorganization of cytoskeletal and nuclear components. One essential step is the separation of centrosomes, which allows the assembly of a microtubule-based mitotic spindle. This has to be spatially and temporally coordinated with other events such as adhesion complex disengagement, assembly of an actin-rich cell cortex and nuclear envelope breakdown (NEB), to ensure chromosome segregation fidelity. Previous methodologies often focused on a single event and failed to provide an integrated view of the process. In this chapter, we describe a method to study mitosis with high resolution, by analyzing the dynamic interplay between centrosomes, nucleus, and cell membrane, using a combination of live-cell imaging and micromanipulation with custom-designed computational tools.
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http://dx.doi.org/10.1007/978-1-0716-1538-6_13DOI Listing
January 2021

SGLT-2 inhibitors: A step forward in the treatment of heart failure with reduced ejection fraction.

Rev Port Cardiol (Engl Ed) 2021 May 31. Epub 2021 May 31.

CINTESIS - Centro de Investigação em Tecnologias e Serviços de Saúde, Porto, Portugal; Serviço de Cardiologia, Hospital das Forças Armadas - Pólo do Porto, Portugal.

Heart failure (HF) is a major health problem with a significant impact on morbidity, mortality, quality of life and healthcare costs. Despite the positive impact of disease-modifying therapies developed over the last four decades, HF mortality and hospitalization remain high. We aim at reviewing the evidence supporting the use of sodium-glucose co-transporter-2 (SGLT-2) inhibitors, as a novel strategy for HF with reduced ejection fraction (HFrEF) treatment. The consistent observation of a reduction in HF hospitalizations in type-2 diabetes cardiovascular safety trials EMPA-REG OUTCOME, CANVAS, DECLARE-TIMI 58 and VERTIS raised the hypothesis that SGLT-2 inhibitors could have an impact in HF treatment. This hypothesis was first confirmed in 2019 with the DAPA-HF publication showing that dapagliflozin on top of optimized HFrEF therapy, reduced HF-hospitalizations and cardiovascular mortality. This was reinforced by the EMPEROR-Reduced publication in 2020 showing that empagliflozin on top of optimized HFrEF therapy, reduced HF-hospitalizations. Both studies established SGLT-2 inhibitors as a fourth pillar of HFrEF prognosis-modifying therapy, in addition to the gold standard triple neurohormonal modulation/blockade.
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http://dx.doi.org/10.1016/j.repc.2021.02.010DOI Listing
May 2021

Influence of seasonal changes and salinity on spinach phyllosphere bacterial functional assemblage.

PLoS One 2021 1;16(6):e0252242. Epub 2021 Jun 1.

US Salinity Laboratory, USDA-ARS, Riverside, CA, United States of America.

The phyllosphere is the aerial part of plants that is exposed to different environmental conditions and is also known to harbor a wide variety of bacteria including both plant and human pathogens. However, studies on phyllosphere bacterial communities have focused on bacterial composition at different stages of plant growth without correlating their functional capabilities to bacterial communities. In this study, we examined the seasonal effects and temporal variabilities driving bacterial community composition and function in spinach phyllosphere due to increasing salinity and season and estimated the functional capacity of bacterial community16S V4 rRNA gene profiles by indirectly inferring the abundance of functional genes based on metagenomics inference tool Piphillin. The experimental design involved three sets of spinach (Spinacia oleracea L., cv. Racoon) grown with saline water during different seasons. Total bacteria DNA from leaf surfaces were sequenced using MiSeq® Illumina platform. About 66.35% of bacteria detected in the phyllosphere were dominated by four phyla- Proteobacteria, Firmicutes, Bacteroidetes, and Actinobacteria. Permutational analysis of variance (PERMANOVA) showed that phyllosphere microbiomes were significantly (P < 0.003) affected by season, but not salinity (P = 0.501). The most abundant inferred functional pathways in leaf samples were the amino acids biosynthesis, ABC transporters, ribosome, aminoacyl-tRNA biosynthesis, two-component system, carbon metabolism, purine metabolism, and pyrimidine metabolism. The photosynthesis antenna proteins pathway was significantly enriched in June leaf samples, when compared to March and May. Several genes related to toxin co-regulated pilus biosynthesis proteins were also significantly enriched in June leaf samples, when compared to March and May leaf samples. Therefore, planting and harvesting times must be considered during leafy green production due to the influence of seasons in growth and proliferation of phyllosphere microbial communities.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0252242PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8168849PMC
June 2021

Follow-up loss in smoking cessation consultation: can we predict and prevent it?

J Thorac Dis 2021 Apr;13(4):2331-2338

Pulmonology Department, Hospital Pedro Hispano, Matosinhos, Portugal.

Background: Cigarette smoking has a considerable health and economic burden in modern society, with increased risk of morbidity and mortality. Therefore, smoking cessation policies and medical treatments are essential. However, cessation rates are low and the abandonment of the consultation is common. The identification of characteristics that may predict adherence will help defining the best treatment strategy. This study aimed to identify predictors of follow-up loss in smoking cessation consultation.

Methods: We made a retrospective observational study, including a cohort of patients who started smoking cessation consultation (April-December 2018). Clinical data from consultations was collected and analyzed with (SPSS, RRID:SCR_002865).

Results: A total of 175 patients was selected (41.1% female), with a mean age of 53±12 years. Eighty-five patients (48.6%) were discharged for abandonment. They had a median pack-year unit 38±36 (P=0.011), Fagerström and Richmond scores of 5±2 and 7±2, respectively. There was an association between women (P<0.001), younger age (P<0.001), depression/anxiety (P=0.023), lower smoking load (P=0.019), starting the treatment in the first appointment (P=0.004) and the abandonment of the consultation. In binary logistic regression, younger age (less than 50 years) (OR =4.39; 95% CI: 1.99-9.70), starting the treatment in the first appointment (OR =3.04; 95% CI: 1.44-6.42) and depression/anxiety (OR =2.30; 95% CI: 1.08-4.88) remained independent predictors of loss in follow-up.

Conclusions: Women, younger age, depression/anxiety, lower smoking load and starting treatment in the first appointment are predictors of follow-up loss, so, these patients may benefit from more frequent evaluations and intensive cognitive approach. This study also raises awareness about the adequate timing to start pharmacological support for smoking cessation.
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http://dx.doi.org/10.21037/jtd-20-1832DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8107513PMC
April 2021

Nucleus-Cytoskeleton Crosstalk During Mitotic Entry.

Front Cell Dev Biol 2021 18;9:649899. Epub 2021 Mar 18.

Instituto de Investigação e Inovação em Saúde - i3S, University of Porto, Porto, Portugal.

In preparation for mitosis, cells undergo extensive reorganization of the cytoskeleton and nucleus, so that chromosomes can be efficiently segregated into two daughter cells. Coordination of these cytoskeletal and nuclear events occurs through biochemical regulatory pathways, orchestrated by Cyclin-CDK activity. However, recent studies provide evidence that physical forces are also involved in the early steps of spindle assembly. Here, we will review how the crosstalk of physical forces and biochemical signals coordinates nuclear and cytoplasmic events during the G2-M transition, to ensure efficient spindle assembly and faithful chromosome segregation.
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http://dx.doi.org/10.3389/fcell.2021.649899DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8014196PMC
March 2021

From the cytoskeleton to the nucleus: An integrated view on early spindle assembly.

Semin Cell Dev Biol 2021 Mar 14. Epub 2021 Mar 14.

Instituto de Investigação e Inovação em Saúde - i3S, University of Porto, Porto, Portugal; Departamento de Biomedicina, Faculdade de Medicina, University of Porto, Porto, Portugal. Electronic address:

Accurate chromosome segregation requires a complete restructuring of cellular organization. Microtubules remodel to assemble a mitotic spindle and the actin cytoskeleton rearranges to form a stiff actomyosin cortex. These cytoplasmic events must be spatially and temporally coordinated with mitotic chromosome condensation and nuclear envelope permeabilization, in order to ensure mitotic timing and fidelity. Here, we discuss the main cytoskeletal and nuclear events that occur during mitotic entry in proliferating animal cells, focusing on their coordinated contribution for early mitotic spindle assembly. We will also explore recent progress in understanding their regulatory biochemical and mechanical pathways.
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http://dx.doi.org/10.1016/j.semcdb.2021.03.006DOI Listing
March 2021

Transcriptional profiling of two contrasting genotypes uncovers molecular mechanisms underlying salt tolerance in alfalfa.

Sci Rep 2021 Mar 4;11(1):5210. Epub 2021 Mar 4.

US Salinity Lab (USDA-ARS), 450 W Big Springs Road, Riverside, CA, 92507, USA.

Alfalfa is an important forage crop that is moderately tolerant to salinity; however, little is known about its salt-tolerance mechanisms. We studied root and leaf transcriptomes of a salt-tolerant (G03) and a salt-sensitive (G09) genotype, irrigated with waters of low and high salinities. RNA sequencing led to 1.73 billion high-quality reads that were assembled into 418,480 unigenes; 35% of which were assigned to 57 Gene Ontology annotations. The unigenes were assigned to pathway databases for understanding high-level functions. The comparison of two genotypes suggested that the low salt tolerance index for transpiration rate and stomatal conductance of G03 compared to G09 may be due to its reduced salt uptake under salinity. The differences in shoot biomass between the salt-tolerant and salt-sensitive lines were explained by their differential expressions of genes regulating shoot number. Differentially expressed genes involved in hormone-, calcium-, and redox-signaling, showed treatment- and genotype-specific differences and led to the identification of various candidate genes involved in salinity stress, which can be investigated further to improve salinity tolerance in alfalfa. Validation of RNA-seq results using qRT-PCR displayed a high level of consistency between the two experiments. This study provides valuable insight into the molecular mechanisms regulating salt tolerance in alfalfa.
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http://dx.doi.org/10.1038/s41598-021-84461-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7933430PMC
March 2021

Towards an effective sensing technology to monitor micro-scale interface loosening of bioelectronic implants.

Sci Rep 2021 Feb 10;11(1):3449. Epub 2021 Feb 10.

Centre for Mechanical Technology & Automation, TEMA, University of Aveiro, 3810-193, Aveiro, Portugal.

Instrumented implants are being developed with a radically innovative design to significantly reduce revision surgeries. Although bone replacements are among the most prevalent surgeries performed worldwide, implant failure rate usually surpasses 10%. High sophisticated multifunctional bioelectronic implants are being researched to incorporate cosurface capacitive architectures with ability to deliver personalized electric stimuli to peri-implant target tissues. However, the ability of these architectures to detect bone-implant interface states has never been explored. Moreover, although more than forty technologies were already proposed to detect implant loosening, none is able to ensure effective monitoring of the bone-implant debonding, mainly during the early stages of loosening. This work shows, for the first time, that cosurface capacitive sensors are a promising technology to provide an effective monitoring of bone-implant interfaces during the daily living of patients. Indeed, in vitro experimental tests and simulation with computational models highlight that both striped and circular capacitive architectures are able to detect micro-scale and macro-scale interface bonding, debonding or loosening, mainly when bonding is weakening or loosening is occurring. The proposed cosurface technologies hold potential to implement highly effective and personalized sensing systems such that the performance of multifunctional bioelectronic implants can be strongly improved. Findings were reported open a new research line on sensing technologies for bioelectronic implants, which may conduct to great impacts in the coming years.
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http://dx.doi.org/10.1038/s41598-021-82589-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7876021PMC
February 2021

Interstitial pneumonia with autoimmune features: A case series and overview.

Respir Med Case Rep 2021 20;32:101350. Epub 2021 Jan 20.

Pulmonology Department, Hospital Pedro Hispano, Matosinhos, Portugal.

The topic of interstitial pneumonia with autoimmune features (IPAF) is a research classification proposed by the European Respiratory Society/American Thoracic Society Task Force: this includes patients with idiopathic interstitial pneumonia (IIP) and clinical features, suggesting an underlying autoimmune process, but who do not meet established criteria for a connective tissue disease (CTD). We aimed to perform a detailed characterization of clinical, serological, and radiological features for our patients with IPAF criteria. Six patients were included, and a comprehensive description of these cases revealed a heterogeneous group in terms of clinical and treatment options. In most patients, it was possible to identify other features and disorders with an autoimmune "background," which may support the inclusion of these patients in the IPAF classification. No deaths or significant decline in lung function occurred, and thus no definitive diagnosis of CTD could be found over 35 months of median follow-up. Therefore, IPAF is a recent concept, with many questions still open in regard to its usage in the ILD field.
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http://dx.doi.org/10.1016/j.rmcr.2021.101350DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7843504PMC
January 2021

Inspiratory muscle training in neuromuscular patients: Assessing the benefits of a novel protocol.

J Back Musculoskelet Rehabil 2021 ;34(4):537-543

Background: Neuromuscular diseases are characterized by the compromise of respiratory muscles, thoracic ventilation, muscle strength and coughing capacity. Patients have low quality of life and increased morbidity and mortality mostly due to respiratory impairment.

Objective: To assess the benefits of adding inspiratory muscle training to neuromuscular patients' treatment and their compliance to the approach.

Methods: We conducted a single-center prospective study with neuromuscular patients with decreased maximal inspiratory pressure. We developed an inspiratory muscle training protocol with three-month duration and once-daily training. The protocol had a progressive intensity that was individually tailored based on patients' baseline characteristics and tolerance. We used Powerbreathe Medic Classic devices to perform the training.

Results: There were 21 patients who met the inclusion criteria and were enrolled in the study. Muscular dystrophy (n= 12, 57.3%) and amyotrophic lateral sclerosis (n= 4, 19%) were the most common diseases. After three months of training, patients increased their maximal inspiratory muscle pressure (p= 0.002) and peak cough flow (p= 0.011). Compliance to the protocol was 99 ± 5.5%.

Conclusions: This protocol showed significant improvements on pulmonary muscles function and might be considered as an adjunct treatment to neuromuscular treatment. However, these positive results require larger further studies to validate the clinical benefits long-term.
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http://dx.doi.org/10.3233/BMR-200141DOI Listing
July 2021

Is the 1-Minute Sit-To-Stand Test a Good Tool to Evaluate Exertional Oxygen Desaturation in Chronic Obstructive Pulmonary Disease?

Diagnostics (Basel) 2021 Jan 22;11(2). Epub 2021 Jan 22.

Pulmonology Department, Pedro Hispano Hospital, 4464-513 Matosinhos, Portugal.

Background: Chronic obstructive pulmonary disease (COPD) is frequently associated with exertional oxygen desaturation, which may be evaluated using the 6-minute walking test (6MWT). However, it is a time-consuming test. The 1-minute sit-to-stand test (1STST) is a simpler test, already used to evaluate the functional status. The aim of this study was to compare the 1STST to the 6MWT in the evaluation of exertional desaturation.

Methods: This was a cross-sectional study including 30 stable COPD patients who performed the 6MWT and 1STST on the same day. Six-minute walking distance (6MWD), number of 1STST repetitions (1STSTr), and cardiorespiratory parameters were recorded.

Results: A significant correlation was found between the 6MWD and the number of 1STSTr (r = 0.54; = 0.002). The minimum oxygen saturation (SpO) in both tests showed a good agreement (intraclass correlation coefficient (ICC) 0.81) and correlated strongly (r = 0.84; < 0.001). Regarding oxygen desaturation, the total agreement between the tests was 73.3% with a fair Cohen´s kappa (κ = 0.38; = 0.018), and 93.33% of observations were within the limits of agreement for both tests in the Bland-Altman analysis.

Conclusion: The 1STST seems to be a capable tool of detecting exercise-induced oxygen desaturation in COPD. Because it is a less time- and resources-consuming test, it may be applied during the outpatient clinic consultation to regularly evaluate the exercise capacity and exertional desaturation in COPD.
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http://dx.doi.org/10.3390/diagnostics11020159DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7911810PMC
January 2021

Continuous flow synthesis of lipophilic cations derived from benzoic acid as new cytotoxic chemical entities in human head and neck carcinoma cell lines.

RSC Med Chem 2020 Oct 19;11(10):1210-1225. Epub 2020 Aug 19.

Institute for Research in Dental Sciences (ICOD) , Faculty of Dentistry , Universidad de Chile , Santiago , 8380492 , Chile . Email: ; Tel: +56 2 29781730.

Continuous flow chemistry was used for the synthesis of a series of delocalized lipophilic triphenylphosphonium cations (DLCs) linked by means of an ester functional group to several hydroxylated benzoic acid derivatives and evaluated in terms of both reaction time and selectivity. The synthesized compounds showed cytotoxic activity and selectivity in head and neck tumor cell lines. The mechanism of action of the molecules involved a mitochondrial uncoupling effect and a decrease in both intracellular ATP production and apoptosis induction.
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http://dx.doi.org/10.1039/d0md00153hDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7652000PMC
October 2020

Production of L-carnitine-enriched edible filamentous fungal biomass through submerged cultivation.

Bioengineered 2021 12;12(1):358-368

Swedish Centre for Resource Recovery, University of Borås , Borås, Sweden.

The edible filamentous fungi are hot candidate for future supply of functional food and feed with e.g. protein, essential amino acids, and compounds with immunostimulant activity. L-carnitine that plays a crucial role in energy metabolism represents a functional compound normally produced by Zygomycetes filamentous fungus in solid-state fermentation. The present study provides the first insights on production of L-carnitine-enriched edible fungal biomass through submerged cultivation of several Ascomycetes and Zygomycetes including , , , and . with 3 mg L-carnitine yield per gram of fungal biomass, indicates great potential on production of this bioactive compound which is remarkably higher than the other tested fungi in this work and also previous studies. In addition to fungal strain, other factors such as cultivation time and presence of yeast extract were found to play a role. Further studies on submerged growth optimization of . in both high-quality recipes and in medium based on low-value substrates are proposed in order to clarify its potential for production of L-carnitine-enriched fungal biomass.
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http://dx.doi.org/10.1080/21655979.2020.1863618DOI Listing
December 2021

Germination and Growth of Spinach under Potassium Deficiency and Irrigation with High-Salinity Water.

Plants (Basel) 2020 Dec 9;9(12). Epub 2020 Dec 9.

US Salinity Laboratory (USDA-ARS), 450 W. Big Springs Rd., Riverside, CA 92507, USA.

Information is scarce on the interaction of mineral deficiency and salinity. We evaluated two salt-tolerant spinach cultivars under potassium (K) doses (0.07, 0.15, 0.3, and 3.0 mmol L) and saline irrigation (5, 30, 60, 120, and 160 mmol L NaCl) during germination and growth. There was no interaction between salinity and K. Salinity decreased germination percent (GP), not always significantly, and drastically reduced seedling biomass. 'Raccoon' significantly increased GP at 60 mmol L while 'Gazelle' maintained GP up to 60 or 120 mmol L. After 50 days under saline irrigation, shoot biomass increased significantly at 30 and 60 mmol L at the lowest K dose but, in general, neither salinity nor K dose affected shoot biomass, suggesting that salinity supported plant growth at the most K-deficient dose. Salinity did not affect shoot N, P, or K but significantly reduced Ca, Mg, and S, although plants had no symptoms of salt toxicity or mineral deficiency. Although spinach seedlings are more sensitive to salt stress, plants adjusted to salinity with time. Potassium requirement for spinach growth was less than the current crop recommendation, allowing its cultivation with waters of moderate to high salinity without considerable reduction in yield, appearance, or mineral composition.
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http://dx.doi.org/10.3390/plants9121739DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7763614PMC
December 2020

Linking diverse salinity responses of 14 almond rootstocks with physiological, biochemical, and genetic determinants.

Sci Rep 2020 12 3;10(1):21087. Epub 2020 Dec 3.

USDA-ARS, U.S. Salinity Lab, 450 W Big Springs Road, Riverside, CA, 92507, USA.

Fourteen commercial almond rootstocks were tested under five types of irrigation waters to understand the genetic, physiological, and biochemical bases of salt-tolerance mechanisms. Treatments included control (T1) and four saline water treatments dominant in sodium-sulfate (T2), sodium-chloride (T3), sodium-chloride/sulfate (T4), and calcium/magnesium-chloride/sulfate (T5). T3 caused the highest reduction in survival rate and trunk diameter, followed by T4 and T2, indicating that Na and, to a lesser extent, Cl were the most toxic ions to almond rootstocks. Peach hybrid (Empyrean 1) and peach-almond hybrids (Cornerstone, Bright's Hybrid 5, and BB 106) were the most tolerant to salinity. Rootstock's performance under salinity correlated highly with its leaf Na and Cl concentrations, indicating that Na and Cl exclusion is crucial for salinity tolerance in Prunus. Photosynthetic rate correlated with trunk diameter and proline leaf ratio (T3/T1) significantly correlated with the exclusion of Na and Cl, which directly affected the survival rate. Expression analyses of 23 genes involved in salinity stress revealed that the expression differences among genotypes were closely associated with their performance under salinity. Our genetic, molecular, and biochemical analyses allowed us to characterize rootstocks based on component traits of the salt-tolerance mechanisms, which may facilitate the development of highly salt-tolerant rootstocks.
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http://dx.doi.org/10.1038/s41598-020-78036-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7712888PMC
December 2020

Optimizing prognosis in atrial fibrillation: A call to action in Portugal.

Rev Port Cardiol (Engl Ed) 2020 Nov 23. Epub 2020 Nov 23.

Unidade Cardiovascular, Hospital Lusíadas Lisboa, Lisboa, Portugal; Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal.

Atrial fibrillation (AF), the most common arrhythmia in the adult population worldwide, represents a significant burden in terms of cardiovascular mortality and morbidity and has repercussions on health economics. Oral anticoagulation (OAC) is key to stroke prevention in AF and, in recent years, results from landmark clinical trials of non-vitamin K oral anticoagulants (NOAC) have triggered a paradigm shift in thrombocardiology. Despite these advances, there is still a significant residual vascular risk associated with silent AF, bleeding, premature sudden death and heart failure. The authors review AF epidemiologic data, the importance of new tools for early AF detection, the current role of catheter ablation for rhythm control in AF, the state-of-the-art in periprocedural OAC, the optimal management of major bleeding, the causes of residual premature death and future strategies for improvements in AF prognosis.
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http://dx.doi.org/10.1016/j.repc.2020.07.011DOI Listing
November 2020

Trackosome: a computational toolbox to study the spatiotemporal dynamics of centrosomes, nuclear envelope and cellular membrane.

J Cell Sci 2020 12 21;133(24). Epub 2020 Dec 21.

i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal

During the initial stages of mitosis, multiple mechanisms drive centrosome separation and positioning. How they are coordinated to promote centrosome migration to opposite sides of the nucleus remains unclear. Here, we present Trackosome, an open-source image analysis software for tracking centrosomes and reconstructing nuclear and cellular membranes, based on volumetric live-imaging data. The toolbox runs in MATLAB and provides a graphical user interface for easy access to the tracking and analysis algorithms. It provides detailed quantification of the spatiotemporal relationships between centrosomes, nuclear envelope and cellular membrane, and can also be used to measure the dynamic fluctuations of the nuclear envelope. These fluctuations are important because they are related to the mechanical forces exerted on the nucleus by its adjacent cytoskeletal structures. Unlike previous algorithms based on circular or elliptical approximations, Trackosome measures membrane movement in a model-free condition, making it viable for irregularly shaped nuclei. Using Trackosome, we demonstrate significant correlations between the movements of the centrosomes, and identify specific oscillation modes of the nuclear envelope. Overall, Trackosome is a powerful tool that can be used to help unravel new elements in the spatiotemporal dynamics of subcellular structures.
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http://dx.doi.org/10.1242/jcs.252254DOI Listing
December 2020

Gene Expression Signatures in AML-12 Hepatocyte Cells upon Infection and Acetaminophen Treatment.

Viruses 2020 11 10;12(11). Epub 2020 Nov 10.

Imunologia Celular e Molecular, Instituto René Rachou, Belo Horizonte, MG 30190-002, Brazil.

Dengue is an acute viral disease caused by (DENV) and is considered to be the most common arbovirus worldwide. The clinical characteristics of dengue may vary from asymptomatic to severe complications and severe organ impairment, particularly affecting the liver. Dengue treatment is palliative with acetaminophen (APAP), usually known as Paracetamol, being the most used drug aiming to relieve the mild symptoms of dengue. APAP is a safe and effective drug but, like dengue, can trigger the development of liver disorders. Given this scenario, it is necessary to investigate the effects of combining these two factors on hepatocyte homeostasis. Therefore, this study aimed to evaluate the molecular changes in hepatocytes resulting from the association between DENV infection and treatment with sub-toxic APAP concentrations. Using an in vitro experimental model of DENV-2 infected hepatocytes (AML-12 cells) treated with APAP, we evaluated the influence of the virus and drug association on the transcriptome of these hepatocytes by RNA sequencing (RNAseq). The virus-drug association was able to induce changes in the gene expression profile of AML-12 cells and here we highlight and explore these changes and its putative influence on biological processes for cellular homeostasis.
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http://dx.doi.org/10.3390/v12111284DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7697769PMC
November 2020

Reducing oral corticosteroids in severe asthma (ROSA Project): a nationwide Portuguese consensus.

Pulmonology 2021 Jul-Aug;27(4):313-327. Epub 2020 Nov 8.

Department of Social Pharmacy, Faculty of Pharmacy, University of Lisboa, Lisboa, Portugal; EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Portugal.

Introduction And Objectives: We aimed to build a national consensus to optimize the use of oral corticosteroids (OCS) in severe asthma in Portugal.

Material And Methods: A modified 3-round Delphi including 65 statements (topics on chronic systemic corticotherapy, therapeutic schemes, asthma safety and monitoring) was performed via online platform (October-November 2019). A five-point Likert-type scale was used (1-'strongly disagree'; 5-'strongly agree'). Consensus threshold was established as a percentage of agreement among participants ≥90% in the 1st round and ≥85% in the 2nd and 3rd rounds. The level of consensus achieved by the panel was discussed with the participants (face-to-face meeting).

Results: Forty-eight expert physicians in severe asthma (specialists in allergology and pulmonology) participated in the study. Almost half of the statements (28/65; 43.1%) obtained positive consensus by the end of round one. By the end of the exercise, 12 (18.5%) statements did not achieve consensus. Overall, 87% of physicians agree that further actions for OCS cumulative risk assessment in acute asthma exacerbations are needed. The vast majority (91.7%) demonstrated a favorable perception for using biological agents whenever patients are eligible. Most participants (95.8%) are more willing to accept some degree of lung function deterioration compared to other outcomes (worsening of symptoms, quality of life) when reducing OCS dose. Monitoring patients' comorbidities was rated as imperative by all experts.

Conclusions: These results can guide an update on asthma management in Portugal and should be supplemented by studies on therapy access, patients' adherence, and costs.
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http://dx.doi.org/10.1016/j.pulmoe.2020.10.002DOI Listing
November 2020

Sirolimus-eluting stents: A small piece of the story of percutaneous coronary intervention.

Authors:
Jorge Ferreira

Rev Port Cardiol (Engl Ed) 2020 Nov 7;39(11):649-650. Epub 2020 Nov 7.

Department of Cardiology, Hospital de Santa Cruz - CHLO, Carnaxide, Portugal. Electronic address:

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http://dx.doi.org/10.1016/j.repc.2020.10.003DOI Listing
November 2020

Epstein-Barr Virus Infection and Thiopurine Therapy in a Pediatric Population with Inflammatory Bowel Disease.

GE Port J Gastroenterol 2020 Aug 28;27(5):318-323. Epub 2020 Apr 28.

Pediatric Gastroenterology Unit, Pediatric Department, Centro Hospitalar São João, Porto, Portugal.

Epstein Barr virus (EBV) primoinfection may contribute to the development of post-mononucleosis lymphomas in EBV-seronegative adult males with inflammatory bowel disease (IBD) under thiopurine therapy, but data on children are sparse. Knowledge of the EBV status may influence the type of surveillance and therapy in a group particularly vulnerable to the occurrence of EBV primoinfection. We aimed to determine the EBV status at diagnosis, the primoinfection rate, and complications in a pediatric Portuguese population with IBD.

Method: This was a retrospective analysis of clinical records of pediatric patients with IBD. Demographic data, EBV status, as well as clinical and therapeutic data on primoinfection were collected.

Results: Of the 250 patients evaluated, 229 (91.6%) had documented EBV screening and 50.8% were male. Mean age ± SD was 13.0 ± 2.8 years at diagnosis and 14.7 ± 2.3 years at EBV screening. EBV IgG serology was positive in 76.0% of patients. A total of 218 patients had been on therapy with azathioprine at some point. The average length of exposure to azathioprine was 4 years, and 91 patients (39.7%) were on azathioprine at EBV assessment. EBV primoinfection was documented in 4 patients (1.6%), all females, 2 of whom were on azathioprine. Two presented clinical signs of infection and 2 were identified at diagnostic screening; the first 2 suspended azathioprine and the other 2 did not initiate it.

Conclusions: A significant proportion of pediatric Portuguese IBD patients are EBV-naïve. Systematic screening of EBV status enables the identification of patients at risk of primoinfection, and the occurrence of symptoms suggestive of acute EBV infection in seronegative patients should lead to rapid confirmation of the diagnosis. Timely diagnosis may allow the adjustment of therapeutic strategy sparing patients from potentially severe iatrogeny.
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http://dx.doi.org/10.1159/000507199DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7506275PMC
August 2020
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